Background: An asylum seeker - adult, child, or young person whose request for sanctuary has yet to be processed by the Government. •UASCYP (unaccompanied asylum seeking child/young person ) - young people who have journeyed to the UK unaccompanied by a parent or legal guardian. They are automatically a Looked After Child (LAC), under the care of the Local Authority. They have full entitlement to free NHS care and other public services. NHS charging regulations do not apply to them.
Following a considerable adverse event where the results of a UASCYP were not communicated to the GP and a positive TB case was missed, this audit sought to find out patterns of diseases in UASCYP, and if investigations are performed within an appropriate timescale and results acknowledged, acted upon, and shared with the young person/foster carer/social worker, and GP.
Method: A list of UASCYP obtained from the clinic input from January 2022 to January 2023. A proforma was designed, and data was collected from e-records. Different variables of each result were coded and inserted into a spreadsheet and the results analysed.
Results: 67 CYP were referred for Initial Health Assessment, and only 36 had investigations recorded on e-records. Results showed the most common finding was low vit D levels, seen in 21(60%) of the CYP. 4 of them (11.1%) had results indicating either previous infection with immunity or acquired immunity from vaccination to hepatitis B, while 1 was hep B positive and had follow-up investigations. 4 CYP (11.1%) had abnormal TB screening test and required further tests. All CXR were normal. 1 had sputum AFB test, which was normal. 1 had an X-ray due to injury. LFT, bone profile, and folate had 3(8.5%) abnormal results, respectively. 2(5.7%) had abnormal heamoglobin electrophoresis. The average time from IHA to investigations was about 1 month (33.2 days). With the earliest being 3 days and the latest being 14 months. Of the 36 that had investigations done, 24 had their results acknowledged and acted upon
Conclusion: There was no significant burden of diseases in the UASCYP. Notable abnormalities were low vit D, followed by hepatitis B and TB although no active diseases and abnormal heamoglobin variants . Our key performance indicators (KPI) for screening UASCYP was not met with regards to timely investigations and communication of results to relevant persons .
Recommendations:
1. Vitamin D supplementation for UASCYP at the time of IHA
2. Prompt screening of UASCYP at the time of their IHA to ensure any infectious disease is picked up early and acted upon to avoid possible spread.
