6067 Screening of accompanied refugee and asylum seeking children: a national survey of current practice

Objectives Accompanied refugee and asylum seeking children (ARASC) are children and young people under the age of 18 years who enter the United Kingdom to claim asylum with, and remain under the responsibility of, an adult. Unaccompanied asylum seeking children, (UASC) undergo a statutory initial health assessment (IHA) by a healthcare professional, but ARASC do not routinely receive a health assessment. This inequity of access to health surveillance may contribute to barriers to access to healthcare. We aimed to describe variation in current practices in health assessments for ARASC in England. Methods We undertook an online survey (using Qualitrics software) to explore the practice of health care professionals with regard to health assessments of ARASC in England. Participants were identified through professional networks using established mailing lists, through British Paediatric Allergy, Immunity and Infection Group (BPAIIG) and British Association of Paediatric TB (BAPT). Participants were not identifiable. We collected information on various aspects of health assessments for ARASC. Data were analysed using Excel. Results We received thirty-five responses, some of which were incomplete. 50% (11/22) of respondents reported using a standardised approach to ARASC screening, and 91% (10/11) of these extrapolated existing UASC guidelines to this population. 43% (6/14) of respondents conducted infectious disease screening on all ARASC, even if asymptomatic. In terms of screening for TB infection, of those using Interferon Gamma Release Assay (IGRA), 60% (6/10) offered screening only in the context of risk factors, such as originating from a country with high prevalence. Blood-borne viruses screening (Hepatitis B, Hepatitis C, and Human Immunodeficiency Virus) was generally offered in all ARASC, rather than only in specific circumstances (60% (6/10), 55% (5/9), 55% (6/11) respectively). Conclusion The proportion of all ARASC receiving any form of health assessment on arrival to England remains unknown and our findings show significant variation in the current practice of these health assessments. The Royal College of Paediatrics and Child Health (RCPCH) has up to date guidance (2022) on healthcare assessment for refugees and asylum seeking children and associated infectious diseases screening. However, our findings, although on a small sample, suggest that throughout England there is inconsistency in adherence to these national guidelines in the ARASC population. There is a need for further education and awareness around the needs of an initial approach to the ARASC population.