The NHS thinks that sexual orientation is about being transgender

But they know that single-sex accommodation is a lie because their systems are based on patients' 'preferred gender', so I guess they couldn't analyse impact on the protected characteristic of sex even if they wanted to?

Interesting article about this here:

medium.com/@anneharperwright/sex-gender-the-nhs-1e8f4e6363a6

Mumsnet thread:

www.mumsnet.com/Talk/womens_rights/3396859-Weve-been-lied-to-about-Single-SEX-wards-since-2010

They have not finished and you have been sent a work in progress.

Equality Impact Assessments are supposed to be completed before the final draft of the policy is written, so that the policy can take into account any findings from the EIA.

The new guidance was published last September.

ThePurported

Did they provide the wrong document?!

It really does look like it. There are a few things that I find odd about it, apart from the emphasis on trans patients, when the aim of the policy is about providing single-sex accommodation.

One is that it seems to have one single author (redacted). It's my understanding that documents such as these are normally produced by more than one person. Also, all the date fields about record keeping are blank.

Is it possible that they didn't actually do an Equality Impact Assessment until I asked for one?

LonginesPrime

What I don't understand is why every other line says 'the guidance in this area is not new' instead of actually doing any analysis- it seems to be suggesting that it's a foregone conclusion that everything's fine on the basis the equality act exists and the reviewer is confident that staff will follow guidance to make sure everyone is happy.

When they say 'the guidance is not new', they seem to be referring to the previous guidance from 2009. This was published before the Equality Act came into force in 2010. I don't know if there was a requirement to complete Equality Impact Assessments before this date, but if there was and nothing in that part of the policy had changed, the findings of the original EIA could simply have been copied over to the new one. If there was no EIA for the original guidance, the work should have been carried out for the new guidance, even though the guidance itself was not new.

I just can't get over the fact that the issue of the protected characteristic of sex isn't a consideration in the provision of single sex accommodation being open to anyone who wants to be in there.

I asked specifically in my FOI request for "All documents showing how the potential conflict between the protected characteristics of sex and gender reassignment was assessed."

They sent nothing except this single document, so I assume they did not consider this potential conflict at all.

Sexequality

There is no legal requirement for NHS Grampian to carry out an Equality and Diversity Impact Assessment on this document as this is intended as a guide.

I think they are right here, although as I've already said, my understanding of legal stuff is far from comprehensive.

As I understand it, if a document is published as a 'guide' as opposed to 'policy', no Equality Impact Assessment is required, because it is expected that anyone using it as a guide to formulate their own policy will do their own EIA.

If they are calling something that is actually policy a 'guide' just to get out of doing an EIA then they are failing in their duties under the Public Sector Equality Duty.

Thanks for your input Badger. There have been some threads on here that go into a lot of detail about legal stuff which I often find hard to follow, so I was hoping for a bit more discussion on this, not least because I've found it difficult to understand everything in this document. I was hoping some of those more knowledgeable posters would turn up to help me out.

Particularly this bit I found confusing:

In terms of the MSA breach guidance, the revisions do not relate to the transgender policy in “Annex B: Delivering same-sex accommodation for trans people and gender variant children”. This is because there has been no change to the policy at annex B since originally published in 2009.

If there has been no change to the transgender policy, why is the Equality Impact Assessment so fixated on the impact on transgender people, to the extent that they think 'sexual orientation' means protection for transgender people?

Maybe my thread title should have been something like 'Help needed to understand FOI response'.

If you want to send it to journos the ReSisters network may be able to help.

I'm not that keen on putting myself in the spotlight, so I don't really want to contact the press myself, but I do think this needs to be seen more widely. But it hasn't generated much interest on here - I originally posted it on Friday and it was on page 2 before I posted this morning - so maybe it's not as interesting as I think it is.

This is under the heading 'Engagement and Involvement' towards the end of the document.

PART D: Engagement and involvement

11. Engagement and involvement activities already undertaken.
How were stakeholders, who could comment on equalities and health inequalities engaged, or involved with this work? For example in gathering evidence, commenting on evidence, commenting on proposals or in other ways? And what were the key outputs?

Engagement included joining the roundtable event to discuss the operational use of the guidance regarding Mixed-Sex Accommodation (MSA) in respect to caring for transgender patients on the 27th June 2019.

It appears from this that the only 'Engagement and Involvement' event was one in which the guidance in respect of transgender patients was discussed, and yet, according to their statement at the beginning of the Equality and Health Inequalities document, this was unchanged since the previous guidance regarding eliminating mixed sex accommodation in hospitals in 2009.

In terms of the MSA breach guidance, the revisions do not relate to the transgender policy in “Annex B: Delivering same-sex accommodation for trans people and gender variant children”. This is because there has been no change to the policy at annex B since originally published in 2009.

Original guidance here. Guidance about transgender patients is at the end (Annex E).
assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/200215/CNO_note_dh_098893.pdf

The Equality Impact Assessment looks more and more bizarre the more I look at it. They seem to think that 'Delivering same-sex accommodation" is more about transgender people than about everyone else.

In the section which evaluates the effect of the guidance on the groups protected under the Equality Act, under 'Age', it says:

a) Does the equality group face discrimination in this work area?
No, the guidance is predominantly about placing patients in the right sex accommodation. The issue in relation to age is around sensitivity resulting from a lack of awareness and acceptability of trans patients by some of an older generation. If issues are raised by patients in this equalities group the guidance provides advice to staff on how to deal with such matters, it is fundamental to the MSA guidance that all patients should be treated in a way that protects their privacy and dignity. The guidance is clear that in situations where sensitivity towards trans patients occurs on a ward there may be some circumstances where it is lawful to provide a different service or exclude a trans person from a single sex ward of their preferred gender but only if this is a proportionate means of achieving a legitimate aim. This relates to all patients and not just those within one of the groups identified within the 2010 Act.

Under 'Religion or belief' it says the same, but replacing 'age' with 'religion or belief'.

The effect on "Trans people or other members of the non-binary community" is covered again in section 6.11.

And again, right at the end:
25. Contributing to the PSED and reducing health inequalities. How will the policy or piece of work contribute to the achieving the PSED and reducing health inequalities in access and outcomes?

The guidance is very clear on the treatment of those patients presenting as transgender or non-binary, it is based on the Equalities Act 2010 and should be upheld by any organisation providing health services.

They appear to think that the PSED is for the benefit of transgender and non-binary people, and not for anyone else.