MSCOS: Working with core outcomes as a set
Sharing perspectives, connecting practice
Ruth Aguele describes the impact of gaps in the current system, and the need for all professionals to be educated and aware in order to provide effective services for survivors.

​Keith Lewis describes how the Modern Slavery Core Outcome Set must operate together.
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​The MSCOS is like the tower in a Jenga game:  If you remove one outcome - one ‘block’, -  the tower becomes unstable;  remove another block and the tower can crash down;  the survivor is failed, they can’t recover, and the chances are they will suffer more exploitation and human trafficking.

​Ruth Aguele describes the dangers of gaps in the current system for survivors.
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There has not been enough collaborative work to ensure that when survivors of modern slavery come into the system, all the support is in place to empower them to become independent, personally stable, financially stable, with safe accommodation. Everyone has dreams of achievement, to make their way for themselves, for example, in training, vocational skills, business, but the system has gaps – it causes survivors to be stuck and there is no growth.

If a person has only one of the core outcomes – for example, education; how do you expect them to focus, to do their best, to be able to study and achieve if they don’t have the others, if they can’t live safely, be financially independent enough to afford their basic needs, if they don’t have the right mental health support.  How do you expect them to grow and leave the system? 

If the MSCOS is not in place a survivor may even be persuaded to return to their traffickers. It may sound strange, ‘why would a survivor who has gone through such a distressing situation with perpetrators consider going back to them?', but it happens because the system as it is does not enable them to feel safe, to be protected and to have hope for their future.
Relevant Practice Models and Frameworks 
for working with core outcomes as a set
To ensure that the MSCOS is embedded across the spectrum of practice for survivors, structural frameworks, professional training, umbrella organisations and hubs which reflect the delivery of all 7 core outcomes are needed.  Some key examples of these are provided below.
National Referral Mechanisms
To read more about the International OSCE/ODHIR NRM Handbook, click below
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​The International OSCE/ODHIR NRM Handbook (2nd Edition, 2022) provides a multi-agency guidance model which all of the 57 OSCE participating States can adapt and apply within their own national systems to ensure that their National Referral Mechanisms meet the highest standards in both design and implementation. 
The Handbook provides an overview of the working methods, procedures and services that are required across the four NRM ‘pillars’:
  1. Identification plus protection;
  2. Individual support and access to services;
  3. Social inclusion; and
  4. Justice and redress​
The NRM Handbook was informed by an international advisory panel convened by ODIHR to ensure multi-disciplinary input of anti-trafficking experts. Consultations included survivor leaders, government representatives, national rapporteurs, academics, lawyers, prosecutors, judges, law enforcement authorities, child specialists, mental and physical healthcare specialists, IGO and NGO anti-trafficking experts and practitioners. The expertise of international survivor leaders was central to the Handbook, and included ODIHR’s International Survivors of Trafficking Advisory Council (ISTAC).
Tiered, Multi-Agency Training
To read more about St Mary's University London's Skills for Care Course, click below
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St Mary's University London's module on Identification, support and care of victims of modern day slavery is aligned with Tier 3 of the Training Standards Framework for the Identification, Care and Support of the Victims and Survivors of Modern Slavery.

This module is aimed to meet the training and development needs of those who either:

  • Work in an organisation providing day-to-day practical support for victims/survivors of MSHT, for example as a support worker or outreach worker.
  • Work in a health and social care provider, law enforcement and criminal justice agency, civil society organisation, education, national or local government, or act as an independent advocate, where most of the individuals they support are victims/survivors of modern slavery, and the support they provide is beyond day-to-day practical support.
  • Are supervisors of those who are providing day-to-day support to victims/survivors of MSHT.
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This module provides the knowledge, understanding and practical skills for individuals to identify, support and care for victims of modern slavery that they may meet in their work. 
The module has a distinctive focus on practical knowledge and skills delivered across four major themes, and will be supported by online materials, teaching workshops led by experts in the field, and face-to-face group sessions to encourage and support reflective practice.

There are six topics taught in this module
  1. Modern Slavery Legislation
  2. Risk and Demand
  3. Meeting people in services
  4. Trauma-informed approach
  5. Cultural Competency and Equality, Diversity and Inclusion
  6. Care and Support Needs
  7. Multi-Agency Working
National Implementation
To read more about the Independent Anti-Slavery Commissioner, click below
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The Commissioner's role is to encourage good practice in the prevention, detection, investigation and prosecution of slavery and human trafficking offences, as well as in the identification of victims. The Commissioner is accountable through their strategic plan and annual reports, which the Secretary of State lays before Parliament, setting out the extent to which objectives and priorities are achieved. ​
Part 4 of the Modern Slavery Act 2015 sets out the role of the UK Independent Anti-Slavery Commissioner. The Commissioner's role is to encourage good practice in the prevention, detection, investigation and prosecution of slavery and human trafficking offences, as well as in the identification of victims. The Commissioner is accountable through their strategic plan and annual reports, which the Secretary of State lays before Parliament, setting out the extent to which objectives and priorities are achieved.  At the current time, the UK has not replaced the previous Commissioner, Dame Sara Thornton, and the role has been open since May 2022.  In the absence of a Commissioner, ‘a reduced office will continue to monitor modern slavery sector activity and developments, attend key meetings and maintain existing relationships.  In the absence of a commissioner, IASC staff attending meetings or engaging with stakeholders will have no remit to provide views or take on or contribute to new work.’ There have also been some questions raised over the level of independence from the UK Home Office that may be exercised by the role of the Independent Anti-Slavery Commissioner in its current form.
 
Independent national co-ordinators and rapporteurs on human trafficking have an annual meeting which is held jointly by the Council of Europe and the OSCE.  They are responsible for monitoring the national implementation of anti-trafficking policies and reports findings. Their tasks include conducting assessments of patterns and trends in human trafficking and measuring the results of anti-trafficking activities. This includes collation of data, statistics and research in close co-operation with relevant civil society organizations and research institutions. They contribute to the development of national and international policies and strategies relevant to combatting trafficking in human beings and improves co-ordination and coherence between all NRM stakeholders and relevant agencies. They respond to, and address the annual report of the national NRM monitoring body.
Collective Partnerships for Action
To read more about The Anti-Trafficking Monitoring Group, click below
To read more about the Human Trafficking Foundation, click below
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Anti-Slavery International hosts and chairs the Anti-Trafficking Monitoring Group (ATMG), a coalition established in 2009 to monitor the UK's implementation of European anti-trafficking legislation and the Modern Slavery Act 2015. The group examines all types of human trafficking, including internal trafficking and the trafficking of British nationals.
ATMG operates according to a human rights-based approach to protect the well-being and best interests of victims of human trafficking. It comprises seventeen leading UK-based anti-trafficking organisations: Anti-Slavery International, Ashiana Sheffield, Bawso, ECPAT UK, Focus on Labour Exploitation (FLEX), Helen Bamber Foundation, Kalayaan, Law Centre (NI), the Snowdrop Project, the TARA service, JustRight Scotland, UNICEF UK, the Children’s Law Centre, Flourish Northern Ireland, the East European Resource Centre, the Scottish Refugee Council and Hope for Justice. It also works closely with the Human Trafficking Foundation.

ATMG plays a crucial part in our advocacy to improve the anti-slavery response of the UK Government.
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The​ Human Trafficking Foundation brings together parliamentarians NGOs, local authorities, law enforcement, academics and other experts throughout the anti-trafficking and modern slavery sector, to learn from their first-hand experience of supporting victims and disrupting trafficking networks in order to inform policy recommendations to Parliamentarians and Government.
​​It grew out of the All-Party Parliamentary Group on Human Trafficking and Modern Slavery with three objectives: 
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  1. To shape policy and legislation by equipping parliamentarians and policy makers, lead government departments, local authorities, police and statutory agencies to better understand the extent and nature of human trafficking, and the need to adjust rapidly to changing trends; 
  2. To provide a sustained and collective voice amongst NGOs, civil society, and voluntary organisations fighting modern day slavery so that short-comings in current policy can be identified and addressed, and how that can best be tackled; and
  3. Identifying opportunities for new and different types of intervention within the rapidly evolving landscape of human trafficking 
Innovatory Research
To read more about the Modern Slavery and Human Rights Policy and Evidence Centre click below
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The Modern Slavery and Human Rights Policy and Evidence Centre was created by the investment of public funding to enhance understanding of modern slavery and transform the effectiveness of law and policies designed to address it. The Centre funds and co-creates high quality research with a focus on policy impact, and brings together academics, policymakers, businesses, civil society, survivors and the public on a scale not seen before in the UK to collaborate on solving this global challenge.

The Centre is a consortium of six academic organisations led by the Bingham Centre for the Rule of Law and is funded by the Art and Humanities Research Council on behalf of UK Research and Innovation (UKRI).

Our mission is to enhance understanding of modern slavery across the globe and transform the effectiveness of law and policies designed to overcome it. We commission impartial research to provide innovative, independent, impartial and authoritative insight and analysis on modern slavery. We aim to drive real policy change and have a transformational impact on the understanding of modern slavery and the responses to it.

Our research is underpinned guided by our three guiding principles.
  1. Effectiveness: the aim that research should address evidence gaps relevant to policy and improve understanding of what works.
  2. Equity: the aim that research should address structural inequalities, root causes and wider issues of social justice alongside a more equitable approach to allocation of research funding.
  3. Survivor-involvement: the aim that research should involve people affected by modern slavery at all stages, from selection, through design, production and implementation.
To read more about the In3 Project click below
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Strengthening violence prevention using innovative and interdisciplinary intervention modelling (In3): integrating public health, crime science, and complexity science
Dr Alys McAlpine University College London, United Kingdom
​This interdisciplinary project will integrate public health and crime science frameworks with complexity science methods to advance new approaches to evidence-based violence prevention research. It will combine realist approaches, empirical mixed methods, Bayesian causal models, and advanced social simulation techniques to identify intervention causal mechanisms and dynamics in silico. These empirically-based models will inform human trafficking prevention while demonstrating the profound capabilities of these methodologies for all violence prevention research. In3 will advance realist complexity approaches to address how interventions work, for whom, in which contexts, and why.

In3 integrates three primary aims:
  • Empirical discovery: identify and interrogate intervention causal mechanisms for primary prevention of trafficking and tertiary prevention of mental ill-health among survivors in the UK.
  • Theory development and methodological innovation: adapt complementary interdisciplinary theoretical frameworks and complexity-appropriate methods for violence prevention and response research.
  • Capacity building: forge new interdisciplinary links between public health, crime science and complexity science approaches to violence research.

​Outputs will include key insights and recommendations for those who develop and implement UK human trafficking interventions, novel interdisciplinary violence prevention theoretical frameworks, new techniques for integrating causal inference and simulation methods for intervention research, and inclusive training materials on the theoretical and methodological developments for violence researchers.
Helpful Resources
NRM Frameworks
To read more about the NRM Handbook, click below
To read more about The UK Slavery and Human Trafficking Survivor Care Standards, click below
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NRM Handbook
  • ​Section 2, Twelve principles for effective NRM structures, pg. 20
  • Section 3, The central role of survivors and survivor leaders in all aspects of NRMs, pg. 23
  • Section 4.3, The NRM structural framework, pg. 31
  • Section 7, The NRM Preparatory Guide and Protocol: for all professionals working with victims and survivors of human trafficking, pg. 68
  • Section 8, Preparatory Guide for working with victims and survivors of trafficking, pg. 69​​
  • Section 12, The NRM Protocol: procedures for all work with survivors of trafficking, pg. 84
  • Section 19, The Adult Needs & Risks Assessment and Ongoing Safety and Support Plan, pg. 310
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The Slavery and Trafficking Survivor Care Standards (2018), compiled and published by the Human Trafficking Foundation. The standards draw on the expertise of 32 organisations from across the anti-slavery sector including care providers, law enforcement, lawyers and medical experts. In October 2017, the UK Government announced that it will adopt the Human Trafficking Foundation’s Trafficking Survivor Care Standards and include them in future NRM victim care contracts: ​“If a potential victim opts to enter the NRM, we must ensure that the care they receive is consistent and meets minimum standards, regardless of where in the country they are being cared for. That is why the Government will adopt the Human Trafficking Foundation’s trafficking survivor care standards as a minimum standard for victim support”.
Multi-agency operational hubs
To read more about the West Midlands Anti-Slavery Network, click below
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West Midlands Anti-Slavery Network
The West Midlands Anti-Slavery Network unites and enables partner organisations to work in collaboration to end modern slavery, human trafficking and exploitation.
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We do this by identifying gaps, influencing change and facilitating solutions in order to protect and advocate for the vulnerable in society.

Our Vision
To be recognised worldwide as leaders in multi-agency partnership working to eradicate modern slavery, whilst ensuring the victims are at the centre of every aspect of our work.
Our Objectives
  • Develop an effective regional multi agency anti-slavery network to raise awareness, reduce the threat and harm of slavery and rescue and support victims of slavery in the West Midlands geographical area
  • Develop strategic partnerships and collaborations with other regional, national and international organisations to tackle modern day slavery, including networks, partnerships, agencies and learning establishments
Robin Brierly, Modern Slavery Consultant on Trafficking and Slavery says:  
 
“If you were to give everyone a piece of paper and ask them to draw a structural diagram for the response to modern slavery in the UK, it would be impossible. You would have many different organisations and agencies with lines all over the place. How do we all join up? How can we cross refer? You need a clear victim care pathway, a recognizable structure that everyone can follow with a nucleus of knowledgeable people.
 
In the West Midlands, it is a bit easier, because we have a clearer structure. We have the police and crime commissioner and the violence reduction partnership which is funded by the Home Office for support of young people 16-25 year olds, and of higher age if a young person is a survivor of trafficking and exploitation. It works with victims of county lines and other gang crime, and recognizes the importance of working frontline, multi-agency and within communities, which is the best way of ensuring identification of victims.
 
We have the Modern Slavery/Human Trafficking Strategic Board which meets quarterly and has representation from 7 local authorities, 3 of which have embedded Modern Slavery Co-ordinators.  
 
We also have the West Midlands Anti-Slavery Network which can identify victims who are within the criminal justice/custody system by scanning custody records and providing tactical advice to officers. The network itself meets quarterly as a group of multiple agencies to share localized trafficking updates, statistics, data and trends and sharing good practice.  Every month the police provide the network with anonymized NRM duty to notify data.  When you are in possession of the data collectively, you can really drill down into understanding trafficking trends, demographics and forms of exploitation in the UK and in your specific region.
 
We also have in place the Slavery Adult Safeguarding Case Conference (SASCC) which is a MARAC equivalent, similar to those established for domestic violence cases.  This has a designated  coordinator and meets whenever there is a need.  It does not cover every case,  but it can raise a multi-agency meeting within 48 hours.  Professionals come together including police, healthcare services and importantly, 3rd sector organisations (charities and NGOs).  They discuss the case, what has happened, how to manage it in relation to individual needs, risks and challenges.  We are fortunate to have many 3rd sector organisations which provide invaluable support – some regions do not have any.
 
In the Care and Support Task Group Forum we gain an understanding of what support each organisation can provide, their geographical coverage and capacity. This includes discussions on how to cross refer and ensure they keep up to date with legislation and process etc. This is a basic first thing to do in a region in my opinion: a mapping of services
 
Across the West Midlands we have formally adopted the public health approach to modern slavery*. Public health approach is community driven, intelligence led and data led, taking a preventative approach to trafficking rather than being in a continuous state of reaction to everything that comes along. 
 
I am developing similar hub systems in Durham and Cleveland. Geographical location is key because each regional system works differently.  We have to think about the good practices and skills that are transferrable to all regions. Although working in multi- agency partnerships is often quoted in guidance and strategies, the modern slavery/human trafficking agenda is based on the presence of good, compassionate people because there is nothing in legislation and much of this work is not in statute – this does have its challenges but also provides opportunities.” 
 
*For more information, see Refining a Public Health Approach to Modern Slavery, by Elizabeth Such, Kate Hayes, Jonathan Woodward, Ines Campos-Matos and April McCoig,
Holistic lens on Human Trafficking / Modern Slavery
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Refining a public health approach to modern slavery with the Office of the Independent Anti-Slavery Commissioner and Public Health England​
New research examines the case for a public health approach to modern slavery and identifies the key components that are considered important in enabling the anti-slavery sector to address modern slavery through a public health lens. 

The research, which includes a report, an interactive framework and a guide for anti-slavery partnerships, has been developed by the University of Sheffield, the Independent Anti-Slavery Commissioner and Public Health England.

Public health approaches have been applied to a range of socially complex and long-standing problems, for example, serious violence. A public health approach is a way of thinking and acting collectively to address a problem that can damage health and wellbeing including: understanding a problem at a population level; framing the problem as part of a complex and interdependent system; collating data and evidence of what works; being prevention focused; protecting health and well-being; encouraging multi-agency working and addressing inequalities, social justice and human rights.  

A public health approach to modern slavery offers an opportunity for coordination of effort across the anti-slavery sector. It has emerged as a promising framework for prevention, for planning at a national and local level and as a means of bringing together existing frameworks with a humane focus. This research, funded by Research England, sought to build on initial research and emerging practice in order to further refine a public health framework to address modern slavery in the UK.
To inform the research, a series of online workshops were held with stakeholders from across the anti-slavery sector and beyond. Learning from these workshops helped to devise and design a refined public health framework to address modern slavery with multiple components including national factors, regional and local factors, service design factors and service delivery factors.
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The research has the following outputs:
  • The full report of findings;
  • The development of a refined interactive framework for a public health approach to modern slavery;
  • A guide for policy, strategy and local partnerships to support them in adopting a public health approach to modern slavery.
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Exploring a public health approach to modern slavery
This reflective article was drafted in November 2020. Since this time, the authors have worked with the counter-slavery sector to co-develop a refined public health framework to address modern slavery (Such et al, 2021). Significant knowledge mobilisation has also occurred with a range of stakeholders, and the Independent Anti-Slavery Commissioner has encouraged the UK Home Office and the Home Secretary to embed a public health approach within the UK’s response to modern slavery (IASC/Home Secretary, 2021). Key references and insights from research in 2021 are available as a collection.

You can read more via here.

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