Healthcare for people seeking sanctuary
Brownlow Refugee & Asylum clinic – The story so far
The journey of the RAAS Clinic began with a simple but powerful belief: that every patient deserves accessible, compassionate, and high-quality healthcare within their community. What started as a purpose-driven idea in response to the Afghan crisis in 2021 quickly evolved into a mission shaped by dedication, resilience, and an unwavering commitment to care. As we witnessed first-hand the immense pressures placed on general practice, we also saw inequities in access and a level of complex need we had never encountered at such scale before.
Supporting patients who were entirely unfamiliar with their surroundings required far more than medical care alone. We were navigating education, culturally aligned expectations, medical needs, and the mental and social wellbeing of individuals often reliant on interpreters and entirely removed from what they once knew. Doing this alongside the day-to-day delivery of an already overstretched primary care service pushed us into unfamiliar territory and demanded that we rethink how care was provided.
We had to react and reframe our approach. Although these patients were attending regular GP appointments, the fragmentation of support was clear. Establishing the RAAS Clinic allowed us to centralise care and wrap a multidisciplinary team around the patient, addressing cultural, clinical, and social needs together. This reduced pressure on GPs while giving patients access to coordinated psychosocial support, not just isolated appointments. Over time, the service has grown to include CSWs, GPs, nurses, care coordinators, social prescribers, mental health practitioners, and specialist services including drugs and alcohol nurses.
We recognise this model is not universally scalable, but with appropriate commissioning it offers a more connected, equitable, and sustainable approach to healthcare for those seeking sanctuary. Ensuring patients can access coordinated services from the point of arrival—without repeatedly retelling their story—remains essential.
Sustaining this work without sufficient funding has been one of our greatest challenges. Demand continues to grow while fragmented commissioning pathways create significant disconnects in care delivery. Yet across Liverpool and beyond, we are fortunate to work alongside organisations and sectors all striving for the same outcome—proving that change is achievable.
The RAAS Clinic was never simply about creating another service. It was about dignity, compassion, and ensuring no patient feels forgotten. From a six-week pilot to four years of impact and national recognition, this journey reflects the resilience of the Brownlow Health team, our volunteers, partners, and supporters. Today marks a milestone—one that reinforces our shared commitment to continuing this mission with hope, collaboration, and determination, now and into the future whilst remembering the importance of doing something the right way and not just because it’s the right thing to do.
Awards
Winners at HSJ Awards 2025 - NHS Race Equality Award: Dedicated Refugee & Asylum clinic
Winners at General Practice Awards 2023 - Practice Team Member of the Year - Farida Laeeq RAAS Care Co-ordinator
Organisations we are working with
4Wings Northwest - Info@4Wings.co.uk
WHISC - annequinton@whisc.org.uk, kirsteensheppard@whisc.org.uk
Liverpool Lighthouse - r.ross-williams@liverpoollighthouse.com
Lancaster University - v.canning@lancaster.ac.uk
Community Inclusion Team - sroor.ali@merseycare.nhs.uk
National Institute for Health and Care Research, North West Regional Research Delivery Network - joanne.henry@nihr.ac.uk
Talking English CIC - talkingenglishcic@gmail.com
Sahir House - Sahir House
Sola Arts - Sola Arts
FFT - FFT
Lighthouse - Lighthouse
CIT Liferooms - CIT Liferooms
Supporting Survival
Patients not passports - Patients not passports
Healthwatch - Healthwatch
Family Refugee Support Network - FRSN
Asylum Link - Asylum Link
These Walls Must Fall - These Walls Must Fall
Merseyside solidarity knows no borders - Merseyside Solidarity Knows No Borders
Royal Liverpool University hospital
Testimonials
“My journey with the RAAS clinic began as a patient, where I experienced first-hand the essential care and support provided to vulnerable individuals, particularly asylum seekers and refugees. Motivated by this experience, I became the first volunteer at the clinic, contributing to its mission and supporting others in similar situations.
“Today, I am proud to be working full-time within Brownlow Health, continuing to serve the community through the RAAS clinic. The clinic plays a vital role in improving access to healthcare, offering compassionate, holistic support, and creating a safe space for those in need. My journey reflects the profound impact of the service—not only on patients, but also on those who become part of its mission. It has been a truly transformative experience, both personally and professionally.”
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“Working in the RAAS clinic at Brownlow Health has been one of the most meaningful experiences of my training. It allowed me to develop a deeper sense of empathy and patience while caring for individuals who have often faced significant trauma, displacement, and barriers to healthcare.
“Each patient encounter carried a unique story, reminding me of the resilience behind their journeys. Clinically, I was exposed to a wide range of complex and often unfamiliar presentations, shaped not only by disease but by social, cultural, and psychological factors. This experience broadened my perspective on what it truly means to provide holistic care.
“The team was exceptionally supportive, fostering a compassionate and non-judgemental environment. Overall, working in RAAS has made me a more reflective, understanding, and patient-centred doctor, and reinforced the importance of expanding such services to ensure equitable access to care.”
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“Our collaboration with the Brownlow Health RAAS clinic has been consistently positive and invaluable to the individuals we support, your team consistently provides compassionate and responsive support to people seeking sanctuary.
“We would especially like to recognise Farida for her exceptional support. Her help with urgent registrations and facilitating timely appointments has made a significant difference to our service users, ensuring they can access care when they need it most. We greatly value our ongoing partnership and look forward to continuing this important work together.”
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“We have worked closely with the staff at the RAAS clinic for some years now. It is an invaluable service that allows us quick and straightforward access into health services for people who would otherwise struggle, particularly those who have been out of touch with services for some time.
“RAAS staff are consistently committed to the overall wellbeing of their patients. They collaborate closely with us, providing relevant documentation in support of applications and requests. We truly value being part of this network of services and professionals who wrap around individuals, each contributing their own area of expertise to a combined effort to keep people safe and well.”
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"It was a great experience attending the clinic. I gained valuable insight into how the service is run and the wide range of clinical issues they manage. The experience has helped inform the development of the clinic we now run at Abercromby. The team were very welcoming and generous in sharing useful resources, knowledge, and practical advice, which I have found incredibly helpful in shaping our own service."
Case Studies
Case Study: From Crisis to Control – Interrupting the Cycle of Suicidal Intent
Background
A patient presented to the Brownlow Health RAAS (Refugee and Asylum Seeker) clinic with severe mental health difficulties, including chronic depression, severe PTSD with vivid hallucinations, and multiple suicide attempts. The condition had escalated over time, leading to repeated crisis presentations and occasional disengagement from traditional services.
The Challenge
The patient frequently attended the clinic in acute distress and disclosed clear, premeditated plans to end their life, including describing how they intended to attempt suicide after leaving the clinic.
Previous service interactions had not been sufficient to interrupt this pattern, resulting in a significant and immediate risk of harm, alongside a deep sense of hopelessness and lack of control over thoughts.
Intervention
The clinic adopted a consistent, relationship-based approach, focusing on:
Regular, structured follow-up appointments
Providing a safe, non-judgemental space to discuss suicidal thoughts openly
Allowing time and space for de-escalation at each visit, with interpreter support where required
Building trust by ensuring the patient felt heard and not dismissed or rushed
Close risk monitoring and collaborative safety planning
Rather than focusing solely on crisis management, the approach prioritised creating a stable, compassionate, and familiar environment to help break cycles of trauma and distress.
Outcomes
Immediate Impact
The patient began to notice a shift, reporting that they could attend the clinic with a clear intention to harm themselves but leave with those thoughts reduced or temporarily gone. This demonstrated the clinic’s ability to create immediate psychological safety.
Ongoing Progress
The intensity and urgency of suicidal thoughts reduced over time
The patient engaged more consistently with follow-up
Increased awareness developed around how support could interrupt harmful thought patterns
The patient’s journey reflected gradual but meaningful progress—from acute crisis states to moments of control and relief.
Key Takeaways
A single trusted interaction can reduce immediate risk
Consistency and continuity are critical in clinical care
Even short-term relief from suicidal ideation can be life-saving
Feeling heard and understood can interrupt harmful thought cycles
Case Study: Choosing Life – Navigating Belief, Risk, and Informed Decision-Making
Background
A patient with complex gynaecological conditions presented during a consultation for urinary tract infection symptoms and was found to have an unplanned pregnancy. The patient came from a highly conservative, anti-abortion background shaped by strong cultural and family beliefs.
The Challenge
The pregnancy posed serious medical risks due to underlying health conditions. At the same time, the patient experienced significant internal conflict between personal beliefs and medical realities.
There was also limited understanding of the medical consequences, and the spouse was involved, requiring sensitive and balanced support to ensure shared understanding without pressure.
Intervention
The GP provided ongoing, patient-centred consultations focused on:
Clear, evidence-based education about medical risks
Open, non-directive discussions allowing the patient to explore personal values safely
Inclusion of the spouse to support shared decision-making
Maintaining a respectful, non-judgemental environment
Time was allowed across multiple appointments to support reflection, ensuring autonomy, dignity, and informed consent throughout.
Outcomes
Through ongoing discussions, both the patient and spouse:
Gained a clear understanding of the risks involved
Explored emotional, cultural, and physical implications
Felt supported rather than judged
The patient ultimately chose to terminate the pregnancy, recognising:
The serious risk to life if the pregnancy continued
The importance of preserving long-term health
Long-term Impact
Increased sense of control over personal health decisions
Strengthened shared understanding between patient and spouse
Improved trust in healthcare services
Key Takeaways
Patients can make complex decisions when supported appropriately
Education and time are essential in high-stakes decision-making
Respecting beliefs while providing medical clarity supports true autonomy
Involving family (where appropriate) can improve outcomes
Case Study: A Safe Home, A New Start – Transforming Outcomes Through Safeguarding
Background
A family presented with significant social and medical needs. Their child had experienced severe perinatal hypoxia, resulting in:
Developmental delay
Severe motor impairment
Limited verbal communication
The family were living in unsafe and unsuitable housing conditions that were negatively affecting the child’s health and development.
The Challenge
The case involved multiple compounding risks:
The child’s complex needs were not being adequately supported
The home environment was unsafe
The family lacked resources and advocacy capacity
Caring responsibilities were overwhelming without formal support
Without intervention, both the child’s condition and the family’s situation were at risk of worsening.
Intervention
The GP initiated an urgent safeguarding referral, highlighting both housing concerns and the child’s medical needs.
Further action included:
Close collaboration with social services
Ongoing follow-up and strong advocacy to maintain urgency
Support for rehousing efforts
Facilitating access to coordinated, holistic care services
The approach focused on both immediate risks and wider social determinants of health.
Outcomes
Immediate Outcomes
The family was provided with emergency accommodation
The child moved into a safer, more stable environment
Overall household strain reduced
Broader Improvements
Access to better coordinated care for the child
More sustainable caring arrangements
Improved opportunities for long-term stability through education and support
Over Time
Care became more structured and consistent
The family transitioned from crisis to stability
A more sustainable balance of responsibilities and support was achieved
Key Takeaways
Housing is a critical determinant of health
Early safeguarding intervention significantly improves outcomes
Strong advocacy and follow-up are essential in complex cases
Whole-family support leads to more sustainable, long-term change
Case Study: Rebuilding Identity and Safety – Supporting an LGBTQ+ Asylum Seeker Through Trauma and Transition
Background
An asylum seeker presented with significant emotional and psychological challenges linked to experiences as an LGBTQ+ individual in their country of origin. In that environment, sexual identity was neither accepted nor understood, leading to years of concealment to avoid social exclusion and harm. This resulted in deep emotional distress, internal conflict, and difficulty with self-acceptance.
The individual sought asylum in the UK in search of safety and the ability to live authentically.
The Challenge
Following arrival in the UK, initial settlement provided access to support networks and mental health services. However, relocation disrupted this stability, causing loss of established support systems, disconnection from familiar professionals, and increased isolation.
At the same time, the individual was navigating the asylum process independently, requiring them to repeatedly recount traumatic experiences and justify personal identity. This process was emotionally exhausting and at times led to self-doubt.
Intervention
Following referral to a specialist clinic, the individual accessed consistent, structured support.
The multidisciplinary team, including a dedicated link worker, focused on:
Re-establishing access to healthcare and mental health support
Providing trauma-informed, person-centred care
Supporting navigation of systems and appointments
Offering reassurance and practical support
A trusting relationship was developed, helping rebuild confidence in engaging with services.
Outcomes
Following intervention, the individual experienced improved emotional stability, reduced isolation, and increased engagement with healthcare services. Care was described as respectful, supportive, and person-centred.
During the asylum process, the individual remained engaged despite ongoing emotional strain and successfully prepared and submitted evidence. Ongoing support reduced isolation, reinforced validation, and encouraged consistency.
Over time, improvements included greater emotional resilience, increased confidence in engaging with professionals, and a stronger sense of identity and self-acceptance.
Key Takeaways
Disruption to support systems can significantly impact stability
The asylum process can be emotionally demanding and retraumatising
Trauma-informed, person-centred care is essential
Coordinated support helps rebuild trust, safety, and confidence
Case Study: Finding Safety Through Language and Trust
Background
A patient presented with complex PTSD, severe anxiety, and depression following extreme trauma, including physical, psychological, and sexual abuse. The patient had fled war and persecution, seeking safety in the UK.
The Challenge
The patient spoke no English, significantly limiting the ability to communicate and worsening mental health. Negative experiences with phone interpreters led to feelings of being unheard and increased isolation.
As a result, the situation escalated to a suicide attempt and episodes of self-harm.
Intervention
The GP referred the patient to a specialist clinic where extended sessions were provided with a trusted, culturally aware practitioner who spoke the patient’s first language.
The approach focused on:
Enabling communication in the patient’s own language
Allowing sufficient time for open discussion without pressure
Using culturally sensitive, non-clinical language
Ensuring communication conveyed empathy and meaning
This helped build trust and encouraged engagement with further support.
Outcomes
The patient reported immediate relief after a small number of sessions, describing it as the first time they felt truly heard since arriving in the UK.
As trust developed, the patient engaged with additional services, including specialist mental health support and external organisations supporting survivors of trauma. Housing stability was achieved after refugee status was granted, and a structured long-term care plan was established.
Over time, the patient showed:
Increased confidence and sense of safety
Greater social engagement
Continued involvement with the clinic, including supporting others
The patient described a shift from suicidal thoughts to renewed hope after being able to communicate and feel understood.
Key Takeaways
Effective communication is essential to safety and recovery
Language-concordant, culturally aware care reduces distress
Trust enables engagement with wider support systems
Compassionate, patient-centred care can transform outcomes
Case Study: First Steps – Transforming a Child’s Future Through Coordinated Care
Background
A male paediatric refugee patient was brought to the RAAS clinic by parents who had refugee status but lacked knowledge of how to access services or integrate into the community. The parents were concerned about their child’s development.
The Challenge
Assessment at the clinic confirmed clear developmental delay. The family spoke no English and had limited understanding of available services, leaving the child without the support needed.
Intervention
The RAAS clinic team and GP worked together to create a coordinated care plan. The child was referred to:
Children’s Social Services
Learning Disability Assessment
Paediatric hospital (including for continence concerns)
Speech and Language Therapy
Parents were also provided with information and referrals to:
The Department for Work and Pensions (DWP)
Social services
Community support groups
Outcomes
Immediate Impact
Over five months, progress was made:
The child began receiving appropriate support
Parents enrolled in English language courses
Carers were allocated
The child started attending a special educational needs (SEN) school
Long-Term Transformation
Following coordinated care, the child walked independently for the first time during a clinic visit, marking significant developmental progress. The child continues to be followed up regularly by the medical team.
Key Takeaways
Barriers for refugee families are often social, linguistic, and systemic, not just medical
Coordinated, multi-agency care is essential
Referrals across health, social care, and education create holistic support
Supporting parents improves long-term outcomes for children
Regular follow-up ensures sustained progress