5. Ensuring equity for underserved groups
Source: gov.uk (2025-12-11)

This chapter explores some of the steps that Changing Futures areas took to improve equitable access to support services.

Why is focusing on underserved groups important?

The Changing Futures programme sought to build services’ understanding and capacity to better engage and support people from groups who were often under-represented among service users experiencing multiple disadvantage – including women, and people from ethnic minority backgrounds. Focusing on these and other underserved groups is important, given that:

1. Even services targeted at people experiencing multiple disadvantage – which are intended to address service exclusion – can fail to reach and engage some groups equitably. The Changing Futures programme mainly reached middle-aged white men: only 36.5% of participants were female, though this varied by area. Similarly, the participation of people from ethnic minority backgrounds was lower than might be expected in some Changing Futures urban areas with ethnically diverse populations.

2. Women and people from ethnic minority backgrounds can experience multiple disadvantage in different ways to white men. For example, racial trauma may form a part of experiences of multiple disadvantage among people from ethnic minority groups. Women can have gender-specific reasons for avoiding engagement with statutory services.

3. There is evidence to suggest that women may form the majority of those experiencing certain extreme forms of multiple disadvantage.

4. Efforts to engage and support more women and minority ethnic groups can be a first step towards building local systems that respond to all forms of multiple disadvantage and do not leave any groups behind. This could also contribute to wider efforts to achieve equitable access to public services.

This chapter explores some of the steps that Changing Futures areas took to improve equitable access to support services. For additional information on how multiple disadvantage can be experienced differently by different groups, and how the Changing Futures programme responded to this, see Evaluation of the Changing Futures programme: Fourth interim report (https://assets.publishing.service.gov.uk/media/67a47f27baccec3af36b3bfc/Evaluation_of_the_Changing_Futures_programme_-_fourth_interim_report.pdf) (PDF, 1277KB).

Things to consider

What changes could you make to improve equity of access and support?
- What groups experiencing multiple disadvantage are being underserved? This might include groups with protected characteristics, or people with shared experiences, such as child removal or immigration status.
- How might problems such as homelessness or mental health needs manifest differently in different communities, or for women compared to men? Be alert to how definitions of disadvantage, eligibility criteria, and routinely collected data could be contributing to inequities in support.
What is available to build on?
- What different sources of local data, including qualitative data, are available to investigate which groups are missing out on support or being poorly served? Bringing together qualitative and quantitative data from multiple sources can be a way to understand more about who are being underserved, and how. It can also help to identify gaps in intelligence, which can be addressed through commissioning research or improving service data collection.
- What previous experience or learning do you or your partners have that can be used to identify changes to local services? Piloting support can be a way to generate learning and influence other services.
Who needs to be involved?
- What local organisations or networks have relationships with and knowledge of the target groups? What services are supporting women and minority groups experiencing multiple disadvantage? Working with and through specialist projects and organisations can be effective, and makes the most of local expertise and relationships.
- To what extent are you working with these organisations now? Explore different ways in which you could partner with organisations that have specialist knowledge and experience. Make sure you involve them in service design and commissioning processes.
- Could your workforce better represent the people you are trying to reach? Consider how you could change your recruitment or commissioning processes to involve people and groups from the communities you need to reach.
What were the barriers?

Lack of visibility of people in local data or to local organisations

Local areas described challenges in identifying women and ethnic minorities who are experiencing multiple disadvantage, and a lack of effective ways to do this. In some cases, data was not collected to enable this identification. Sometimes stakeholders described having what they presumed would be effective channels for identifying people, but these did not always work:

We went out to specialist organisations that work with different ethnic minorities, and said to them, ‘Who are the people that you think we should be working with, can you give us names or details that you would like to see support of?’ And I guess the reality is that we actually got very little back, and I’ve never fully understood why that was.

Mistrust and poor communication by services with communities

In some cases, Changing Futures described a lack of trust towards local services from women and people from ethnic minority backgrounds. Women who had experienced child removal avoided presenting to services. There was a perception among some Changing Futures areas that ‘those communities look after themselves’, or that there was a problem of trust between local communities and services. However, when a team member in one area carried out some research with people from ethnic minority communities, they found instead a lack of communication and contact from public services, with the communities described not receiving information or being engaged:

I got the feeling from what we did hear back that some groups were just, sort of, saying, ‘Nobody tells us anything. Nobody invites us to these spaces. We don’t know about these programmes. We don’t hear about them.’

Lack of understanding on how to adapt services for different groups

Changing Futures areas also described services not understanding the need for different approaches for different groups, and a lack of detailed knowledge about the type of support different groups needed, or how to adapt services accordingly. This includes adapting support for people who are neurodivergent. For instance, one Changing Futures project described how an autistic member of the team would tailor support for neurodivergent service users, but that not all services they worked with were willing to do this.

What worked well

Using a wide range of data to identify ‘missing’ groups of service users

Areas used data on referrals and participation in their services to identify differential levels of access and engagement for different groups of people. Where a Changing Futures service could see that they were not working with as many service users from a particular community as they expected, they worked with colleagues or partners to use data to understand those gaps. For example, when one area noticed that their cohort was largely white, they began examining ethnicity data.

Others used data from other services, such as adult social care and the NHS, to identify specific needs among people experiencing multiple disadvantage in their local area. Examples include data on street-deaths, insecure immigration status, and women who had experienced child removal. People missing from services can also be absent or inaccurately represented in the data. One stakeholder pointed out that often adults with autism are undiagnosed, and so this need does not appear in the data. Another highlighted that services do not always collect data on protected characteristics:

…some services, when we’ve asked for [demographic data] we’ve had real pushback … that’s often couched in the narrative of, ‘Doing this, collecting demographics reinforcing difference,’ instead of understanding that, ‘Understanding the demographics of a particular community, or of your service users, allows you to shape your support offer based on who’s accessing your service.’ And it allows you to ask particular questions like, ‘Who is not coming?’ You know? ‘Who is not arriving at our doors? Why are they not arriving at our doors? What can we do to reach them?’

Stakeholders also looked at what hidden needs were being identified in other Changing Futures areas, and reached out to community and specialist organisations to see what their service user data showed:

We went to specialist women’s organisations and said ‘Who do you have?’ And they came back with lists and lists of people.

As well as using data, areas commissioned or carried out research and consultations to better understand multiple disadvantage within different communities. This included working with specialist organisations.

Building links and sharing intelligence with specialist and community organisations

An early action by many Changing Futures areas was to build links with, or make use of existing relationships with, specialist and community organisations. The aim was to access intelligence on different groups, and inform organisations of the support available for people experiencing multiple disadvantage. Such specialist organisations may already be delivering a service focused on multiple disadvantage. For instance, several Changing Futures areas worked with networks that brought together organisations working with women experiencing various forms of disadvantage. Others described gaining more information on different ethnic minority groups by reaching out to community organisations and using community networks and social media:

So, I’m part of as many forums as I possibly can be around inequality, so there’s a fantastic WhatsApp group that I’m involved in … and that gives me loads of different information from community groups, including BAME communities, the local mosques around what they’re delivering within their communities to support.

Reaching out to staff in Changing Futures and other services who were from different communities was a way of gathering more insight:

They’ve got a very massive South Asian community there and they’re not having people come forward from those backgrounds, and we were talking about what we can do to try and change that, basically. And [Changing Futures staff member] was saying, you know, it’s really difficult, it’s a trust thing.

Questioning definitions and eligibility criteria

The Changing Futures programme’s decision to use a definition of multiple disadvantage that encompassed domestic abuse enabled more women experiencing multiple disadvantage to access support, compared to earlier multiple disadvantage programmes.

Over the course of Changing Futures, local areas continued to develop an awareness of the effects that definitions and eligibility criteria have on different groups. One stakeholder explained how the language used to talk about multiple disadvantage could affect whether communities recognised that available support was relevant to them:

And I think the other thing is, where referrals come from, how SMD [severe and multiple disadvantage] is described, because in some communities – I mean, in most communities actually – SMD sounds a bit abstract. People wouldn’t see themselves in it, but they might be experiencing those difficulties.

One area reviewed data from service users who had been assessed but had not quite met the threshold for the multiple disadvantage service, to understand how multiple disadvantage may manifest differently according to a participant’s ethnicity. They found that people from South Asian backgrounds may be more likely to experience particular kinds of housing need (for example, overcrowding). The area then adapted their definition of housing needs so that people experiencing overcrowding would be picked up during assessments and supported accordingly.

Diversifying teams: changing approaches to recruiting and training workers

Changing Futures areas used several strategies to ensure that their workforce could better engage and support underserved groups. First, projects recruited staff with diverse characteristics to deliver services to specific groups, because they recognised the value of a range of perspectives stemming from diverse backgrounds and experiences. This could improve frontline delivery and the trust that different groups had in a service:

And because we have a diverse team, people are bringing different things to that referral, offering up other suggestions and maybe other thoughts about what might be going on for that individual, what might work, what might not work, all of that kind of stuff.

Areas also delivered training and awareness-raising sessions, workshops, forums and ‘ideas spaces’ to share knowledge and practice regarding the experiences and needs of marginalised groups. In contrast to ‘off-the-shelf’ equality, diversity and inclusion training, Changing Futures areas produced resources that looked at diversity within the context of multiple disadvantage and trauma – for example, exploring racial trauma. One area developed training relating to people from ethnic minority backgrounds, including anti-racism training, and also commissioned training on intersectionality within domestic abuse – see the Case study on Plymouth: Connecting learning support to improvement activity (#Plymouth). Areas also disseminated research findings through local stakeholder events, to reach different audiences.

Commissioning specialist organisations

Changing Futures areas worked closely with specialist organisations who were already in contact with and understood target communities. Some Changing Futures projects funded caseworkers or outreach workers within specialist organisations, or commissioned them to deliver multiple disadvantage projects. These arrangements enabled outreach to (or referral of) people from different groups to those addressed by Changing Futures, and helped ensure that support was tailored.

This approach also created links between mainstream and specialist services, and contributed to greater understanding of multiple disadvantage within specialist services. For example, one area embedded multiple disadvantage workers in both a women’s organisation and an organisation specialising in supporting people from ethnic minority backgrounds who were experiencing multiple disadvantage. As a result, there was greater information exchange between the organisations. For example, a Changing Futures women’s group met with the women’s organisation, and exchanged information on the different activities available to service users:

That could have happened before, before we had the [embedded worker], but it didn’t. I think we just improved our understanding of what Changing Futures is and how it worked and what’s going on, and that’s to everybody’s advantage really.

Commissioning and funding that recognises one size does not fit all

Changing Futures areas identified that in some cases, separate services are needed for women and minorities experiencing multiple disadvantage. For example, women who have been victims of abuse may need a space that is not only trauma-informed but separate from men’s services, so that they do not run the risk of encountering perpetrators. Areas worked with commissioners to set up women-only spaces, including replicating multi-agency hubs within spaces where women feel safe:

So, for example, our colleagues in substance use or housing, what we’ve said to them is, ‘Can you get your workers co-located with specialist women’s organisations? Could you look at having separate, women’s only spaces in the city somewhere?’ That sort of thing … you’ve heard of warm spaces nationally, or welcoming spaces, can we build on that and create safe spaces for women?

Another area described working with commissioned services to enable them to adapt what they do for different groups:

We’ve supported that organisation to think about how it can adjust its behaviour change programme. So, [it] is an organisation that works with people who cause harm, whether in intimate relationships or not, and … the predominant 99 per cent of the cohort has been older men. And what we’ve done is supported [the organisation] to look at how they might adjust that programme so it’s targeted more effectively to work with younger people…

Using networks and forums to identify opportunities to improve services

In some areas, Changing Futures teams introduced and led forums to focus on and drive improvement in supporting specific underserved groups. For example, one area led a forum on women experiencing multiple disadvantage. This had cross-sector and lived experience representation, and considered the challenges, areas for improvement, and actions needed for change.

Other areas created a Black-led forum and an anti-racist working group, bringing together global majority stakeholders and, in the case of the anti-racism working group, allies. These forums connect stakeholders from different services to build awareness of one another’s work, agree on changes required in the system, and identify opportunities to collaborate to improve services and systems. They also provided a reflective space for people to consider their own experiences and practice, and seek support and advice from others. These forums can have wider ripple effects:

And so, what was really nice is the allyship network was able to just provide a space to listen, to hear them out and then give a little bit of advice. But not in any particularly directive way, of just kind of going, ‘Oh well, maybe you could try this or you could try that.’

And it’s led to them going back to their organisation and saying, ‘Why don’t we have an anti-racist policy? We need to do this.’ And that’s now going up to the board and they’re looking to bring in some training.”

Other areas have joined forums to increase the focus on multiple disadvantage locally, and to facilitate greater joining-up between activities targeted at specific underserved groups and work relating to multiple disadvantage. For example, in one area the Changing Futures team are a member of the Gypsy Roma working group, and in another they are part of an action group to improve outcomes for women going through the criminal justice system.

Case study: Sheffield – Identifying and addressing a gap in support for women with experience of child removal

Improving support and systems for women experiencing multiple disadvantage was one of Changing Futures Sheffield’s priority areas. The team’s work on child removal demonstrates the value of working with people from underserved groups and specialist organisations, to both identify and develop responses to unmet needs.

The Changing Futures team used data from multiple sources to build a better understanding of where in the system women were not being engaged effectively, and why this might be. This included analysis of referral data from and discussions with a range of statutory services, workshops with women accessing services in the local area, and analysis of monitoring data on women supported by Changing Futures.

They found that statutory services were struggling to engage women effectively, despite a high volume of referrals. Women were often mistrustful of statutory services because of previous negative interactions with them, especially relating to the removal of their children. Three-quarters of the women being supported by Changing Futures at that point had experienced child removal, yet there were few services in Sheffield supporting them, and those that existed had strict eligibility criteria that limited access for some women.

Having identified this gap in support, the team conducted further research to confirm the likely need and demand, to understand more about the nature of support that women might benefit from, and to build a business case. One particularly important finding was that there was a gap in accommodation for women affected by child removal.

Changing Futures Sheffield presented their research findings at every opportunity, and with a wide range of stakeholders. The team had been meeting regularly with Target Housing, a social landlord organisation aiming to develop a women-specific service, and the findings struck a chord with them. Target Housing agreed to collaborate with the Changing Futures team to design and introduce a new service. The partners sought grant funding from the National Lottery for an eighteen-month pilot, which provided an opportunity to test and learn through service delivery.

Target Housing and the Changing Futures team worked to design the service in consultation with women who had experienced child removal. Women were recruited from clients of Changing Futures, Target Housing and other local services. Consultation sessions focused on women’s experience of the process of child removal, to identify how services could have better supported them. Women explained how they felt alone, unsupported and unrepresented through care proceedings, and found the processes involved overwhelming and difficult to navigate without help. They also highlighted that they would have benefited from earlier advocacy and support when pregnant or going through care proceedings. This insight heavily informed the design of the service.

The pilot service, named ‘Growth’, supported women at risk of child removal, as well as those whose children had already been removed, and prioritised women with accommodation needs. The main service could support twelve women at any one time; it provided supported accommodation with space for children, to allow overnight visits, as well as one-to-one support and advocacy, psychological therapy, support with care proceedings, including access to a solicitor, and peer support.

The Changing Futures team and Target Housing also pursued opportunities to increase awareness and understanding of the needs, experiences, and support gaps for women experiencing multiple disadvantage and child removal. Through day-to-day engagement with services, Changing Futures and Target Housing helped services to identify more appropriate ways of engaging with women who have experienced child removal. For instance, they drew attention to the potentially traumatising effect of asking women about their past experience of child removal, if this information was not necessary for support planning. They also encouraged services to be sensitive in the language used when discussing motherhood and children. Target Housing worked with the pilot service’s peer support group to develop toolkits on navigating care proceedings for women and the professionals supporting them, to improve their understanding of the process and women’s rights.

At the time of writing, continuation funding for the service had not been secured. However, the increased local focus on and understanding of child removal as an issue specifically affecting women experiencing multiple disadvantage, and the positive reception of the pilot service, has prepared Sheffield to provide more effective support in the future.

Case study: Westminster – ‘Micro-commissioning’ and building the capacity of organisations supporting underserved groups

Eastern European rough sleepers were regularly flagged in case escalation forums and co-production groups in Westminster, as caseworkers were struggling to support them. They were also overrepresented in safeguarding forums and death reviews, particularly street deaths related to alcohol use. Caseworkers faced difficulties including language barriers, and a lack of understanding about, and resources available for, people with no recourse to public funds.

Changing Futures Westminster commissioned Barka (https://barkauk.org/), a by-and-for lived experience organisation supporting people from Central and Eastern Europe who are experiencing homelessness, to deliver a pilot to improve support for this group. Their experience demonstrates that community organisations can better assist underserved groups, but may need capacity-building support and adjustments to the commissioning process to do so.

Barka engaged people in their own language to understand what their needs and concerns were. They had knowledge of the legal systems in both the UK and people’s home countries to help respond to those concerns, and, where appropriate, support their repatriation. They were able to help people enter rehab in their home country, because rehab in the UK often proved inaccessible for people who were not UK nationals. Barka also offered translation support to other services working with Eastern European rough sleepers, and shared their knowledge about the barriers this group might be experiencing, along with practical solutions.

As Barka was a relatively small-scale lived experience organisation, it was necessary for Westminster City Council (the lead organisation for Changing Futures Westminster) to be flexible in their usual commissioning requirements. This included relaxing required levels of professional indemnity insurance, frequency of meetings, and monitoring reports.

If you’re working with by-and-for organisations that might be mainly made up of volunteers, you’ve got to meet them halfway in terms of the things you want and the things you can make do on. You’ve got to recognise your service landscape is an ecosystem, and if you have found an organisation that is new to your ecosystem, they’re going to need support to get embedded within it and use their resource to the best effect. That takes time, but it’s time well spent.

The pilot initially involved a small amount of funding (£10,000), which was extended once it was clear that it was working well. In addition to positive outcomes for participants, Barka’s input has helped caseworkers to feel less ‘stuck’ when trying to support this group.

The Changing Futures Westminster team also put in place strong support mechanisms to encourage partner organisations to work with Barka, thereby facilitating relationship-building with these organisations. For example, at the start of the pilot they held an event introducing Barka to organisations relevant to their work. They then held a series of face-to-face meetings with organisations that were interested in working with them, to understand the organisations’ needs in relation to Eastern European rough sleepers, and how Barka could help them respond. This ensured Barka’s time was being used effectively, and also encouraged partner organisations to trust that working with Barka was worthwhile. They also hosted a steering group to maintain oversight of Barka’s work and support them through any issues they encountered. Finally, they produced a short report following the initial pilot, highlighting the quick wins they had achieved, to further encourage partner organisation buy-in. Those organisations are now proactively approaching the Changing Futures Westminster team to suggest people who would benefit from Barka’s support.

Changing Futures Westminster described their approach with Barka as ‘micro-commissioning’. It involved an initially small pot of funding, which did not require a competitive tendering process, and provided hands-on support to help embed them in the support landscape; this prepared them for future, possibly larger, commissioning opportunities. They highlighted the importance of understanding the council’s procurement code, and opportunities for navigating this in a way that is beneficial for commissioning small by-and-for organisations, which may lack the resources to respond to standard procurement requirements. They also emphasised the need to provide capacity-building support, including bid-writing training and introductions to other funders, to help them obtain further funding.

Lessons learned

Don’t make assumptions about which groups are underserved

In some cases, the groups that Changing Futures areas identified as underserved differed from stakeholders’ expectations or what was being monitored. For example, one area noted that while local services focused on monitoring ethnicity, analysis of the data available on women suggested there should have been a greater concern for gender equity:

A lot of organisations weren’t even looking at service delivery through the lens of gender. So, accessibility of data was really poor, where we did have it, it seems to suggest that women were less present in support services but were overrepresented in forums of concern, so safeguarding, MARAC, stuff like that … we got some really interesting stuff from women about why that might be and what was going on there.

Changing Futures projects also identified that where people belonged to more than one excluded group (sometimes termed ‘intersectionality’), such people could experience extreme forms of exclusion from services. For example, one stakeholder described the exclusion experienced by some groups of women migrants:

Having an insecure immigration status is a significant [multiple disadvantage] that is not recognised as [multiple disadvantage] … if they have children there’s a lot more complexities for that particular woman. A lot of refuge places that are made available to women with no recourse to public funds don’t take in children, for example.

Lived experience groups may also need to be diversified

Changing Futures co-production activity often recruited participants from among service users. As a result, lived experience groups are likely to mirror the lack of diversity in services. As one interviewee explained:

I think our [service user] groups really reflect the service. So, [the organisation] who hold the main contract, it is primarily a housing service that supports rough sleepers which tend to be white, male, middle-aged men.

Diversifying the opportunities available for people with lived experience to get involved may help. For example, one Changing Futures project initially only had a lived experience board, but found that not everyone was comfortable in that environment. Thus, they developed different forums and meetings that would enable people with lived experience to be involved in different ways, including a drop-in session:

So, we’ve tried to create different ways for people to start to come in including, kind of, drop ins. We’ve got ¼ sessions where they can come in and collaborate and chat and stuff, and it’s a bit of a community. We have much stronger diverse voices on the experts by experience board than we used to. But it’s attracted new people in and actually, they’ve brought friends or associates or advised people to come along, and they’ve put their foot in the door as well.

Another area set up co-production groups for specific groups to work on issues most relevant to them. For example, a co-production group for young people identified key challenges with housing; they were able to feed back directly to those managing the young adults pathway, about the improvements they would like to see.

Case study: Westminster – Diversifying the workforce by changing recruitment and development

The City of Westminster is highly diverse, with 56% of its residents born outside the UK. Engaging and supporting people from global majority backgrounds was a key focus for Changing Futures Westminster. 11 (#footnote11) They wanted to diversify their staff team to make it more representative of the community it served, build the community’s trust in the service, and increase the cultural sensitivity of support. Their experience demonstrates the value in taking a second look at human resources policies and processes, to identify how to reduce barriers to equity.

The team’s ‘specialist practitioner’ role (similar to a caseworker) required a higher education qualification. In the initial pool of applicants for the role, those with a higher education qualification were predominantly white. However, the team received high-quality applications from people from global majority backgrounds who did not have a higher education qualification but had strong experience, understanding of the local community’s needs, and a passion to meet these needs. They therefore decided to remove the requirement for this qualification, and instead placed greater emphasis on relational skills, relevant lived and learned experience, experience of working closely with people experiencing multiple disadvantage, and a robust understanding of trauma-informed practice and interventions.

They also changed recruitment processes to assess skill in engaging and supporting people from global majority backgrounds. This included asking applicants to review and comment on a case study of a fictional young person of mixed heritage, to assess applicants’ cultural sensitivity; particularly their awareness and understanding of the impact the young person’s ethnicity might have had on their experiences. Applicants had to interact and try to engage with a former Changing Futures participant, who was roleplaying as a potential participant who was reluctant to engage in support. This participant then gave feedback to the hiring manager. This helped in assessing applicants’ ability to build a rapport with people with lived experience of multiple disadvantage, which was felt to be particularly important when supporting people from global majority backgrounds, who may have been especially let down by services in the past. It also helped applicants who might not thrive in more traditional, structured interviews to showcase their skills.

“What are the things that mean people from the global majority might not have been able to access services? They don’t trust them, they feel they can’t communicate with them, they can’t build that rapport with somebody, they don’t think that service is there to meet their needs. So, the foundation of our approach is relationship-based. Staff who can make sure people feel listened to, heard and valued. Then you can build the other skills.”

The team was able to hire people with strong engagement skills and cultural sensitivity, as well as being ethnically diverse. Once recruited, training supported the staff’s understanding of historical race relations in the UK, to help contextualise some of the challenges participants might be facing. They also trained staff to incorporate cultural considerations into therapeutically informed support for people using genograms 12 (#footnote12) (diagrams of family relationships).

Getting started: Identifying missing viewpoints

Each of us has a range of experiences and perspectives that can help us to be alert to the needs and experiences of different people. Our experiences can also be a source of misunderstandings or assumptions about others: for example, grouping people together who are not truly similar, or assuming that one person’s experience of a problem or service is the same as for others.

Together with your team or partners, take some time to think about the different roles or identities that you collectively have, and those you do not.

Different identities or experiences that Changing Futures local areas found made a difference to people’s experience of multiple disadvantage included:
- neurodiversity, brain injury or learning difficulties
- gender, and gender-specific experiences such as violence against women and girls
- being a parent, including of children who are separated from you
- ethnicity and nationality, including EU nationals, Gypsies and Travellers
- immigration status: for example, being an asylum-seeker or refugee, or having no access to public funds
- age, particularly being a younger person
- sexual orientation
- having no or limited English language skills
Consider:
- What groups are/are not represented in your volunteers or lived experience groups?
- What groups are/are not represented in your frontline workforce?
- What groups are/are not represented at senior management level?
- What groups are/not represented in organisations you work with or partner with?
Resources and further reading

Sosenko, F. Johnsen, S. and Bramley, G. (2020), Gender Matters: Gendered patterns of severe and multiple disadvantage in England (https://lankellychase.org.uk/publication/gender-matters/). Research demonstrating how using an alternative definition of multiple disadvantage reveals a different picture of who experiences multiple disadvantage, and showing the extent of domestic abuse among women experiencing multiple disadvantage.

Al-Hurraya and University of Nottingham (2024), Experiences of severe and multiple disadvantage within ethnically diverse communities in Nottingham (https://healthandcarenotts.co.uk/wp-content/uploads/2021/05/Race-Health-Inequalities-and-SMD-Research-Report-June-2024.pdf). This report explores the role of racism and identity in the experiences of multiple disadvantage within Nottingham’s ethnic minority communities. It was commissioned by Nottinghamshire Healthcare NHS Foundation Trust, NHS Nottingham and Nottinghamshire Integrated Care Board, and Nottingham City Council.

Justine Adams, Highlight report on women facing multiple disadvantage and child removal (https://img1.wsimg.com/blobby/go/222b8b50-a3aa-464b-b5a6-7ed89a649fed/downloads/Women%20and%20Child%20Removal%20Highlight%20Report.pdf?ver=1739543740409.). This research report, compiled by Changing Futures Sheffield, evidences the gap in services for women who have experienced child removal.

Solace Women’s Aid (2025), Women’s Rough Sleeping Census (https://www.solacewomensaid.org/womens-rough-sleeping-census/). Women are under-represented in rough sleeping statistics. The Women’s Rough Sleeping Census collects data to increase the visibility of women who are rough sleeping, build understanding, and advocate for change.

Ministry of Housing, Communities and Local Government (2024), Understanding domestic abuse interventions for women experiencing multiple disadvantage (https://assets.publishing.service.gov.uk/media/66150832eb8a1bb45e05e296/Women_experiencing_multiple_disadvantage_-_a_rapid_evidence_assessment.pdf) (PDF, 521KB). A rapid review completed as part of the Changing Futures evaluation. The report summarises evidence on effective interventions that help women experiencing multiple disadvantage to access and engage with services.

(11) Westminster has adopted the term ‘global majority’ instead of ethnic minority. This case study uses Westminster’s preferred terminology. ↩ (#note11)

(12) Many Changing Futures Westminster participants were born in the UK, although their parents were not. Genograms can help participants to think about how intergenerational experiences, including those related to their culture and ethnicity, such as family members’ arrival in the UK as immigrants, may impact a person and their relatives’ current behaviour and experiences. ↩ (#note12)