7.2 Provision of Medico-legal Reports Provision of medico-legal reports supports the recovery of victims: their account has been heard, their injuries observed and documented, and their experiences affirmed. The expertise of HBF in reporting the physical and psychological effects of torture in medico-legal reports has been recognized by the UNHCR, the UK immigration and criminal courts and the UK Home Office.90 HBF’s reports have been instrumental in influencing the way that the UK legal system responds to medical evidence and in setting precedents for how they will deal with medical evidence in the future.91 The outcome of immigration and/or criminal legal procedures is integral to every aspect of our clients’ safety and future welfare, so this work is prioritized as necessary. All medico-legal documentation is conducted in accordance with HBF’s therapeutic working methods and the spirit and principles of the Istanbul Protocol. The use of the Istanbul Protocol to underpin medico-legal reports can protect victims of trafficking from further re-traumatization because decision makers are able to refer to detailed and authoritative clinical evidence which minimizes the need for further investigative questioning. Medico-legal reports must be produced to meet strict legal deadlines. This presents HBF with serious challenges but it is a vital service for clients. Provision of medico-legal reports may assist victims of trafficking to secure legal recognition and protection through refugee status as a victim of trafficking or the UK’s National Referral Mechanism(NRM)92 procedures; reports can provide corroborating evidence when victims act as witnesses for the prosecution of their traffickers or assist in their defence if they are prosecuted for crimes committed while under the influence/control of traffickers. The potential to provide medical evidence may prevent victims from being administratively detained or their case being transferred into inappropriate “fast track” asylum procedures. It can help them to obtain compensation for crimes committed against them as a victim of trafficking 93 and provide support for their specific housing, welfare and wider medical and therapy needs. Conducting an initial assessment “I find that taking a good medical history leads into the trafficking case … “It is ideal to have a light and spacious room in which to assess the client. I accompany them into the room, ensuring that if they have any pain or disabilities, they are assisted with these before we begin. I always introduce the interpreter as soon as they enter. I offer them some water and invite them to sit down and make themselves comfortable. “Appropriate eye contact, body language and use of space are the keys to a successful assessment. It is important that the client does not feel that there are any barriers to communication; I keep my desk to the side of us both so that there is plenty of open space and the client feels that they are on equal terms with me, unlike in a formal ‘interview’. “Note taking should be as unobtrusive as possible. I ensure that I’ve read all the relevant documents including detailed information about trafficking from their country beforehand so that I can concentrate on those issues that are unclear, and avoid the client having to repeat traumatic aspects of their history unnecessarily. “I begin by explaining client confidentiality and informed consent. It is essential for the interpreter to hear this as well, as it reminds them that the individual is a victim of crime in this country. It is important that the client understands that HBF cannot act without their express permission, and also that HBF is an organization of clinicians which is entirely independent of the UK authorities. “I make sure that the client knows from the outset that this is not a formal interview: it is an opportunity for them to talk about how they are feeling and for me to see if there is anything we can do to help. I tell them that we can meet over several sessions, and that they are welcome to stop or take a break at any time. Handling Claims Involving Allegations of Torture or Serious Harm in the Non-detained Pilot Process , R (on the application of AM) v. Secretary of State for the Home Department, AZ (Trafficked women) Thailand v. Secretary of State for the Home Department, 91