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Dr Kate Warren Registrar in public health NHS Walsall. From OUTside to INvolvement. Partners in the project: - WELCOME - WRASSA - WARMA - Citizens Advice Bureau - NHS Walsall - Walsall Council Funded by Government Office West Midlands: Migration Impacts Fund

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from outside to involvement
Dr Kate Warren

Registrar in public health

NHS Walsall

From OUTside to INvolvement
from outside to involvement1
Partners in the project:


- WARMA - Citizens Advice Bureau

- NHS Walsall - Walsall Council

Funded by Government Office West Midlands: Migration Impacts Fund

Aim – Reduce the impact of migration on health and other public services in Walsall

From OUTside to INvolvement
new migrants who are they
New migrants – who are they?

Asylum seekers including unaccompanied children


Refused asylum seekers

Economic Migrants


Others via Points based system

Family reunion

Overseas students

Undocumented migrants

the scale of migration in walsall
The scale of migration in Walsall

Numbers doubled after expansion of the EU to over 1200 new migrants per year

Majority from South Asia and Eastern Europe

Over 100 asylum seekers housed by the Border Agency

Unknown numbers of refugees

Unknown numbers of undocumented migrants

Small numbers of Looked After Children

issues for walsall
Issues for Walsall
  • Variation (policy, economy, housing capacity)
  • Not a “critical mass” for specialist services such as Birmingham/Coventry
    • Reliance on voluntary sector and short term projects
  • Services require extra time and resources
  • Mobility of migrants – continuity of care
  • Tight geographical spread
  • Holistic/social approach to health needed
commissioned activity
Commissioned activity
  • Certification for volunteers to provide advice
  • Drop-in / phone-in: information for clients
  • Arts and social events as engagement tools
  • Recruitment to local involvement channels
  • Training and collaboration with services
  • Regional networking
  • Translated resources produced and shared

(Welcome to the West Midlands website)

Primary care

Access to General Practice

Appropriate use of services – Choose Well

Translation tools / interpreters

Awareness of staff – cultural norms, entitlements to healthcare

Maternal and child health

Identification and appropriate care for migrant women with specific problems e.g. Female Genital Mutilation

Integration of NICE guidance and pathway for vulnerable women in service specification for midwifery

Child protection awareness

Mental Health

Pre-migration factors

War, torture, rape, persecution

Post-migration factors

Poverty, poor housing, social isolation, immigration processes, language barrier

Cultural perceptions of mental health

Awareness of specialist area in MH services

Creative writing workshops resulting in a published booklet

Health protection

Blood borne viruses – HIV, Hepatitis

Encouraging testing


Symptom awareness

Sex workers

South Area Partnership

social determinants of health and other issues

Poverty – benefits



Education/training including ESOL

Social isolation

Community cohesion

Social determinants of health and other issues
what now
Importance of retaining specialist knowledge and momentum

Capacity building in voluntary sector

Embedding lessons learnt into commissioning processes

Elements of service delivered by different agencies

Changes in Public Health- can this help?

What Now?