Friday 28 June 2019

Universal Credit and survival sex – a hostile policy in practice?

Post by Laura Seebohm, Changing Lives, Executive Director – Innovation and Policy

I recently provided evidence to the Work and Pensions Select Committee on the relationship between Universal Credit and survival sex. By both shining a light on this important issue, and promoting the terminology of ‘survival sex’ – sex work conducted to meet basic needs in the absence of other options - the Committee had a significant opportunity shape the public policy debate on this issue.
Changing Lives first coined the term ‘survival sex’ when we supported women who had experience of selling sex to carry out peer research, interviewing 86 of their peers across Tyne and Wear back in 2007. The findings highlighted the overwhelming correlation between selling sex and poverty, deprivation and social exclusion. Women disclosed they were turning to survival sex to meet their immediate needs; to pay for food, for a place to stay, laundry, to fund an addiction, and often to support their children. We have repeated this methodology in other towns and cities over the past 12 years and the findings have not changed.

What has changed quite significantly is the number of women faced with destitution. They see selling sex as their ‘only option’ when faced with unprecedented levels of financial hardship. They tell us time and time again that this relates to welfare reform - specifically the roll out of Universal Credit.

Changing Lives has five specialist services for people involved in survival sex, sexual exploitation and sex work across the North and Midlands, supporting nearly 700 people at any one time. Most of the women we work with come to us with a range of vulnerabilities, alongside survival sex. Many report trauma and abuse as children continuing into adulthood, poor mental health and addiction, poor education and employment opportunities, homelessness and experience of the criminal justice system. Most also present as courageous, amazingly resilient and articulate, with an array of talents and strengths that see them through.

However, they are severely disadvantaged by Universal Credit. This is a system which appears to be designed to be alienating and impenetrable for people who need it most – those with little money, living on tight budgets and with limited financial capability. It is exacerbated for those who have low levels of ‘social capital’; they do not have people in their lives who they can turn to for support when times are hard.

Key issues our services consistently report are:
  • People frequently have no formal ID, no bank account, and are not digitally literate and have no access to the internet – making it impossible to claim Universal Credit.
  • The timescale for processing a new claim is commonly five to six weeks - but delays can take up to 11 weeks. 
  • It is possible to access Advance Payments while a claim is processed. But the rates of repayment are excessive and non-negotiable, leaving people in extreme financial hardship. 
We know of people who have been given £250 as an advance payment with no indication of how long this should last (six weeks). If this does not cover rent (which it often doesn’t) homelessness is inevitable. The difference with Universal Credit is that any deductions are taken from the one ‘universal’ benefit, so there is no capacity to protect rent, for example (as the old system would have provided with a separate housing benefit entitlement).

Survival sex can feel like the only avenue available. And when benefits are reinstated with deductions of £150 including the advance payment, people are left with such small amounts to live on that it is impossible to sustain their health or welfare at even the most basic level. It is of no surprise that people sell sex in order to survive, especially those with children to care for.

We see women doing this for the first time; we see women returning to sex work years after they have left; we see up to a third of women we support choosing not to apply for Universal Credit at all. They all say selling sex is their ‘last resort’. As Heidi Allen MP, Vice Chair of the Committee said, “if the system is not a safety net, you run out of options”.

There was a concern raised by a number of women giving evidence to the Committee that dehumanising processes and subsequent levels of poverty we see resulting from welfare policy have been deliberately built into the administration of Universal Credit. There is a suggestion that there has been a deliberate act of making people poorer by using the welfare system as a hostile tool. The widespread shared experience of all of us giving evidence would certainly suggest that this is the case.

Work and Pensions Committee: Universal Credit and Survival Sex - oral evidence

Since the Committee a number of us who gave evidence were invited to meet with Secretary of State Amber Rudd and Will Quince MP at the Department of Work and Pensions (DWP). They are adamant that there is no policy or directive ‘from the top’ to deliberately create a system that is impenetrable for people in need. They also accepted that the evidence provided by women we support is not ‘anecdote’ (as previously claimed in a DWP letter to Frank Field and his Committee) but genuine cause for concern.

The following day Will Quince MP, Minister for Family Support, Housing and Child Maintenance made some conciliatory steps to further demonstrate this point. He apologised for the initial response by DWP, and concluded that ‘We need to make sure people’s lived experience matches our policy intent’.

It is the responsibility of Changing Lives, and the many other organisations who gave evidence, to work with the Committee to hold the government to account on this matter. We need to make sure we never tolerate a system where survival sex is ever anyone’s last resort.

About Changing Lives

Changing Lives helps over 17,000 people change their lives for the better each year. We are a national charity dedicated to supporting people with the most complex needs to make meaningful and lasting improvements to their lives. We have around 100 projects in England and over 500 dedicated staff, supporting people experiencing homelessness, domestic violence, addictions, long-term unemployment and more.

Friday 21 June 2019

Is there life beyond the PhD?

Posted by Priyanka Vasantavada, PhD researcher, School of Health and Social Care, Teesside University

Living my Jane Austen fantasy
Don’t ask me if there is? It’s not afterlife. Or is it? But it is a question every PhD student has wondered about during the ups and downs of their PhD journey (unless you have a permanent job and are doing a part-time PhD). So how do you deal with it when this sort of ‘limited existentialism’ strikes? What do you say when the world around you repeatedly asks, “what next?”.

I just curl up in my bed and binge watch screen adaptations of Jane Austen novels or any good costume drama, science fiction series or even fantasy; for what can be better than some good old escapism? Does it answer the question? No! Does it help me forget it? Yes!

So last summer when I received an email from the Graduate Research School of my university regarding a Life Beyond PhD conference being held at Cumberland Lodge, Windsor; I jumped with excitement. I knew I wanted to go for it the moment I saw the pictures of the Lodge. Not unlike Pride and Prejudice protagonist Ms Elizabeth Bennet who started seeing Mr Darcy in a favourable light after visiting Pemberley. Don’t get me, or Ms Bennet, wrong for we both saw the merit in the conference and Mr Darcy respectively, but their residences certainly recommended them.

Cumberland Lodge, Winsor Great Park
Here was an opportunity blending my fantasy and reality - a four night residential conference with hospitality in the actual former residence of a real-life princess…. hello Disney! What more could I have asked for? (*cough*… Cumberland Lodge Scholarship …*cough*). The conference programme was designed to highlight the value of PhDs (both within academia and industry) and it also promised opportunities for sharing research and career aspirations, exploring collaborative and interdisciplinary ways of working, and presenting to a diverse, non-expert audience.

My supervisor considered it to be a good opportunity for me; owing to the nature of my PhD which marginally borders on public engagement in research and public health. She was kind enough to recommend me to the school for sponsorship and I daydreamed my way to the Windsor great park on a balmy summer afternoon.

Conference delegates
All the delegates were welcomed and given a tour of the historical building by the education officer of the lodge. The tour was followed by a session on research culture in the UK topped with a drinks reception. A delicious dinner was served shortly thereafter, and the delegates had fun in the group games session which included a pop quiz, table tennis, and snooker. I don’t think I ever made so many friends in such a short period of time!

The second day centred around PhD researcher development with sessions on self-leadership, speaking and writing techniques, and wellbeing and mental health. Unsurprisingly the session on mental wellbeing: research-based thoughts, issues and toolkit commanded most delegate participation, as the mental health of a PhD researcher is almost always never considered in academia. The conference drew delegates from disciplines across science, art and literature and yet everyone identified with mental health issues in PhD life!

Me and fellow Teesside University
PhD researcher David Oluwadere
On the third day, delegates were divided into four groups and were given the opportunity to present their project to their group mates who were of a different subject background. Every delegate received feedback from their peers on their overall presentation skills and comprehension of content. My colleague David Oluwadere, studying Environmental Sciences at Teesside University, presented on agronomic biofortification technique as a means of increasing zinc concentration and bioavailability in wheat using seaweed. I presented my project on the public perception of community water fluoridation in the UK. The presentations were followed by sessions by PhD graduates on their life after PhD and on public engagement in research.

The fourth day focussed on interdisciplinary research and working in designated groups we were challenged to address a problem by developing interdisciplinary research proposals within the day. These proposals were pitched to a panel of judges in order to seek funding. This was an exercise in developing our collaborative skills and emphasised the importance of interdisciplinary approaches to problem solving. It also demonstrated how a problem is viewed differently by people from various disciplines. Humble brag, but the team I was part of, won the proposal contest and were gifted a box of chocolates.
Winners of the interdisciplinary research proposal contest 

The conference closed with a session on, “Why is a PhD worth it?”. In addition to the conference presentations which were highly informative and relevant, I will always remember the experience for living in a historic aristocratic building, ‘taking a turn’ about the Windsor great park (channelling heroines of Jane Austen and Charlotte Bronte), the late night banter with friends in the sitting rooms of the lodge, playing games and striking the keys of an out of tune piano in the basement in evenings, and being served dinner in a fashion reminiscent of Downton Abbey.

If you feel that this is something for you (fantasising is optional), visit the the Cumberland Lodge website to find out more.

Getting a job after PhD is subject to availability and visa status, but life beyond PhD is open to endless possibilities. So, I believe that instead of speculating about the future, we should try to live in the moment and savour the #phdlife while it lasts!


Friday 14 June 2019

Battle planning to reduce childhood obesity

Michael Chang, Co-founder, Health and Wellbeing in Planning Network

Latest statistics show that obesity prevalence is highest in London, the West Midlands and the North East and there is a significant gap in children living in the most and least deprived areas. So I am supportive of Local Planning Authorities (LPAs) using relevant planning powers at their disposal to promote a healthier food environment to help reduce childhood obesity levels and close the inequalities health gap.

Here I want to reflect on efforts by councils to introduce planning policies and guidance to manage unhealthy food environments around schools and other educational settings. It follows on from a previous blog on whether councils have what they need to help tackle obesity?

The context of this blog is the recent session from the draft New London Plan examination on draft Policy E9 C which seeks to control proposals containing hot food takeaway uses (A5 class use in planning terminology) within 400 metres walking distance of an existing or proposed primary or secondary school. Many other local authorities are proposing similar policies and undergoing similar stages of the local plan in the North East and other parts of the country.

The London Plan is the Mayor of London's strategic planning document and sits above individual borough Local Plans. It sets out 'issues of strategic importance' (note terminology used) for all of London while individual borough issues are dealt with at borough level. It is a powerful and influential planning document for borough level planning policies and planning decisions across the 32 London Boroughs and the City of London. It is as upstream as you can get in terms of policy influence. Other areas with Combined Authorities or joint planning units will also be developing these strategic planning documents.

London Plan examination held at London City Hall
What is an examination?

Draft policies need to be tested through an ‘examination’ before they can be adopted by councils. Don't let the terminology put you off - essentially an independently qualified person(s) from the Planning Inspectorate carries out an inquisitorial process on whether to accept, suggest revisions or reject the proposed policies. Often policies on takeaways fall at this hurdle and are subsequently watered-down or deleted altogether.

Policy approaches to managing fast food takeaways

Fast food takeaways, in planning terms in England (Wales, Scotland and Northern Ireland will have their own variations of the use class classification), is a specific use class - A5 - for selling food to be consumed off the premises. Planning permission is needed for change of use to A5 from other uses such as a hairdressers. There are many 'planning' approaches to managing fast food takeaways and only recently have the approaches been influenced by a need to tackle public health issues such as obesity. Latest research by Keeble at al. found 50.5% of LPAs had a policy specifically targeting takeaways with 34.1% focused on health. Planning Practice Guidance, Health and Wellbeing Paragraph 6 sets out examples of approaches for consideration including over-concentration and proximity to certain activities.

Opposing arguments

There are opponents to takeaway policies who believe them to be overly restrictive. Their arguments have some merit, particularly against economic reasons in areas desperate for economic activity. I would suggest policies can be justified as part of a package of policies to tackle unhealthy environments as well as prosperous diverse local economies. Common themes from those opposing include:
  • "The policy does not meet National Planning Policy Framework (NPPF) soundness tests"
  • "There is no objective evidence for any link between the incidence of obesity and the proximity of hot food takeaways to schools" 
  • “Obesity is complex and you can’t narrow it down to just takeaways”. 
  • "The local area has the lowest percentage of overweight or obese children" 
  • "There are unintended consequences for local jobs and employment" 
  • "The policy would limit consumer choice and access to retail" 
  • "The policy would also ban healthy takeaways and does not address unhealthy food sold in other non-A5 outlets".

Hold your ground: defending a 'sound' takeaways policy

This singular policy issue or public health intervention of managing takeaways is deceptively complex, and battles are taking place up and down the country as councils defend the soundness of policies against objectors as well as the probing questions from inspectors. When defending a takeaway policy, there should be a combination of the following:
  • Valid consideration: Be confident that efforts to tackle obesity through the environment can be a material planning consideration.
  • Planning basis for obesity: Recognise that the NPPF requires planning to consider all three social, economic and environmental factors equally. But make sure there are priorities on tackling obesity through the environment in local health strategies. 
  • Local evidence: Do your research and build up a local evidence base, including the use of up to date data and mapping to demonstrate the scale and location of the problem. This should also include knowing the background of those who operate local businesses – independent or chain. 
  • Whole systems approach: Take a corporate approach by referring to programmes such as promoting healthier catering, food growing and education to demonstrate the action is part of a cross-council initiative. Also demonstrate you are planning for a healthy weight environment, and that the takeaways policy is an important part of the jigsaw. 
Researchers, local government and national agencies are aware of these practical challenges hindering local action to make it less easy for kids to become overweight. Concerted efforts and peer support are needed so let’s keep the conversations going.


Friday 7 June 2019

Take it away: a masterclass in healthy takeaways

Post by Scott Lloyd, Advanced Public Health Practitioner at Public Health South Tees and Karen PearsonCatering Monitoring & Advisory Officer at Redcar & Cleveland Council

Whether it is the Golden Cod or the Taste of India, independent hot food takeaways get a bad rap in Public Health circles. They serve food and drink that is predominantly higher in fat, salt and sugar and may contribute to noise pollution and other environmental ills. Furthermore, they may not be the best option for our beleaguered high streets as they tend to be shuttered up during the daytime.

Up to March 2018, for a variety of reasons (including health), 164 out of 325 Local Authorities (50.5%) have introduced powers through Local Plans or Supplementary Planning Documents (SPD) that aim to restrict the proliferation of hot food takeaways (Keeble et al. 2019)[1].

Watch this video to find out more about how we worked with takeaway owners
(click here if the video doesn't appear above)

But let’s be honest – that horse has already bolted. Analysis by Public Health England has shown that there is an average of 96.1 hot food takeaways per 100,000 population in England (Public Health England, 2018)[2].

Where we work in Redcar and Cleveland, the Local Authority introduced a SPD in 2008 that restricted the percentage of hot food takeaways (A5 class use in planning terminology) in any commercial centre to no more than 5% - but even then, each commercial centre already had more than 5% hot food takeaways.

So we have to accept that hot food takeaways are here to stay – at least for the foreseeable future. Many Local Authorities have implemented interventions such as award schemes that engage these businesses to support them to improve the healthiness of their food offerings, but with limited evaluation (Hillier-Brown et al. 2017)[3]. Indeed, we have a Food4Health award in Redcar and Cleveland, which is open to all out-of-home caterers. We were doing OK in engaging hot food takeaways but we wanted to try something different.

In 2015, the Foodscape team organised a Fuse Quarterly Research Meeting on developing interventions with out-of-home caterers. One of the presentations was by Louise Muhammad from Kirklees Council on the healthy takeaway masterclass that they had developed and delivered to over 20% of the eligible businesses on their patch. The masterclass was described as a three-hour session in which hot food takeaway owners and managers learn about the small, sustainable changes they can make so their food is a little healthier without costing a huge amount or that will actually save them money/generate new custom.

A few months later, we travelled down to Huddersfield to watch a masterclass being delivered. It was clear from the start that this was something that engaged businesses and had potential. The decision to repeat it in Redcar and Cleveland was easy.

Takeaway owners and managers learning about small changes to make their food healthier
We worked with the teams from Kirklees and Foodscape to deliver our first masterclass in May 2016. In line with what Kirklees do, we invited hot food takeaways with a food hygiene rating of three or above – the feeling was that any outlets with less than this really needed to concentrate on food hygiene first. In total, 181 invitations were sent out and 18 attended, representing 10% of those eligible – a figure that we practitioners were happy with (if not all the academics!).

The Foodscape team conducted a mixed methods evaluation to explore the acceptability and feasibility of the masterclass intervention (Hillier-Brown et al. 2019)[4]. The takeaways businesses that attended made a variety of pledges – the ones that required less effort and cost (e.g. reducing salt and sugar in pizza dough) were implemented more so than other more potentially costly or difficult changes (e.g. stocking reduced sugar tomato ketchup).

Pledging to use healthier alternatives
Has this work made the hot food takeaways in Redcar and Cleveland healthy? No it hasn’t. Like the rest of us, businesses owners have a living to make and will cater to what their customers want. But as an example, Carol - the owner of a sandwich shop in Guisborough who stars in the film above - pledged to take 10% of the sugar out of her baking. Did her customers notice? No. Did, this make her flapjacks ‘healthy’? Of course not but they are now a little healthier. Hence, has the masterclass via all the pledges made their food offerings a little healthier? Probably.

We have since delivered a further six masterclasses, with the offer extended to other out-of-home caterers such as restaurants. About 30% of all eligible takeaways in Redcar and Cleveland have now attended a masterclass, with follow up support provided by the Food4Health award.

Engaging with hot food takeaways can be difficult. We are now struggling to attract new businesses onto the masterclass and may hit a saturation point at 35% or 40% of those who are eligible. Some owners have other priorities and some may not accept the healthy eating messages. Also, some hot food takeaway owners are not even resident to the UK so engaging them is nigh on impossible. But we have to continue to try.

Another key learning point is that we need to work more closely with suppliers. The majority of masterclass attendees pledged to start using healthier alternatives, such as reduced sugar tomato ketchup or reduced salt soy sauce but they were unable to source these items from suppliers at a reasonable cost or not at all. Hence, wider work is needed with suppliers which, as one of the other Foodscape projects showed, is possible (Goffe et al. 2019)[5].

But the masterclass is an acceptable and feasible intervention to engage a good proportion of hot food takeaways. We will continue to deliver it once or twice a year as long as there is sufficient demand. We’re hoping to run the next class in September, so lookout for that.

What the masterclass doesn’t do is engage the big operators such as McDonald’s and Just Eat, accepting that the latter works mainly through local independent takeaways (but what requirements can the national corporation specify on their local deliverers?). It’s likely that national work is needed with those corporations, continuing the good work of Public Health England and others.

We also need to be mindful of the potential impact of “dark kitchens” – potentially the “satanic mills of our era”. But I’ll save that for another time…

Read our handy Fuse research brief to find out more about the Foodscape study.

  1. Keeble, M., Burgoine, T., White, M., Summerbell., C., Cummins. S., Adams, J. (2019). How does local government use the planning system to regulate hot food takeaway outlets? A census of current practice in England using document review. Health & Place, 57, 171 – 178.
  2. Public Health England (2018). Fast Food Outlets: Density by Local Authority in England. Available at: [accessed 27 May 2019] 
  3. Hillier-Brown, F.C., Summerbell C.D., Moore, H.J., Wrieden, W.L., Adams, J., Abraham, C., Adamson, A., Araújo-Soares, V., White, M., Lake, A.A. (2017). A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis. BMC Public Health, 17 (1), 93.
  4. Hillier-Brown, F. C., Lloyd, S., Muhammad, L., Goffe, L., Summerbell, C., Hildred, N. J., ... Araújo-Soares, V. (2019). Feasibility and acceptability of a Takeaway Masterclass aimed at encouraging healthier cooking practices and menu options in takeaway food outlets. Public Health Nutrition.
  5. Goffe, L. Hillier-Brown, F., Hildred, N., Worsnop, M., Adams, J., Araújo-Soares, V., Penn, L., Wrieden, W., Summerbell, C.D., Lake, A.A., White, M., Adamson, A.J. (2019). Feasibility of working with a wholesale supplier to co-design and test acceptability of an intervention to promote smaller portions: an uncontrolled before-and-after study in British Fish & Chip shops. BMJ Open, 9 (2), e023441.