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

Yes, this from PC made my jaw drop
"The context is the team grappling w some very difficult issues, the service expanding rapidly with bots of new clinicians...we needed support rather than criticism."

Constructive criticism from someone with specific responsibilities for safeguarding and a bigger foot in the outside world was exactly what they needed, not being "split off" from and "polarised" to the trust/real world responsibilities , and being left to look further inwards.

Thanks for the comprehensive postings @ItsAllGoingToBeFine

Constructive criticism from someone with specific responsibilities for safeguarding and a bigger foot in the outside world was exactly what they needed, not being "split off" from and "polarised" to the trust/real world responsibilities , and being left to look further inwards.

I guess the culture of requiring unquestioning validation and affirmation didn't just apply to the service users...

@ItsAllGoingToBeFine

AP - par 20 - wld you agree that only recently the central S-g team have been referred to that way? PC - don’t know … Would see the trust safeguarding team and central safeguarding team as the same thing

Ap - p398 SB - GIDS board paper July 2018 - on 402 you say we’ve completed a review of how safeguarding concerns are documented… appointed a team safeguarding lead who will liaise with the central team; suggests you’ve just appointed GR as lead

PC - I understand that a big distinction is being made between link and lead. In GIDS itself he became the safeguarding lead on the ground. There wasn’t a specific date that he became it. Sorry that’s not more concrete but that’s my reality
Ap - that’s fine

395 - email from PC saying she will identify someone as a link. Pc - don’t know where word comes from but intention is to improve communication betw GIDS and trust safeguarding team

Ap - 249 - GIDS organisational chart. GR there - and he’s a senior?
PC - yes one of the management team. Pc confirms that exec sits above that

PC says nothing was put in writing about GR’s role. It was about communication and having a named individual in the team. And it evolved from there
… I was aware of the want to have other leads in other services but there wasn’t a job description at the time

With such woolly headed thinking from Polly Carmichael, I am no longer surprised at the lack of record keeping/outcomes for the young people accessing GIDS.

"There wasn’t a specific date that he became it. Sorry that’s not more concrete but that’s my reality"

Your reality? Anyone else had a job without a start date?

The word 'complicated' has been used an awful lot. Is it a get out of jail free word? Words like complex and complicated always get my alarm bells ringing.

I guess the culture of requiring unquestioning validation and affirmation didn't just apply to the service users...

I remember being taught once upon a time that people working with groups with specific needs will often take on some of the characteristics of that group. The example given was managers in a homeless shelter being very particular about their 'belongings' (small work supplied items such pens etc) reflecting their client's concern for the few items they owneed.

"There wasn’t a specific date that he became it. Sorry that’s not more concrete but that’s my reality"

This was for a safeguarding post but no one (including the empoyee himself) knew when he actually assumed that responsibility??? So children could be at risk but ignored because he thought it wasn't his responsibility but other people did? Or clinicians wouldn't know who to refer onto as does he do that job or not? I presume if a case where there was safeguarding failures during that time this individual would be able to say it wasn't him and no one could say otherwise?

Yes, I have to say I was sniggering at Polly’s word choices and phrasing.

And this:

I think what’s missing from this, and I realise this is an employment tribunal, is that this is about children and families and cases are complicated… it’s not intended to undermine SA in any way at all.

Is the implication that PC thinks SA doesn’t understand the cases because they’re complex? If so…. wow! 😮

Is the implication that PC thinks SA doesn’t understand the cases because they’re complex? If so…. wow! 😮

It seems to be a 'theme' that they think they are special so normal rules don't apply.

From the outside this looks like a complete car crash of a service at GIDS, and as someone else said no wonder there were no proper records to provide to the Court in the Kiera Bell case. This service is dealing with children fgs, it should be robust and disciplined and safeguarding should be the number one priority not massaging feelings of clients, their parents or the people who work there.

I am appalled by what is coming to light here.

It can be hard to follow at times and it does seem very confrontational in the Tribunal, there also seems to be one hell of a blame culture and a not my job/problem, Guv attitude - it's horrendous that this is a service dealing with vulnerable children.

@Tibtom

I guess the culture of requiring unquestioning validation and affirmation didn't just apply to the service users...

I remember being taught once upon a time that people working with groups with specific needs will often take on some of the characteristics of that group. The example given was managers in a homeless shelter being very particular about their 'belongings' (small work supplied items such pens etc) reflecting their client's concern for the few items they owneed.

That's really interesting.

This reminds me of working with children from chaotic families where professionals can begin to mirror the chaos in their own work. It's why you need close supervision and good inter agency collaboration to ensure that the needs of the child stays centred.
It's also why, when disasters happen, the reviews usually highlight the systemic failures of the professionals involved. Often they've bought into the family chaos, identified and paid attention to the demands of the dysfunctional adults and ignored the needs of the vulnerable child at the centre.

Missed a bit... In other words safeguarding the child gets ignored / forgotten about with terrible consequences.

The mirroring conversation is interesting; I know a lot of teachers/have been in a lot of schools and have always thought that the atmosphere amongst the adults is rather, well, childish, even out of school now I have half an idea as to why!

Seriously though, this thread is invaluable; thank you.

@Tibtom

I guess the culture of requiring unquestioning validation and affirmation didn't just apply to the service users...

I remember being taught once upon a time that people working with groups with specific needs will often take on some of the characteristics of that group. The example given was managers in a homeless shelter being very particular about their 'belongings' (small work supplied items such pens etc) reflecting their client's concern for the few items they owneed.

This is a basic of organisational dynamics. The Tavi has a well established organisational dynamics consultancy team. They could have been a more useful resource than a new medical director solo and juggling different demands. It would have meant the service director acknowledging a dynamic problem between the service and the outside world that needed working through and sorting out, not reinforcing. I'd expect it to be a generally understood principle in a specialist dynamic psychotherapy unit at least at senior level. Was GIDS not one?

Ok, we're off again ...

THREAD: DAY 7 – Sonia Appleby v Tavistock and Portman Trust employment Tribunal

SA - Sonia Appleby
YG - Yvette Genn, Tavi counsel
AP - Anya Palmer, SA counsel
EJG - employment judge Goodman

Before what's set to be a busy day of witnesses, perhaps a helpful thing to clarify: Dr Sinha explained several times that he interviewed 31 people for his review of GIDS. It's perhaps worth noting that these weren't all members of GIDS staff, as stipulated by terms of reference t.co/9vi87ni6l1

Taken from GIDS review and action plan on Tavistock website. Six named posts are listed here. Assuming all four members of GIDS Executive were interviewed, this leaves 21 other members of GIDS staff.
t.co/3AY000MdNu

Today we are set to hear from:
Dr Polly Carmichael (PC) - Director of GIDS
Garry Richardson (GR) - Senior social worker and safeguarding lead for GIDS
Craig de Sousa - Director of HR, Tavistock Trust
And possibly several GIDS clinicians

AP continues questioning of PC...
AP asks about a whole team member in either Nov or Dec 2019
PC confirms both London and Leeds teams would be present
AP (AS Wpar 15) -

AS says: "I cannot remember when, but definitely before I met Dr Sinha when he conducted his review on 7 January 2019, we were first explicitly told by Polly not to take any safeguarding concerns to Sonia. I believe it may have been December 2018."
He also says: "Dr Carmichael seemed to be very stressed and she told the teams that
she could not understand all this concern about the safeguarding issues that Sonia clearly had an agenda, and that she was making all our lives difficult."

AP - do you remember saying these things?
PC - No i don't
AP - AS was very explicit in his evidence and remembering very clearly. you did say these things didn't you?
PC - No, i didn't. there had been earlier meetings where we talked about DB report, but i can't place the context

PC - i didn't say those things but there is a distinction to be made with the clinical work of the service and the patients... partic at that time there are two things - one is the clinical discussion often around indiv cases...

the other is different discussions about the service model, issues that people are concerned about such as sexuality and rise in assigned females etc...

i think it's absolutely untrue to say that concerns about safeguarding issues i couldn't understand them. I think if issues are raised, they were taken very seriously.

AP - AS was very specific.
PC - no it's not what i said. and if he'd had a problem with anything i'd said he should have raised it... i did not say that, much of this is second hand
AP - this is first hand evidence from AS.

PC - if anyone was upset by anything i'd said that should have been raised
AP - AS did raise it with Dr Sinha
PC - the review was much later

AP - AS met with Dr S 7th Jan, so that would be a short time afterwards, wouldn't it?
PC - Indeed
AP - he says that at p1452. He says a number of things:
"people were not encouraged actually
to talk to the safeguarding team outside the GIDS safeguarding team..."

"... until September or October this year when Gary
Richardson was placed as a safeguarding lead in GIDS, but up until then there was a very clear message actually from senior management about being really cautious about how we talk to the safeguarding team at the Tavi...

"and specifically Sonia Appleby...She thinks that Sonia Appleby has a very clear agenda about GIDS and she thinks we are not on top of the safeguarding concerns in GIDS and...

"especially in the last how many months until the announcement of the review, there was a
message actually towards the clinicians at least to people who are talking to Polly directly about
having to be really cautious about how we talk to Sonia about safeguarding issues..."

AP - And Dr Sinha appears to deflect that doesn't he
PC - I can't speak for Mr S...

PC - Dr Spiliadis clearly has his own perception, and i'm not going to speculate where that comes from... and that is incorrect. i come back to my point there were exceedingly strong feelings in the team and some felt that their concerns were not being addressed within the team.

i wouldn’t agree with that - there were attempts ongoing to address their concerns, but they felt that wasn't the case and took their concerns to other people. i think this is confused... there was not a directive, written or not, not to go to Sonia
AP - it's not a matter of perception is it? Either AS is right and you did say this, or you are right, and you didn't
PC - i think the context is there are exceedingly strong feelings around dif approaches or understandings about what is the best approach in this field...

and certainly there are discussions in the team about these v difficult issues and i think that is dif from the c;inical functioning of the team and sonia and i do not believe that there was a directive not to speak to sonia or an undermining of concerns...

indeed we bent over backwards to accommodate these concerns... these beliefs arose from discussions about how to treat people with GD

AP - Dr C, you can't both be right - either you're telling the truth or AS is. it's that simple isn't it?
PC - i can only imagine that in general discussions about v emotive issues in team - and around the time of the review where SA's name was associated with the bell report -

i'm sure there were discussions about individuals' feeling about nature of the work and working with young people... i can say quite honestly that i couldn't tell you what SA feels, so i don't think i'm saying specific things with that regard.

this was a v emotive issues; there was a lot going on. dif groups of people felt they needed to go and speak to people and i put to you where there is lots and lots of discussion about things things get amplified and distorted ...

and i'm saying i can't imagine saying those things in that form
AP - let me put it to you one more time - you're alleged to have said don't go to Sonia, she has an agenda about GIDS... Is there anything you said that could have been misconstrued ?

PC - i cannot remember anything i said at that time that could have been misconstrued in that way
AP - P490 - Points to four texts from Melissa Midgen. AP says that tribunal heard from ACC that she was present at a meeting where team told to go to Garry, and not Sonia

PC - what has been said to the team is go to G in the first instance and that is not the same as don't go to Sonia... as we've heard from Anastassis he went to Sonia without telling me...

i think there was a feeling that people were going to Sonia - that's fine. but i think it's important those discussions are had in the team. we cannot get to grips with these very important issues about how to treat young people with GD if we don't discuss these v difficult cases

PC - I would go further than that... i think we needed to be aware of the issues arising but that it not, therefore, don't go to sonia. and people were going to sonia... GR is a highly respected member of the team and people think his input is valuable

AP – these texts are from MM who has spoken to ACC and is passing that on to Anna Hutchinson. Texts included “the executive are trying to steer people away…” and “To suggest people try to avoid Sonia is not right”

PC – this is exactly how things get confused and amplified… where things are split and there are groups of people with a particular view and they’re clearly exercised – it was obviously of great concern to them…

I would suggest that the exec is being positioned.. and it is not the case. What does it mean to say the exec are trying to manage safeguarding? We have a responsibility to provide a safe service. Safeguarding underpins all that we do

(my comment: PC is not coming out of this well at all.)

AP – you said these are groups of people with a very particular view – you’re suggesting they have an agenda aren’t you?
PC – I think you’re reading too much
AP – well what did you mean?

PC – I think it’s clear from the text that they are in communication with each other and …
AP – of course people are exorcised about it, because they think it’s not right…
PC – I did not say that about Sonia… so we’re going to have to agree to differ

AP - there is a huge difference betw I may have said this and it’s been misconstrued and this is a group of people with a particular agenda
PC – I did not say that and you’re putting words into my mouth

AP – Par 36 AH statement (118 W) – Dr Hutchinson says: “I believe they are the texts when I first heard that the exec were trying to manage safeguarding in house and were steering people away from Sonia.”

PC – That is her interpretation.. my interpretation is that there was an agreement which Sonia was part of… that safeguarding would be more rooted within the service… and that yes the team were told the appropriate process was to go through Garry in the first instance...

but quite aside from that there was nothing to stop anyone going to safeguarding… but it was also about the team being aware of safeguarding issues

AP – Par 33 Dr Bristow’s statement (80) “Dr Hutchinson told me and Dr Prescott that she had heard from another former colleague, Dr Melissa Midgen … said that in a full team meeting that Polly had told the team not to speak to Sonia. That is my recollection.”

AP - I appreciate it’s not first-hand evidence but clearly supports the first hand evidence of AS and ACC
PC – this is second and third hand info – so is it not a refection of the same conversation we’ve just been talking about?

My answer would be the same – in the first instance go to Garry, and if not Sonia or central safeguarding. So I think in the team ‘we were embedding that practice.’

AP – I want to turn to individual instances where you told people not to go to Sonia (101W) and goes to AS’s statement
Do you recall having 1-2-1 meeting with MR S?

PC – I do recall a couple of meetings with Mr S about cases – they weren’t formal meetings…I’ve talked with anastassis about complex cases. Don’t partic recall speaking to about them on his own, but I may have

Anyone else who regularly deals with safeguarding concerns amazed by all this?
I regularly put in safeguarding alerts/concerns, usually to my organisations own safeguarding and simultaneously to social services externally. It would never cross my mind to think anyone might be offended, or that I need to be careful about who I tell first. And I feel pretty confident that I don't need to - we're all in the business of protecting vulnerable people,.
I'd hate to be in an organisation that puts reputation before protecting vulnerable peopel.

They are talking about fabricated and induced illnesses. One if the safeguarding concerns was a case like this. And the way PC talks about it makes it sounds like it's something they know is sometimes an issue.

"PC – No I don’t… on the basis of the evidence I’m aware of I don’t believe it happened.. and I believe I would recall it because FII in the team was quite an issue…"

What does that mean?

AP – AS says: “Polly’s message about Sonia’s position towards GIDS developed and intensified over these recurring meetings, “that Sonia has a very clear agenda about GIDS: that being that “Sonia does not think we are on top of safeguarding concerns”.

PC – it’s just incorrect to say we had recurring meetings…
AP – I suggest you did say those things to him
PC – No I didn’t

AP – Look at paras 23 – 27, he talks about a specific case where he had concerns about Fabricated or induced illness (FII)… do you recall discussing this case with him?

PC – No I don’t… on the basis of the evidence I’m aware of I don’t believe it happened.. and I believe I would recall it because FII in the team was quite an issue…
AP – is it the case that none of this happened or you don’t recall it?

PC – On the suggestion that he and I talked about this case in the past prior to it being raise din an email by SA I do not recall talking to him about the case. The first time I did talk to him about the case, I recall, is ..

.following an email from S saying that she had been contacted by the designated nurse… to be completely clear (quotes from par 23) – and I do not refer talking to Anastassis about this case at that time in several meetings.

However, at a later date Sonia was contacted by the local designated nurse (par 26) – and that is when I spoke to him… he then says (par 27) that he went to polly’s office. I don’t recall that and I don’t understand that because when he looked at sonia’s email he was going away

AP – is it possible that he’s popped his head round the door to speak to you – and you’ve not put the cases together as being the case he’s talked to you about on the phone?

PC – I don’t recall speaking to Mr S about this case, but as you say it’s possible. But I don’t recall. I recall other cases I’ve talked about with Mr S

AP – Quotes AS: “Polly called me on my mobile whilst I was at my other job ...Polly sounded very worried, she told me that she was very anxious and worried and was asking me what was happening with the case because Sonia was chasing GIDS...

"I replied to Polly that this was the case I was talking about in consultation when I had serious concerns about safeguarding and you, Polly, had told me not to take this case to Sonia.”

PC – I do remember the case. If there had been such serious issues that Mr S felt there were issues he could only discuss with me and not GR there was no record of this on care notes… I did call him…

In fact I wanted to reassure him we had this in hand in terms of passing on the info requested. I do not agree … with the explanation being put here… what I can say is that when contacted by Sonia I did a thorough review of the notes and...

apart from no record of any conversation... with myself it was clear that safeguarding had been raised locally… the interpretation that I would tell anyone don’t do safeguarding and put forward for physical intervention is not correct.
PC – I know that if anyone in the team brought a concern about sg to me I would take it v seriously, I would listen... it is not my role to take a directive role to tell them how to conduct their cases.
AP – well that’s exactly what he’s saying in this case

AS "A few days after this call I went to Polly’s office and we started talking about this case. Polly was downplaying the significance of safeguarding concerns. Polly then told me that and we should be really careful when talking to Sonia...

"I understood she was not happy that Sonia had got involved with the case. Her words were ‘you should not just take cases to Sonia – you should discuss things internally and avoid talking to Sonia
as I don’t know what her issue is with GIDS’.
Do you remember that conversation?

PC – That conversation did not take place… firstly, he was out of the country at that point… I wld not downplay the sig of sg concerns. If FII is mentioned in any context… it is an exceedingly serious concern and that should be discussed with Sonia

... – absolutely it’s not true that I would say that. It’s also not true that I would be unhappy about Sonia being involved in that case. Sonia had been contacted by the designated nurse.

StellaAndCrow I completely agree. I work somewhere where we regularly encounter safeguarding concerns. Recording them and passing them on to the correct external body is part of the job. There are cases where it is very complicated to work out how to handle something - for example if everyone suspects that there is an issue but there is no evidence to enable any action to be taken. Or where everyone knows that an adult is at risk but they themselves don't want anyone to do anything. But that doesn't mean that you don't still log the concern somewhere and explain why you did whatever you did.

It really looks here like PC is saying "if there was something that was a real safeguarding concern we would of course take it very seriously" whilst finding excuses (including not taking any action) for why other people's concerns weren't serious enough to do anything about.

I find that very similar to a lot of people's response to sexual assault allegations: rape is wrong, rapists should be locked up and the key thrown away ... But my Nigel would never do that ... There must be some misunderstanding ... She was asking for it etc etc. It's a form of moral abdication that allows someone to feel like they are on the 'right' side while simultaneously ignoring and minimising anything uncomfortable.

PC is using the everyone is lying and is wrong except me and if they are not I can't recall or remember defence, and this is a person in a position of seniority in a service dealing with vulnerable children - words fail me.

Manderleyagain I think FII may have been a hot topic at GIDS because of the re J case:
www.familylaw.co.uk/news_and_comment/re-j-a-minor-2016-ewhc-2430-fam

Mother said 4-year old child was trans, services disagreed, mother wanted kid to live in stealth, big court battle, child placed with father and subsequently desisted. Mermaids offered lots of support to mum and came out looking very bad.