Refugee and unaccompanied asylum seeking children and young people: current UK asylum process and access to healthcare

These pages were developed in partnership with the Child Protection Standing Committee and the Advocacy Committee to support paediatricians in the assessment and management of children and young people of refugee background, with links to key external information and resources.

Current UK asylum processes

 A refugee wishing to stay in the UK must apply for asylum on the basis of the Refugee Convention (or Article 3 of the European Convention on Human Rights). To be eligible they must have left their country and be unable to go back because of fear of persecution. If a person is granted refugee status the Government recognises that they fit the 1951 Refugee Convention definition of a refugee (or Article 3 of the European Convention on Human Rights).

 “owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country” Article 1.

Refugees should apply for asylum when they arrive in the UK or as soon as they think it would be unsafe to return to their own country. After applying, refugees will have a meeting with an immigration officer (known as a ‘screening’) and then an asylum interview with a caseworker.

Decisions about application are usually made within 6 months. Further information can be found on the Home Office website.

Unaccompanied asylum seeking children and young people

A young person judged to be under 18 years of age, without an adult to care for them, is entitled to the same rights as other looked-after children and young people, including accommodation, some finance, education, statutory health assessments, support and reviews. 

This group of young people will most likely be given discretionary leave to remain until 17 ½ years old leaving detailed processing of an asylum application for when they are older. They are entitled to legal aid. Therefore as much information as possible should be gathered using an appropriate interpreter at an early stage as this will be relevant to their application. 

Specific guidance for unaccompanied asylum seeking children and young people:

Access to healthcare

Refugee and unaccompanied asylum seeking children and young people have the same rights to care as UK nationals.The Refugee Council provide a fact sheet in a variety of languages which contains information on healthcare eligibility and access for people seeking asylum in the UK. The Refugee Council have also developed an information pack for refugees which provides information about accessing health services.

For babies, children and young people born outside the UK, the usual route is for obtaining an NHS number is to have one allocated through GP registration.  In England, there is no set length of time that a patient must reside in the country in order to become eligible to receive NHS primary medical care services. Therefore everyone is eligible to register with a GP practice. For further information, see NHS England’s Standard Operating Principles for Patient Registration.

Specific guidance on accessing NHS services is available for Scotland and Wales. In 2015 new regulations were introduced in Northern Ireland meaning that all refugees and asylum seekers (including refused asylum seekers) are not required to pay for their healthcare treatment, including primary care and secondary care.  

Specialist referral should be made in the usual way; however paediatricians should be aware of factors which may impact on a child or family being able to make appointments such as language barriers and transport.

Where appropriate, a personal child health record (red book) should be issued. These are available from the health visitor and local health clinics and for some local authorities, online.#

Kent has developed a website containing key documents, templates, tools and clinical guidance used to support the health needs of unaccompanied asylum-seeking children. Many of these resources have been developed by subject matter experts and are published for use within Kent and to share learning across the UK.