GIDS being sued by their safeguarding lead.

[ItsAllGoingToBeFine]

(Text from their crowdfunder)

My Details

My name is Sonia Appleby. I am a qualified social worker (1981); adult psychoanalytic psychotherapist (I992); MSc. in health psychology, (research) and MBA. I have a long career safeguarding and protecting children in social care, health and as a children’s guardian in public and private proceedings.

I am currently the Named Professional for Safeguarding Children and the Safeguarding Children Lead at the Tavistock and Portman NHS Foundation Trust. I am therefore still employed by the Trust against which I am bringing my claim.

What is Safeguarding?

In all NHS trusts and organisations there are professionals such as myself, who work with other internal departments and external agencies to ensure there are 'root and branch' systems to keep patients and service users safe. This means responding to patient/service users' personal experiences, also including their environmental, familial, community/peer circumstances and sometimes any of the aforementioned domains could require the intervention of other professionals in different agencies. Safeguarding children and young people also concerns ensuring there is a sufficiently, healthy culture that does not unwittingly contribute to potential harm regarding the people who use and deliver NHS services.

Safeguarding within the Trust

My primary task is to ensure that clinicians protect their patients/service users from avoidable harm and are also able to recognize and appropriately respond to situations where under 18s are in need of safeguarding. My secondary task is challenge practices which are either harmful or could lead to harm. The Trust is commissioned by NHS England to deliver a National Gender Identity Development Service (GIDS), which provides services for children and adolescents diagnosed with gender dysphoria. The treatments available also include "puberty blockers".

I have sought to ensure the principle of ''safeguarding children and young people'' is upheld whilst service users are being assessed and treated within the GIDS service.

My Claim

I lodged a whistle-blowing claim in November 2019 at the Central London Employment Tribunal. Since then I have made 2 applications to amend my claim as new information came to light.

In my claim, I allege that because I made "protected disclosures" to my line manager regarding concerns raised by GIDS staff ( that the health or safety of patients was being, had been or was likely to be endangered), I was subjected to detriments.

I allege these detriments are:

i) the Tavistock misused it's own procedures to besmirch me and therefore jeopardize the role of safeguarding within the Trust;

ii) there was an unwritten but mandated directive from the Tavistock management that safeguarding concerns should not be brought to my attention despite being the Trust Safeguarding Children Lead;

iii) and, clinicians were discouraged from reporting safeguarding concerns to me.

I also allege various other detriments.

Further to disclosures made to Newsnight by former staff, BBC Newsnight produced a programme focusing on the allegation that the Trust did not want to report any concerns to me. www.bbc.co.uk/news/health-51806962

and you can watch it here

Found that GIDS wasn't correctly using the trust's care notes system (electronic record) and instead using their own form, and this posed a problem.

The CQC assessment of Tavistock GIDS service in January 2021 identified serious problems with record keeping

The Inspection report is damning. Inspectors found:

Staff did not always manage risk well. Many of the young people waiting for or receiving a service were vulnerable and at risk of self-harm. The size of the waiting list meant that staff were unable to proactively manage the risks to patients waiting for a first appointment.
For those young people receiving a service, individual assessments were not always in place with plans for how to manage risks.
Staff had not consistently recorded the competency, capacity and consent of patients referred for medical treatment before January 2020.
Staff did not develop all-inclusive care plans for young people.
Records of clinical sessions did not include any structured plans for care or further action.
Staff did not fully record the reasons for their clinical decisions in case notes. There were significant variations in the clinical approach of professionals in the team and it was not possible to clearly understand from the records why these decisions had been made.
www.transgendertrend.com/care-quality-commission-inspection-gids-inadequate/

(446/7/8) YG brings up s/g audit from May 2018 and then meeting in June, which results in some action points. With the exception of Dr Senior having a conversation with Sally, it seems to me these are all external things, rather than involving the service

SA - i can see that and i think i've made clear this was a very complicated scenario that i could not solve by myself. It was likely it would result in something transformational happening to the service...

...but what i was doing was meeting with Garry, and these were by this point in the presence of Sally Hodges, and also included Dr C... there were some very basic s/g issues that we needed to attend to

YG - Dr R's recall is that there were meetings but they were about other things, than specifically about trying to come up with an action plan

SA - i believe that Dr C and Dr H wrote to the gids service seeking both of them to bring about a multi-pronged form of remedy... at that time i was doing my very best to make sure the right people were involved in this conversation...

I had learned from the previous autumn that this wasn't just a matter for safeguarding, but needed involvement from all key stakeholders in the organisation, and frankly it was like trying to herd cats. Solution to complicated, serious situations does not happen overnight...

SA - "I was trying to engage the organisation to understand the magnitude of difficulties."

YG now on July 2018 - proposed meeting with Dr Bell, Polly Carmichael and SA. YG suggests that PC felt blind-sided...

SA - the suggestion is that somehow i was acting as an intermediary for Dr Bell. If anyone wanted to find out from Dr Bell what he was doing then surely they'd be best to follow up with him?

YG cites email (just mentioned) from Sally Hodges and PC to gids staff. Do you respond to Dr Hodges given you'd been so involved in raising the concerns?

SA - I can't remember whether i did or didn't but what i was v pleased to see was that Dr Hodges... and Dr C, given they'd co-written the response, was that they'd copied in the CEO to the email correspondence which wld lend a great deal of authority, which i was v pleased about

YG - what i'm concerned about is that you don't appear to respond to dr hodges in a collegiate way and instead you respond to dr bell to critique the email communication... i wonder why you thought that the course to take rather than lending support to dr hodges?

SA - dr hodges was already very aware - and i want to make it v clear - that i was as supportive as i could be within my role... and i was v pleased that dr hodges and dr carmichael had the foresight to alert the CEO...

...the fact that Dr bell then wrote to me and i responded is no indication of disregard for dr hodges. she actually says pointedly to Dr bell that she is aware of my help and is grateful for it and makes the point that I am keeping her abreast of concerns...

...To read into that that i was disregarding of Dr hodges and dr Carmichael's involvement is frankly unhelpful.

SA clarifies she thought response from SH and PC was robust and told Dr Bell it was a v good response; that they understood it was their responsibility to deal with the challenges...

...He had asked whether she would join him in writing to gids staff to say they could speak to them at any time and she thought that 'provocative'.

YG again questions why, given her raising of concerns for a year, SA didn't write to Sally Hodges to say she was pleased with email to gids
SA: "i don't ordinarily send congratulatory emails to someone who does something that it required" ...

...but that is not to suggest i wasn't supportive.

YG again questions why, given her raising of concerns for a year, SA didn't write to Sally Hodges to say she was pleased with email to gids

Haha who does this? And if she had, wouldn't that be twisted to look like she 'had an agenda'?

(my note - it's quite a stretch of the imagination to suggest that a social worker should be responsible for operations, processes, IT-systems, record keeping and communication across multiple agencies)

(my note - my interpretation is that their digital services, IT systems, operations, processes and/or the use of them, was not fit for purpose. As a result serious complicated safeguarding concerns were not captured, communicated or acted upon)

(my note - and the nit-picky grilling of which emails Sonia replied to shows a weak defence imo)

(need to step away for 30 mins)

Quite a lot of the questioning is trying to show how PC was 'blindsided' by sa's actions, and sa was a meany for not congratulating senior people for doing their job. There is an expectation that everyone should be softly softly and kind, even if they are raising really important things and trying to get systems set up that will protect patients. There doesn't seem to be any denial that the things were really important. They want her retrospectively to have taken the apologetic tone that lots of women end up taking in meetings - 'that's such a good point but I don't mean to be a pain but maybe we should think about it in this different way and consider this other thing if you don't mind sorry'. (I'm exaggerating but they don't like her being direct and not thinking enough about senior people's feelings).

YG again suggests that SA was not supportive of gids in helping to overcome the issue of the service not recording s/g issues in care notes. SA again disagrees and says she was supportive

Discussion of case where designated nurse from Cambridgeshire calls SA. She says gids view of this is that she should have referred to GR, but says NHS protocol dictates that they wld directly contact the named professional - and that is exactly what happened...

SA - i responded to that and we made a plan. and when i came off the call i alerted mr richardson. i also looked at care notes record to be informed.

In essence the concern was why did the trust make a safeguarding referral to CAMHS service rather than local authority who have statutory duty to address that. Without further info i couldn't address that, so i alerted GR and looked at case record

SA - it's not that anyone is disregarding the gids service, the protocol would always be that the named professional (i.e SA) wld be contacted first, irrespective if GIDS had its own s/g lead
YG - But GR was aware of the case so looks like you're undermining him.

SA - i'm not undermining him. (SA goes into some extra detail)

Lunch break!!

YG again suggests that SA was not supportive of gids in helping to overcome the issue of the service not recording s/g issues in care notes. SA again disagrees and says she was supportive

Discussion of case where designated nurse from Cambridgeshire calls SA. She says gids view of this is that she should have referred to GR, but says NHS protocol dictates that they wld directly contact the named professional - and that is exactly what happened...

SA - i responded to that and we made a plan. and when i came off the call i alerted mr richardson. i also looked at care notes record to be informed.
In essence the concern was why did the trust make a safeguarding referral to CAMHS service rather than local authority who have statutory duty to address that. Without further info i couldn't address that, so i alerted GR and looked at case record

SA - it's not that anyone is disregarding the gids service, the protocol would always be that the named professional (i.e SA) wld be contacted first, irrespective if GIDS had its own s/g lead

YG - But GR was aware of the case so looks like you're undermining him.

SA - i'm not undermining him. (SA goes into some extra detail)
Hannah Barnes
@hannahsbee
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3m
LUNCH

Hannah Barnes tweeting
YG again suggests that SA was not supportive of gids in helping to overcome the issue of the service not recording s/g issues in care notes. SA again disagrees and says she was supportive

SA - i responded to that and we made a plan. and when i came off the call i alerted mr richardson. i also looked at care notes record to be informed.

In essence the concern was why did the trust make a safeguarding referral to CAMHS service rather than local authority who have statutory duty to address that. Without further info i couldn't address that, so i alerted GR and looked at case record

Sorry InvisibleDragon you beat me to it!

SA - it's not that anyone is disregarding the gids service, the protocol would always be that the named professional (i.e SA) wld be contacted first, irrespective if GIDS had its own s/g lead
YG - But GR was aware of the case so looks like you're undermining him.

SA - i'm not undermining him. (SA goes into some extra detail)

Lunch.

Uh oh cross posting. Seeing double!

SA - it's not that anyone is disregarding the gids service, the protocol would always be that the named professional (i.e SA) wld be contacted first, irrespective if GIDS had its own s/g lead
YG - But GR was aware of the case so looks like you're undermining him.

I find it very difficult to comprehend that an NHS Trust would instruct its legal team to prioritise niceities over child protection principles. It raises a additional questions about the capabilities of Tavistock and Portman NHS Trust management.

I'm aghast that this is the Tavistock's defence - to pretend they don't understand safeguarding?

@Caorthann

SA - it's not that anyone is disregarding the gids service, the protocol would always be that the named professional (i.e SA) wld be contacted first, irrespective if GIDS had its own s/g lead YG - But GR was aware of the case so looks like you're undermining him.

I find it very difficult to comprehend that an NHS Trust would instruct its legal team to prioritise niceities over child protection principles. It raises a additional questions about the capabilities of Tavistock and Portman NHS Trust management.

Exactly - isn't one of the basics of safeguarding that you never assume that action has been taken?

I mean if someone is contacting the safeguarding lead at the Tavistock that they feel the GIDS safeguarding are not acting appropriately - it's totally within the remit of the Tavistock lead to enquire into that case. To see it as 'undermining' fails safeguarding.

The judge should stop this, it's wasting time.