Pride as Hull becomes first ‘CCG of Sanctuary’

‘PROUD’: Hull CCG Chair Dr Dan Roper

Hull’s Clinical Commissioning Group has become the first in the country to be a ‘CCG of Sanctuary’ in recognition of its work to provide equality of healthcare for migrants and asylum seekers. Simon Bristow spoke to its chair, Dr Dan Roper

Hull’s Clinical Commissioning Group (CCG) has become the first in England to formally offer dedicated support to migrants and asylum seekers.

The organisation will announce it has become a CCG of Sanctuary today to coincide with Refugee Week 2021.

Awarded by the City of Sanctuary movement, it is a formal commitment to safeguard the rights of migrants and asylum seekers, and to ensure they have equal access to health services.

The accreditation deepens Hull’s determination to be a welcoming place for some of the world’s most vulnerable people, who are often fleeing persecution or war, following a City of Sanctuary award to Hull City Council, and the University of Hull being a University of Sanctuary.

Hull CCG chair Dr Dan Roper said: “I’m very proud. I think it’s not only a fantastically good cause, of course it is, I’m really proud of the way that everybody bought into it. They really have done and have really taken it on board.

“People like to be creative in the workplace and everybody was equal partners in it. The work everybody’s done has been fantastic and it’s a really good story.

“The challenge for us now is to make sure what we’ve done is spread out. We are going to continue the steering group and management group and make sure it’s not a plaque stuck on a wall.

“What we are very conscious of is this is the beginning, not the end of a process. What we have got to do is make sure we continue with it.”

Work done by Hull CCG in preparation for Sanctuary status will provide a template for partner organisations in the NHS, most immediately in the Humber, Coast and Vale region.

But Dr Roper’s latter point about legacy will resonate with all CCGs following the announcement that they are to be abolished and replaced by larger “integrated care systems”.

Explaining how Sanctuary status came about, he said: “Sanctuary contacted is in February 2020 to ask if we would consider it, because the university is a University of Sanctuary and Hull is a City of Sanctuary through the local authority.

“They said we don’t have any health organisations, would you consider being the first, and as the sort of person who likes to say yes rather than no I thought it would be a good idea.

“As a city we’ve got a history with the emancipation movement and as a port, and then what happened is it became pretty clear we weren’t going to exist from around next year.

“And as an organisation we’ve always had from our inception a very strong patient participation framework – patient surveys, a people’s panel – and we’ve always worked with hard-to-reach groups, so it seemed a logical extension.

“And what’s really important to me is if the organisation’s not going to exist anymore it needs some positive stories to tell its staff.”

‘IT WAS A LOGICAL EXTENSION TO WHAT WE DO’: Dr Dan Roper

The CCG had to cover three areas – learn, embed, and share – and also developed a toolkit

Dr Roper said: “We developed a work plan with which we looked at these three areas, and a set of things we would need to do around planning, and what experiences are like for refugees and asylum seekers seeking healthcare.

“We’ve produced a toolkit, it can be used by any health provider organisation. It looks at it in those three areas - what an organisation should do if it wanted to fulfil all the criteria for being a health provider of sanctuary.

“I would say all the things we’ve done and put in place is around things like making sure your policies reflect the needs of migrants and asylum seekers, making sure they are involved in reviews of serious incidents, to make sure it comes up to scratch.

“What we wanted to do was put it all in an easily accessible format for people to use.”

The CCG has also produced a QR code, which staff can attach to a key fob, which can be scanned on a mobile phone to provide a direct link to its website.

“I don’t think anybody has done this, it’s pretty unique,” Dr Roper said.

“If somebody comes to present at the front desk of a GPs’ surgery, or they’ve got particular mental or social or psychological needs when they first present, they may not have the knowledge of all the different things that are available.

“You take a picture on your mobile and it’s a link to our website.”

People in these vulnerable groups may also attend at A&E and not be registered with a doctor.

‘WE MADE SURE VACCINATION RATES WERE AS HIGH AS POSSIBLE’: Dr Dan Roper

One way the CCG has already been reaching out to vulnerable groups was through the Covid-19 vaccination programme.

Dr Roper said: “One thing we recently did is to make sure vaccine rates were as high as possible in priority groups, and the only way to do that was to get registered with general practice; that was the trigger for vaccination.

“We had a massive drive to make sure everybody was registered with a practice, because asylum seekers, irrespective of status, are entitled to NHS treatment – there were quite a few misconceptions about that.”

The CCG has been working with two former asylum seekers – Abdul, and Cecil Jones, a manager of the Open Door charity.

Dr Roper also had particular praise for three colleagues at the CCG who have been leading on the Sanctuary work: patient engagement officer Christine Ebeltoft; adult safeguarding lead, Dave Blain; and Agnieszka Zychowicz from the communications team

“I couldn’t praise my team highly enough; they’ve done an unbelievable amount of work on it,” he said.

Sian Summers-Rees, chief officer at City of Sanctuary, said: “We are delighted to award NHS Hull CCG after a Sanctuary awards assessment, which included people with lived experience and local voluntary sector organisations.

“We are impressed by their commitment to listening to people with lived experience of sanctuary and ensuring their welcome and inclusion to ensure equal access to healthcare by training staff to recognise their unique barriers.

“They have embedded this work into policies and procedures and have a nominated lead at executive level.

“They are the first awarded CCG of Sanctuary as part of our Health of Sanctuary awards work, and with upcoming changes will share their learning and support with the wider NHS across the Humber, Coast and Vale to apply our principles and ensure the continuation of equality of access and a warm welcome for people, often traumatised by their background as refugees.

“Their work has set a high bar for others to follow. However, there is more work to do together and we will build on our partnership with Doctors of the World, to develop safe surgeries and inspire others nationally to follow the Hull CCG initiative.”

‘IT’S ABOUT EQUAL ACCESS TO HEALTHCARE’: Dr Dan Roper being interviewed by The Hull Story

Hull began receiving dispersed asylum seekers in 2000, and currently has been 450 and 500.

The city took in just over 100 Syrians over a five-year period under the Syrian Vulnerable Persons’ Resettlement Scheme.

Since 2006, just over 1,000 refugees have been resettled in Hull.

It is estimated that at least 8,000 people living in Hull have lived experience of sanctuary. Although people stop legally being a refugee when they obtain British citizenship, they still have that experience of seeking and finding sanctuary.

Dr Roper said: “What I would stress is this has never been any sort of political statement or viewpoint around migration, asylum-seeking or refugees – it wouldn’t matter if there were 100 or 1,000.

“It’s about making sure they get the same access to healthcare as everybody else. It’s an equality thing, it’s about making sure everybody gets equal access to services.”

Dr Roper, 62, has been in post for eight years and retired as a GP five years ago. The five-year gap from general practice would normally have required him to step down from the CCG Board, but he sought permission from the council of members, the GPs, to alter the constitution to allow him to stay on for another year to oversee the transition into the new system.

“I think eight years in any position people want new ideas,” he said. “But when they announced they were going to abolish CCGs I felt to land the final year on somebody else would be a bit unfair so I sought permission to allow me to do another year” he said.

Dr Roper will step down at the end of March next year.

• NHS Hull CCG is an ‘outstanding’ rated, clinically-led health care organisation that works in close partnership with GP practices, providers of health services, local government, the local public sector, local voluntary and carer groups, patient representatives and the general public. Its 32 local GP practices serve the local registered patient population of over 300,000 people across the city. It aspires to excellence in everything it does in order to deliver its vision of Creating a Healthier Hull.