Escalation, first responders and local safeguarding routes

Concerns about modern slavery may require involvement from adult or child safeguarding teams, the police, local authorities or designated first responders. Reception staff should follow the practice escalation pathway rather than attempting to manage referrals on their own.

Escalation is a report of factual concern, not an accusation. It hands responsibility to someone authorised to assess risk and decide next steps. If the safeguarding lead is unavailable, the concern must still be passed on so it has clear ownership.

Escalation may involve

• Practice safeguarding lead or deputy
• Duty clinician or practice manager
• Emergency services for immediate danger or serious urgent harm.
• Local authority adult or child safeguarding routes
• Police safeguarding routes where crime, immediate risk or serious threat is present.
• National Referral Mechanism first responders where appropriate.

First responders and the NRM

The National Referral Mechanism (NRM) is the UK process for identifying and supporting people who may be victims of modern slavery. Not all organisations or staff are registered first responders, and reception teams are not expected to decide whether an NRM referral is appropriate on their own.

Your role is to raise the concern via local safeguarding routes so a qualified professional can assess consent, age, capacity, immediate safety and healthcare needs, and then consider referral options.

Adults and consent

First responder referrals are specialist processes; frontline staff should escalate so the right organisation can decide the next step.