Support for adult victims of trafficking and exploitation - guidance: consultation analysis

10. Question 8 – Health and wellbeing

Question: Does the guidance set out clearly the approach to health and wellbeing for adult victims of human trafficking?

Percentages may not total 100% due to rounding.

Positive Comments

Some respondents welcomed the emphasis on trauma-informed, victim-centred healthcare and the clear recognition that survivors should be supported to make informed decisions about their care. Respondents valued the inclusion of information on healthcare entitlements, access to NHS services regardless of immigration status, crisis support pathways and hospital charge exemptions.

Need for further clarity

Respondents sought greater clarity on healthcare pathways, available support and the respective roles and responsibilities of support providers, NHS services and other agencies. Several respondents highlighted uncertainty about who is responsible for coordinating access to healthcare, how referrals should be managed, and what obligations support providers retain when treatment is delayed or unavailable.

There were calls for clearer explanations of mental health and psychological support pathways, including how survivors access support through primary care, specialist trauma services and crisis services. It was suggested that the section should better reflect existing arrangements and terminology, with some respondents suggesting that a broader focus on psychological wellbeing and mental health is needed rather than a narrow focus on treatment alone.

Respondents also sought more information on decision-making processes, timescales for accessing support, what constitutes a reasonable timeframe for treatment, and how support decisions are made on a case-by-case basis. Some felt the guidance did not clearly explain what support survivors are entitled to receive, the extent of survivor involvement in support planning, or what options are available where support is considered unsuitable, unavailable or insufficient. A number of respondents also called for mechanisms that would allow survivors to challenge decisions or request a review where healthcare needs are not being met.

Need for practical information

Many respondents requested more practical information to help both survivors and practitioners navigate healthcare systems in practice. Suggestions included clearer service pathways, flowcharts showing routes into healthcare at different stages of recovery, and practical case examples illustrating how support should operate in common scenarios, such as responding to a victim in crisis.

Several respondents recommended a simplified, survivor-facing version of the guidance which clearly explains healthcare rights, support options and referral pathways in accessible language. Respondents also highlighted the importance of written communication, including appointment reminders and explanations of healthcare processes.

A recurring theme was the need for greater recognition of practical barriers that can limit access to healthcare, such as waiting lists, workforce pressures, delays in accessing specialist services, language barriers, interpretation needs and transport difficulties. While respondents welcomed the emphasis on healthcare rights and entitlements, some felt the guidance did not sufficiently acknowledge the gap that can exist between entitlement and timely access to services.

Suggested additions to the Guidance

Respondents suggested expanding the section to provide more detailed information on psychological support, trauma counselling, specialist mental health services and access to national trauma services. Some considered psychological support to be central to recovery and felt that this should be reflected more strongly within the guidance.

There were also calls for additional information on sexual and reproductive healthcare, substance use support and support for survivors experiencing multiple and complex needs, including trauma, mental ill health, learning disabilities and addiction. Several respondents emphasised the importance of national consistency in access to specialist psychological services.

A number of respondents recommended broadening the focus from healthcare treatment alone to include wider wellbeing and recovery. Suggested additions included information on education, volunteering, employment opportunities, community participation and social inclusion activities. Respondents also highlighted the importance of culturally sensitive approaches, recognising that attitudes towards mental health and counselling may vary across different communities, as well as the need for stronger recognition of gender-specific experiences and links to violence against women and girls services and pathways. Greater emphasis on integrated, multi-agency working and holistic recovery planning was also recommended.

Other concerns or comments

Some responses emphasised the need to ensure that no survivor is disadvantaged in accessing healthcare because of their immigration status, difficulties navigating services or gaps between agencies.