Are you in Devon, Bristol, North Somerset or South Gloucestershire? Tell NHS your view on trans guidelines NOW

[anotherFOIrequester]

Happy New Year!

Starting a new thread with the aim of putting all the information in one place as I now have a clearer picture.

Old thread here: www.mumsnet.com/Talk/womens_rights/3755711-Help-FOI-request-trans-guidance-in-NHS-in-South-West?pg=1

The NHS CCG for Bristol, North Somerset and South Gloucestershire are adopting 'best practice' guidance for trans patients that you can read here:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_5Nov19_item6.4.pdf

There is no consideration of women or anyone else with protected characteristics, eg 'Providing education to other service users in a ward to prevent ignorant or transphobic comments is, if successful, a better solution than having to protect or isolate the trans service user'.
There has been no equality impact assessment, no risk assessment and no consultation with patients who don't identify as transgender.

The guidance is produced by Bristol charity SARI (Stand Against Racism and Inequality) but the meeting minutes below reveal that the lead writer is Cheryl Morgan, director of the Diversity Trust:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_3Dec19_item3.pdf

Morgan is a transwoman who attended a menopause event and claims the ability to breastfeed:

medium.com/@elsaegret/abusive-misogynist-activist-writes-nhs-policy-in-bristol-21dd02cc4c9c

Morgan has also used abusive language to women for many years:

www.thetimes.co.uk/article/police-used-violent-transgender-activist-for-equality-training-x0mktgclw

SARI and the Diversity Trust have form:

medium.com/@elsaegret/stitch-up-bristol-fashion-f1eb298e28da

The guidance also features the logos of North Bristol NHS Trust and Devon Partnership NHS Trust. I have FOIs pending with both of them to establish what's happening there.

In response to women contacting the BNSSG CCG, they are now conducting an EIA, for what that's worth.

The good thing is we are disrupting the usual 'under-the-radar' proceedings before this is signed off - this is the time to contact them if you're in those areas, or if you're in Devon, or if you live elsewhere but use those NHS services.

Bristol/South Glos/North Som: [email protected]

North Bristol NHS Trust: [email protected]

Devon Partnership NHS Trust: [email protected]

That sounds a little bit positive Nothingcomes :-))

I was wondering previously how practical/possible it might be to ‘swap’ enquiries between us. You have risk to employment reasons for hesitating to make an FOI request, I have specific reasons for not being able to ask my child’s school about their RSE content.
There are many other people apparently in similar situations so I wonder if there would be anything to prevent us making specific enquiries on behalf of people who would be risking too much to do so?

gardenbird I'd be up for that

update on the EIA coming in Oct meeting - which public aren't allowed to attend: bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_6Oct20_agenda.pdf

Hi @anotherFOIrequester when I click on the link in your latest post the agenda document says "the meeting will (my italics) be accessible to members of the public".

Yes you're right - that's the 'Open Agenda' but there is also this agenda which is solely a motion to exclude the press and public. I don't know why they do this.

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_6Oct20_agendaAM.pdf

@nothingcomestonothing

gardenbird I'd be up for that

Oops sorry I missed this - do you want to dm me?

@nothingcomestonothing

gardenbird I'd be up for that

Although on reflection I’m not sure that we could make it work in a sensible and safe way - sorry scrub that.

Oh anotherFOIrequester. How confusing. Do they always do this?

Antibles I don't know! Not every time at least.

The latest:

bnssgccg-media.ams3.cdn.digitaloceanspaces.com/attachments/govbody_6Oct20_item6.1.pdf

Struck by two things - they're really keen to say that this isn't policy or clinical guidance but a 'communications product'

And nothing about single sex wards and services. We have to get to the point where these trans guides say something like 'HCPs should ensure patients understand that any treatment they receive will not change their sex and does not grant them access to spaces and services for the opposite sex'.

Good that all the blockers and hormones for kids stuff is out.

Thanks.

Good points OP. I daresay the paragraph you suggest is the sort of thing that actively brings TRAs out screaming about exclusion which might explain the absence. At this point, is there any further scope for the public to write and suggest things or is it too late?

Thanks for the update. Is there any way if finding out which women’s groups they spoke to and how they contacted members of the public for the consultation?
I have had no further response to my more local enquiry, not even when I asked when I might expect a reply

Thanks @anotherFOIrequester, I hadn't seen that update.
I believe the CCG are aware now that there is a direct conflict between the needs of women patients and the wishes of trans patients, between the current NHS guidelines (which allow single sex wards to admit the opposite sex based on gender) and the Equality Act's legal single sex spaces (specifically wards) for women, and safeguarding principles.

Last year the Health Secretary stated he planned to change the NHS policy but nothing has been announced.

The CCG deliberately did NOT tell GP surgeries and patient groups of the previous 'guidelines' - if they try and reintroduce them we need to bring sunlight and publicity for their abusive policy, and we need to be ready to do this....

This is going to be a looooongg post - info/updates on 3 different NHS bodies.

DEVON - I don't live in Devon but I really want women there to know that right now they are not guaranteed that a male rapist won't be in the next bed on their women's ward.

This policy is still in place: www.dpt.nhs.uk/resources/policies-and-procedures/clinical/supporting-transgender-non-binary-and-intersex-patients

It's now due for review - November 2020 - so if you're in Devon please pressure them to review it and ensure it doesn't violate the rights of women patients. I will FOI to ask for details of the review.

BRISTOL/NORTH SOMERSET/SOUTH GLOUCESTERSHIRE: Had a reply to FOI asking for details of BNSSG CCG's meetings with women's groups and transgender groups about the trans patients guide. The women's groups were too frightened to allow minutes to be taken. Top woman-representing thanks. The CCG, a public body subject to FOI, conveniently allowed minutes of their meetings with SARI, the trans guidline authors, to be be written by SARI, a charity not subject to FOI, and told me to ask SARI for the minutes. They have done exactly this before - I did email SARI who didn't even reply to my email. The legal advice is secret.

www.whatdotheyknow.com/request/details_of_eia_process_for_suppo

BRISTOL UNIVERSITY HOSPITAL TRUST
thebristolcable.org/2020/11/trans-broken-arm-syndrome-healthcare-nightmare-for-trans-people-is-about-more-than-hormones/
The writer of this bizarre article which says trans people are turned away from A and E when they have broken arms and legs (!) is apparently on a working group to write trans policy in this Bristol hospital trust. Have asked for details: www.whatdotheyknow.com/request/transgender_care_policy_working#incoming-1678261

Diversity Trust, who work with SARI and are run by Cheryl Morgan the author of the original BNNSSG guidance who claims to able to breastfeed depsite being male, seem to have captured the local Healthwatch patient's voice org and used them to influence hospital trust trans policy - see this letter from the hospital trust in 2018: www.diversitytrust.org.uk/wp-content/uploads/2018/10/Final_response_October2018.pdf

Thanks - one of my friends recently refused care at Southmead hospital (in the other hospital Trust in Bristol ) as she needs same sex intimate care and wards. The Patient care Manager at North Bristol Hospital Trust (which covers Southmead, Clevedon hospitals etc) sent her the Privacy and Dignity Policy which states:

• all accommodation is single sex
• but men can self ID into the single sex wards/ bays for the opposite sex (so it's all mixed sex except for the single rooms)

and in addition advised

• the Trust don't know the biological sex of their staff (as they just use passports as ID, which are self ID)- so they don't know if a male staff member identifies as female (an issue of consent when a female patient needs same sex intimate care)
• and muddle sex and gender in all policies, so don't consider women's needs as a sex / safeguarding at all
• the Impact assessment of the Privacy and Dignity Policy did not consider the impact on sex/ women at all - and said religious believers would welcome it- misogyny, lies and dishonesty throughout.

This is a huge issue for women needing intimate procedures/ wards or care to be carried out by same sex staff . (In the end my friend's GP had to ring a Dr she knew at the hospital to agree details as the situation was urgent, and the GP referral letter wasn't enough to be sure). Hospital policies are a total mess, and the government has still not acted despite what the Health Secretary promised last year.www.telegraph.co.uk/news/2019/03/04/nhs-review-transgender-policies/
The Trust Privacy and Dignity Policy is due for review so Please email the patient services manager so she knows this affects other women too [email protected]

After my friend's experience I asked the CCG about their trans policy review and the hospital Trust consent issues and they replied
'The CCG has asked NHS England to confirm whether or not there will be any amendments to this guide. .. In the meantime, providers will continue to follow their internal processes around consent, risk assessment and managing admissions..The responsibility of ensuring that patient consent, dignity and privacy are upheld sits with individual providers'.

In other words, women don't matter to them and we need to keep making our voices heard so they can't ignore us. They will ignore the Equality Act regarding women's privacy, dignity, safety and consent for the trans guidance review .

and here's the Health Secretary's email if you want to chase him up direct to update the NHS policy as he promised last year! !
[email protected]

Thanks for that info watermonster will do that little job tomorrow

Just realised, that may be his constituency e-mail. Should be e-mailing him as Secretary of State. They have a written address but are not responding to correspondence at the moment (due to Covid-19). You have to fill in the on-line form

water has your friend considered submitting evidence to the Women and Eq trans inquiry which closes next week?

NHS trusts need to get on top of this now - the no. of women in this position - or shoudl I say becoming aware that they are in this position - is growing every day. Did your friend make a formal complaint?

Ultimately it does have to come from the top nationally but I do think it makes the case for that to happen if NHS is constantly hearing from woman at local level.

This is a huge issue for women needing intimate procedures/ wards or care to be carried out by same sex staff

I read the policy for my trust in the SW. It's all about "inclusion" for those who identify as transgender. Which is important of course - the point that a non-normative identity can often mean familial rejection is a strong one.

But, there's only one point at which the impact on single sex wards & treatment is mentioned. They cite the Equalities Act about "proportionate action for a legitimate aim", but don't give policy guidance to hospital staff - it's very much left as an individual case by case decision, which, as lawyers have shown, is NOT the intention of that phrase which allows biological sex to be considered over the legal "fiction" of gender reassignment.

Most unsatisfactory. If you're ill, in pain, elderly, how are you going to be able to advocate for yourself, apart from flat out refusal of treatment?

@anotherFOIrequester- Friend didn't have any idea about trans stuff until this hospital referral, and says she can't submit evidence about the impact as the Committee won't guarantee confidentiality.

Making a formal hospital complaint is fine when you are healthy, but when you are receiving ongoing medical care and are ill and vulnerable not everyone has the strength to do so. The Patient Services Manager is now aware of the issue though.

Thanks FOI - I did chase our Devon trust a while ago for a response and update on the policy review but haven’t heard anything yet. I’ll give them a nudge.

It’s my birthday coming up and I’m going to treat myself to a day of writing letters and completing the GRA consultation:-)). And maybe some Sherry