Refugee, asylum-seeking and newly arrived children — branching viva

Viva — Branching structured oral

Stem. A nine-year-old girl arrives in your clinic six weeks after her family fled a conflict zone. She has no immunisation record and speaks a language none of your nurses share. Her mother is anxious about what you will tell the caseworker. [1]

Branch 1 — Classification and consent authority

Examiner: How do you classify this child's migration status and stage of journey, and what does that mean for consent? [1]

Model answer. She is a newly arrived child seeking protection, so depending on her legal pathway she is a refugee (if protection is recognised) or an asylum-seeker (if the claim is pending). Her stage is on arrival — the screening window. I classify both because the status sets the legal context and the stage sets where the catch-up window sits. For consent, she is with her mother, so I clarify whether the mother holds parental responsibility or whether an appointed guardian or the state shares it; for a young child there is no mature-minor capacity, so consent rests with whoever holds parental responsibility. I document the answer because it governs every intervention that follows. [1] [3]

Examiner follow-up: Her mother is anxious about what you will tell the caseworker, and neither speaks English. How do you proceed? [6]

Model answer. I use a trained, professional interpreter — never the child and never an untrained staff member — because professional interpreters improve communication, safety and outcomes. Through the interpreter I state conditional confidentiality aloud: what we discuss stays private unless I am worried the child is not safe, someone else is being hurt, or the law requires me to act. I am explicit about what the caseworker will and will not receive, share the minimum necessary and lawful, and tell them before I share anything that crosses a threshold. [6] [1]