Human trafficking and exploitation: guidance for health workers

Advice how to recognise and help victims of human trafficking and exploitation.

What is in place to help trafficked persons?

In Scotland, the Human Trafficking and Exploitation (Scotland) Act 2015 introduced new offences and powers to detect and tackle trafficking and required a national strategy to be developed. The first national strategy was published on 30 May 2017, and highlighted the following three key action areas to drive forward progress in Scotland[1]:

  • Identify victims and support them to safety and recovery
  • Identify perpetrators and disrupt their activity
  • Address the conditions, both local and global, that foster trafficking and exploitation

The Strategy also identified a fourth key area of work around child victims of trafficking and exploitation.

The National Referral Mechanism (NRM)

At a UK level, the National Referral Mechanism provides a framework designed to assist in identifying victims of trafficking, and provide them with appropriate care and support. The process is as follows[19]:

Stage 1: Reasonable grounds

Where a potential victim of trafficking is identified, an agency categorised as a First Responder will refer him/her to the Single Competent Authority (SCA) within the Serious and Organised Crime directorate of the Home Office. The SCA makes all NRM decisions, regardless of nationality or immigration status of the potential victim.

Adults must give their consent to be referred to the NRM, however children (defined as under 18) should always be referred.

First Responders in Scotland are:

  • Police Scotland
  • British Transport Police
  • Border Force
  • Trafficking Awareness Raising Alliance (TARA)
  • Migrant Help
  • Local authorities
  • Gangmasters and Labour Abuse Authority (GLAA)
  • Home Office Immigration Enforcement
  • Home Office Visas and Immigration
  • Salvation Army

The SCA will decide whether there are reasonable grounds to believe the individual is a potential victim of human trafficking. This is called the Reasonable Grounds (RG) Decision. They aim to make this decision within five working days of referral. The First Responders and the person concerned will be notified by letter of the outcome.

If the decision is positive, potential victims in Scotland will be provided with support and assistance for a minimum period of 90 days while deciding what they want to do. A negative decision means the person will not be entitled to the same protection and assistance afforded to those with a RG Decision.

Stage 2: Conclusive Grounds

The SCA gathers additional information during the recovery period to make a Conclusive Grounds (CG) Decision on whether the referred person is a victim of human trafficking. It is expected that this decision will be made as soon as possible following day 45 of the recovery period however this is dependent on the individual circumstances of each case. Again, notification of the decision is made by letter.

Next Steps:

Following a CG Decision, the person may be granted discretionary leave to remain in the UK for one year to assist with any police investigation and prosecution, which can be extended if required. The Home Office may also consider granting discretionary leave to remain in the UK depending on an individual's circumstances or may provide support for a person to return home.

In Scotland, potential victims who enter the NRM are provided with a minimum support period of 90 days or until a CG Decision is reached, whichever comes first. Support can also be provided before a RG is reached, after the 90 days has passed and can be extended for a period following the CG Decision.

Access to support should only be provided where the adult consents to enter the NRM and is not dependent on the adult assisting with a criminal investigation or prosecution.

Support and assistance may include (but is not limited to): accommodation; day-to-day living; medical advice and treatment (including psychological assessment and treatment); language translation and interpretation; counselling; legal advice; information about other services available to the adult and repatriation[20].

NB There are cases in Scotland and the rest of the UK where adults have not sought referral to the NRM[21]. There are a number of reasons for this; some cannot see any additional benefits of doing so, others fear and mistrust the authorities, there may be immigration difficulties, or it could be due to fear of reprisal from the traffickers.

A decision by an adult not to consent to a referral must be respected.



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