People Seeking Asylum and Refugees’ Experiences of Accessing Health Services in Wirral
This qualitative insight project explored how people seeking asylum and refugees (PSA&R) access and experience healthcare in Wirral. Using focus groups with PSA&R, mini focus groups with professionals and a co-design workshop, the work identified the challenges individuals face when navigating the UK system, including language barriers, digital exclusion, disrupted continuity of care and complex housing transitions. The research also highlighted enablers such as trusted community organisations, partnership working, guided support and peer networks. Findings from this qualitative work will contribute to Wirral’s broader health needs assessment and support ongoing system improvement across health, voluntary, and local authority services.
Insights gathered: August 2025 - September 2025
- Mental health and wellbeing
- Migrant health
- Physical health and wellbeing
- Ethnic minority communities
- Experience of service provision
- People seeking asylum and refugees
Insights gathered by
Qualitative Insight Team, Public Health – Wirral Council.
Aim
To understand lived experiences of people seeking asylum and refugees as they navigate health services in Wirral and to identify structural, cultural and practical barriers influencing access, engagement and outcomes. This work forms Phase 1 of a wider two-year programme examining migrant health needs, to inform system level improvements and contribute to Wirral’s Asylum Seekers and Refugees Needs Assessment. The study sought to amplify resident and frontline voices to generate insights that can shape more inclusive and equitable service design.
People engaged with
This research engaged people seeking asylum and refugees alongside professionals working across stakeholder organisations, including GPs, public health staff, interpreters, healthcare workers, and voluntary, community, faith, and social enterprise (VCFSE) sector organisations. Participation occurred through focus groups, mini focus groups and a co-design workshop. Ultimately over 70 people were engaged.
Methods
Insights were gathered through qualitative research between August and September 2025. Focus groups were held with people seeking asylum and refugees (PSA&R) to explore shared experiences of accessing healthcare, communication challenges and the impact of unfamiliar systems. Eight mini focus groups took place with professionals including GPs, public health staff, interpreters, healthcare workers and VCFSE sector organisations, enabling exploration of operational pressures and system level challenges. A co-design workshop brought PSA&R and professionals together to validate themes, map real versus ideal healthcare journeys, and co-develop practical solutions. Recruitment used stakeholder partnerships and snowball sampling to reach varied perspectives. Data collection occurred in organisational and community settings. Thematic analysis was used, comparing PSA&R and professional viewpoints to identify patterns, divergences and structural issues. Insights were reviewed and shaped into themes covering navigation, access barriers, enabling factors and system improvements. No names were used to protect participant identities.
Key insights
Insights revealed four interconnected themes shaping how people seeking asylum and refugees (PSA&R) experience healthcare in Wirral. Participants consistently described difficulty understanding and navigating the UK healthcare system on arrival, often bringing expectations from their home countries where direct, walk-in access to doctors is the norm. Many were unaware that GP registration is required before care can be accessed, resulting in delays, missed appointments, and confusion about referral processes, prescription rules, and the roles of different professionals such as midwives, health visitors, and antenatal teams. These early experiences were compounded by limited orientation upon arrival and low digital literacy, which made automated systems such as PATCHS and the NHS App difficult to use. Delays in receiving or replacing medication, particularly when home country treatments were unavailable or unlicensed, further contributed to stress and disrupted continuity of care.
Barriers to access affected every stage of a healthcare journey. Language was one of the most critical issues, with PSA&R frequently unable to access interpreters in the language, dialect or gender they needed. Interpreters were sometimes unavailable for urgent appointments, and quality varied, with some participants reporting poor translation or breaches of confidentiality. Many relied on family members or peers to interpret, raising concerns about accuracy and privacy. Written communications, including appointment letters and prescriptions, were often provided only in English, leading to missed or misunderstood information. Digital exclusion restricted the ability to book appointments, especially where surgeries required 8am phone or online contact, since most community organisations that provide support open later. Long phone queues, difficulty finding correct contact numbers, and limited access to Wi-Fi or data intensified these challenges. Housing instability further disrupted healthcare engagement, as frequent Home Office relocations broke continuity of care, caused missed letters, and created financial strain through increased travel costs. PSA&R described significant stress during transitions to refugee status, including the risk of homelessness and the loss of established support networks. Mental health needs were widespread but frequently unmet, with participants describing trauma, stigma, cultural barriers to therapy, and exhaustion from repeatedly retelling traumatic histories. Parents also often prioritised children’s health over their own, especially when living in temporary accommodation lacking cooking facilities, which affected nutrition and wellbeing.
Alongside these barriers, insights highlighted important enablers that supported positive experiences. Community organisations across Wirral played a central role in helping PSA&R register with GPs, book appointments, understand medications and build confidence in navigating health systems. Informal drop-ins provided trusted, low-pressure settings where individuals could seek help, connect socially and access guidance. Professionals described how partnership working, such as joint home visits between community organisations and health teams, improved engagement and reduced anxiety. PSA&R valued guided, step-by-step support, especially when registering for digital systems or learning how to communicate with health services. Volunteering opportunities, peer support and culturally familiar environments helped individuals build confidence, purpose and a sense of belonging. Travel support, including vouchers and informal transport arrangements by community staff or volunteers, enabled attendance at appointments that might otherwise have been financially or logistically impossible.
Participants called for clear, translated information about how the UK healthcare system works, strengthening interpreter systems, digital literacy support, practical English language courses tailored to healthcare navigation and improved signposting. Better coordination across services, continuity during housing transitions and trauma-informed approaches were viewed as essential for reducing stress and improving engagement. These insights collectively highlight the need for a more coherent, accessible, and empathetic healthcare system that reflects the realities of PSA&R in Wirral.
Quotes
“One word can change everything in medical situations.”
“They need to feel safe and be given time to build trust with professionals.”
How have the insights been used/shared?
These insights form Phase 1 of Wirral’s two-year Migrant Health Needs Assessment programme. The insights from this first phase contribute to Wirral’s Asylum Seekers and Refugees Needs Assessment, providing a detailed understanding of the lived experiences of PSA&R and the system level issues affecting their access to healthcare. Findings have been reviewed and approved within Wirral Council’s governance process and will support health, voluntary and local authority partners to improve service design and strengthen partnership working. The insights have already informed collaborative discussions through the co-design workshop, where professionals and PSA&R jointly identified actionable priorities for system change.