Policy paper

National partnership agreement on meeting the health and wellbeing needs for people seeking asylum in England 2025-2028 (accessible)

Published 30 July 2026

Applies to England

Purpose of the agreement

This document sets out the partnership agreement between the Home Office, UK Health Security Agency, the Department of Health and Social Care and NHS England.

National and regional partnership working has already been established through the Strategic Health Oversight Group structures, to identify the needs and risks of adults and families residing in all HO non-detained accommodation across the asylum system, including initial, contingency and dispersal accommodation in England. This agreement marks the next step on partnership working by establishing a commitment to co-operation and cohesiveness between the organisations who can support the health and wellbeing needs of people seeking asylum in England.

Whilst based on the national partnership agreement for immigration removal centre (IRC) health care^{[footnote 1]}, this agreement is focused on health and wellbeing support within the community for those living in non-detained settings. There are overlaps between the two agreements to ensure continuity of care across community and detained settings.

The Home Secretary has announced the most sweeping reforms to tackle illegal migration in modern times, to remove the incentives which draw people to the UK illegally and scale up removals of those with no right to be here. Whilst we recognise the health inequalities experienced by different cohorts in the UK population, including people seeking asylum, this partnership does not symbolise any preferential treatment. It reasserts that healthcare in the UK is prioritised by public health and clinical need only.

By working in partnership, we can support access to healthcare to address immediate health needs, provide medication, identify and treat communicable diseases, and undertake preventative interventions such as vaccinations. This is consistent with the health offer to the resident UK population, reduces the risk of communicable disease transmission and the operational burden for both the Home Office and the NHS.

This national partnership agreement sets out:

• The defined roles and responsibilities of the four national partners.

• Our commitment to working together and sharing accountability for delivery through our linked governance structures.

• Our core objectives and priorities for 2025 - 2028, which will be delivered through a workplan to be agreed by all parties. The workplan will provide the details of the activities to deliver these priorities.

• The core aspects of our partnership working which are underpinned by our shared goals, values, and commitment to ensure Clarity, Consistency, Openness, Trust and Communication between partners.

• The input of the broader environment and valuing perspectives from across the sector, including local authorities (LAs), Voluntary, Community and Social Enterprise organisations (VCSEs), Strategic Migration Partnerships (SMPs), individuals with lived experience and other stakeholders who regularly interact with people seeking asylum.

• Why it is important to strengthen and build partnership working in this space, so that the health and wellbeing of people seeking asylum can be met as effectively as possible.

Agreement partners

Though we are made up of four organisations, each with distinct roles, this partnership agreement helps us to collaborate and align our priorities.

• Home Office (HO): asylum support: the Home Office has a discretionary power, as set out in the Immigration and Asylum Act 1999, to support asylum seekers (including any dependants) who would otherwise be destitute. This includes by meeting the essential living needs of destitute asylum seekers, including by providing accommodation where this is needed.

• UK Health Security Agency (UKHSA): prevents, prepares for and responds to infectious diseases and environmental hazards, including providing health protection expertise, guidance and coordination of incident response.

• NHS England (NHSE): lead the NHS in England to deliver high-quality services for all, supporting and empowering integrated care boards as health service commissioners.

• Department of Health and Social Care (DHSC), including the Office for Health Improvement and Disparities (OHID): Support ministers in leading the nation’s health and social care to help people live more independent, healthier lives for longer.

For further information on the roles and responsibilities of local, regional and national teams, see Appendix 1.

When developing this partnership agreement, we have sought the perspectives of parties who work closely with us on delivery.

Health inequalities experienced by people seeking asylum

OHID^{[footnote 2]} describes health inequalities as avoidable differences in health outcomes between groups or populations, such as, differences in how long we live, or the age at which we develop preventable diseases or health conditions. Causes of health inequalities and disparities are complex, but inclusion health groups (which include people seeking asylum) experience significantly worse health outcomes. This includes stigma and discrimination due to social exclusion, multiple overlapping risk factors for poor health, such as, poverty, violence and complex trauma, and inconsistent recording of people seeking asylum in electronic records (such as healthcare databases). These experiences frequently lead to barriers in access to healthcare and poor health outcomes.

To address health inequalities, not only is it important to ensure the provision of good quality healthcare, but it is also important to address the wider determinants of health, such as access to good, safe housing, access to nutritious food and social connections as described by The Health Foundation^{[footnote 3]}. It is also pertinent to understand the additional challenges people seeking asylum may face, for instance, lack of access to preventative healthcare if coming from countries with poor health infrastructure, difficult and traumatic migration journeys, and, once in the UK, lack of trust in government funded services, and other specific risks e.g., infection transmission risk in communal settings. People may also have specific challenges with language barriers, health literacy and understanding how to navigate the NHS, as outlined in the BMA refugee and asylum seeker patient health toolkit^{[footnote 4]}.

It is not just the responsibility of the health and social care system to support the health and wellbeing needs of people seeking asylum; others can and should influence this, for example, local and national government, VCSEs, the private sector, media and local communities.

Inclusion health populations are identified as a target population in the Core20PLUS5 framework^{[footnote 5]} which is NHS England’s national approach to inform action to reduce healthcare inequalities at both national and system levels. Our partnership will endeavour to ensure that people across the asylum system, are offered access to high-quality health and wellbeing support throughout their asylum journey. We will support access to healthcare and wellbeing services and facilitate continuity of care by influencing the design of services to make them as effective and user centred as possible. Healthcare services will include those aimed at communicable and non-communicable disease prevention. We will ensure that the design of these services will be evidence-informed and will have built-in evaluation processes to ensure services are performing effectively.

People seeking asylum have a right to access to healthcare in the UK. Health and wellbeing support to people seeking asylum should be commensurate to the standards received by existing residents in England, appropriate to their needs and reflecting the circumstances of their migration, journey, and immigration status. These services are to be made available based on clinical and social need, and in line with recommendations from the Migrant Health Guide^{[footnote 6]}, NHSE’s Framework for Action Inclusion Health^{[footnote 7]}, and HO policies.

Our core shared objectives and commitment to deliver

Our commitment is underpinned by four core, shared objectives. Against each one of these objectives, the partners will agree priorities to be delivered during the lifetime of the Agreement. For 2025 to 2028, ten key priorities have been agreed.

Baselining and meeting needs

Seeking to expand and improve access to a systematic health and wellbeing assessment to people seeking asylum who arrive in England. We will endeavour to offer a healthcare assessment early in the asylum seeker’s journey, aimed at identifying and managing any initial health and wellbeing needs, including disease prevention and health protection interventions to mitigate any risks for themselves and the wider community.

Priorities for 2025-28

1. Baselining of physical and mental health needs

Improve the health and wellbeing of those seeking asylum, securing timely and appropriate assessment, support and treatment including an appropriate focus on the needs of those with vulnerabilities.

2. Public health interventions

Improve individual and collective health outcomes by promoting and increasing access to preventative, diagnostic and screening programmes for infectious and non-communicable diseases for those seeking asylum, as well as enhancing capability to manage outbreaks of infectious disease in accommodation settings. Ensure settings have access to appropriate Infection, Prevention and Control (IPC) advice to reduce outbreak risk.

Providing continuity of health and wellbeing support

Policies and protocols (and their implementation) will be aligned to provide continuity of support during the accommodation pathway.

Working closely with local authorities around social care, including the data share between NHSE and LAs will also improve health and wellbeing, tackle health inequalities and is cognisant of wider determinants of health (irrespective of the accommodation model, location, length of stay or immigration status).

Priorities for 2025-28

3. Access to healthcare

Collectively seek to address the existing barriers, including but not limited to, knowledge about eligibility for NHS services, financial limitations preventing attendance, challenges of semi secure or remote settings, and language barriers.

4. Data flow (infrastructure)

Ensure relevant information systems are linked to support the effective flow of data between different organisations and providers to enable a comprehensive picture about the needs, risks and challenges faced by people seeking asylum, and supports service delivery, timely outbreak response work and public health intelligence.

5. Move on

Facilitate continuity of access to health and wellbeing support. Ensure those seeking asylum have sufficient information about UK health services and are enabled to advocate for their needs without facing barriers. Across government we will ensure that all partner systems work together to transfer information when individuals are moved across regional boundaries (data flow).

Keeping people safe

All organisations will ensure robust safeguarding procedures to help protect those who may be vulnerable, or at risk of increased vulnerability as a result of their circumstances. The statutory agencies responsible for safeguarding adults and children are local authorities, health, and police, who share responsibility and accountability. However, we all have an important role to play in identifying those at risk and sharing relevant information with statutory agencies so they can fulfil their legal responsibilities.

Priorities for 2025-28

6. Safeguarding adults and children

Ensure our safeguarding mechanisms effectively identify safeguarding issues to protect children and adults at risk. By working in partnership, we recognise how people seeking asylum often have multiple, interlinked vulnerabilities and we will work with other experts and wherever possible prevent avoidable, detrimental health outcomes e.g. infection outbreaks, modern slavery.

7. Suicide prevention

Learn lessons to prevent death and self-inflicted harm and, improve related practice by developing and strengthening multiagency approaches to managing individuals at risk of causing serious harm to themselves or others.

8. Data sharing (information)

Improve the quality of data and intelligence collection(s) and enable better data sharing between partners to support the needs analysis of people in our care and support development of effective health outcome measures.

Supporting systems

National agencies will work collaboratively to support local providers and local/regional commissioners to adapt and respond to the changing (and ever increasing) demand on local systems to meet the health and wellbeing needs of those seeking asylum and mitigate any public health risks for communities.

Priorities for 2025-28

9. System changes

Work collectively to ensure that health services and those supporting wider wellbeing are aligned to support those seeking asylum as the design of the asylum accommodation estate changes in response to emerging health needs and risks and government policies over the period 2025-2028.

10. Funding

Ensure a whole system approach across government that seeks to recognise and implement funding streams that supports comprehensive delivery of health and wellbeing services to those seeking asylum.

At a local level, partnership approaches should be adopted using the same principles outlined in our four core objectives and ten priorities. To enable this at a local level, we will engage with Integrated Care Boards (ICB), Strategic Migration Partnership (SMP) and local authorities who are responsible for the commissioning and delivery of services in their area and for their populations.

Underpinning the core shared objectives and key priorities is a commitment to ensure the service user voice is represented and heard throughout our delivery and governance arrangements. We will involve people with lived experience through existing group networks on a regular basis to provide insight and support for our future projects, programmes, and joint working plans.

How we will deliver

We will support the delivery of our four partnership objectives by:

• Focusing on our ten priorities.

• Building on and developing existing partnership mechanisms.

• Meeting the strategic objectives and public task responsibilities of all partner organisations.

• Working together with local partnerships to deliver improvement activities and projects.

• Delivering through a workplan that outlines activities, projects and associated deliverables, measures, timelines, and owners.

The four organisations are committed to developing an agreed workplan to deliver the priorities and will include the governance and evaluation method to ensure our partnership objectives are met. The workplan will set out priorities against each one of the objectives. These priorities will be delivered by ensuring that the work completed by each partner under their individual functions and responsibilities is complementary and congruent. Some priorities may be interdependent and may also depend on appropriate funding being available over the period.

Progress against delivery will therefore be reviewed at regular interval through the governance groups. As it is important that we are able to measure and demonstrate progress against these priorities, the workplan sets out ownership of work and some initial metrics to track success.

Partnership governance

We are jointly committed to and accountable for delivering shared objectives, within our legal and statutory framework remits. We recognise our respective statutory responsibilities and independence, but we must work together to ensure provision of safe, legal, appropriate and effective care, which improves health outcomes for all individuals in Home Office provided accommodation. Our governance structures support delivery of our shared objectives and priorities.

• At senior Department level, the Strategic Senior Health Oversight Group (S-SHOG, currently co-chaired by HO and DHSC)^{[footnote 8]} will govern the overarching principles of this partnership agreement and monitor progress on deliverables.

• At an operational Department level, the Tactical Senior Health Oversight Group (T-SHOG, currently co-chaired by HO and DHSC) will lead activities outlined in the workplan and report into the S-SHOG.

• At regional level, regular engagement is undertaken between HO, ICBs, SMPs, LAs, NHSE regional teams and Regional Directors of Public Health (RDPH), and UKHSA Health Protection Teams (HPTs) to discuss local community impacts, accommodation needs and health and wellbeing support for the asylum population.

• Separate to this, governance structures exist in each individual organisation with officials empowered to direct Department activities. These are used to ensure that decisions impacting on organisational spending and delivery, are signed off and disseminated through the appropriate channels.

Delivery governance

Effective delivery of our objectives will be observed by existing scrutiny bodies.

Independent Chief Inspector of Borders & Immigration (ICIBI)

The ICIBI monitors and reports on the efficiency and effectiveness of the immigration, asylum, nationality and customs functions carried out by the Home Secretary and by officials and others on their behalf. The chief inspector is a public appointee and independent from government whose reports are laid before Parliament.

National Audit Office (NAO) and Treasury

The NAO scrutinises public spending for Parliament and is independent of government. The NAO and Treasury scrutinise and hold the Partnership to account for spending on healthcare, delivered across the accommodation estate, and publish public reports on their findings.

Care Quality Commission

The Care Quality Commission monitors, inspects, and regulates health and social care services provided by hospitals, care homes, ambulance, mental health services, care in home, and doctors and dentists in England.

Local authorities

In order to carry out their oversight duties, local authorities can require relevant NHS bodies and health service providers, to provide information and attend meetings to answer questions. Through their Local Safeguarding Children Boards (LSCBs), and their Safeguarding Adults Boards (SABs) structure, local authorities lead and co-ordinate the effectiveness of the safeguarding work of their members and partner agencies, to protect children and adults at risk.

Parliament

The Home Affairs Committee (HASC) is a cross-party committee of MPs responsible for scrutinising the work of the HO and its associated bodies. They examine government policy, spending and the law in areas including immigration, security, and policing.

Healthwatch

An independent consumer champion for health and social care across England, working to ensure consumer views are represented locally and nationally.

Internal Organisational Governance

Partner organisations have in place, internal (regional/national) governance, to support NHS England quality standards through health provider contracts and collaborative commissioning.

Signatories

• Director of Asylum Support, Home Office

• Director General, Global and Public Health and Emergencies Department of Health and Social Care

• Interim Chief Medical Advisor, UK Health Security Agency

• Chief Executive, NHS England

Appendix 1

All teams

• Working in partnership with people and communities
• Working in collaboration across government departments and national, regional and local agencies
• Promoting practical actions to improve health and wellbeing

Local system teams

Home Office accommodation providers are commissioned by the Home Office to provide a range of support services to people seeking asylum, (i.e. accommodation and catering) and can provide support and signposting to access other services.

Local authorities are responsible for services and functions supporting people and businesses within their area (e.g., housing, education, social care and public health), including scrutiny, and work collaboratively to address the wider determinants of health.

Integrated care boards (ICBs) commission healthcare services for their temporary and permanent resident population, including agreeing and implementing inclusion health strategy. ICBs also bring the local NHS together to ensure the healthcare needs of their communities are met, and together with local authorities, act as the stewards of local population health outcomes and equity.

Hospitals and trusts provide emergency services, as well as secondary, tertiary and specialist care for physical and mental health conditions. This includes maternity and neonatal services.

Primary care networks, GP practices and other primary care organisations (e.g. pharmacists, dentists and optometrists) are the front door of the NHS and can help improve access for inclusion health groups, including asylum seekers and other migrants.

Regional teams

Strategic Migration Partnerships are local government led partnerships funded by, but independent of, the Home Office, whose role is to coordinate and support delivery of national programmes in asylum and refugee schemes, as well as agreed regional and devolved migration priorities.

Local Government Association regional groupings are a voluntary and independent body, which is run and supported by their member councils, bringing together local councils to collaborate on joint strategic issues and/or in order to have a greater impact.

UK Health Security Agency health protection teams provide public health advice and operational support to NHS, local authorities and other agencies.

Office of Health Improvement and Disparities (OHID) lead on health improvement by building evidence and developing policies to shape and drive health improvement and equalities priorities for government. OHID regional public health teams support the delivery of national and regional priorities for prevention and health inequalities and ensuring a joined-up approach to public health, building strong interfaces with different teams and areas of public health across the regional system.

NHS England regional teams support local decision making, effective system working and delivery (including statutory intervention if required), empowering local NHS leaders to make the best decisions for their local populations. Regional teams continue to fulfil some of the commissioning functions for specialised, highly specialised services and healthcare services for people in detained and secure settings.

National and regional teams

Home Office has a discretionary power, as set out in the Immigration and Asylum Act 1999, to support asylum seekers (including any dependants) who would otherwise be destitute. This includes by meeting the essential living needs of destitute asylum seekers, including by providing accommodation where this is needed.

Ministry of Housing, Communities and Local Government oversees housing, planning, local government, communities, and devolution in the UK.

UK Health Security Agency is responsible for protecting every member of every community from the impact of infectious diseases, chemical, biological, radiological and nuclear incidents, and other health threats. For people in our care this means:

• receiving specialist public health advice on health security
• infectious disease surveillance and quality assurance of health protection services
• development and application of the evidence base to inform policy and practice in health security

Department of Health and Social Care’s role is to support ministers in leading the nation’s health and social care to help people live more independent, healthier lives for longer. Responsibilities include making sure the department and arm’s length bodies deliver on agreed plans and commitments and to make sure the legislative, financial, administrative and policy frameworks are fit for purpose and work together.

NHS England leads the NHS in England to deliver high quality services for all, including providing strategic leadership forNHS organisations, overseeing ICBs and driving innovation and transformation, including designing and supporting the NHS IT infrastructure. NHS England is also responsible for the commissioning of specialised services and highly specialised services and for the provision of healthcare services for people in prisons and other detained settings or ‘prescribed accommodation’.

1. National partnership agreement for immigration removal centre (IRC) healthcare in England 2022 – 2025 ↩

2. Health disparities and health inequalities: applying All Our Health - GOV.UK (www.gov.uk) ↩

3. What builds good health? - The Health Foundation ↩

4. Refugee and asylum seeker health toolkit ↩

5. NHS England » Core20PLUS5 (adults) – an approach to reducing healthcare inequalities ↩

6. Migrant health guide - GOV.UK (www.gov.uk) ↩

7. NHS England » A national framework for NHS – action on inclusion health ↩

8. To provide system stewardship to ensure that we work in partnership to meet our statutory duties for health and care delivery, health protection, public health, accommodation, and safeguarding for asylum seekers. ↩