A significant outcome of the global crisis for refugees has been the abandonment of forced migrants to live in makeshift camps inside the EU. This paper details how state authorities have prevented refugees from surviving with formal provision, leading directly to thousands having to live in hazardous spaces such as the informal camp in Calais, the site of this study. We then explore the violent consequences of this abandonment. By bringing together thus far poorly integrated literatures on bio/necropolitics (Michel Foucault; Achille Mbembe) and structural violence (Johan Galtung), we retheorize the connections between deliberate political indifference towards refugees and the physiological violence they suffer. In framing the management of refugees as a series of violent inactions, we demonstrate how the biopolitics of migrant control has given way to necropolitical brutality. Advancing geographies of violence and migration, the paper argues that political inaction, as well as action, can be used as a means of control.

ObjectivesTo thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries.DesignSystematic review and qualitative thematic synthesis.MethodsSearches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs.ResultsTwenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes.ConclusionsA range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group.

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PurposeThe purpose of this paper is to consolidate policy, research, evidence and good practice around strategies tackling fuel poverty and affordable warmth for older people aged over 60 to support the development of more effective services for this life course stage and to tackle physical and mental health inequalities. Design/methodology/approachWe consolidate current policy, research, evidence and examples of good practice in exploring effective interprofessional approaches that contribute to affordable warmth for older people through 'desktop analysis'. We support this with qualitative data from Health and Wellbeing Boards, health inequalities and environmental health from research comprising 4 longitudinal case studies in the Midlands and North of England over 18 months and semi structured interviews with members and support officers. A total of 50 interviews were undertaken and 55 hours of Health and Wellbeing Board meetings observed. FindingsThere are numerous older people living in fuel poverty. The depth of fuel poverty increases with age particularly the over 75s and physical and mental ill health are affected. There are an increasing number of tools to help estimate health care costs around the cost effectiveness of interventions and there is a real need for more local evidence about what is working well, how and why. However there is no mandatory requirement for fuel poverty strategies and more creative local strategies are required taking organisational and interprofessional relationships into account. The emphasis in integrated care provides new impetus and scope to encourage preventative services but these new partnerships need to be effective in what is a complex policy environment. There is still a long way to go in places. The challenges of ageing are numerous, complex and not fully understood and sit across multiple policy areas. Originality/valueFuel poverty strategies tend to be delivered on a geographical or income bases rather than by life course approach and a focus on older people. We need to focus more specifically on older people, a rapidly growing population and to better understand thermal properties of our ageing housing stock and how best to intervene to protect and improve health and safety. Emerging approaches need to overcome artificial statutory and non statutory divides and move toward sustainable, evidence based affordable warmth strategies for older people to protect and improve health.