Case Study: Cardiff and Vale Health Inclusion Service (CAVHIS)


Cardiff’s population includes many vulnerable groups including asylum seekers and refugees, sex workers, people experiencing homelessness, and prison leavers. Each of them has specific needs, however, they share many common issues such as a higher-than-average incidence of post-traumatic stress, mental health problems, substance use, risk of infectious diseases, housing problems, and poverty.

Responding to groups with diverse needs in Cardiff

The Cardiff and Vale Health Inclusion Service (CAVHIS), a health service for groups that face significant challenges when attempting to access health and social care, was set up to respond to these diverse needs. It is situated in the centre of Cardiff and managed by the Primary, Community, and Intermediate Care Clinical Board. The service has been developed over the past three years to deliver an integrated service with cross-sector partners providing care to traditionally excluded groups. 

The service began as Cardiff Health Access Practice (CHAP) and was resourced to provide health screening to newly arrived people seeking asylum who were placed in Cardiff for Home Office initial assessment. The current model registers those newly arrived in Cardiff via the asylum ‘irregular routes’.

Widening the ambition of integrated primary care services

The initiative was re-branded in September 2021 as CAVHIS to reflect the ambition to provide a wider service which now includes limited urgent primary care for multiply excluded single homeless individuals - via outreach clinics into frontline hostels - and primary care for individuals who, due to episodes of violent behaviour, are judged to need a security presence. The longer-term vision of the service is to develop, in partnership with local authorities and the third sector, services to provide an integrated and co-located health inclusion service. 

The service currently offers registration for the multiply excluded homeless, homeless prison leavers, high-risk sex workers, newly arrived people seeking asylum and refugees with care needs requiring more intense input, and Roma Gypsy and Traveller people who are mobile.

Cardiff and Vale Health Inclusion Service

The CAVHIS provides access to public health screening and short term support for a wider cohort of individuals who find it hard to access healthcare and who are not registered with a GP.

Visit the CAVHIS website to find out more
The logo of the Cardiff and Vale Health Inclusion Service which depicts a multi-coloured sunflower.

About the writers

Dr Ayla Cosh stands in front of a white wall designed with large green text.

Dr Ayla Cosh

Clinical Director for Cardiff and Vale Health Inclusion Service

Dr Ayla Cosh is a GP and the Clinical Director for Cardiff and Vale Health Inclusion Service. Ayla has worked in areas of high socioeconomic deprivation in frontline and non-clinical settings to tackle the issues people in ‘health inclusion’ groups face when accessing healthcare, and the challenges organisations face while providing care to these groups. For three years she has been working with colleagues in health, local authority and third sector to implement an integrated, co-located service to increase access to health care, reduce health inequalities and provide a more equitable service.