Advice and guidance on the health needs of migrant patients for healthcare practitioners.
Assessing the health of migrant children
Migrant children may not have received the same developmental checks and preventive care in their country of birth or origin as children born in the UK. In addition to the checklist for assessing migrant patients, some further considerations when assessing migrant children are listed below.
Child health and development
Check whether infants have received appropriate neonatal screening.
Refer infants and children to their local child health service:
- midwife in the 28 days after birth
- health visiting service for 0 to 5 years
- school nurse service for school-aged children 5 to 19 years
Some areas may have an advice line for families, or services that migrant families can be signposted to for more support.
Consider the child’s general growth and development. Assess concerns with infant and child feeding, nutrition, underweight or overweight or faltering growth. Migrant children may suffer from vitamin A deficiency, iodine deficiency, vitamin D deficiency or anaemia.
Refer children to nutrition, feeding and/or breastfeeding advice and support where needed.
Encourage those eligible for the Healthy Start scheme to apply.
Consider the child’s dental health and vision and hearing, and refer for assessment where necessary. Assist migrant children to access preventive dental interventions like fluoride varnish to help prevent dental decay, which is available for free for all children accessing NHS dental care.
Identify any disabilities that the child may have been diagnosed with in their country of birth or origin, or any concerns that have not yet been diagnosed. Help children and their families to access multidisciplinary interventions, advocacy and support services in their local area.
Children of migrants may have higher neurodevelopmental risks than those of non-immigrant populations. There is some evidence that they may receive late diagnosis and therefore miss beneficial early interventions. Identify any undiagnosed neurodevelopmental disorders, or any risks which may have not yet been addressed, and make appropriate referrals.
Refer to assessing patients with symptoms for unwell children who have recently arrived from abroad.
Opportunistically ask parents about any travel plans to visit family or friends in their country of origin. See NaTHNaC for travel health advice.
Language and culture
Familiarise yourself with language interpreting and translation guidance.
Children should never be used as interpreters.
Consider your role in safeguarding children during interpreted consultations
Be aware that religions and cultures may have different beliefs and practices concerning infant and child health. Some cultural practices and the migration journey may also expose children to non-infectious environmental hazards. Discuss these sensitively with parents and caregivers.
Access to NHS care
Support migrant families to register all infants and children with a GP practice as soon as possible.
The Royal College of Paediatrics and Child Health has developed resources to support access to healthcare for migrant and/or undocumented children. This includes a flowchart to help health professionals support vulnerable migrant children and families to understand charging regulations and exemptions.
Refer to the NHS entitlements page of the migrant health guide for more information.
Vulnerable migrant children
Each child’s migration journey is different and can be unsettling or traumatic. Take time to understand a child’s migration journey through speaking to them, their parents or caregivers, and their family members. Consider the emotional, behavioural and physical health impacts of their experiences.
Some migrant children are particularly vulnerable. This includes children:
- arriving in the UK unaccompanied
- who are asylum seekers and refugees
- who experience of or be vulnerable to female genital mutilation (FGM)
- who are victims of human trafficking
- who are victims of child sexual abuse, child sexual exploitation or domestic abuse (including seeing, hearing or experiencing the effects of abuse)
Financial support for asylum-seeking mothers
Asylum-seekers who are pregnant mothers or mothers of young children are eligible for financial support to buy healthy food for themselves and their child.
They are also eligible for a one-off maternity payment if the baby is due in 8 weeks or less, or the baby is under 6 weeks old.
Use the country pages of the migrant health guide for health concerns relevant to specific countries.
The Royal College of Paediatrics and Child Health has guidance on migrant children’s rights to access healthcare and a checklist of actions for refugee and unaccompanied asylum-seeking children.
The Children’s Legal Centre Migrant Children’s Project helps refugee, asylum seeking and migrant children to obtain the services and assistance to which they are legally entitled.
The Kent Children’s Commissioning Support Team has developed a website to share learning, tools, templates and guidance on caring for unaccompanied asylum seeking children (UASC). It includes clinical guidance for primary care and paediatric healthcare workers on the health needs and health assessment process for UASC.
The British Red Cross SAFE project has developed e-learning courses to enhance the knowledge and skills of professionals and family-based carers who provide care and support to unaccompanied and separated children in Europe.
The Children’s Society Refugee Toolkit informs practitioners about the needs, rights and entitlements of refugee and asylum seeker young carers and their families.
The NSPCC Child Trafficking Advice Centre can provide further advice for professionals worried that a young person may be a victim of trafficking via their helpline: 0808 800 5000.
Refer to Best Start in Life commissioning guidance for information about health visiting service referral and entitlements.
Healthy Start: information about the scheme and the role of health professionals.
Spotting the Sick Child: a new interactive tool commissioned by the Department of Health to support health professionals in the assessment of the acutely sick child.