Longitudinal impacts of no recourse to public funds on health and wellbeing for children and families in England

Research Question: What are the health impacts of having NRPF and how are they mitigated by support under section 17 of the Children Act 1989’?

Background: The NRPF rule prevents most temporary migrants from accessing social security benefits and social housing. People who are subject to immigration control also face restrictions in accessing secondary healthcare, and charging for NHS services, acting as a disincentive to seeking healthcare in England (Worthing et al. 2021). If a family becomes destitute, one of the few statutory support provisions is ‘child in need’ support under Section 17 of the Children Act 1989.

Section 17 allows local authorities to provide services including housing and subsistence support for children who are “unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development.” Although there is a growing research literature about the impact of the NRPF rule on children and families, little is known about the longitudinal effects of living with NRPF, or the differing outcomes for families who have access to section 17 support and those who do not.

Aim: To explore the longitudinal impact of support under Section 17 of the Children Act 1989 on the health and wellbeing of families with NRPF.

Objectives: To understand - a. The experience of support under Section 17 of the Children Act 1989 and its role in relieving destitution and improving health outcomes for children with NRPF; b. How the denial of recourse to public funds impacts on child health; c. The areas of good practice in supporting children and families with NRPF, and the risk factors relating to public health for people with NRPF.

Methods: A quantitative survey of public health indicators will be used to assess the self-reported changes in health and wellbeing over time, and the differences in outcomes between households who have section 17 support and those who do not. A sub sample of panel members will be recruited for qualitative semi-structured interviews and photo elicitation exercises with children to explore in more detail the impacts of NRPF, and the areas of good practice which improve health outcomes.

Timelines for delivery: The project will commence in October 2024, with data collection starting in January 2024. Questionnaires and semi-structured interviews will be repeated at 6 months intervals for 30 months.

Anticipated impact and dissemination: We will publish protocols on the NIHR Open platform, and present our findings at three research conferences over the course of the research. Following feedback from the conferences and consultation with the stakeholder group, we will publish the results and analysis in open access peer reviewed journals. We anticipate writing one policy analysis paper, one paper which focuses on the quantitative findings, and one which focuses on the qualitative findings.

Regular updates will be issued, freely accessible to a general audience in the form of a blog/podcast series on the project website which will publish updates on the project at three-month intervals. The results and findings will be used to develop a 'public health and NRPF toolkit’ to embed the findings for clinicians and social care practitioners.

An end of project workshop for public health and care workers will outline the findings for health and care practitioners, and explore the implications for public health practice with migrants.