Background Physical and psychological morbidity is high in trafficked people but little is known about their experiences of accessing and using healthcare services while, or after, being trafficked. Aim To explore trafficked people's access to, and use of, health care during and after trafficking. Design and setting A mixed-methods study - a cross-sectional survey comprising a structured interview schedule and open-ended questions - was undertaken in trafficked people's accommodation or support service offices 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 In total, 136 trafficked people (from 160 contacted) participated in the open-ended interviews of whom 91 (67%) were female and 45 (33%) male. Participants reported being trafficked for domestic servitude (n = 40; 29%), sexual exploitation (n = 41; 30%), and labour exploitation (for example, agriculture or factory work) (n = 52; 38%). Many responders reported that traffickers restricted access to services, accompanied them, or interpreted for them during consultations. Requirements to present identity documents to register for care, along with 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 people who have been trafficked. Conclusion 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 these people can be supported to access care, especially if they lack official documentation. © British Journal of General Practice.

Health services accessibility Primary health care Trafficking in human beings minority groups Immigration qualitative

doctor patient relation Disclosure minority group interpersonal communication human immigration statistics and numerical data controlled study Agriculture clinical practice Human Rights Abuses human rights abuse Cross-Sectional Studies interview Young Adult cross-sectional study Humans Adolescent worker Interviews as Topic male England female consultation sexual exploitation identity human trafficking organization and management thematic analysis adult major clinical study structured interview Practice Patterns, Physicians' crime victim Delivery of Health Care health care delivery Health Services Accessibility primary health care documentation Crime Victims