Joint Royal Colleges Ambulance Liaison Committee (JRCALC) clinical guidelines 2019.Bridgwater: Class Professional Publishing; 2019

Aveyard H. Doing a literature review in health and social care, 2nd edn. Maidenhead: McGraw-Hill International (UK); 2014

Broad R, Turnbull N. From human trafficking to modern slavery: the development of anti-trafficking policy in the UK. Eur J Crim Policy Res.. 2018; 25:(2)119-133

Brown SR. Q methodology and qualitative research. Qual Health Res.. 1996; 6:(4)561-567

Chisolm-Straker M, Richardson LD, Cossio T. Combating slavery in the 21st century: the role of emergency medicine. J Health Care Poor Underserved.. 2012; 23:(3)980-987

Flanagan SM, Hancock B. ‘Reaching the hard to reach’—lessons learned from the VCS (voluntary and community sector). A qualitative study. BMC Health Serv Res.. 2010; 10

Global Slavery Index. United Kingdom: Global Slavery Index. 2018. https// (accessed 8 February 2020)

Hathaway J, Willis G, Zimmer B. Listening to surviors’ voices: addressing partner abuse in the health care setting. Violence Against Women. 2002; 8:(6)687-719

Health and Care Professions Council. Standards of proficiency—paramedics. 2014. https// (accessed 5 December 2020)

Health Education England. TRF Module 1 - Identifying and supporting victims of modern slavery. 2013. https// (accessed 9 December 2020)

Helle S, Steele S. Cutting edge or ignored resource: assessing the uptake and content of the NHS e-Learning for healthcare on ‘identifying and supporting survivors of modern slavery’. J Public Health (Oxf). 2019;

Hemmings S, Jakobowitz S, Abas M Responding to the health needs of survivors of human trafficking: a systematic review. BMC Health Serv Res.. 2016;

Home Office. Modern slavery: duty to notify. 2016. https// (accessed 5 December 2020)

Home Office. A typology of modern slavery offences in UK. 2017. https// (accessed 5 December 2020)

Macias-Konstantopoulos W. Human trafficking: the role of medicine in interrupting the cycle of abuse and violence. Ann Intern Med.. 2016; 165:(8)582-588

Mason-Jones AJ, Loggie J. Child sexual exploitation. An analysis of serious case reviews in England: poor communication, incorrect assumptions and adolescent neglect. J Public Health (Oxf).. 2020; 42:(1)62-68

McKeown B, Thomas D. Q methodology, 2nd edn. London: Sage; 2013

Metcalf EP, Selous C. Modern slavery response and recognition training. Clin Teach.. 2020; 17:(1)47-51

NHS England. Modern slavery awareness. 2016. https// (accessed 5 December 2020)

Office for National Statistics. Domestic abuse in England and Wales. Main points. 2019. https// (accessed 5 December 2020)

Oram S, Abas M, Bick D Provider responses treatment and care for trafficked people. Final report for the Department of Health Policy Research Programme. Optimising identification, referral and care of trafficked people within the NHS.London: Department of Health; 2015

Paterson B, Thorne S, Canam C, Jillings C. Meta-study of qualitative health research: a practical guide to meta-analysis and meta-synthesis, 1st edn. Thousand Oaks (CA): Sage; 2001

Price K, Nelson BD, Macias-Konstantopoulos WL. Understanding health care access disparities among human trafficking survivors: profiles of health care experiences, access, and engagement. J Interpers Violence.. 2019;

Ross C, Dimitrova S, Howard LM, Dewey M, Zimmerman C, Oram S. Human trafficking and health: a cross-sectional survey of NHS professionals’ contact with victims of human trafficking. BMJ Open.. 2015; 5:(8)

Royal College of Nursing. Modern slavery. 2017. https// (accessed 5 December 2020)

Sawyer S, Parekh V, Williams A, Williams B. Are Australian paramedics adequately trained and prepared for intimate partner violence? A pilot study. J Forensic Leg Med.. 2014; 28:32-35

Sawyer S, Coles J, Williams A, Williams B. Preventing and reducing the impacts of intimate partner violence: opportunities for Australian ambulance services. Emerg Med Australas.. 2015; 27:(4)307-311

Substance Abuse and Mental Health Services Administration. SAMHSA’s concept of trauma and guidance for a trauma-informed approach. 2014. https// (accessed 5 December 2020)

Definition of modern slavery. 2017. https// (accessed 5 December 2020)

Testa D. Hospital health provider experiences of identifying and treating trafficked persons. Australian Social Work. 2020; 73:(1)92-104

The Independent Anti-Slavery Commissioner. Duty To Notify The Home Office Of Potential Victims Of Modern Slavery. 2016. https// (accessed 9 December 2020)

Thompson CD, Mahay A, Stuckler D, Steele S. Do clinicians receive adequate training to identify trafficked persons? A scoping review of NHS Foundation Trusts. JRSM Open.. 2017; 8:(9)

The role of the paramedic in identifying modern slavery

02 February 2021
Volume 13 · Issue 2



Modern slavery is the recruitment or harbouring of people through the use of force and coercion for exploitation. Paramedics have significant potential and unique opportunities regarding the detection, prevention and combating of modern slavery.


To analyse the literature relating to modern slavery and synthesise it for paramedic practice.


Following a structured literature review, a comparative analysis was undertaken of articles concerning the relationships between modern slavery and healthcare.


Five major themes were identified: barriers to healthcare access; causes of missing the indicators of trafficking; clinician knowledge; the need for training and education; and trauma-informed practices.


Paramedics are in an optimal position to identify and intervene in cases of modern slavery. The introduction of survivor-centred education is recommended to better understand the barriers to healthcare access.

After completing this module, the paramedic will be able to:

Modern slavery, which includes human trafficking, is the recruitment, movement, harbouring or receiving of people through the use of force, coercion, abuse of vulnerability or deception for the purpose of exploitation (Such et al, 2017). The Global Slavery Index (2018) estimates that 136 000 people in the UK are living in modern slavery and one in eight clinicians comes into contact with a victim (a person still trapped in a modern slavery situation) at least once in their career (NHS England, 2016). Due to the higher prevalence in urban areas, however, this is likely to be a massive underestimation (Home Office, 2017).

Clinicians are in a unique but time-restricted position to help those who are being trafficked as barriers to healthcare means they may only seek help in emergency situations (Price et al, 2019). However, many health professionals are unaware of the issue itself or its magnitude. The limited contact practitioners have with this group means missing the indicators of modern slavery has a greater impact because it may force the victim to return to their exploiter (Ross et al, 2015).

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed