Department of Primary Care & Public Health, School of Public Health, Imperial College London, London, UK
Northwick Park Hospital, Department of Paediatrics & Child Health, London North West Healthcare NHS Trust, London, UK.
BMJ Paediatr Open. 2022 Apr;6(1). doi: 10.1136/bmjpo-2022-001435.
To assess variation in current practice of initial health assessments (IHAs) for unaccompanied asylum-seeking children (UASC) across England.
Cross-sectional survey.
Type of routine assessment carried out, threshold to specialist referrals and facilities available to complete IHA.
Eighty-six health professionals responded across England; 47% had received training in UASC IHA and 33% in UASC mental health issues. The majority (80%) of IHAs were conducted with translator support and 7% of participants reported Child and Adolescent Mental Health Services (CAMHS) input. Around half of clinicians (53%) performed tuberculosis and bloodborne virus screening for all UASC, while other infectious diseases (IDs) screening was symptom and risk factor dependent. Overall, 14% of clinicians routinely comment on age assessment and 76% share the IHA report and health plan with UASC. The time allocated for assessment range between 30 and 90 min.
There is significant variation in practice around UASC IHAs across England, notably around CAMHS input, time allocated, translation facilities and ID screening. The results suggest that, an increase in resources available for UASC teams, improved access to specialist services and further training on UASC health are all needed. Guidance that aims to set a best practice framework for UASC IHA delivery such as a 'one-stop shop' model would help to standardise UASC IHA across the country.
评估英格兰各地目前对无人陪伴寻求庇护儿童（UASC）进行初始健康评估（IHA）的实践情况。
横断面调查。
进行的常规评估类型、向专家转诊的阈值以及完成 IHA 的可用设施。
英格兰有 86 名卫生专业人员做出回应；47%接受过 UASC IHA 培训，33%接受过 UASC 心理健康问题培训。大多数（80%）IHA 在翻译支持下进行，7%的参与者报告儿童和青少年心理健康服务（CAMHS）的投入。大约一半的临床医生（53%）对所有 UASC 进行结核病和血源性病毒筛查，而其他传染病（IDs）筛查则取决于症状和危险因素。总体而言，14%的临床医生定期对年龄评估发表意见，76%的临床医生与 UASC 分享 IHA 报告和健康计划。评估时间分配在 30 至 90 分钟之间。
英格兰各地对 UASC IHA 的实践存在显著差异，特别是在 CAMHS 投入、分配时间、翻译设施和 ID 筛查方面。结果表明，需要增加 UASC 团队的可用资源、改善专科服务的获取途径以及进一步对 UASC 健康进行培训。旨在为 UASC IHA 提供设定最佳实践框架的指南，例如“一站式服务”模式，将有助于在全国范围内规范 UASC IHA。
