The Gap
Every year, thousands of survivors of torture, trafficking and sexual violence seek asylum in the UK. The clinical impacts of their abuse can be catastrophic: many endure chronic physical pain and severely debilitating psychological symptoms, and some are suicidal.
The scale of unmet need
Despite the fact that most survivors will interact—often repeatedly—with clinical services in the UK, the vast majority are never asked about the abuses they have suffered. As a result, corresponding health needs are not routinely identified or documented within clinical settings.
What our pilot showed
TortureID’s pilot evaluation of survivors registered with a Yorkshire GP practice showed that:
- 66% of survivors had no prior documentation of abuse in NHS records
- Only 27% had previously been asked about any history of human rights violations
- 88% had significant unmet mental health needs
- Nearly 1 in 10 were at acute suicide risk, requiring urgent safeguarding intervention (provided by TortureID)
Why this matters for survivors, clinicians and the NHS
The consequences are significant and urgent:
Survivors’ physical and psychological traumas remain untreated, while safeguarding risks—including re-trafficking, self-harm, and suicidal ideation—are often missed
Clinicians face repeated consultations without understanding underlying causes
For the NHS, this results in avoidable crisis presentations, A&E attendances, and inefficient use of limited resources
In addition, Home Office decision makers increasingly request medical records to inform asylum decisions. Where abuse is not recorded, survivor credibility is undermined, decisions are delayed, and individuals may face prolonged uncertainty or refusal. This systemic gap has consequences across healthcare provision, safeguarding, and legal protection.
Why clinicians don’t ask
In feedback on training provided to over 900 clinicians, respondents told us they:
• Do not ask about torture because they fear re-traumatising patients
• Lack confidence in how to ask about abuse
• Are unsure how to appropriately document and respond to disclosures and harm suffered
System-level barriers and rising need
These concerns are well-founded. The UK’s healthcare systems have no operational mechanism for identifying survivors of human rights abuses or for documenting harms amongst asylum-seeking patients. Ten-minute GP appointments are not compatible with complex trauma disclosure; electronic health records lack prompts or guidance; and there are no standardised training pathways or clinical guidelines to support safe enquiry and documentation.
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The situation is further exacerbated by an ever-growing need for clinical support and action due to:
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Increasing refugee flows and UK asylum applications
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Diminished funding for legal aid work for asylum practitioners
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A corresponding and significant decrease in the commissioning of expert medico-legal reports of torture and other abuses
This is the gap TortureID works to address.
How We Respond
Sustainable, cost-efficient change requires shifting identification and response into routine healthcare. TortureID shifts the recognition and documentation of survivors of torture from a specialist activity into everyday clinical practice.
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Our work supports clinicians and services to recognise trauma, ask safely about harm, document clinical findings appropriately, identify health and safeguarding needs, and connect people to the care and support they need.
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Our long-term aim is to help build a healthcare system in which survivors are recognised earlier, clinical information is used safely and effectively, and trauma-informed assessment becomes part of routine care.
How Our Model Works
TortureID’s work is organised around four connected areas.
2. We give clinicians practical tools
We create simple prompts, clinical letter templates, and guidance for use in busy healthcare settings. These help clinicians record key information, identify risks, take appropriate next steps, and respond to common requests around housing, asylum support, safeguarding, and healthcare access.
3. We provide specialist Health Assessments
Some survivors need more time and clinical depth than routine NHS appointments can offer. Our hour-long, trauma-informed Health Assessments identify and document the impact of torture and abuse, with an emphasis on health needs and safety concerns. A detailed clinical letter is produced and fed into NHS records, helping to support future care, practical support, and protection.
Unlike approaches reliant on specialist referral pathways, TortureID works within the services where survivors already present. Together, this approach embeds recognition, documentation and response within mainstream systems—improving care, strengthening safeguarding, and making more effective use of limited resources.