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Update on our work in Ukraine

Doctors of the World in the UK want to share an update video regarding our activities in Ukraine. The update comes from François De Keersmaeker, Director of Doctors of the World Germany.

Doctors of the World in Germany are leading our response to the ongoing Russian invasion and cruel war in the country.

They are in constant contact with staff inside Ukraine as well as those who have evacuated to the border ‘influx’ areas.
Since we’ve received the video, we’ve had the following updates from the team:

• We have around 80 national staff in Ukraine. They’ve withdrawn from Luhansk temporarily but have donated all of our medical supplies to local hospitals.

• The team continue to work as much as they can. For example, midwives and psychologists are providing online consultations.

• We’ve sent an emergency team to the EU border with Ukraine to re-organise our programme and plan how best to help.

• We’re in the process of obtaining medical supplies for health facilities throughout Ukraine. So far, we’ve provided surgical equipment and supplies to treat injuries to three hospitals.

We are so grateful for all those who have donated to our emergency Ukraine appeal so far. If you haven’t had the opportunity to donate, you can here.

We’ll be putting all donations to good use, providing help and support as best we can both in Ukraine and in the countries surrounding Ukraine who are providing safe havens to refugees. The team will need to be flexible, as the situation unfolds and until some much hoped for stability or peace arrives.

It has been tough watching the pictures of bombs and missiles exploding in civilian areas. Our hearts and thoughts are with the people of Ukraine at this time.

A look back at 2021

For many of us, these have been the longest two years of our lives.

A lot has changed since the UK first went into lockdown in March 2020, what hasn’t changed though is the commitment by Doctors of the World to ensuring universal access to healthcare in the UK and abroad.

Despite the vaccine, despite the reduction of restrictions affecting our day to day lives, the pandemic continues to hit the most vulnerable in our society hard.

Health and social inequalities have widened. New barriers to healthcare have emerged, with the rapid shift to online healthcare leaving those without the means to access it cut off from vital care and support.

Our staff, volunteers and supporters have consistently risen to these challenges, working tirelessly to ensure Doctors of the World can continue to help people in vulnerable circumstances get medical care and advice.

Here are seven ways that we were able to make a difference in 2021:

Being there for the community

Doctors of the World is committed to going where others won’t, to provide life-saving medical care and support to excluded communities. That’s why, with great excitement, we took delivery of a second mobile clinic in April 2021.

The mobile clinic allows us to take healthcare to this who need it most. Take a tour of our mobile clinic and as you’ll see, the mobile clinic contains everything our team needs to provide basic medical care on the road.

Isabelle Pereira is a Doctors of the World clinic volunteer, and to her our clinics offer the chance to empower people in vulnerable situations to exercise their basic human right to health, and access to healthcare.

“They can be in a very dark place…and they need to be helped, to be supported to get out of that dark place,” she said. “I think they appreciate the friendly face, the friendly smile…and not being judged.

“Basically, they feel safe when they are in the clinic, or when they talk to us, so it’s nice to support people who have lost their hope or lost trust in the system.”

To support the wider national effort to get as many people vaccinated against COVID-19 as possible, Doctors of the World ran a series of vaccine clinics in Lewisham during 2021. These clinics were designed and delivered to reach communities who may not have otherwise had access to a GP to receive the vaccine.

As well as this, we have continued to run our clinics virtually, provided our helpline throughout the year, and where possible held in-person clinics to ensure that when people need us, we are there.

Our homeless outreach services have also continued throughout the pandemic, and you can find out what a night with these services is like, here.

Overcoming language barriers with translated health information

The UK has a hugely diverse population, and with that comes a huge diversity in the languages used across the country. That’s why, following on from the success of our translated resources in 2020, in early 2021, we launched our COVID-19 Vaccine Advocacy Project and produced a suite of translated COVID-19 resources.

The COVID-19 resources included information and guidance in written, video, and animated form, as well as information and guidance on other health issues, in over 60 languages.

This project, the first of its kind in the UK, was created to ensure that everyone in the UK has access to COVID-19 services. This includes the vaccines, regardless of immigration status or personal circumstances.

As well as producing translated COVID-19 information resources, DOTW has played a proactive advocacy and coordination role in the roll-out of the UK’s vaccination programme throughout the year.

You can sign up to our COVID-19 Vaccine Advocacy Project mailing list to find out more.

Putting people with lived experience at our heart

2021 saw the introduction of the Doctors of the World National Health Advisors (NHAs). The NHAs are an advisory group of people with lived experience of migration and healthcare exclusion, and they work to ensure migrants have a greater influence over healthcare policy and practice at the charity.

Abie is one of the new DOTW National Health Advisors, and she took on the role to make a difference. She said, “I joined the DOTW National Health Advisors because I want to make a change, and because of the way migrants are treated.” Abie continued, “my dream is to see all refugees and asylum seeker being treated as equal.”

People with lived experience of healthcare exclusion know best the impact of policies and services that affect and are available to them. Their voices and insights should be at the centre of changing attitudes among the general public, making well-informed decisions, ensuring services are inclusive, and driving sustainable policy change in healthcare.

Meet the NHAs and find out more on our website.

Supporting the NHS to provide services to refugees and migrants

2021 saw our Safe Surgeries network go from strength to strength. As we ended the year, there were over 600 Safe Surgeries throughout the UK who have committed to ensuring that people without ID, a home address, or proof of immigration can access primary healthcare. In all, the number of Safe Surgeries has doubled since the beginning of the pandemic.

Doctors of the World will continue to provide support, training, and resources to GP surgeries across the UK throughout 2022 to continue to grow our Safe Surgeries network and ensure even wider access to primary care.

As well as this, in early 2021, Doctors of the World hosted an online vaccination seminar aimed at improving access to the COVID-19 vaccine for marginalised communities across the UK. We also launched our Inclusion Health Self-Assessment Tool and supported the production and launch of the NHS England GP access cards.

The Inclusion Health Self-Assessment Tool allows primary care networks to assess and examine their engagement with the groups within their local communities who experience the high levels of health inequalities. This is vital to ensuring that as many people as possible can receive the care that they need and are entitled to.

The NHS England GP access cards are aimed encouraging GP registration and ensuring that no one is missed during the COVID-19 vaccine rollout. Regardless of your immigration status, everyone in England is entitled to register with a GP.

It is crucial that GP practices do not turn people away if they lack proof of ID, address, or immigration status. People can also register if they do not know or do not have an NHS number.

Responding to emergencies

In August 2021, a terrible earthquake and tropical storm hit the island of Haiti. Nearly 2,500 people lost their lives and nearly 13,000 people suffered injuries. Doctors of the World chapters from across the globe were quickly on the ground providing vital medical supplies, medical care, and other humanitarian aid, to those effected. Our supporters in the UK alone raised around £10,000 to help with these relief efforts.

At the cutting edge of research

The Doctors of the World team have been at the cutting edge of research, supporting academics from leading universities in exploring issues such as sexual and gender based violence, the barriers migrants face when accessing healthcare, and the unmet health needs of street sex workers.

This work puts the voices of the people we work with at the heart of the conversation, and it helps shape future policy to make life better for those living in vulnerable circumstances.

Our team of experts work tirelessly to shine a light on those who are so often marginalised, and our research will continue to go from strength to strength in 2022.

Fighting for change

Through letters to politicians, protests, and through campaigning for improved policies around migrant healthcare, Doctors of the World has continued to push the Government to be kinder and fairer.

Late in 2021, Doctors of the World staff and NHAs joined thousands of others in Parliament Square to protest the cruel Nationality and Borders Bill. You can hear what NHA, Thabo, had to say about it in this video.

We have also been actively campaigning as part of the Hands Up For Our Health coalition on issues such as, NHS charging, access to the COVID-19 vaccine, and much more. This campaigning led to over 1,000 people writing to their MP to call for healthcare for all.

2021 was another challenging year, but your support enabled us to help thousands of people across the UK. All of the team at Doctors of the World appreciates and values your support, and we look forward to working with you in 2022.

A round-up of DOTW COVID-19 vaccine resources

The Doctors of the World vaccine project is approaching its first anniversary, so we wanted to recap on some of the resources we have available for professionals and individuals needing support and information.  

Registering with a GP and booking a vaccination

Earlier in the summer, we published an animation on how to register with a GP and book vaccine appointments. This animation is now available in 23 languages.  

We have complemented this with an A3 poster and A5 leaflet to help inform people about migrants’ entitlement to register with a GP and book a vaccine. 

These resources are aimed at supporting outreach activities and communicating migrant rights with local communities. 

Translated Health Information Hub  

This year we also launched our Translated Health Information Hub. This hub allows you to find and download the translated health information resources on a range of topics in over 60 languages.   

You can filter our resources by language, topic, or type and we have also added the option of downloading the videos and animations so they can be shared offline. 

Included within the Translated Health Information Hub is translated COVID-19 guidance. This is to ensure that language is not a barrier to accessing COVID-19 vaccines.  

Vaccine Confidence Toolkit  

We have produced a COVID-19 Vaccine Confidence Toolkit to support communities and voluntary organisations delivering their own vaccine confidence events. 

This toolkit includes a set of slides, speaker notes, infographics, guidance on how to deliver an information event. As well as video and text FAQs that will enable organisations to empower their community to make an informed decision about the COVID-19 vaccine.   

External resources added to our Translated Health Information Hub

Amongst the external resources we have added to our Translated Health Information Hub is the letter on entitlement to NHS services for migrant patients from NHS England, as well as the booster leaflets available in 25 languages.

Joint letter: Concerns about the health implications of the Nationality and Borders Bill

Doctors of the World, alongside other leading healthcare organisations, has written to the Home Secretary in the wake of last week’s tragic loss of life in the English Channel.

The letter outlines our collective opposition to the Nationality and Borders Bill due to its lasting and profound harm to the health and wellbeing of people in need of refugee protection.

————

Dear Secretary of State,

We write to you in the wake of last week’s tragic loss of life in the English Channel, as organisations representing medical professionals and patients, to raise concerns about the health implications of the Nationality and Borders Bill. In its attempt to establish a two-tiered asylum system based on the way a refugee enters the UK, the Bill undermines established international protection rules and practices and breaks international law. The United Nations Refugee Agency has described these changes as “a recipe for mental and physical ill-health”.

If passed, the Bill will bring in sweeping changes to the asylum system, including establishing large-scale reception centres in the UK and offshore asylum processing sites, which will cause lasting and profound harm to the health and wellbeing of people in need of refugee protection. Our concerns are based on a wealth of evidence from individuals held on Manus and Nauru Islands under the Australian Government’s offshore detention policy and our work supporting people in asylum accommodation across the UK.

We strongly oppose the Nationality and Borders Bill as it stands and urgently call on you to establish a kinder, fairer, and more effective approach to supporting refugees, regardless of how they arrive in the UK, including a community-based accommodation system that enables meaningful access to health services.

A group of medical organisations and health bodies wrote to you on 26 November 2020 expressing concern about the use of Ministry of Defence sites to house people seeking asylum. The letter highlighted the sites’ unsuitability for this purpose due to the lack of access to adequate and appropriate healthcare services, public health risks resulting from a lack of compliance with COVID-19 regulations, and the risk of re-traumatisation triggered by accommodation in former military barracks. Despite this warning, and Public Health England’s advice against using Napier Barracks because of the coronavirus pandemic, no action was taken. Residents were left managing health needs alone and reports of suicidal ideation were frequent. An inspection by the Independent Chief Inspector of Borders and Immigration found individuals “suffering from serious underlying physical and mental health conditions, including one case of active TB at Napier”, and there have been two avoidable and significant coronavirus outbreaks in the Napier site.

We are deeply concerned by plans to establish large-scale reception centres to accommodate up to 8,000 people, and that Napier Barracks is viewed by the government as a prototype for these  centres. As medical organisations, our experience of supporting vulnerable individuals in Napier Barracks and Penally Camp, as well as medical evidence from Greece which operates similarly large reception centres, show this type of large-scale accommodation prevents people from accessing medical care and presents a real risk to public health. This type of accommodation is also inappropriate for people seeking asylum, many of whom will have experienced torture, exploitation and abuse, and are at risk of severe psychological distress and re-traumatisation. Medical assessments conducted by Doctors of the World with residents of Napier Barracks with psychological and physical conditions found most people (77%) did not know if they were registered with a GP. Evidence from MSF teams working with hundreds of adults and children contained in large reception centres on Greek islands since 2016 demonstrated acute levels of mental health suffering.

The Bill’s proposal for asylum seekers and refugees to be detained offshore indefinitely whilst their asylum claims are processed is deeply alarming from a health perspective. Australia has implemented a policy of offshoring refugees and asylum seekers on Manus and Nauru Islands since 2012, resulting in severe and well documented harm to people’s physical and mental health whilst concealing their suffering from public scrutiny. This must not be replicated by the UK. MSF’s mental health project on Nauru Island responded to shocking levels of mental illness among asylum seeker and refugee patients linked to the offshore processing policy. Sixty percent of patients had suicidal thoughts and 30% actually attempted suicide, while ten children and two adults were diagnosed with the rare, life-threatening condition Resignation Syndrome, which requires medical care to keep the individual alive. The policy also perpetuated a system of violence, physical and sexual abuse of those detained and led to more than 1,200 people being medically evacuated from Nauru to Australia to receive medical care not available on the island. Many were evacuated for psychiatric reasons after years of distress on the island.

In light of these serious mental and physical health concerns, we are calling for the government to scrap the plans to establish offshore asylum processing and ensure that all asylum seekers who arrive in the UK remain in the country whilst their asylum claim is processed, by removing clause 28 from the Bill. We also call on government to withdraw plans to introduce UK-based reception centres and make a full commitment to house people seeking asylum in the UK within our communities.

Yours sincerely

Ellen Waters, Director of Development, Doctors of the World UK
Dr John Chisholm CBE, Medical Ethics Committee Chair, British Medical Association
Prof Maggie Rae, President, Faculty of Public Health
Sonya Sceats, Chief Executive, Freedom from Torture
Kerry Smith, CEO, Helen Bamber Foundation
Rosalind Bragg, Director, Maternity Action
Vickie Hawkins, Executive Director, Médecins Sans Frontières (MSF UK)
Emma Ginn, Director, Medical Justice
Hooi-Ling Harrison, Chair, Public Health Special Interest Group of Royal College of Emergency
Medicine
Gill Walton, CEO, Royal College of Midwives
Dr Edward Morris, President, Royal College of Obstetricians and Gynaecologists
Dr Adrian James, President, Royal College of Psychiatrists

DOTW contribute to ground-breaking report on sexual and gender-based violence

A ground-breaking report from University of Birmingham has found that there are too many barriers stopping refugee and migrant survivors of sexual and gender-based violence in the UK getting essential health support they need.

The report, Forced migration and sexual and gender-based violence, led by the University of Birmingham’s Professor Jenny Phillimore, shows that victims of sexual and gender-based violence (SGBV) who have been forcibly displaced from their home country are let down by UK health and immigration services. Survivors have high levels of vulnerability and physical and mental health needs and the majority are not accessing health support.

Service users who came to Doctors of the World clinic for health care after surviving violence were amongst those who told their stories to researchers. Leading migrant health experts from Doctors of the World also advised on how the current health system does not meet the needs of survivors of violence, stopping them from disclosing their experience and accessing the essential support they need.

People gave their stories of violence before fleeing their country and on the journey to the UK. These included restriction of movement, physical and verbal abuse, humiliation, torture, starvation, human organ trafficking and slavery, sexual violence, labour exploitation, blackmailing, being thrown into the sea (or threat of), deprivation of possessions including medicines and official papers, or being abandoned. However, once in the UK, many SGBV survivors continued to experience violence and/or were placed at risk of suffering when they couldn’t access services, or the system mistreated them when they did access them.

The combined effects of years of violence and experience of UK systems generated high levels of trauma resulting in physical and psychological harms.

‘I am so tired, psychologically, and physically. I see nightmares every night. I get panic attacks I can’t stop shivering every time I think I might be deported to be killed back home’, said Jordan, a female asylum seeker.

A traumatic asylum process with long decision making and indecisive and inhumane interviews retraumatised victims and stopped them disclosing. Unstable and risky housing caused stress and trauma whilst people waited for an asylum decision. Some forced migrant women were dependent on violent partners for their immigration status and believed they had to endure abuse if they were not to be deported. Respondents talked about injuries and sexually transmitted diseases sustained during their journeys wherein they were unable to access post-rape prophylaxis with some respondents giving birth to children of rape.

Despite this high level of health need and vulnerability the majority of survivors received no physical or mental health support. Many were too fearful to seek medical help or report violent incidents to the police in fear of being deported or being charged for their medical care. Others suggested that health professionals lacked knowledge of lived experiences of forced migrant survivors and the barriers they faced accessing services such as frequent changes of address, language barriers and having No Recourse to Public Funds (NRPF). Lack of training and time to help survivors disclose SGBV experiences meant that both physical and psychological conditions went untreated.

Amardeep Kamboz, Head of UK Services at DOTW, said “At our clinic we see people who have fled to the UK for safety with many different and harrowing experiences of sexual violence, and who haven’t seen a doctor. They’re often worried they’ll be deported or charged for their care. Our doctors do their best to provide care, but they really need access to the NHS and specialist support systems to receive the ongoing care they deserve. We try to get them GP registration and are sometimes turned away because they don’t have proof of ID or address.”

“The whole process made me feel hopeless, made we wish I was dead, made me feel exhausted of everything. I thought coming to the UK would be a fresh start for me, from the trauma I experienced back home – but that was not the case. My life in the UK is a life of pain. I feel hopeless, destroyed and drained.”Erina, a survivor of SGBV who was interviewed by the SEREDA project.

Recommendations included:

Health Policy and Guidance

• Ensure all asylum seekers, including those in initial accommodation and hotels, receive timely information and support to access healthcare and are registered with a GP as soon as possible
• Strengthen healthcare provision for forced migrant SGBV victims and support practitioners to develop capacities to recognise and respond to SGBV
• Home Office, Department of Health and Social Care and Office for Health Improvement and Disparities to ensure firewall between health data and the Home Office and continue improving transparency of communications to refugee and asylum seeker populations about the limited circumstances in which personal data can be shared between Home Office and the NHS
• Department of Health and Social Care to review communication about the exemption from NHS charging for victims of violence as it is not widely known about or used
• Office for Health Improvement and Disparities (OHID), NHS England and NHS Improvement to produce guidance for healthcare professionals about how to support victims and good practice to integrate trauma-informed practice into training and education at different levels
• Ensure GP registration policies do not exclude asylum seekers and that GP frontline and clinical staff understand asylum seekers’ entitlement to primary and secondary care and the possibility they may lack proof of address or ID or immigration documents
• Royal Colleges to provide support and guidance on SGBV and migrant health to enable their members to work effectively with SGBV victims
• Department of Health and Social Care, OHID, NICE and Royal Colleges and Faculties to develop guidelines for good practice to integrate trauma-informed practice into training and education at different levels, building on the online Migrant Health Guide
• Increase NHS capacity to offer specialist mental health support to forced migrant victims.

Frontline healthcare provision

• Implement training for health professionals and support personnel to enable them to identify and support SGBV victims and to raise awareness of referral pathways
• Ensure clinical training covers the specific vulnerabilities and needs of forced migrants and especially SGBV victims
• Inform all patients about their right to request female clinicians, and to request an interpreter.

More information on SEREDA project is available online While the full report can be downloaded here along with the UK Executive Summary.

Joint letter: Safe routes, compassion and fairness need to be at heart of Government’s approach to people seeking sanctuary

Doctors of the World has signed a joint letter, alongside 150 other organisations, asking the Government to sit down with people who’ve gone through the asylum system, and their advocates, to create a new, more compassionate, and effective process which puts safety first.

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Following the tragic deaths of at least 27 people in the English Channel – including children – it is time for serious action. We cannot stand by and let this Government’s harsh rhetoric and ill-thought-out approach go unchecked.  

This Government’s policy of grabbing cheap headlines and blaming the French authorities while paying them millions of pounds to build fences around the Channel ports has not worked. Now people fleeing conflict, persecution and war have paid the ultimate price. We know from the warehouses overflowing with donations for Afghan refugees that the public believes in the right to seek safety. That same public cannot stand for this.  

Instead of trying to blame people seeking safety for its own failures, this Government must step up to its responsibilities and focus on saving lives. 

For a start, parliamentarians must rethink the Nationality and Borders Bill. Not only will these new laws take a wrecking ball to the very principle of refugee protection, but we know they are unworkable. They will push desperate people further into the arms of smuggling gangs and will only inflame our international partners who we need to work with to ensure people seeking sanctuary can do so safely. 

We also need a cast-iron commitment from this Government that it will not pursue its policies on offshoring or pushbacks, which will cause even more harm and make deaths in the Channel even more likely.  

Above all, this tragedy shows how urgent it is for this Government to work with its international partners to create more routes to safety for refugees. This Government demands refugees take official routes, but for most people, these simply do not exist. Refugees are left with little option but to arrive here hidden in a plane or lorry or crammed onto a small boat.  

We are calling on this Government to make a long-term commitment to: 

• create a compassionate asylum system that treats all people seeking asylum in the UK with kindness and dignity 
• resettle at least 10,000 refugees each year from around the world 

• reinstate the Dubs Agreement to protect child refugees from exploitation 
• expand family reunion so that more people can be reunited with their loved ones 
• introduce a humanitarian corridor 

We ask the Government to sit down with people who’ve gone through the asylum system, and their advocates, to create a new, more compassionate, and effective process which puts safety first. Now, if ever, is the time to do so. 

Signed by 

Barrow Cadbury Trust, Dame Sara Llewellin DBE  

Refugee Action, Tim Naor Hilton, CEO 

Refugee Council, Enver Solomon, CEO 

Freedom From Torture, Sonya Sceats, CEO 

Scottish Refugee Council, Sabir Zazai, CEO 

Asylum Matters, Andrea Vukovic & Paul Hook, Co-directors 

Abigail Housing, Amanda Church-Mcfarlane, Co-Chief Executive Officer  

Action for Refugees in Lewisham, Sophie Wickham, Director 

ACH, Fuad Mahamed, CEO 

Allies for Justice, Steven Shyaka, Lived experience campaigns coordinator  

Amber Film and Photography Collective Laura Laffler, Director 

Asylum Aid, Ian Kane, Legal Services Manager 

Asylum Link Merseyside, Ewan Roberts, Centre Manager 

Asylum Support Appeals Project  

Asylum Welcome, Mark Goldring, Director 

AVID (Association of Visitors to Immigration Detainees), Ali McGinley, Director  

Baca, Jimmy Zachariah, CEO 

Bail for Immigration Detainees, Annie Viswanathan, Director 

Big Leaf Foundation, Evie Booton, Campaigns Coordinator  

Baobab Centre For Young Survivors in Exile, Jodie Bourke, Senior Manager 

Boaz Trust, Ros Holland, Chef Executive 

Body & Soul, Emma Colyer, Director  

Bradford City of Sanctuary, Will Sutcliffe, Chair 

Breaking Barriers, Matthew Powell, CEO  

Bristol Defend the Asylum Seekers Campaign, Jo Benefield, Coordinator 

Bristol Reclaiming Independent Living (BRIL), Mark Williams, Founder 

British Association of Social Workers, Dr Ruth Allen, Chief Executive 

Bromsgrove and Redditch Welcome Refugees, Yvonne Rendell, Chair 

Calais Action, Libby Freeman & Caroline Gregory, Founder 

Cambridge Convoy Refugee Action Group, Catharine Walston, Chair of Executive Committee 

Campaign Bootcamp, Sarah Miguel, Co-Leader 

CARAS, Eleanor Brown, Director 

Care4Calais, Clare Moseley, Founder  

Caritas Diocese of Shrewsbury, Ben Gilchrist, CEO 

Carlisle Key, Diana Vlad & Iain McNee, Housing Support Officer and Operational Manager 

Channel Rescue, Kim Bryan, Co-founder  

Choose Love, Cherno Jagne, COO  

Citizens of the World Choir, Becky Dell and Matilda James, Musical Director and Exec Producer 

City of Sanctuary Sheffield, Tom Martin, Director 

City of Sanctuary UK, Sian Summers-Rees, Chief Officer  

Civic Leicester, Ambrose Musiyiwa, Facilitator 

Common Space Common Humanity, Dave Plumb, Coordinator 

Compass Collective, Leah Gayer, Co-director  

Coventry Refugee and Migrant Centre, Toni Soni, Centre Director 

Curious Monkey, Zoe Connel, Project Coordinator for Arriving 

Detention Action, Bella Sankey, Director 

Doctors of the World, Ellen Waters, Director of Development 

Donate4Refugees, Amber Bauer, Founder 

ECPAT UK (Every Child Protected Against Trafficking), Patricia Durr, CEO 

Equanicity, Cryton Chikoko, Co-founder 

FAST (First Aid Support Team), Nynke van Dijck, Founder  

Fences & Frontiers, Lewis Garland, Founder / Chair 

FODI (Sunderland), Steve Newman, Chair 

Good Chance Theatre, Naomi Webb, Executive Director 

Govan Community Project, Traci Kirkland, Head of Charity  

Greater Manchester Immigration Aid Unit, Denise McDowell, Chief Executive 

Haringey Migrant Support Centre  

Hastings Community of Sanctuary, Jane Grimshaw & Polly Gifford, Co-Chairs 

Hay Brecon and Talgarth Sanctuary for Refugees , Ailsa Dunn, Secretary 

Helen Bamber Foundation, Kerry Smith, CEO 

Herne Hill Welcomes Refugees, Terry Morin, Chair 

Herts for Refugees, Angus Clark, CEO 

Homeless Network Scotland, Maggie Brunjes, Chief Executive 

Hope for the Young, Matt Blacker, CEO 

HOPE not hate, Nick Lowles, CEO 

Hope Projects, Phil Davis, Director 

Host Nottingham, Rebecca Kogan, Project Coordinator 

Humans for Rights Network, Maddie Harris, Director/Founder 

IMIX, Emma Harrison, CEO 

Immigration Law Practioners’ Association, Nicole Francis , Chief Executive 

Interfaith Scotland, Maureen Sier, Director 

JRS UK, Sarah Teather, Director 

Justice and Peace Scotland (Catholic) Bishops’ Conference of Scotland, Jill Kent  

Justice First, Jason Hussein, Project Manager 

Kids in Need of Defense UK (KIND UK), Katie Fennell, National Coordinator 

KRAN, Dr Razia Shariff, CEO 

Latin American Women’s Rights Service, Elizabeth Jiménez-Yáñez & Dolores Modern, Policy co-coordinators 

Leeds Destitute Asylum-seekers Support, Jenny Willison, Trustee 

Lewisham Refugee and Migrant Network, Rosario Guimba-Stewart, Chief Executive 

Liberal Democrats for Seekers of Sanctuary, John Skipworth, Chair of Council 

Liberty, Martha Spurrier, Director 

LOSRAS (Lewes Supports Refugees), Gill Tipping, Co-Chair 

Love Welcomes, Abi Hewitt, CEO / Founder 

Love 146, Philip Ishola, CEO 

Malvern Green Space  

Methodist Church, Geoff Charlton, Local Preacher 

Micro Rainbow, Sebastian Rocca, CEO

Migrant Destitution Fund, Sian Mullen, Action Group Member 

Migration Mobilities Bristol, Bridget Anderson, Director 

Migrants’ Rights Network, Fizza Qureshi, CEO 

Migrant Voice, Nazek Ramadan, Executive Director 

NACCOM, Bridget Young, Director  

NATECLA, Rachel Öner, Co-Chair 

Norfolk Schools of Sanctuary, Jake Rose-Brown, Founder 

North East Law Centre, Rachel McPeake, Project Administrator 

Nurses United UK, Anthony Johnson, Registered Nurse and Lead Organiser 

O’s Refugee Aid Team, Onjali Rauf, Founder and Author 

Open Aye, Becky Duncan, Director

Our Second Home, Amos Schonfield, Director 

Pathways Trust, Tara Pollitt, Operations Manager 

Pollination, Yasmine Balfour-Lynn, Co-Founder 

Praxis, Sally Daghlian OBE, CEO 

Race Equality Foundation, Jabeer Butt OBE, CEO 

Rainbow Home (North East England), Alessandra Mondin, Project worker 

Rainbow Migration, Leila Zadeh, Executive Director 

RAMFEL, James Tullett, CEO 

Reading City of Sanctuary, Maggie Filipova Rivers, Manager 

Reading Refugee Support Group, Nick  Harborne, CEO 

RefuAid, Anna Jones, Co Founder 

Refugee Action, Lizzie Hobbs, GPP Team Administrator 

Refugee Education UK, Catherine Gladwell, Chief Executive 

Refugee Legal Support (RLS), Efi Stathopoulou, Programmes Manager 

Refugee ReSETTLEment, Paul  Kelly, Project leader 

Refugee support East London and Essex, Pam Derwin, Admin   

Refugee Survival Trust, Elaine Cameron, CEO 

Refugee Trauma Initiative, Zarlasht Halaimzai, CEO and Co-Founder 

Restore (a project of Birmingham Churches Together), Jeremy Thompson, Manager 

Right to Remain, Lisa Matthews  

Room to Heal, Elli Free, Director 

Routes, Daisy Jacobs & Leyla McLennan, Co-directors 

Royal College of Nursing, Geoff Earl, Council Member (personal capacity) 

Runnymede Trust, Alba Kapoor, Senior Policy Officer 

Rural Refugee Network, Nadia Potts, CEO 

Safe Passage, Beth Gardiner Smith, CEO 

Samphire, Indre Lechtimiakyte, Legal and Migrant Support Manager 

Say It Loud Club, Aloysius Salle, Executive Director 

Screen Share UK, Moses Seitler, Director 

Scotswood Garden, Karen Dobson, CEO 

Seeking Sanctuary, Phil Kerton, Co-Director 

Settle Area Refugee Support, Angie Pedley, Treasurer 

Social Workers Without Borders, Naomi Jackson 

Solidarity With Refugees, Ros Ereira , Director 

Sophie Hayes Foundation, Red Godfrey-Sagoo, CEO 

Southampton & Winchester Visitors Group, Chris Stephens, Chair of Trustees 

Southampton Action, Nikki Walters, Chair 

Stand for All, Daniel Sohege, Director 

Stories of Hope and Home, Stephanie Neville, Project Manager 

Student Action for Refugees, Emily Crowley, Chief Executive  

Swindon City of Sanctuary, Nicola Wood, Charity Manager 

Tees Valley of Sanctuary, Suzanne Fletcher, Housing Co-ordinator 

The Cotton Tree Trust, Janet Gilbert, General Manager 

The Iona Community, Robert Swinfen, Convenor of Migration & Asylum Network 

The Jewish Council for Racial Equality (JCORE), Dr Edie Friedman, Executive Director 

The Mercy Hub, Jeremy Cain, Coordinator 

The Pickwell Foundation, Susannah Baker, Founder 

The Refugee Rights Project, Izzy Hughes, Founder 

The William Gomes Podcast, William Gomes, Director 

the3million, Nicolas Hatton, CEO 

Together with Migrant Children, Nick Watts & Jane Goldsmid, Co-Directors 

Trauma Foundation South West, Judy Ryde, Founder/Clinical Director 

UKCEN, Claudia Holmes, Founder  

Vauxhall Community Law and Information Centre, Siobhan Taylor-Ward, Solicitor 

Voices in Exile, Mel Steel, Director 

Voices Without Borders, Joss Duncan & Ewa Lelontko, Co-founders 

Waging Peace, Maddy Crowther & Sonja Miley, Co-Executive Directors 

West Cumbria Refugee Support Network, Kelly Davis, Chair 

West End Refugee Service, Hannah Barnes, Director  

Women for Refugee Women, Alphonsine Kabagabo, Director 

Young Roots, Jo Cobley, CEO 

Doctors of the World intervene in migrant healthcare rights case in the High Court

Doctors of the World has provided evidence and legal arguments in an important case – about denying healthcare to people living in the UK without secure immigration status – which was heard in the High Court on 16 November 2021.

The judicial review, brought by an undocumented migrant, challenges the lawfulness of an NHS trust’s decision not to provide scheduled haemodialysis under the NHS (Charging of Overseas Visitors) Regulations 2017 (“the Charging Regulations”). Doctors of the World were granted permission to intervene in the case.

The Secretary of State for Health and Social care was also been granted permission to intervene in the case.

Doctors of the World hopes the case will provide clarity on the application of the Charging Regulations to ensure that people with serious medical conditions who are living and settled in the UK are not denied the urgent healthcare they need.

Doctors of the World provided evidence and made legal submissions to the High Court which drew upon their policy expertise and case examples from the organisation’s Hospital Access Project, where treatment had been withheld or partially withheld from undocumented migrants.

Doctors of the World UK, represented by Janet Farrell of Bhatt Murphy Solicitors, will intervene by way of written and oral submissions. The claimant is represented by Deighton Pierce Glynn.

Anna Miller, Head of Policy and Advocacy at Doctors of the World:

“Managing a serious health condition alone, without the support of a doctor or access to medication is a horrendous situation that nobody should be placed in. In Doctors of the World’s experience the case before the court is far from unique so we are glad the court recognises the organisation’s considerable experience of the Charging Regulations and supporting people denied medical care and granted us permission to intervene.

“This case is an example of Doctors of the World’s key concern with the Charging Regulations, namely how they should be applied to people who are not visitors to the UK but long-term residents. In our clinic the people we see are people who are living in this country, and often have been for decades, people who are part of our communities, with families, children and their whole lives in this country.”

Amardeep Kamboz, Head of Services at Doctors of the World:

“Optimal health is essential for a person’s wellbeing and quality of life, and to be able to fulfil their personal ambitions and their potential in society. It is a right no one should be denied. At DOTW we have met many people with conditions such as cancer, heart conditions, kidney diseases or serious reproductive health issues that have been denied treatment or given a sub-standard level of care solely based on their immigration status.

“Many people that we meet at DOTW have lived in the UK for many years with family, friends and communities around them. Most are attempting to navigate a highly complex immigration system, often over very long periods of time. Through our clinic services we have witnessed on multiple occasions how the current Charging Regulations fails to recognise the complexity of people’s individual circumstances and in doing so, does not mitigate against dangerous precedents being set by NHS Trusts in which it is acceptable for some people in our communities to not get the medical care they need.”

Dr Hannah Fox, from Doctors of the World:

“At Doctors of the World, we have mounting evidence that the complex charging laws are misunderstood and misapplied by NHS Trusts, leaving people without essential and often lifesaving treatments. I have read letters from consultants imploring senior managers to allow them to treat a patient in urgent need of medical care. There is no doubt that these regulations are applied unfairly, cause great harm and are at odds with the founding ethos of the NHS.”

Janet Farrell, Solicitor, from Bhatt Murphy Solicitors:

“This case raises important issues about the meaning of “urgent treatment” within the NHS charging regime. Doctors of the World UK have serious concerns about whether migrants are able to access to urgent treatment as is permitted by the regulations, and they welcome the opportunity to intervene in this case. It is plainly of critical importance to many very vulnerable people that NHS Trusts get this right.”

-ENDS-

Notes to editors

About the case

In 2017 the UK government introduced new restrictive laws placing duty on NHS trusts to withhold NHS secondary care services from undocumented migrants living in the UK if the patient does not make payment before receiving the service unless doing so would prevent or delay the provision an immediately necessary service or an urgent service. There are exceptions for some services, such as A&E and in the case of communicable diseases, and for very vulnerable individuals, such as victims of trafficking.

Doctors of the World’s casework and research evidences urgent healthcare services being withheld from migrant patients who are living and settled in the UK. In many cases, patients’ faced a legal or practical obstacle which meant they could not leave the UK yet urgent healthcare was withheld. This includes people with an outstanding legal claim for leave to remain in the UK, which meant they could not be removed until their case had concluded and may result in them being granted permission to stay in the UK indefinitely.

The NHS (Charging of Overseas Visitors) Regulations 2017 form part of the Government’s hostile environment policy which aims to reduce the size of the UK migrant population by limiting access to public services and making life difficult for people living in the UK without immigration status. Charities and medical organisations have voiced concern about the negative impact of the Charging Regulations on patient care and clinical staff, calling for their suspension. According to a survey of British Medical Association members, doctors face pressure when making clinical judgements regarding a patient’s need for care.

It is hoped the case will provide much needed clarity on the application of the Charging Regulations and urgent treatment, minimising scope for misunderstanding and the withholding of medical care from people with serious medical conditions who cannot reasonably be expected to leave the UK.

About DOTW’s intervention

Doctors of the World UK is intervening in the case to assist the court by providing its experience of how the Charging Regulations are applied to undocumented migrant patients.

The case raises important issues in relation to how the charging regulations are applied to seriously ill patients who have been living in the UK for long periods of time and cannot reasonably be expected to leave the country anytime soon, for a variety of reasons. Based on DOTW’s considerable experience of the Charging Regulations, the case is not unique and illustrates a broader level of misunderstanding and adverse risk to vulnerable patients.

Doctors of the World UK provide health clinics for people excluded from NHS services and, since 2018, have run a specialist service for people refused NHS secondary care services to address problems arising from the Charging Regulations. The organisation has supported over twenty people in the past two years who are being denied medical care, including cancer treatment, surgery and dialysis and gynaecology services, having been assessed as not “ordinarily resident” in the UK. The work of the service and Doctors of the World UK’s policy expertise has formed the basis of the intervention.

About Doctors of the World

Doctors of the World UK is part of the Médecins du Monde international network, an independent humanitarian movement. Doctors of the World UK supports the rights of everyone, regardless of immigration status, to claim their right to health and medical care. In the UK the organisations runs and runs services providing medical care, information, and practical support to people unable to access NHS services. Our patients include refugees, asylum seekers, survivors of human trafficking, people experiencing homelessness, sex workers, migrants with insecure immigration status and Gypsy, Roma, and Traveller communities.

Open Letter to the Rt Hon Sajid Javid, Secretary of State for Health and Social Care

Doctors of the World and The 3 million have written to The Rt Hon Sajid Javid MP, Secretary of State for Health and Social Care to raise our concern that people who received their COVID vaccinations abroad or in a pop-up/walk-in vaccination centre without an NHS number are not recognised by the NHS as vaccinated.

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12 November 2021

Dear Secretary of State for Health and Social Care,

In July, you said that “by reopening quarantine-free travel for travellers who have been fully vaccinated in European countries and the USA, we’re taking another step on the road to normality which will reunite friends and families and give UK businesses a boost.”

We felt hopeful that EU citizens and other foreign nationals living in the UK could resume visiting their families and friends abroad, and enjoy the same freedoms as their British counterparts when returning home in the UK.

Unfortunately, people who received their vaccinations abroad with vaccines approved by the Medicines and Healthcare products Regulatory Agency (MHRA) (because the pandemic meant they were stuck abroad, or were for example caring for a family member) have been telling us that due to an anomaly, they haven’t been able to enjoy the same freedoms.

Their vaccinations received in other countries, including for instance the EU, can get them through the UK border without the need to quarantine, but their jabs are not recognised by the NHS Track & Trace system.

“We were contacted by NHS Track & Trace because we were in “contact” with someone who tested positive, and told we had to self-isolate because, from the NHS’s perspective, we’re un-vaccinated. Had we received our vaccinations in the UK we’d have been exempt from having to self-isolate.

“An alternative is for us to get re-vaccinated in the UK (as we have decided to do), but that increases the risk of side-effects for us, and it deprives others of the jabs we’ll claim.”

We appreciate an agreement was reached with the European Union on this issue on 28 October 2021, yet the NHS website indicates that it is not possible to register vaccinations abroad with the NHS, but that the issue “is being worked on and an update is expected shortly”. That text hasn’t changed in the last three months.

The same issue is affecting people who have been fully vaccinated at a pop-up /walk-in vaccination centre, but who don’t have an NHS number and are not registered with a GP.

Until this issue is resolved, thousands of EU citizens and foreign nationals who are fully vaccinated still have to self-isolate any time someone in their surroundings tests positive to the COVID-10 virus, or worse, re-vaccinate which is not following Government, JCVI and NHS vaccination advice, and which risks side effects.

We have family members, friends, colleagues and neighbours across the country who call the UK home but are continuously in fear of having to isolate, who cannot fully participate in public life, in the economy, or in our communities despite being fully vaccinated.

Secretary of State, we are asking you to show leadership again and enable everyone who calls the UK home, and who has been doubly vaccinated by vaccines approved in the UK, to be able to be recognised by the NHS as vaccinated, regardless of where they got their jabs or whether they are registered with a GP.

Yours,

Ellen Waters, Director of Development, Doctors of the World UK
Nicolas Hatton, CEO, the3million

List of Multilingual Resources for Afghans

To support people from Afghanistan, Doctors of the World has compiled a list of resources for individuals and for professionals who are working with them.

The official languages of Afghanistan are Pashto and Dari (which is a variation of Farsi), and we have also included Urdu as it has been reported that a number of caseworkers have been working with families to whom Urdu is their primary language.  

How to register with a GP and Book a Vaccine: Pashto/ژبه پښت, Farsi/فارسی, Urdu/اردو

COVID-19 Guidance: Dari/زبان دري, Pashto/ژبه پښت, Farsi/فارسی, Urdu/اردو

COVID-19 Infographic: Dari/زبان دري, Pashto/ژبه پښت, Farsi/فارسی

COVID-19 Vaccine Guidance: Dari/زبان دري, Pashto/ژبه پښت, Farsi/فارسی, Urdu/اردو

Wellbeing Guidance: Dari/زبان دري, Pashto/ژبه پښت, Farsi/فارسی, Urdu/اردو

Keeping young people healthy: Pashto/ژبه پښت, Farsi/فارسی

Migrants’ Right to Healthcare: Dari/زبان دري, Farsi/فارسی

Selfcare Infographic: Dari/زبان دري, Pashto/ژبه پښت, Farsi/فارسی

Do keep checking our Translated Health Information hub where you can filters the documents by keyword, narrow by topic or select your language or type you are looking for. 

Public Health England  

On this page you can find more resources produced by Public Health England. Resources include more COVID-19 Vaccine guidance, the blood clotting guidance as well as the flu vaccine and pregnancy.  

New report reveals the extent of the barriers migrants face accessing healthcare during the pandemic

Doctors of the World (DOTW) and the University of Birmingham (UoB) have today published, Migration and Vulnerability during the Pandemic: Barriers to Wellbeing, which has revealed that refugees, asylum seekers and migrants reported higher levels of bad health and inadequate housing during the COVID-19 pandemic, as well as difficulties registering with a GP and accessing remote healthcare services, suggesting significant unmet healthcare needs.

Conducted by leading academics from UoB, using data from DOTW, and funded by the Nuffield Foundation and the Economic and Research Council, the report has examined health, housing and economic situations. It has also looked at the reasons why individuals needed to access DOTW’s services and how often services were accessed.

Participants, whose data has anonymously reported on, come from four categories of migrants with insecure immigration status: refugees; asylum seekers; refused asylum seekers, and undocumented migrants.

Concerningly, the number of requests for consultations dropped from 178 in January 2020 to 58 in September 2020, at one of the many peaks of the pandemic, which at the same time there was a significant increase in the number of service users reporting ‘bad’ or ‘very bad’ health.

The majority of the consultation requests were around help with GP registration; help with NHS costs; queries about antenatal care; queries about immigration; queries about A&E and walk-in clinics, and queries and advice about secondary care (including charging). This finding provides further evidence that people with insecure immigration status are often not registered with a GP and are largely excluded from NHS services, and has implications for the COVID-19 vaccination programme which requires individuals to have an NHS number and an active GP registration in order to book a vaccination appointment.

In addition to this, the number of people accessing DOTW services who reported to be in insecure/inadequate housing situations rose from 44% to 62.8% during the pandemic. However, the number of people reporting as roofless/homeless dropped slightly from 6.3% to 6.1%.

The data was collected as the government launched the ‘Everyone in’ policy (27 March 2020) to provide hotel and emergency accommodation to all people sleeping on the streets regardless of immigration status, which allocated £3.2million of funds to local authorities in England to bring all those living on the streets into self-contained accommodation as a response to the Covid-19 crisis and suspended all evictions from Home Office asylum accommodation. During this period the numbers of asylum seekers living in hotel accommodation increased dramatically with the research indicating that they were struggling to access much needed healthcare whilst living in hotels.

The report makes a number of policy recommendations aimed improved public health measures and at supporting those in vulnerable circumstances in accessing healthcare. These include:

• Remote provision clearly does not enable contact from all migrants requiring support to access healthcare. As the UK returns to a greater degree of normality reinstating some face-to-face provision is important to ensure all needs are addressed;

• The increase in asylum seeker users and deterioration in general health in this group points towards potential problems with a) access to healthcare for those housed in hotels b) the health of those living in hotels. The Asylum Providers Accommodation contract should be amended so the statement of requirements includes people in initial / contingency accommodation receiving support to register with a GP following the HA Select Committee recommendation^[1];
• Provision of Wi-Fi or data should be a priority for people living in poverty so that they are not excluded from services as they move online;
• GP surgeries should be encouraged to continue to register new patients throughout the pandemic;
• Increasing migrants and practitioners understanding of knowledge of the healthcare system, especially awareness of the charging exception. This is vital for both healthcare professionals and individuals at risk of vulnerability. Clear guidance should be provided on the government website in different languages;
• Given that not everyone has been vaccinated, it is necessary to distribute free face masks to individuals at risk of vulnerability, because they often rely heavily on public transport and lack resource to purchase PPE.

You can find the full list of recommendations in the report.

Anna Miller, Head of Policy and Advocacy at Doctors of the World, said: “This report makes for stark reading. Unable to access NHS services, forced to manage health conditions alone and struggling with poor housing, the report shows just how difficult the pandemic has been for people with insecure immigration status. And the importance of this cannot be understated – our pandemic response relies on whole population having good access to medical care and being able to protect themselves from the virus.”

Jenny Phillimore, Professor of Migration and Superdiversity at the University of Birmingham said: “Our analysis clearly indicates that the shift from face to face to virtual or phone services risks excluding the most vulnerable migrants. We are also concerned about the increase in numbers of asylum seekers accessing the service – this demonstrates, as several organisations have suggested, that the accommodating asylum seekers in hotels makes access to much needed healthcare services difficult.”

Alex Beer, Welfare Programme Head at the Nuffield Foundation, said: “The effects of the Covid-19 pandemic have exacerbated existing inequalities and vulnerable groups have faced particular adversities. This important research shines a light on the unmet health needs and precarious living situations faced by refugees, asylum seekers and vulnerable migrants, and highlights the need for policymakers and service providers to ensure that vulnerable groups have the means and support to access the health services they are entitled to.”

Migration and Vulnerability during the Pandemic: Barriers to Wellbeing was funded by the Nuffield Foundation and with additional support from the UK’s Economic and Social Research Council’s (ESRC) Urgency Fund.

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[1] https://publications.parliament.uk/pa/cm5801/cmselect/cmhaff/562/56208.htm#_idTextAnchor087

Safe Surgeries provide hope for vulnerable members of our communities excluded from 76% of UK GP practices

Leading health charity, Doctors of the World (DOTW), is today celebrating the 500 GP surgeries across the UK who have signed up to the charity’s Safe Surgeries initiative. By signing up, these GP surgeries are committing to ensuring that they will provide a safe and secure environment for vulnerable people in their community to access healthcare.

This milestone is particular cause for celebration after an investigation by the Bureau of Investigative Journalism and The Independent found that fewer than a quarter of GP surgeries (24%) surveyed in cities across England, Scotland and Wales would register someone without proof of address, proof of ID or legal immigration status[1].

Launched in 2018, the Safe Surgeries initiative recognises the barriers to healthcare access that exist – particularly for migrants, refugees, street homeless people, and many others in vulnerable circumstances – including administrative and language barriers. GP surgeries who sign up to the initiative are leading by example and working tirelessly to ensure that nobody in their community is excluded.

Everyone living in the UK is entitled to register and consult with a GP. It means we can prevent and treat illness early and create a healthier society for everyone. Yet too many people are left behind, denied access to healthcare, despite having the right to it.

A Safe Surgery can be any GP practice which commits to taking steps to tackle the barriers faced by many vulnerable people in accessing healthcare. At a minimum, this means declaring your practice a ‘Safe Surgery’ for everyone and ensuring that lack of ID or proof of address, immigration status, or language are not barriers to patient registration.

Anna Miller, Head of Policy and Advocacy at Doctors of the World, said: “Doctors of the World is delighted to have reached the milestone of having 500 GP practices sign up to be Safe Surgeries. It means that 500 communities across the country are actively welcoming their most vulnerable and ensuring that anyone who needs it can receive the medical attention they need.

“Access to primary healthcare is the right of anyone living in the UK, yet many GP surgeries don’t recognise their responsibility to some of the most socially excluded members of their community. This has to change if we are going to tackle the health inequalities which continue to challenge our health service.”

Dr Hannah Fox, a GP based at the Lawson Road Surgery in Norwich – which is a Safe Surgery, said: “As a GP I believe that everyone in the community should be able to access appropriate and timely healthcare with ease. If an individual in vulnerable circumstances faces barriers to accessing a GP practice, then GPs and nurses cannot provide preventative care, intervene early and manage long-term conditions. This results in a higher burden of disease and increased mortality for those excluded. It also has detrimental effects on population health, leading to widening health inequalities in our society.  

“This widening gap in health outcomes is driven by the ‘hostile environment’ for migrants which was introduced in 2012 and undermines the core principles of the NHS. As this last year has shown, it is impossible to tackle public health issues, such as the COVID19 pandemic, if we don’t actually provide healthcare to the whole of the community.

“Becoming a Safe Surgery is an important step in tackling these inequalities, preventing exclusion of those in vulnerable circumstances from essential primary care. We need to work towards a more inclusive model of healthcare, and ensure our practices are safe and welcoming environments for all. I encourage all GP practices to sign up and become a Safe Surgery!”

Saleh is a member of the DOTW National Health Advisors, and he has been supporting migrants in accessing healthcare in his community by working in a Safe Surgery in south London: “I am a refugee from Syria, I have been in the UK for five years. I enjoy helping and guiding people who have difficulties registering with a GP.

“In our surgery, we sometimes receive registration forms from patients who want to join our surgery, but they don’t have proof of identity or address. We accept them without these documents because they are entitled to be registered with a GP.

“I know from personal experience that if you don’t have utility bills in your name and have not been able to open a bank account, because you usually need proof of address to do that, it can be difficult to find other documents that will be accepted as proof of address.”

As well as the opportunity to better advocate for patients, becoming a Safe Surgery offers GP practices additional benefits:

• Support to fulfil contract obligations as defined in NHS England guidelines e.g. preventing ID and proof of address being barriers to registration;
• Support successful CQC inspections by helping practices deliver an Effective, Responsive and Caring service;
• Support staff learning and skills-building through free training, information-sharing and resources;
• Membership of a community of providers which actively promotes a better NHS, helping to tackle health inequalities and provide accessible healthcare for those that need it.

To find out more about the Safe Surgeries initiative, download the Safe Surgeries resources, and to find out how to register as a Safe Surgery, visit the Doctors of the World website.

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[1] https://www.thebureauinvestigates.com/stories/2021-07-15/most-gp-surgeries-refuse-to-register-undocumented-migrants