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Citation

Westwood J, Howard L, Stanley N, Zimmerman C, Gerada C & Oram S (2016) Access to, and experiences of, healthcare services by trafficked people: findings from a mixed-methods study in England. British Journal of General Practice, 66 (652), pp. e794-e801. https://doi.org/10.3399/bjgp16X687073

Abstract
Background  Trafficked people experience high levels of physical and psychological morbidity, but little is known about trafficked people’s experiences of accessing and using healthcare services during or after their trafficking experiences.  Aim  To explore trafficked people’s access to and use of healthcare during and after trafficking  Design  Mixed methods study (cross-sectional survey comprising of a structured interview schedule and open-ended questions).  Setting  Trafficked people’s accommodation or support service offices in locations across England. Method Participants were asked open-ended questions regarding their use of healthcare services during and after trafficking. Interviews were conducted with professionally qualified interpreters where required. Thematic analysis was used to analyse the data.  Results  136 trafficked people participated, 91 (67%) female and 45 (33%) male. Participants reported being trafficked for domestic servitude (n=40; 30%) sexual exploitation (n=41; 31%) and labour exploitation (e.g., agriculture, factor work) 52 (39%). One-fifth (n=26, 19%) reported access to health care services while trafficked, most often general practitioners (GPs) surgeries and walk-in-centres. Many reported that traffickers restricted access to services, accompanied them or interpreted for them during consultations. Requirements to present identity documents to register for care and poor access to interpreters were barriers to care during and after trafficking. Advocacy and assistance from support workers were critical to health service access for trafficked people.  Conclusions  Trafficked people access health services during and after the time they are exploited, but encounter significant barriers. GPs and other practitioners would benefit from guidance on how trafficked people can be supported to access care, especially where they lack official documentation.

Keywords
health services accessibility; immigration; minority groups; primary health care; qualitative; trafficking in human beings

Journal
British Journal of General Practice: Volume 66, Issue 652

• Published version