What is Modern Slavery?

Modern slavery exists in all countries across the world, with the Global Slavery Index estimating that there are 45.8 million victims.  There are many forms of exploitation Including; forced labour, debt bondage, sexual exploitation, criminal exploitation, and domestic servitude. There is no such thing as a‘typical victim’ of slavery. Victims can be men, women, or children of all ages, ethnicities and nationalities. The British Government estimates that there are around 13,000 people in modern day slavery in the United Kingdom. Many victims in the UK are foreign nationals who are brought into the country, but it is important to remember that British nationals are at risk of slavery and exploitation as well.

Modern Slavery and Health

The PROTECT Report (2015) identified that trafficked people reported contact with health services. The services commonly reported were, GP surgeries, walk-in-centres, accident and emergency departments, and maternity services. Healthcare workers are in a unique position to identify and support victims; however, the report also noted the people face many barriers when accessing healthcare. Many responders reported that traffickers restricted their access to healthcare or accompanied them (often interpreting for them) during consultations. Others were unable to access health services because they lacked identity documents to register, did not speak sufficient English, or had concerns about potential repercussions from traffickers or authorities.

Key indicators of risk; If the person:

• is accompanied by someone who appears controlling, who insists on giving information and coming to see the health worker;
• is withdrawn and submissive, seems afraid to speak to a person in authority and the accompanying person speaks for them;
• gives vague and inconsistent explanation of where they live, their employment or schooling;
• has old or serious injuries left untreated;
• either gives vague information or is reluctant to explain how the injury occurred or to give a medical history;
• is not registered with a GP, nursery or school;
• has experienced being moved locally, regionally, nationally or internationally;
• appears to be moving location frequently;
• appearance suggests general physical neglect;
• struggles to speakEnglish;
• has no official means of identification or suspicious looking documents.

What to do if you suspect:

Communicate – All Nurses who feel that a patient may be at risk of being trafficked, in a trafficking situation, or has been in a trafficked situation, should raise their concerns by following their Trust’s safeguarding procedures.

Document – In compliance with The Code clear and accurate records of the concerns should be recorded. A complete history of the patient’s journey not only helps to ensure patient safety but can also become significant to any subsequent legal processes. 

Escalate – National Modern Slavery Helpline:  0800 121 700. While the NHS is except from the Duty to Notify health care professionals are encouraged to make a voluntary notification in accordance with legal obligations of confidence. – PLEASE CHAMPION!

Further Reading

Protect Report 2015: http://www.kcl.ac.uk/ioppn/depts/hspr/research/CEPH/wmh/assets/PROTECT-Report.pdf 

Trafficking Survivor Care Standards 2015: http://www.humantraffickingfoundation.org/sites/default/files/Trafficking%20Survivor%20Care%20Standards%202015.pdf

Caring for Trafficked Persons; Guidance for Health Providers 2009: http://publications.iom.int/system/files/pdf/ct_handbook.pdf

Stolen Smiles: A Summary Report on the Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe 2006: http://www.lshtm.ac.uk/php/ghd/docs/stolensmiles.pdf

Identifying and supporting victims of modern slavery: guidance for health staff

About our guest hosts

Louise Cahill - I am a final year adult nursing student at the University ofHertfordshire. I have been a humanitarian volunteer for more than 10 years both nationally and internationally, with a focus in recent years on human trafficking. Over the past three years I have worked directly with victims of trafficking and sexual exploitation, and since entering my nursing degree, with a focus on their health needs. I present at universities with a focus on the role of student nurses in identifying and supporting individuals at risk of, orin trafficking situations.

Hilary Garratt - is the Director of Nursing in NHS England and Deputy Chief Nursing Officer for England, supporting Professor Jane Cummings, Chief Nursing Officer for England. Hilary leads a nursing and midwifery team in NHS England that focuses on a number of national statutory functions and professional development priority areas. Hilary is a registered Nurse and Health Visitor with over 30 years' experience of working in the NHS. Hilary has held a number of director posts and a deputy chief executive post in both Commissioning and Provision and has been working at National Director level for the last 4 years. Hilary also volunteers for BBC Children in Need and is a committee member that undertakes grant making for the North of England.  Not only does Hilary have time to be a National Director, a volunteer for BBC Children in Need and a mother to three children but is also a trustee of a charity, "Giving to Gambia" and enjoys working in the Gambia for a short time each year as a volunteer to support initiatives that improve health and wellbeing.