Published on 17th February 2026
When you support some of the most marginalised women in society, flexibility isn’t a luxury – it’s essential.
Traditional drug services are necessarily designed around structure, appointments and processes. But when you’re meeting women in the middle of a red-light district late at night, explains Julie Smedley, who leads IRIS: River Liverpool’s sex worker support service, “that model doesn’t always fit. You have to meet people where they are, literally and emotionally.”
Innovation often relies on someone being prepared to speak up, to advocate, and to keep asking the questions that might otherwise go unheard. As Julie says:
Her commitment is deeply personal, with lived experience of domestic abuse, substance use and recovery. “This work helps me personally as well as professionally,” she says. “It’s my way of paying forward the support I’ve had, and everything I’ve learned, to women who are fighting to survive and thrive.”
A service designed around women’s lives
In 2020, Julie watched a documentary about women sex working in Liverpool. They often found themselves in dangerous conditions, with little support and even less compassion.
One evening, unable to stop thinking about them, Julie joined Streetwise, an outreach bus providing harm reduction in red light areas. What she saw confirmed what the women already knew: existing services weren’t set up in a way that they could feasibly access. Most of the women had no phone or address, so expecting them to remember – and attend – an appointment in a week’s time simply wasn’t realistic.
Julie joined the outreach team and spent months building trust. She heard the same message from the women again and again:
If you were where we are, we’d come."
That insight changed everything. IRIS was designed as a drop-in clinic in the red-light district, removing barriers around travel, money, safety and timing. The name IRIS (Inspiration, Resilience, Independence, Strength) was chosen by the women themselves, to reflect their challenges, hopes and strengths. The project opened as a pilot in 2020 through With You, and the response was immediate.
"On our first morning’s outreach, we saw ten women working at 6am. When we opened, we were inundated."
The current building, a church, is old, and in need of repair. But inside, Julie and the team have created a place of calm. The wellbeing room has comfortable sofas, snacks and hot drinks, and women can sit, rest, and feel safe.
The IRIS team is small: Julie, a medical prescriber and workers, including men. “It’s important that the women experience positive male figures,” Julie explains. “Not all men are perpetrators or pimps. Breaking down that belief matters – safe relationships are possible.”
Partner agencies play a vital role, too. The service brings together drug and alcohol support, prescribing, blood-borne virus testing, naloxone, sexual health, housing advice, smoking cessation, and domestic and sexual violence support, all under one roof.
Improving oral health and restoring dignity
Oral health is one of the biggest unmet needs. Substance use, poverty and long periods without access to healthcare take a heavy toll on teeth and gums.
In response, the Dentaid bus – a mobile dental unit – regularly attends IRIS, providing treatment on site. IRIS has also partnered with Liverpool Dental Hospital on a research project exploring the oral health experiences of the women, studying the intersecting harms that create a downward spiral in oral health.
Funding has also been secured for a collaborative art project with the hospital, developed with the women, not about them. The women have been invited to give feedback, choose colour schemes, and shape the artwork. The final designs will become large-scale wall pieces and a mural.
While the Dentaid bus provides excellent dental treatment, it does not currently offer dentures, and this remains a critical gap. Many women have lost teeth as a result of long-term drug use, and the impact on their confidence is profound – as is the associated stigma.
For Julie, the long-term goal is clear: use the strength of the research partnership to secure referrals to Liverpool Dental Hospital for dentures. As she says:
The research is brilliant in its own right, but it has to lead somewhere. For these women, that means getting back their smiles and their self-esteem."
Commitment and trust
Consistency has been key to boosting the project’s reputation. Early in the week, Julie reminds women where she’ll be, who will attend the drop-in, and encourages them to come for scripts or medical reviews. By showing up week after week, Julie has built strong relationships, as confidence and trust grow over time.
One woman Julie supported was living in a hostel and attending multiple drop-ins each week. She’s now nine months drug-free and preparing to volunteer. “She’s become a role model. Other women say, ‘I want to be like you.’ And she tells them, ‘If I can do it, anyone can.’ That’s powerful.”
Another moment still stays with Julie. A woman who had been missing for six months was brought back to IRIS by her family. “Her mum said, ‘This is the only place I knew to bring her.’ That was enough for me. That’s why this matters.”
The ladies’ resilience astounds me. I am in awe of the way they keep going and with a smile on their faces. I'm just astounded by the way they keep bouncing back, and I feel protective of them, too."
Looking ahead
In early 2026, a new women’s hub will open in the heart of the red-light district. With more frequent drop-ins, a safe, warm and welcoming space, and stronger outreach links, Julie believes recovery will become even more achievable. The hub will house IRIS and the many partners that make the project a success, such as the Red Umbrella project, Axess Sexual Health, Streetwise, Pearls Project and the Whitechapel Centre’s housing team.
This holistic support is crucial:
When someone is ready, there’s a very small window. This hub is about making sure that moment doesn’t pass."
Julie’s long-term vision is clear: a peer-led service, run by women with lived experience. “That’s the dream. Because no matter how much you care, you haven’t walked in their shoes. Lived experience changes everything.”
Her advice to others wanting to develop similar services is simple: “Ask the women what they want. Don’t assume. Let them lead. Involve partners from the beginning, take services to where people are, and remember, this is about dignity.”
For Julie, that’s what IRIS is really about: "Giving women a voice. Removing barriers. And treating people with the respect they deserve."
From one of our women
"I was in a hostel and Julie came […] she told me to come to the IRIS project. I didn't go because I was too busy using [drugs] and working on the road but she came back to get me and took me there.
I had a lot of things going on and I never kept appointments, but at the project everything was done in one place: blood-borne virus and pregnancy testing; housing workers are there; and the sexual health team. I got on a methadone script on the same day.
I could never stay on my script or keep my appointments before, but the IRIS project being right where we work has made all the difference."
The IRIS project in numbers
Face-to-face-contacts: 297
Hepatitis C tests: 31
Non-medical prescribing reviews: 26
Full risk review: 30
Issued with naloxone: 58 women
Pregnancy tests: 30
Current caseload: 52 women