Innovative Street Sex Worker Engagement Initiative


The NHS SMPA exists to develop the collaboration between service users, carers and organisations, enabling services to provide the best quality care. As part of this, we want to share stories of great practice, such as this low threshold initiative developed for street sex workers by Cheshire and Wirral Partnership NHS Drug Substance Misuse Services.

Those who elected to join the initiative were provided with 30mgs oral methadone, which they could pick up on any or all days, 7 days a week. This gave the participants the option of choosing whether they wanted to work, and gave them a safety net.

Two pharmacies were part of the team delivering the initiative, working in partnership to closely monitor risk.

To be involved in the project, the sex workers were expected to attend a 3-monthly clinic. The clinic format was devised by service users and was available for:

  • Rape Crisis Intervention
  • Genito-urinary medicine services for smear tests and Sexually Shared Infections, high
  • vaginal swabs and any necessary treatments
  • Family planning for depot contraception injections
  • Midwives for pregnant service users
  • Needle and syringe exchange
  • Condom provision
  • Vaccination for hepatitis A and B
  • Direct referral to colposcopy and appointments were provided at the time of attendance.

Other services available included the ability to: dress wounds, listen to breathing sounds to identify respiratory disorders, examine injecting sites, monitor drug use and move into mainstream treatment if that is what the person wanted.

As well as the obvious direct benefits for service users, the initiative also improved relationships between the services involved. Access to services (both as part of the one stop shop and separate to this) improved for the sex workers.

Are you working on an inspirational project? Please tell us about it.