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

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

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?

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

It appears as if NHS Tavistock GIDS is applying relationship counselling principles above the requirement that senior staff discharge their reponsibilities to care for the very vulnerable children who are patients.

(P472 475, par 76 SA) YG is discussing Tavistock electronic notes system, Care Notes. What more did you do to facilitate changes to better document in GIDS staff?

SA - the patient safety officer was to help GIDS with this administrative task…
But as already pointed out earlier, Dr Hodges requested that I step away until October to allow these changes to be embedded… I think she says she expects Mr R to come back with a plan

YG - were you aware that for some time GIDS had been missed off an all-trust email circulation list re: updates to care notes? SA - yes. I believe it was a matter that the patient safety officer uncovered
YG - the role you’ve got now, you say, is ltd, while GR and SH take other matters forward SA - I basically put myself on hold, at the advice of SH, until October.

YG - in august 2018 there’s a change of leadership. Dr Dinesh Sinha is appointed and he becomes your line manager? SA - yes, he does YG - he has a different style toner Senior and from outside the trust?
SA - yes he was

YG says he hit the ground running. CQC inspection, Bell report submitted to governors and the review that followed afterwards. Were you familiar with the reason that the reason why Dr Sinha was given that job was that he was a new person and did not have a side whatsoever?

SA - I did not know that

YG - re: your relationship with him, would you accept it wasn’t surprising that you did not have the engagement you perhaps would have liked to have in a less busy time?

SA - I wld have preferred to have had more contact albeit from what you’re saying he had to hit ground running

YG - would you agree it was not an easy relationship? He will say that you were not used to rather closer management in his style?

SA - I don’t agree. I had monthly supervision with Dr Senior and wld see at least once or twice depending on number and complexity of issues in trust re: safeguarding.

YG - fact is when dr Sinha was your manager you operated without close consultation with him: in oct 2018 you’d asked GR for safeguarding data.

S- - every quarter I have to collect safeguarding data -every single service where child is primary patient has exactly the same request. So rather than ask patient safety officer to get the data I was encouraging GR to undertake these audits himself, following our talks in Aug
… and these are the kind of requests I make to every single service.

YG - I can’t see you providing that level of detailed explanation other than in an email to sally Hodges

SA - GR would know that every quarter I look at this data. If he wasn’t aware, I’d be surprised but we could have moved on from that.

YG - it’s only when SH challenges it that you provide the data SA - I wrote directly to Garry saying this is what we need, referencing our conversations in august

YG says SH advises that GIDS is under a sig burden at the time, gathering data for NHSE. You don’t take account of this

SA - I think this is a misunderstanding the emails. I acknowledge they were compromised in providing the data because they were providing data to another body

YG - I’m going to suggest that you’re suspicious about GIDS not providing information you think needs to be provided without accepting any difficulties at all. This is all part of your belief that.. (inaudible)

SA - if you read what i say I say I didn’t know this and I’ll ask the patient safety officer so I don’t think your portrayal of me is accurate
YG - we’ll see

YG references email from Dr Sinha asking to explain the data request you had made… you take that’s a some kind of extremely poor treatment of you. Why are you upset by Dr S asking you to be managed by him?

SA - I was less upset and more curious as to why he wasn’t aware that as a safeguarding lead I would collect quarterly data

YG - he makes a perfectly reasonable request - why do we need this information from GIDS and who has requested it?

SA - as far as I was concerned… I responded to my line manager - unfortunately he may not have seen my email, but I was really concerned that his response was cancel the meeting with GIDS. But this was 2018. My statement is written in 2021 & by then I had formulated a dif view

YG - it was nothing more sinister than seeking clarification over a data request

SA - I did the very best I could. My line manager asked me for context and i provided it… just to make sure I wasn’t wrong footing myself I sought to clarify with him….

SA - It seems to me the line of questioning is basically whatever I did, I was wrong… you’re suggesting suspicion, when in fact I was cautious…
I responded to dr Sinha in a timely way providing him with the context he sought.

YG - let's go to your meeting re: GIDS review... you produced a document...

SA - it's not simply as an aid memoir, but as a document to submit as part of the review...

YG - in the interview you had, i'm going to suggest he puts a similar line of questions that he puts to everyone else... you suggest that's he's interrogating you or ill-mannered...

SA: I want the court to know that I was never given the opportunity to review the transcript… he was ‘very cool’ in his treatment…But I very strongly felt he did not want to hear about the very serious concerns clinicians had brought to me

SA - it was not a review about me, it was a review about the service. And the service includes the people who work for the service

YG - the purpose of the review and it was designed to capture the views of people in the service.

YG - and he interviewed 31 people… and at the end he said is there anything else you want to tell me?

SA - yes

YG - and confidentiality was promised and that was to garner open views… the report is also accompanied by an action plan…

SA -yes

YG - I’m looking at C and one of the actions is to develop an SOP for GIDS and you worked on that with PC and GR didn’t you?

SA - yes

This is so hostile and confrontational. Instead of denying or disproving Sonia's claims, it seemed the defense is to try to pick apart the nuance of every interaction

YG - had you seen that action plan prior to court bundle?

SA - yes
SA confirms there’s nothing controversial in it, needs to be redefined over time, but I took part in action 14

YG - surprised you didn’t mention action plan in your statement. You pick up one word in the whole report (p1507) and decide that’s about you. It’s a rather self important observation on your part.

SA - what I wanted to point out in a witness statement that has a v specific focus was that dr Sinha seems to make a point himself as to whether safeguarding team itself was being respectful

YG - you disrespect all the work that has gone into this report and interpret it as being about you

SA - No.

you disrespect all the work that has gone into this report and interpret it as being about you

WTF. Is this normal from the opposing barrister? It seems very high on negative opinion and low on fact, as well as unneccessarily aggressive.

YG - there’s nothing in action plan that sidesteps or disregards your role. Do you agree?

SA - yes…

YG - you didn’t have any concerns that referrals were going to dr Senior and then dr McKenna…

SA - obv there are conversations that take place within services that s/g leads are not going to sighted about, but where s/g issues are brought to the safeguarding team we agreed it wld be recorded in the safeguarding inbox. And they were not.

(Explains this wasn’t Mr R’s responsibility, but rather the person he was having conversation with)

WTF. Is this normal from the opposing barrister? It seems very high on negative opinion and low on fact, as well as unneccessarily aggressive.

I work for one of the medical regulators and in my experience it’s normal for barristers to be adversarial when cross examining witnesses. SA is represented and her barrister will be quick to object if the questioning becomes unreasonable.

This is cynical and pretty poor from the Tavistock's legal representative, given (a) the scathing CQC report, (b) the Keira Bell judgement, and (c) the interim materials coming out of the Independent Review by Dr Hilary Cass.

Cass says she is in communication with, among others, the Tavistock about her inquiry and next steps. I hope she wonders, from this, if the Tavistock is acting in good faith, and indeed capable of improvement.

EJG - so people who were meant to record these conversations were you and Dr McKenna?

SA - correct

YG - you suffered ill health in 2019 and absent until May. Not your fault, but that contributed to you being unable to build a relationship with dr Sinha

YG - I think it was explained that you line manager needed to know details in order to manage any needs for your return to work

SA - I didn’t actually know that those documentations had to go to line manager and not HR. That had changed and when I realised i did send direct

YG - he’s trying to be supportive and helpful

SA - yes I can absolutely see that and I did absolutely everything he requested of me.

YG - your witness statement makes out things to be much darker than they actually were

SA - I’m not putting a ‘bleak perspective’ on it. I thought it would be helpful to agree a time to speak when I came back. Which is exactly what happened.

(Discussion of meeting between Dinesh Sinha and SA)

Yg - back to work meeting was not designed in any way to strip Gounod your functions?

SA - as far as I can ascertain, no it was not

YG - what is the evidence to show that you are perceived or being treated as a pariah? (Par 125)

SA - since the latter part of 2017 I was trying to raise concerns within the trust and I said as early as June 2018 I was cast as a person asking difficult questions

YG - where?

SA - it’s in the correspondence

EJG - bottom of page 418(???)

Looks like they've stopped for the day and/or hannahsbee has been called away.

CQC assessment January 2021,

Staff access to essential information
Information needed to deliver patient care was available to all relevant staff, although we found that staff kept records in an unstructured and poorly organised manner. This meant that it could be difficult to find important information quickly. For example, records did not include documents giving all the key information about young people such as details of the person or people with parental responsibility or professional contacts in other agencies such as schools and CAMHS. Records did not include care plans. Risk assessments did not include comprehensive risk management plans and some were not completed fully. Assessments were not recorded in a structured manner. This meant it would be difficult for someone unfamiliar with the young person to understand the work that had been carried out.

Observer interview with Dr David Bell after the Bell vs Tavistock judicial review,

Bell’s report anticipated the concerns of the high court and he feels vindicated by its judgment. “It was jaw-dropping,” he says. “Because it was very strong.” As he read it, he was struck by details that have not been widely reported, particularly those involving a lack of data, a problem he had raised himself (GIDS was unable to produce for the court any data relating to outcomes and effects, whether desirable or adverse, in children who had been prescribed puberty blockers; nor could it provide details of the number and ages of children who had been given them). But the experience was painful, too: “I felt concerned that we’d moved away from the values [of care] the trust has embodied for so long.” He is astonished the judgment seems to have had so little effect on the organisation of GIDS. “Ordinarily, heads would roll,” he says. “The management structure has changed slightly, but it feels like window-dressing.”

www.theguardian.com/society/2021/may/02/tavistock-trust-whistleblower-david-bell-transgender-children-gids

Tavistock and Portman Trust are appealing the finding of the judicial review and this is due to be heard next week 23/24 June.

@Caorthann

Tavistock and Portman Trust are appealing the finding of the judicial review and this is due to be heard next week 23/24 June.

Apologies but I'm getting lost What judicial review?

Keira Bell & Mrs A vs NHS Tavistock judicial review is being appealed. This is heard next week.

Blimey, already?

and:
Were you familiar with the reason that the reason why Dr Sinha was given that job was that he was a new person and did not have a side whatsoever?

What "side"? (Assuming this isn't a typo) -isn't this admitting implicitly that there were 'sides'?

That's the date given on Keira Bell's Crowdjustice update.

Dr David Bell is an intervenor, also from the same update,
also 7 intervenors who want to see the judgement of the Divisional Court overturned. These are the University College London Hospital NHS Foundation Trust, the Leeds Teaching Hospitals NHS Trust, Brook, Gendered Intelligence, The Endocrine Society, the Association of Lawyers for Children and Liberty.

Allison Bailey QC via Twitter,

1/ BREAKING: Explosive testimony on Day 4 of Sonia Appleby's case Employment Tribunal against GIDS.

• Clinician Dr Churcher Clarke gave evidence (witness summoned) that Dr Polly Carmichael, head of GIDS, told her not to go to Sonia Appleby with safeguarding concerns.

2/ Dr Churcher Clarke - Sense that the senior Executive team had a sense that following the leaked report by Dr David Bell, which raised safeguarding concerns, people were out to get GIDS.

3/ Dr Churcher Clarke - Focus of Dr Polly Carmichael was not on the safeguarding concerns raised by Dr David Bell but on who had spoken to him.

There was a "are you with us or against us" mindset.

4/ Dr Churcher Clarke - it wasn't her experience that Dr Polly Carmichael was concerned about the safeguarding issues raised by Dr Bell.

5/ Dr Churcher Clarke - was concerned about a GIDS patient who was convicted of sex offending and wanted to transition, in part so they wouldn't be recognised. Concern that this was not viewed as a safeguarding issue.

The hearing resumes on Monday 21/6/21

twitter.com/BluskyeAllison/status/1405558398247112710