Early integration outcomes for refugees resettled in England and Wales: 2015 to 2021

• Between 2015 and 2020, approximately 16,350 refugees were resettled in England and Wales under the Vulnerable Persons Resettlement Scheme (VPRS) and the Vulnerable Children's Resettlement Scheme (VCRS).

• Those resettled are primarily of Syrian nationality (91%), with slightly higher proportions of males (52%) than females (48%), and around half (50%) aged under 18 years on arrival; two years after arrival, most are still living in the local authority where they were first resettled (over 80%).

• The majority of refugees resettled under VPRS and VCRS (76%) registered with NHS services within a year of arrival and in 2021, 43% report their health as very good compared with 48% for the population of England and Wales as a whole.

• Similar to the population of England and Wales as a whole, the percentage of refugees resettled under the VPRS and VCRS reporting very good health declines with age for both females and males, and the proportion reporting a disability is 18%, the same as the population of England and Wales.

• In 2021, refugees resettled under the VPRS and VCRS are most likely to live in houses (78%) rather than flats (19%) or multiple occupancy, converted or commercial buildings (4%) (percentages do not sum to 100% because of rounding); 98% live in social or privately-rented housing. 

• The majority (69%) of refugees resettled under the VPRS and VCRS live in households that have the required number of bedrooms to prevent overcrowding, a further 21% live in housing with fewer bedrooms than required (overcrowded).

This new analysis is based on experimental data into early integration outcomes for refugees resettled under the Vulnerable Persons Resettlement Scheme (VPRS) and the Vulnerable Children's Resettlement Scheme (VCRS) in England and Wales. Between 2015 and 2020 approximately 16,350 refugees resettled in England and Wales under the VPRS and VCRS.

Taken together, refugees resettled under the VPRS are primarily of Syrian nationality (91%). There were slightly higher proportions of males (52%) than females (48%), and around half (50%) are aged under 18 years on arrival. The Home Office have published statistics on refugees resettled under the VPRS and VCRS (Table Res_D01).

This analysis covers access to health services, migration moves, and deaths based on linked administrative data from the Home Office, NHS England and General Register Office (GRO). It also includes self-reported health, illness and disability and housing based on linked Census 2021 data. Our analysis is experimental and may change as we continue to update linkages. Further detail on the Refugee Integration Outcomes (RIO) cohort study data can be found in Section 7: Data sources and quality.

Two years after arrival, most Vulnerable Persons Resettlement Scheme (VPRS) and Vulnerable Children's Resettlement Scheme (VCRS) refugees are still living in the local authority where they were first resettled (over 80% for each arrival year cohort). A cohort is defined as a group of people with a shared characteristic moving forward through time. In this case we use year of arrival to define cohorts.

We compare flows from area of initial resettlement to where VPRS and VCRS refugees live in 2021 (Figure 2).

By 2021, the number of VPRS and VCRS refugees resettled in London increased from 1,044 to 1,159 (up 11%). All other grouped regions saw decreases in the number of VPRS and VCRS refugees. Proportionally, the highest decreases were for Southern England (8%) and East Midlands and Wales (8%). Approximately 784 (5%) had either moved from England and Wales or their region was unknown.

Figure 2: By 2021, the number of VPRS and VCRS refugees living in London increased from 1,044 to 1,159 (11%), whereas most other grouped areas saw a decrease

Refugees resettled under the Vulnerable Persons Resettlement Scheme (VPRS) and the Vulnerable Children’s Resettlement Scheme (VCRS), flows between areas from time of resettlement to 2021

Notes:

1. This analysis is based on linked NHS Personal Demographics Service (PDS) data up to July 2022 and excludes those who did not link to either the PDS data or have yet to register with NHS services.
2. The chart reflects VPRS and VCRS refugees' known area at two time points; at first resettlement (2015 to 2020) and at 2021. Moves between these time points are not accounted for.
3. Areas are grouped as following because of some low counts, North East and North West England, East Midlands, West Midlands and Wales, London, and South East and South West England.
4. Unknown is where the area could not be assigned to a record because of postcode data quality issues or postcode was missing. Cross-border embark refers to moves from England and Wales to Scotland or Northern Ireland.

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VPRS and VCRS refugees no longer in England and Wales

We investigated how many VPRS and VCRS refugees had moved to Scotland or Northern Ireland since following their initial resettlement in England and Wales, or had died, by linking NHS Personal Demographics Service (PDS) data and death registrations respectively. PDS may record lower numbers of cross-border moves as an individual would have to notify a GP that they are moving country.

By 2021, less than 1% (75 refugees) had moved from England and Wales to Scotland or Northern Ireland following their initial resettlement. This is based on individuals notifying their doctor that they had moved. A further 50 (less than 1%) had died since arriving in England and Wales.

Registration with NHS services

Local authorities and community sponsor groups play an important role in helping Vulnerable Persons Resettlement Scheme (VPRS) and Vulnerable Children's Resettlement Scheme (VCRS) refugees resettle in the UK. One way is encouraging VPRS and VCRS refugees to register with NHS services. Across all arrival cohorts the proportion of VPRS and VCRS refugees registering with NHS services is consistently high at over 95%. Overall, the majority (76%) registered within a year of arrival and this proportion has steadily increased year on year. The analysis presented in this section is based on linked data and excludes those who did not link to NHS Personal Demographics Service (PDS) data or have yet to register with NHS services.

General health

The health and disability analysis presented in this section is based on linked Census 2021 data and excludes those who did not link to Census 2021 data. Health and disability are self-reported in Census 2021.

Percentages in this article for self-reported health at Census 2021 are age-standardised. Health and age are closely related, with older people more likely to be in poorer health. Age-standardised proportions (ASPs) account for different age structures in populations and are more appropriate than crude percentages when drawing comparisons. See further information on age-standardised proportions in Section 6: Glossary.

General health by age and sex

In 2021, 43% of VPRS and VCRS refugees reported their health as very good; this compares to 48% for the population of England and Wales as a whole.

Similar to our general health of the population of England and Wales as a whole estimates, the percentage reporting very good health declines with age for both males and females (Figure 4). Among female and male VPRS and VCRS refugees aged 0 to 24 years, approximately 60% rate their health as very good which declines to approximately 30% for those aged 25 to 44 years. In comparison these percentages are approximately 75% for females and males aged 0 to 24 years in the England and Wales population and 51% and 54% for females and males aged 25 to 44 years respectively.

Older VPRS and VCRS refugees (aged 45 years and over) are less likely to rate their health as very good, with only 6% of females and 10% of males rating their health as very good. This compares with 28% of females and 29% of males aged 45 years and over in the England and Wales population. Female (48%) and male (42%) VPRS and VCRS refugees aged 25 to 44 years are more likely to rate their health as good than fair, bad or very bad compared with 37% of females and 36% of males in the general population.

Disability and age are closely related, with older people being more likely to be disabled in the population as a whole. For this analysis the data on disability has not been age-standardised.

In 2021, across both England and Wales, the proportion of disabled VPRS and VCRS refugees is approximately 18% and is the same as the population of England and Wales as a whole.

The housing, tenure and health analysis presented in this section is based on linked Census 2021 data and excludes those who could not be linked to Census 2021 data.

Housing

In 2021, regardless of arrival year, the majority of Vulnerable Persons Resettlement Scheme (VPRS) and Vulnerable Children's Resettlement Scheme (VCRS) refugees (approximately 99%) live in private households and less than 1% live in communal establishments. Those living in private households are most likely to live in houses (78%) rather than in flats (19%), or multiple occupancy, converted or commercial buildings (4%) (percentages do not sum to 100% because of rounding). Less than 1% of VPRS and VCRS refugees live in mobile homes or temporary structures. Figure 6 shows housing by arrival year. The majority (88%) of households contained four or more people (Figure 7).

Occupancy ratings provide a measure of whether a household's accommodation is overcrowded or under-occupied (Figure 8). The majority of VPRS and VCRS refugees live in households that have the required number of bedrooms (69%) to prevent overcrowding. A further 21% live in housing with fewer bedrooms than required (overcrowded) and 10% live in housing with more bedrooms than required (under-occupied).

Tenure

In 2021, the vast majority of VPRS and VCRS refugees (98%) live in rented housing (either social housing or privately rented). Those arriving in 2015, 2016 and 2017 are more likely to live in social housing (67%, 50% and 51% respectively). Those arriving in 2018 and 2019 are more likely to live in privately-rented housing (46% and 45%) compared with 21% in 2015, 38% in 2016 and 37 % in 2017. Interestingly, for those arriving in 2020, more live in social housing (49%). This varied pattern may reflect social housing availability.

Around 1% of resettled refugees own their home either outright or with a mortgage (Figure 9). This supports previous Office for National Statistics analysis of migrants and housing, which suggests residents born abroad have lower home ownership rates and are more likely to live in social or privately-rented housing.

Age-standardised percentages

Age-standardised percentages (ASPs) allow a fairer comparison in health and disability outcomes between populations living in different areas and over time, as they account for differences in the population size and age structure. Further information about the benefits of using age-standardised measures for health is explained in our Age standardising data: What does this mean and why does it matter? blog. 

To calculate an age specific percentage for each age group:

M_k equals (d_k divided by p_k) multiplied by 100

Where:
M_k equals the percentage of people rating their health as very good in age group k
d_k equals the the number of people rating their health as very good in age group k
p_k equals the Vulnerable Person Resettlement Scheme (VPRS) and Vulnerable Children's Resettlement Scheme (VCRS) population in age group k
_k equals the age group

General health

A question on self-assessed general health was included in Census 2021. Each person in the household was asked to rate their health as very good, good, fair, bad or very bad. Self-assessed general health draws together an individual's perception of all aspects of their health and well-being. This assessment is not based on a person's health over any specified period. It is useful in indicating general well-being, health-related quality of life, the experience of long-term illness and the relative risks of future admission to hospital, impairment and mortality. However, because of the self-reported nature, conclusions in this article may differ from studies that use health data based on GP records and other objective sources.

Census 2021 was conducted during the coronavirus (COVID-19) pandemic. This may have influenced how people perceive and rate their health and therefore may have affected how people chose to respond. 

Disability

People who assessed their day-to-day activities as limited by long-term physical or mental health conditions or illnesses are considered disabled in Census 2021. This definition of a disabled person meets the harmonised standard for measuring disability and is in line with the Equality Act (2010).

Accommodation type

The type of building or structure used or available by an individual or household as reported in Census 2021.

This could be:

• the whole house or bungalow
• a flat, maisonette or apartment
• a temporary or mobile structure, such as a caravan

Household

A household in Census 2021 is defined as:

• one person living alone
• a group of people (not necessarily related) living at the same address who share cooking facilities and a living room or sitting room, or dining area

Occupancy rating bedrooms

Whether a household's accommodation is overcrowded, ideally occupied or under-occupied. This is calculated by comparing the number of bedrooms the household requires with the number of available rooms reported in Census 2021.

The number of bedrooms the household requires is calculated according to the bedroom standard, where the following should have their own bedroom:

• adult couple

• any remaining adult (aged 21 years and over)

• two males (aged 10 to 20 years)

• one male (aged 10 to 20 years) and one male (aged 9 years and under), if there are an odd number of males aged 10 to 20 years

• one male aged 10 to 20 years if there are no males aged 0 to 9 years to pair with him

• two females (aged 10 to 20 years)

• one female (aged 10 to 20 years) and one female (aged 9 years and under), if there are an odd number of females aged 10 to 20 years

• one female aged 10 to 20 years if there are no females aged 0 to 9 years to pair with her 

• two children (aged 9 years and under) regardless of sex

• any remaining child (aged 9 years and under) 

An occupancy rating of:

• minus 1 or less implies that a household's accommodation has fewer bedrooms than required (overcrowded)

• plus 1 or more implies that a household's accommodation has more bedrooms than required (under-occupied)

• 0 suggests that a household's accommodation has an ideal number of bedrooms

Further detail on occupancy is available in our Housing, England and Wales: Census 2021 bulletin.

Tenure type

Whether a household owns or rents the accommodation that it occupies as reported by Census 2021.

Owner-occupied accommodation can be:

• owned outright, which is where the household owns all of the accommodation
• with a mortgage or loan
• part owned on a shared ownership scheme

Rented accommodation can be:

• private rented, for example, rented through a private landlord or letting agent
• social rented through a local council or housing association

This information is not available for household spaces with no usual residents.

Vulnerable Persons Resettlement Scheme (VPRS) and Vulnerable Children's Resettlement Scheme (VCRS) data

The VPRS and VCRS were established by the UK government to resettle vulnerable adults and children. The VPRS was launched in 2014 for those in greatest need, including people requiring urgent medical treatment, survivors of violence and torture, and women and children at risk. The scheme aimed to resettle 20,000 people fleeing the conflict in Syria by March 2020.

The VCRS was launched in 2016 with the aim of resettling up to 3,000 at-risk children and their families from the Middle East and North Africa (MENA) region. The region consists of 19 countries including Algeria, Bahrain, Egypt, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Palestine, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates, Yemen. 

By the time the schemes closed in February 2021, the total number of individuals resettled in the UK through the VPRS was 20,319, with a further 1,838 resettled through the VCRS.

Refugee Integration Outcomes (RIO) cohort study data

The Refugee Integration Outcomes (RIO) cohort study is a collaboration between the Office of National Statistics (ONS) and the Home Office to fill an evidence gap in understanding the integration outcomes of resettled refugees and those seeking asylum in England and Wales between the years 2015 to 2020.

We linked NHS Personal Demographics Service (PDS) data, Home Office border systems data, General Register Office (GRO) death registrations data, and Census 2021 data to cohorts of refugees who were resettled in England and Wales or granted asylum between 2015 and 2020 to understand their early outcomes. The analysis in this report refers to refugees resettled under the VPRS and VCRS only.

The analysis in this article is based on linked data and excludes those who did not link to either the NHS PDS data or Census 2021 data. Linkage rates to Census 2021 for resettled refugees are very high (more than 90%). We achieved lower linkage rates for asylum refugees and are investigating how to improve linkage before publishing information on asylum refugee outcomes.

Further detail on linkage methods is available in our Refugee integration outcomes data-linkage pilot: Census 2021 linkage methodology update.

Census 2021

The census is undertaken by the ONS every 10 years and is the largest statistical exercise that we undertake, producing statistics that inform all areas of public life and that underpin social and economic policy. It asks questions about a person, their household and their home. In doing so, it provides a wealth of information at small geographies to inform local planning and decision-making. More information is available on the About census page.

The census is a rich data source that includes numerous integration indicators for a point in time, for example families and households, housing, education, English and Welsh language proficiency, employment, and health.

NHS Personal Demographics Service (PDS) data

The NHS PDS data hold demographic details of users of health and patient care services in England and Wales. As we linked to these datasets previously, more information on the data we use from the PDS can be found in our Refugee Integration Outcomes (RIO) data linkage pilot methodology.

Death registrations data

Death registrations data hold all registration details of registered deaths in England and Wales. Deaths in England and Wales should be registered within five days of the death occurring, however, where a coroner investigation is required, there are some circumstances where death registrations can be delayed.

The Refugee Integration Outcomes (RIO) cohort study was set up to fill an evidence gap in understanding integration outcomes for refugees resettled under the Vulnerable Persons Resettlement Scheme and Vulnerable Children's Resettlement Scheme.

We recently extended the RIO cohort study coverage to include cohorts of asylum refugees living in England and Wales who were granted asylum between 2015 and 2020. NHS Personal Demographics Service (PDS) data, Home Office border systems data and Census 2021 data were linked to asylum refugee cohorts. Asylum refugee data are more challenging to link because of the diversity in nationalities in this group, being predominantly younger males, and more transient. We will look to improve linkage rates for the remaining asylum refugee residuals that we could not link to NHS PDS data, Census 2021 data and Home Office border systems data.

The RIO cohort study covers England and Wales currently, but there are plans to expand this study to Scotland and Northern Ireland, and other humanitarian and protection routes in the future. This is subject to data availability, agreement from data suppliers, quality and funding.

Future updates on RIO linkage will be published as we link additional administrative data. We plan to link updates for Home Office border system data, NHS PDS data, and birth registrations in the next iteration of RIO. This iteration will also include additional information available on death registrations such as age at death, location, causes of death. Future iterations of RIO will include linkage to employment and benefits data, education and health data. We will extend our analysis articles to cover refugees granted asylum, subject to quality of the linked data.