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Making Places Work for Women: Gender and Systems Change

A Discussion Paper by The Point People and Giselle Cory

The most marginalised women in our communities rarely face just one form of disadvantage. Their lives are complex; they experience gendered inequalities and discrimination, usually underpinned by experiences of abuse and poverty. They can face overlapping and interlinked problems like poor physical and mental health, addiction, homelessness, offending and involvement in prostitution. Any combination of these issues can create what is often referred to as ‘multiple disadvantage’. Agenda exists to ensure this group of women get the support and protection they need. Our research has found one million women in England face both poverty and high levels of violence and abuse. This group are disproportionately likely to have mental health disorders (55%); alcohol addiction (28%); and experiences of homelessness (21%).

The way current services are configured do not work for this group of women and too many fall through gaps in support. Specialist women’s services are few and far between and increasingly struggle for funding. Gender is rarely thought about in service design, commissioning and delivery. Mixed services too often lack a gendered understanding, agencies often work in silos and provide inadequate support meaning women and girls are unable to get the help they need to turn their lives around. For example, homeless and drug services are often dominated by men, meaning they can be intimidating and unsafe places for women, especially those who have histories of experiencing abuse. As a result women are less likely to use them, which may lead to an assumption by providers that women do not need these services. Meanwhile, Agenda research has suggested women are not routinely being asked by mental health services about experiences of abuse, which means they may not be getting the right care. At the same time, some domestic and sexual abuse services are limited in their ability to support women with the most complex needs, with referrals into refuges for women with substance use support needs less likely to be successful than referrals for other women.

When women are unable to access the right support or accommodation not only do their needs go unmet but they can be trapped in abusive relationships or in other insecure and precarious situations. They can be left to spiral from crisis to crisis, with huge resulting costs to them, their families and society as a whole. Evidence shows that women’s services, particularly those that take a holistic ‘whole person’ approach, can lead to improved outcomes and have a positive impact on women and their families. These translate into social benefits as well as economic ones, with the potential for significant longterm savings to the state. But this is about more than money, it is only right that in a fair and just society, the most disadvantaged women have the chance to rebuild their lives and fulfil their potential. To do that, Agenda believes that systems and services must work better for women and girls experiencing multiple disadvantage. Both national policy change and local place based systems change are critical in achieving this.

By place-based systems change, we mean work aimed at tackling and changing the ‘system’ - structures and ways of working - in a specific geographical area. This can include policies, routines, relationships, resources, power structures and values. It could include the work of councils, health services, voluntary organisations, the criminal justice system and so on. The potential for place-based system change is increasingly relevant in the context of devolution where strategic and financial decisions are increasingly made at local levels. While there is a growing body of evidence around place-based systems change, there has been limited work which takes a gendered approach. That is why Agenda, supported by the Lankelly Chase Foundation, wanted to commission this discussion paper to build on the existing evidence base and consider how systems and services in a locality can be redesigned to take into account the particular experiences of women and girls. With the systemic problems facing women outlined above, local authorities and organisations coming together to understand the issues women face and taking a new joined up approach to tackling them, could have a hugely positive impact on the most disadvantaged women.

This discussion paper, written by The Point People for Agenda, draws on qualitative research and the existing literature on gender, place based change and systems change. It identifies some barriers to achieving placebased systems change for women experiencing multiple disadvantage. These include poor data collection, which fails to present an accurate picture of the situation for women, unrealistic commissioning of services, siloed working, difficult funding conditions for voluntary sector organisations and cultural barriers.

But these issues are not insurmountable and the paper proposes corresponding principles that can help address these, with an emphasis on increasing understanding and knowledge, being open to new ways of working and collaboration, and strengthening leadership. We have proposed some key recommendations for funders, local organisations and councils, and central government to help develop this work further.

Place-based change should be personcentred; that means starting with the women themselves, rather than starting with the services around them and trying to make women’s lives fit. With this in mind, we believe place-based systems change has the potential to positively impact women’s lives. By being more open and inclusive, making better use of limited resources and focusing on social as well as economic value, they open up the possibility of local areas finding better ways of supporting women experiencing multiple disadvantage.