Title: Optimising identification, referral and care of trafficked people within the NHS
Funder: Department of Health (England)

Abstract: Background Available research indicates that human trafficking frequently has serious and often long-term health implications. Reports from post-trafficking assistance and medical outreach services suggest trafficked people have difficulty accessing the services they need. This is due, in part, to logistical, cultural and language challenges, and exacerbated by the absence of a coordinated health sector response. NHS staff have an important role to play in England’s trafficking response, including identifying and referring trafficked people to support services, receiving trafficked people referred into their care and participating actively in cross-sector service coordination. Yet, there is no current evidence on optimal methods of identification, referral and treatment, or which NHS staff are most likely to see trafficked adults and children. Aims The proposed research will provide evidence to inform innovation in the NHS response to human trafficking, specifically in the identification and referral of trafficked people, and safe and appropriate care to meet their health needs. The objectives are: To synthesise evidence on the number of trafficked adults and children identified and using NHS services in England, the healthcare needs of trafficked people, and their experiences and use of healthcare; To document NHS experience, knowledge and gaps about trafficked people’s health care needs; To provide recommendations, materials and dissemination strategies to support NHS staff to identify, refer and care for trafficked people and to become a strategic partner within the UK National Referral Mechanism (NRM) and with other agencies. Research plan and methods of investigation We will meet objective 1 by a) systematically reviewing literature on health outcomes associated with human trafficking, and related health services and policies; b) analysing data on the numbers, profile, health needs and care pathways of trafficked people identified in England; and c) collecting data from trafficked people. To meet objective 2, we will a) conduct in-depth interviews with NHS staff and non-NHS professionals involved in responding to human trafficking (e.g., shelters, police, social services); and b) survey NHS staff to investigate awareness of human trafficking, training needs, delivery mode and resources required to identify, refer and treat. We will meet objective 3 by a) developing and evaluating bespoke NHS information and training materials informed by our study findings and our training package for health professionals (previously piloted in low and middle income countries); and b) synthesising findings to inform NHS strategy and role within the NRM. Research team Our multidisciplinary team is comprised of clinical and research experts on health, human trafficking and other forms of violence. Team members conducted some of the first-ever studies on health and trafficking and UK-specific trafficking and health policies, authored the “ WHO Ethical and Safety Recommendation” for trafficking research, “ Caring for trafficked persons: Guidance for health providers”, and “WHO Violence Against Women Guidelines” (publication 2012). They have conducted research on trafficked women’s mental health and currently provide care within specialties (e.g., emergency, primary care, psychiatry, maternity, child welfare and safeguarding) often required by trafficked people. dr Oram, who will be conducting quantitative and qualitative fieldwork, conducted extensive research on UK trafficking policy with professionals involved in trafficking-related care. The team will be guided by an advisory panel including trafficked people and representatives from agencies with human trafficking expertise. Potential impact/influence, users and wider stakeholders Findings will support the development of well-informed NHS care approaches. Evidence on trafficked people’s health and NHS interaction and providers’ experiences and concerns about care will indicate NHS information needs. Research on NHS training needs and effective modes of delivery will contribute to the development of bespoke materials and innovation diffusion. Most importantly, this work will help trafficked people receive safe and appropriate healthcare.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE