Indicators at reception, on the phone and online

Indicators of modern slavery can be subtle. A single sign does not prove exploitation, but repeated signs or signs combined with fear, control or restriction should prompt further attention.

Reception staff may notice details clinical teams do not, such as who controls phone calls, who insists on speaking, whether letters or messages are safe, whether a patient can attend alone, or whether a patient looks frightened of being overheard.

Communication indicators

• Someone else always speaks, translates or answers questions
• The patient appears unable to speak freely or regularly looks to another person before answering.
• Contact details belong to another person, for example an employer, companion or landlord.
• The patient asks not to be called, texted, emailed or sent letters and cannot provide a safe alternative contact plan.

Practical and identity indicators

• The patient does not know their address, employer, workplace or phone number
• Someone else holds identity documents, bank cards, appointment letters or medicines
• The patient is moved frequently or gives inconsistent details about where they live or work.
• Appointments are repeatedly cancelled or rearranged by another person

Health and behaviour indicators

• Untreated or repeated injuries, especially work-related wounds or injuries with vague explanations.
• Exhaustion, malnutrition, poor hygiene or unsuitable clothing
• Fearfulness, withdrawal, distress or reluctance to be alone with staff
• Sexual health, pregnancy, mental health or substance-use concerns that occur alongside clear control or lack of freedom.

Do not rely on stereotypes

Focus on observable facts: control, fear, restriction, dependency, inconsistency and unsafe communication.