Health professionals’ knowledge, attitudes and practice around identifying and responding to children exploited by “county lines” in the United Kingdom: a scoping review

Abstract

Background: County lines is a term used to describe gangs and organised criminal networks involved in exporting illegal drugs into areas across the United Kingdom.  They exploit children and young people to move and store drugs, weapons and money.  It is argued that county lines exploitation is more than a policing problem and represents a major public health concern, with children and young people involved with drugs, violence, criminal and sexual exploitation, trafficking and modern slavery, exposed to short- and long-term physical, emotional, and generational risks to health, and is a major safeguarding concern. The aim of the scoping review is to map out the existing evidence base around health professionals’ knowledge, attitudes and responses to county lines, examine current practice, to synthesise findings and identify gaps in evidence, and identify areas for further research.

Methods: A total of 111 studies from 7 databases were identified, duplicates were then removed, studies were then reviewed by title and abstract, then selected for full text screening against the exclusion and inclusion criteria.  A manual search of reference lists and a grey literature search was completed and identified 8 further articles. A total of 8 studies were included in the review, 2 peer reviewed articles and 6 grey literature studies.  The Arksey and O’Malley five stage methodological framework was followed throughout.

Results: The scoping review highlighted there is currently limited evidence around health professionals’ knowledge, attitudes and practice.  However, it does highlight that county lines exploitation is insufficiently understood, children are not being recognised as victims, multiagency working is disjointed, there is inadequate data collection and information sharing, and very few practitioners felt adequately equipped to tackle county lines exploitation. It proposes although health professionals are often placed at a critical site for responding and identifying to victims, they are missing opportunities.

Conclusion: Future research should be conducted with health professionals to provide a broader evidence base of the attitudes, responses, knowledge and practice of health professionals, to gain a richer understanding and look at ways to improve practice.