When slavery hides in the symptoms - are we ready to see it?

Intoxicated, antagonistic and with no clear reason for being in the emergency department, a patient discloses information strongly suggesting that he has been a victim of labour exploitation, the most common form of modern slavery. This significant consultation demands prioritisation and trauma-informed expertise. As well as addressing immediate healthcare needs and safety, the complex sequelae of modern slavery must be considered. Victims are encountering healthcare services. Yet healthcare professionals don't feel equipped to recognise the signs or know what questions to ask, while key gaps within the healthcare service prevent these patients receiving the support they need. At all levels of professional development, the practice of safeguarding is not prioritised. This is due to lack of effective training and emphasis on softer communication and safeguarding skills. Simulation training provides a safe, educational environment to build confidence and practice conducting these challenging, complex consultations. Safeguarding leads, who receive these referrals from frontline staff, should be equipped to understand the complexity of modern slavery and the strengths and weaknesses of the support services available. Finally, healthcare professionals must be involved in shaping the wider national survivor-focused response to modern slavery. © Royal College of Physicians 2019. All rights reserved.