Aims

This study aims to evaluate the information provided online by 16 London Primary Care Trusts [PCTs] to meet the health needs of the local refugee population.

Methodology

A survey was designed to evaluate information published on websites of selected PCTs throughout London. Since precise data on refugee populations in London do not exist, PCTs with an estimated refugee population of greater than 2.5% of the total refugee population in London were selected. Of the 31 London PCTs, 18 met the criteria for inclusion and 16 of these had a website. Websites were searched using a comprehensive search strategy for information pertaining to refugees: the terms refugee[s] and/or asylum seeker[s] were entered if a search facility was available; all areas of websites were scrutinised to ensure no information was overlooked irrespective of whether a search function existed; and information or relevant documents pertaining to refugees were evaluated. A quantitative approach was used to analyse the data. A 5-point Likert type scale was developed specifically for this study from 1=excellent to 5=none. A pilot study was first undertaken to assess the clarity and precision of the framework. The article contains several boxes and tables outlining the data obtained in the study.

Key Findings

The majority of PCTs [n=14, 88%] have no information regarding attempts to educate the public about the needs of refugees. More than two-thirds of the PCTs published little or no information about refugee involvement in service provision or sources for further support for refugees. Little information was provided by the majority of PCTs about specialist services for specific refugee groups such as women or children or provided data on local refugee populations. Two items were rated good or excellent for the majority of PCTs: evidence of a thorough health needs assessment and coordination of services. Findings were further analysed by determining mean, mode, range and standard deviation from the mean. Data obtained from individual PCTs showed that one-third of PCTs provided little or no information for the majority of items, three PCTs provided an excellent standard of information and the remaining eight PCTs achieved a variety of scores. Total scores from PCTs showed a wide range in the standard information provided. Six PCTs [38%] published excellent information regarding advocacy and interpretation services contradicting previous literature which suggests that these services are often lacking in refugee healthcare provision. One third of the PCTs provided good information about services for refugees with three PCTs providing a comprehensive welcome pack in 42 languages. However, nine PCTs provided little information. The majority of PCTs [n=10] provided needs assessments which contradicts literature which claims that health professionals lack awareness about the healthcare needs of refugees.

Conclusions and recommendations

Variation in these findings suggests the need for an accepted standard of service provision for refugees. Policy makers need to consider involving refugees in service development to be in line with government initiatives calling for greater user involvement. A lack of information on some websites indicates that there is a need to update published information in line with government initiatives. The study also suggests that the healthcare needs of refugees remain largely unmet. Certain PCTs in Haringey, Enfield, Barnet and Croydon appear to provide good services and thorough information about services. On the other hand, trusts in Lambeth, Southwark and Lewisham seem to make an effort to address the needs of refugees but provide little information. High-achieving trusts should act as a role model for other trusts to set new standards in refugee heath-care.