Advice and guidance on the health needs of migrant patients from Ukraine for healthcare practitioners.
If the patient is new to the UK:
- explain to them how the NHS works and their entitlements to healthcare
- discuss how this compares to the healthcare system they’ve been used to
- follow guidance on how to comprehensively assess new migrant patients
- ensure that they are up-to-date with the UK immunisation schedule
- ask about any travel plans the patient may have to visit friends and relatives in their country of origin
Screen all new entrants, including children, for tuberculosis (TB).
Due to a low prevalence, ascertain any risk factors for hepatitis B infection that may indicate the need for screening.
Consider screening for hepatitis C because of a considerably higher prevalence than the UK.
There is a risk of typhoid infection.
Consider nutritional and metabolic concerns.
Work with a professional interpreter where language barriers are present.
Consider the impacts of culture, religion and gender on health.
Assess for mental health conditions.
Refer pregnant women to antenatal care.
No charges for the use of most NHS services for new arrivals from Ukraine
The Department of Health and Social Care (DHSC) amended the NHS Charges to Overseas Visitors Regulations 2015 on 17 March 2022, to ensure that anyone who is ordinarily resident in Ukraine, but lawfully in the UK, from 24th February is exempt from charge for NHS treatment (except assisted conception services) in England.
This exemption reflects that of the Family and Sponsorship routes to ensure that those fleeing Ukraine, who are in the UK lawfully, are not charged to use the NHS in England (aside from assisted conception). This exemption will be reviewed before mid-September.
For further information on the visa routes available for Ukrainian nationals, please see: UK visa support for Ukrainian nationals - GOV.UK (www.gov.uk).
A Written Ministerial Statement made on 17th March 2022 provides additional information on the amendment, please see: Written statements - Written questions, answers and statements - UK Parliament.
There is a high incidence of TB approximately 73 per 100,000 population, so:
- screen all new entrants (including children) for TB according to NICE guidelines
- refer to TB services promptly if screening is positive
- maintain long term vigilance for symptoms of TB even if initial screening is negative
- be aware that TB is a notifiable disease
Sexually transmitted infections and HIV
Take a sexual history, and:
- screen for STIs and HIV according to risk as specified in the UK national standards and guidelines
- test all sexually active patients under the age of 25 for chlamydia
There is a low rate of HIV (≤1%), so offer and recommend an HIV test if the patient:
- falls into a high risk group
- is newly registering in a high prevalence area
There is a low prevalence of hepatitis B, so:
- offer screening for hepatitis B to all pregnant women during each pregnancy
- immunise appropriately babies born to mothers who are hepatitis B positive, and follow up accordingly
- be aware that the UK has a universal infant immunisation programme for hepatitis B and a selective immunisation programme for higher risk groups
There is a risk of typhoid infection, so:
- ensure that travellers are offered typhoid immunisation and advice on prevention of enteric fever
- remember enteric fever in the differential diagnosis of illness in patients with a recent history of travel to or from this country
Travel plans and advice
Ask opportunistically about any travel plans the patient may have to visit friends and relatives in their country of origin. People who travel to visit friends and relatives (VFR travellers) should visit the Foreign, Commonwealth and Development Office for overseas travel advice and National Travel Health Network and Centre (NaTHNaC) for country specific travel advice prior to leaving the UK.
Nutritional and metabolic concerns
There is a moderate risk of anaemia in adults (estimated prevalence in non-pregnant women is 20 to 40%) and pre-school children (estimated prevalence is 20 to 40%), so:
- be alert to the possibility of anaemia in recently arrived migrants, particularly women and pre-school children
- test as clinically indicated
Consider the possibility of vitamin D deficiency in people who may be at risk due to:
- darker skin
- those who are not often outdoors
- those who cover up most of their skin when outdoors
There is a high risk of vitamin A deficiency.
There may be a risk of risk of mild iodine deficiency due to inadequate iodine intake.
Reproductive health indicators
|Reproductive health indicator||UK||Ukraine|
|Number of children per woman [note 1]||1.7||1.2|
|Use of contraception [note 2]||71.7%||65.4%|
Note 1: lifetime average
Note 2: by woman of reproductive age or partner
Health indicators and health care
WHO Global Health Observatory has a summary of health indicators and health care in Ukraine.
Culture, politics and history
|Russian [note 1]||29.6|
|Other [note 2]||2.9|
Note 1: regional language
Note 2: includes small Crimean Tatar, Moldovan/Romanian, and Hungarian speaking minorities
Source: The World Factbook.
The main religions in Ukraine are:
- Orthodox, which includes the Orthodox Church of Ukraine (OCU), Ukrainian Autocephalous Orthodox Church (UAOC), and the Ukrainian Orthodox-Moscow Patriarchate (UOC-MP)
- Ukrainian Greek Catholic
- Roman Catholic
Source: The World Factbook.
Migration to the UK
In response to the Russian invasion of Ukraine, 2 UK government visa schemes have been launched:
- the Ukraine Family Scheme allows applicants to join family members or extend their stay in the UK
- the Ukraine Sponsorship Scheme allows Ukrainian nationals and their family members to come to the UK if they have a named sponsor under the Homes for Ukraine Scheme
The latest data on applications to come to or stay in the UK under these schemes is available from the Home Office and UK Visas and Immigration.
At the time of the 2021 census there were over 37,500 people from Ukraine living in England and Wales.
Source: Office for National Statistics
Arrivals from Ukraine: advice for primary care
The UK Health Security Agency has produced guidance for primary care professionals concerning arrivals from Ukraine.