Debate: People trafficking

People being trafficked into the UK and forced into slavery are on the increase. Many of these victims come into contact with health care services so nursing and/or midwifery professionals should be able to identify the signs and know how to act on them, in particular understand referral processes and safeguarding pathways, as well as the clinical needs of those who access health care.

It is estimated that there are over 45 million people trapped in modern slavery across the globe.

Current estimates by the Home Office (2014) suggest that there are 13,000 men, women and children known to have been trafficked into or in the UK, for a variety of reasons including domestic work; rural and farm; food processing; sex workers; criminal activity including cannabis cultivation, street crime, forced begging and benefit fraud; forced or sham marriages, and organ removal.

One in eight NHS staff in England think they have seen a victim of trafficking in their practice and one in five victims report having come into contact with health care services during the time they are trafficked .

It is vital that all nurses and midwives have an understanding of access to health care by victims/survivors, and how they may present. Equally important is that health care professionals are aware of how to proceed, and what pathways and formal referral mechanisms (such as the National Referral pathway) are available to support best safeguarding practice. 

A victim of modern slavery may display a variety of health care issues including evidence of long-term multiple injuries; indications of mental, physical and sexual trauma; sexually transmitted infections; pregnancy; disordered eating or poor nutrition; fatigue or symptoms of psychiatric and psychological distress.

The PROTECT Team at Kings College London published Human Trafficking: improving the UK’s health-care response, a policy briefing in March 2017. Its specific recommendations for Health Education England, the Royal Colleges, and professional organisations responsible for setting training standards for NHS staff, include providing targeted training to respond to trafficked people’s needs and ensuring adequate training for NHS professionals.

In 2012, as part of its National Gender Based Violence and Health programme, NHS Scotland produced Human Trafficking – What Health Workers Need to Know about Human Trafficking, which identified that health providers who encounter a trafficked person, or other exploited individual, have a unique opportunity to provide care and referral options which may be an individual’s first step towards recovery and safety.  It gives advice on how to identify people who have been trafficked, support disclosure and what to do if someone is suspected of having been trafficked.

The Scottish Government has just completed a consultation on its proposed Trafficking and Exploitation Strategy, with the final version due to be published by the end of May 2017. The strategy will support people who encounter victims to understand signs, know what to do and have access to specialist advice and support. It will also ensure that coherent person/child-centred support processes are in place that enable victims to recover and build resilience.

In Northern Ireland, the Department of Health and the Police Service of Northern Ireland have published joint guidance on working arrangements for the welfare and safeguarding of child victims of human trafficking.

The Wales Anti-Slavery Leadership Group provides oversight and direction for tackling slavery and people trafficking in Wales. It co-ordinates between devolved and non-devolved partners and third sector organisations. Wales has the only government in the UK to employ an anti-slavery co-ordinator, whose role is to make Wales hostile to slavery and to co-ordinate the best possible support for survivors.

The RCN has recently launched a web page on modern slavery and has also produced a pocket guide on modern slavery, which is being distributed to all RCN Congress delegates this year.