The Wildflowers outreach clinic is breaking down barriers to provide vital support to some of the country’s most vulnerable women, says Luci Weir.
Women who sell sex are a very hard to reach group for support services. The women are exploited by perpetrators due to their vulnerabilities, and on top of this they are discriminated against and judged by communities, professionals and even their peers.
In Peterborough, we found that the women in our cohort weren’t engaging with any support services at all. They’ve been let down so many times, and as a result they don’t trust professionals. I wanted to do things differently, and with the support of local partners, our Empowering Women Everywhere (EWE) project has been bringing support directly to the women who need it most.
In 2020, EWE launched our outreach clinic Wildflowers to proactively bringing support directly to vulnerable women. The project began after I reached out to a local GP, Dr Ruth
Beesley of Boroughbury Medical Centre, to discuss vulnerable women who were not engaging in primary care. As one of the women informed me at the time, addressing their health was not high on their list of priorities. Every fortnight, I go out into the community to meet women where they’re at – and at whatever stage they’re at in their own journey. Wildflowers is a safe, non-judgmental space for the women to meet with the brilliant Dr Beesley and her team to access a range of services to support their sexual, physical and mental health.
It was important to build rapport to get the women on board and trust us. The things they experience on a regular basis are horrendous, and act as a significant barrier to engaging with support. They rarely report the crimes they regularly experience, for fear of not being believed or listened to, and many don’t trust police officers. With our support, things are starting to change, and we are now seeing more women reporting crimes as their trust continues to grow. Four years on, Wildflowers has gone from strength to strength.
Wildflowers has helped us to dramatically improve cervical screening rates among the women we support. Since we launched the clinic, our cervical screening rates have increased from 19 per cent to 93 per cent, and our aim is to reach 100 per cent this year. This will save lives, and it has all been thanks to the growing trust between us and the women – they know that we’re there to support them, in a way that works for them.
As our cervical screening rates improved, we soon realised the next challenge – ensuring that the women at risk of developing cervical cancer felt able to access necessary colposcopy services at local hospitals. Through the screenings we run at Wildflowers, we identified eight women at risk, but quickly realised that each of them faced significant barriers to accessing and engaging with support. Some of them have experienced traumatic and stigmatising interactions with professionals in the past, while others didn’t have stable accommodation where they could receive appointment information.
Many of the women have also experienced extreme sexual trauma – childhood sexual abuse, domestic violence, and rape. The result of this is they tend to feel huge amounts of shame and distress when requiring examination. They also find trust extremely difficult, especially when feeling vulnerable and scared.
Following discussions with UKHSA and North West Anglia NHS Foundation Trust, we’ve been able to establish a dedicated colposcopy clinic at Stamford and Rutland Hospital for vulnerable women. The idea was for us to collect the women in our outreach van and bring them directly to the clinic, where they could be better supported to engage.
Further to this, we’ve arranged to work with the lab at Norfolk and Norwich University Hospital to ensure smear tests taken as part of Wildflower clinic sessions are picked up by the new colposcopy clinic – an important step in ensuring the women receive efficient, streamlined care. To help us break down barriers and ensure the women feel safe to engage, the clinic is female-led, trauma informed, and encourages peer support among the women themselves.
The women who attended the clinic on the day were understandably anxious and needed a lot of encouragement. I was able to sit with the women throughout the procedure, and they were treated with the utmost care, compassion, and respect by Dr Rebecca McKay and her team.
The bravery and sense of achievement of the women was evident. Unfortunately, not all of the women we had identified were able to attend, but the respect and dignity shown to those who did attend has encouraged their peers to take part in the future. We’re now preparing for our third clinic next month.
When people try and tell me women who sell sex have a choice, I tell them they don’t always have a choice. Not one of the women we work with thought they would ever end up in the situation they find themselves in – life’s circumstances have brought them there. People don’t know what’s happened to the women along the way, and the role of EWE is to advocate on their behalf and to make sure they have access to the support they deserve – Wildflowers and now the colposcopy clinic both have a huge role to play in breaking down barriers and making sure this vision becomes a reality.
The project has evolved and saves lives, and this would not have been possible without the support of the Peterborough public health commissioning team, or without the funding for my role from the Terrence Higgins Trust.
I would love to see this work emulated nationally. If I could give one piece of advice it would be that this work cannot be done in isolation – effective partnership working is the key. The possibilities are endless when we work together.
If you’d like to find out more about the work of the EWE project, please get in touch: lucille.weir@cgl.org.uk
Luci Weir leads EWE (Empowering Women Everywhere) at Change Grow Live’s Aspire Recovery Service in Peterborough