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Routine Enquiry

Routine enquiry is a structured, trauma-informed approach to identifying people who have experienced torture or human rights abuses within healthcare settings. It involves asking all patients—sensitively and consistently—about these experiences as part of standard clinical care.

How it works

Rather than relying on visible signs or assumptions, routine enquiry:

  • is built into everyday health assessments

  • uses clear, non-judgemental questions

  • takes place in a safe and private environment

 

​This ensures that people are given a consistent opportunity to disclose experiences that may otherwise remain hidden.

What happens after disclosure

​When a patient shares an experience of abuse, this may lead to:

  • further clinical assessment

  • appropriate treatment or referral

  • documentation in the medical record

  • safeguarding action where necessary

 

Routine enquiry is not about collecting information for its own sake—it is about enabling appropriate, informed care.

Where it is used

​Routine enquiry can be embedded in:

  • new patient health assessments in primary care

  • refugee and asylum health services

  • community and specialist settings

 

​TortureID’s work focuses on integrating routine enquiry into practical NHS workflows, making it feasible in real-world clinical environments.

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Click here to read TortureID’s letter in the British Journal of General Practice (May 2025)

Many people seeking asylum have experienced torture or other forms of human rights abuse—but most are never identified within healthcare systems. Without being asked directly, these experiences often remain undisclosed.

The impact of not asking

When torture and trauma are not identified:

  • physical and psychological symptoms may be misunderstood

  • patients may not receive appropriate care

  • safeguarding needs may be missed

  • important medical evidence may not be documented

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This can have long-term consequences not only for health outcomes but also for securing protection in the UK, social support, safety, dignity, and the chance to rebuild a life.

The impact of asking

Routine enquiry changes this. By creating safe, consistent opportunities for disclosure, it helps to:

  • identify survivors who would otherwise remain unseen

  • improve clinical understanding of patient needs

  • enable appropriate referrals and support

  • support documentation of abuse where relevant

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In many cases, simply being asked—and past harms being recognised —can be a critical step in a person’s rehabilitation journey.

A core part of good clinical practice

International standards, including the Istanbul Protocol, recognise the importance of identifying and documenting torture. Routine enquiry supports clinicians to meet this responsibility in a structured and practical way.

Routine enquiry is most effective when supported by clear guidance, practical tools and training.

Good practice principles

Routine enquiry should always be carried out in a way that is safe, respectful, and trauma-informed. This includes:

  • asking in a private and safe environment

  • using professional interpreters where needed

  • explaining clearly why you are asking

  • respecting a person’s choice not to disclose

  • responding appropriately and avoiding re-traumatisation

SystmOne and EMIS templates for suspected human rights abuses

Templates developed in collaboration with Ardens support clinicians to identify, document, and respond to human rights abuses as part of routine clinical care. Designed to integrate directly into NHS clinical systems, they make routine enquiry more practical and efficient within busy primary care settings.

 

These templates:

  • guide structured, sensitive information gathering

  • support consistent documentation using prompts, tick-boxes, and coded fields

  • automatically generate pre-formatted clinical letters based on the information entered

  • ensure information is clearly recorded within the patient's electronic health record to support continuity of care

 

The templates are available within SystmOne, one of the two main electronic patient record systems used by GP practices in England (the other being EMIS). Thanks to our collaboration with Ardens—a company that develops clinical templates and decision-support tools for NHS primary care—the SystmOne version has been made available as Open Access. This means any GP practice using SystmOne can access and use the templates, even if they do not subscribe to Ardens' wider suite of products.

SystmOne & EMIS Screenshot Guide
Template letters to support people seeking asylum

We have worked in collaboration with Doctors of the World UK to develop a set of practical letter templates to support clinicians working with people seeking asylum.

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Designed for use in primary care, these templates have been downloaded more than 1,000 times, reflecting the demand for practical resources that support clinicians in this area.

 

The templates are designed to help primary care teams respond to common requests, including:

  • providing supporting information for asylum applications

  • responding to requests from legal representatives

  • supporting patients with housing, healthcare access, and other needs

  • raising safeguarding concerns where appropriate

 

They aim to reduce administrative burden while enabling clinicians to produce clear, consistent, and appropriate documentation.

Access the letter templates
Training
View training page
Learning resources

In addition to our training, TortureID contributes to educational resources used by clinicians across primary care and mental health services. These materials support ongoing learning and provide practical guidance on working with people seeking asylum and those who have experienced human rights abuses.

 

Information for primary care teams

Clinical information for healthcare providers about working with people who have experienced human rights abuses and are seeking asylum.

 

GPUpdate handbook (primary care resource)

We contributed an article on safeguarding and providing effective care for refugees and people seeking asylum, distributed to over 44,000 primary care staff and included as a permanent resource within the GPUpdate handbook.

 

Seeking Asylum and Mental Health: A Practical Guide for Professionals (Cambridge University Press)

TortureID contributors authored chapters in this multidisciplinary textbook, which provides practical guidance for professionals working with people seeking asylum across mental health, healthcare and related services.

 

Working with Interpreters in Psychological Therapy: The Right To Be Understood (Routledge)

Co-authored by a TortureID board member and BACP Senior Accredited psychological therapist, this book is a practical and helpful guide for therapists that outlines best practice in working with interpreters.

 

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