NHS Policy Audit - working party

[KnottyAuty]

Following on from Thread #23 of the Peggie v NHS Employment Tribunal. Anyone who wants to help with survey/audit of paperwork against the Equality Act protected characteristics please join here 😊

The consultation process is important to highlight - particularly as, in most of these trusts, consultation - if any has been done - has only been with groups like Stonewall and local LGBTQIA++++ groups, etc.

I have not yet come across any consultation with women’s groups or religious groups or any others who may also have valid reasons to object to purportedly SS spaces actually being stealth mixed-sex spaces.

Knotty, I salute you. It's brilliant work.

The one build I'd have is whether it's worth explicitly pointing out the number of trusts where this information wasn't actually provided at all, and we had to result to FOIs from another citizen. So they're not just misleading with words, they're actively trying to conceal and stop us joining the dots.

Just had a random google about DATIX and this came up (NHS Wales - don't know if it's the same system in England, Wales, Scotland or even if this is accurate). Redress Module

Anyway, looking at this there's a way to record sexual assault even if no specific category under 'injury details'. and 'incident details / what happened'. Under 'incident type' it appears to be a drop down list of categories but there are free text fields which could be searched for 'rape' or 'sexual assault'. Even if this is not exactly the dataset used, I bet there are free text fields, it would be a failure if there were not. So I think the response to the FOI is disingenuous. They basically don't want to spend any time looking. What a surprise they're being disingenuous

It's a response designed to shut down pesky women who think this should be recorded by a taxpayer funded service.

However keeping clear data on rapes and sexual assaults seems like it should be something that is prioritised over lots of the word salad we've found. For a start, It doesn't seem very fair to transmen id-ing into the male spaces with the types of humans more likely to commit sexual assault if this data isn't kept, so one could almost say transphobic (but only to female trans people, so no-one cares? Apparently sex matters?).

Hopefully there are some medics on here that could comment.

Other fields include 'method violence or aggression was received by' and 'has perpetrator been identified' and 'please provide as much information as is known about the perpetrator'.

There was one Scottish one done - can't remember which - where the EqIA screening mentioned that a survey had been done and 11 "written responses" objecting to aspects of self ID but it was glossed over and ignored. I had wondered how many verbal comments they received as a veil was drawn over that. I worked out from staff numbers and average % that there were more objections than trans staff in the whole trust - and that was likely to be a suppressed number of complaints if there was a threat of disciplinary...

This is the rest of the answer from the FOI above:

Under Contributory Factors Violence and Aggression we have the drop-down of Sexual Abuse, however this is not the same thing and would result in unreliable data.

We carried out a word search in the Situation field for Sexual Assault and Rape. Some of the
adverse events are of “Verbal aggression of an explicit or sexual nature, including threats of
rape” almost all due to poor mental state, however none are actual Sexual Assault or Rape.
Therefore, there is nothing we can provid. As per Section 17 of the Freedom of Information
(Scotland) Act 2002 formally I must advise that we do not hold this information.

Ah so they did a little bit more work. The problem is, if they're determined to deny something has happened and staff have pressure on them to deny reality, there will be no record. As in the case of the actual rape backed up by CCTV.

https://www.womensrights.network/_files/ugd/18f02a_431d87ff57d24e5c9124d3109fe0d83f.pdf

Criticism of this system from 2023 - again research having to go totally beyond what an ordinary person would be able to access or understand to get at the facts

Am just picking up Lewisham @KnottyAuty, and this came up, which I’m sure will surprise none of us here:

www.dailymail.co.uk/news/article-13462167/nhs-backlash-trans-policy-staff-comply-damned.html

@KnottyAuty thanks for all your hard work on this. Agree headings to break up the content will be helpful - you've already presented in sections though so probably just a formatting thing.

I'm wondering if it is worth referencing the NHS Constitution (and handbook)?Handbook to the NHS Constitution for England - GOV.UK It looks as if none of the London NHS Trusts are adhering to the Constitution.

In spite of both removing the PC of sex and replacing it with the invented PC of gender, (mis-attributed to Equality Act 2010), the section covering single sex spaces for patients in the Handbook (updated 24 Jan 2025) uses "sex" not "gender" (no exceptions are included in this section).

See C+P of both sections below:

"Right: “You have the right to access NHS services. You will not be refused access on unreasonable grounds.”
NHS services will always be available for the people who need them. No one can deny you the right to access these services because of your age, disability, race, gender or gender reassignment, sexual orientation, pregnancy and maternity, religion or belief, or marital or civil partnership status. Access to NHS services is not denied in situations where patients pay for additional private care separately. Further information is set out in the government’s response to Professor Richards’s report, Improving access to medicines for NHS patients (2008).
If you are in the armed forces, the Ministry of Defence and the NHS are responsible for your medical care. Primary care will generally be provided by Defence Medical Services and secondary care by the NHS.
Source of the right
The Equality Act 2010 makes it unlawful for a public authority in the exercise of its functions, and for other persons exercising public functions (including public authorities) providing goods, facilities or services to the public, to discriminate on specified grounds (subject to exceptions).
The National Health Service Act 2006 places duties on NHS England and ICBs to have regard to the need to reduce inequalities in access to, and outcomes from, healthcare services for people, and to assess and report on how well they have fulfilled this duty.
Furthermore, NHS England, ICBs, NHS trusts and NHS foundation trusts must act in accordance with administrative law: their policies and decisions must be in accordance with their statutory duties, be reasonable and procedurally fair. In addition to the legislation on discrimination, therefore, it would be unlawful for those bodies to refuse access to NHS services on unreasonable grounds."

"Pledge: “The NHS pledges that if you are admitted to hospital, you will not have to share sleeping accommodation with patients of the opposite sex, except where appropriate, in line with details set out in the handbook to the NHS Constitution.”
Providers of NHS-funded care are expected to eliminate mixed-sex accommodation except where it is in the best overall interest of the patient involved, or reflects their personal choice.
This means that patients should not have to share sleeping accommodation with others of the opposite sex and should also have access to segregated bathroom and toilet facilities. Patients should not have to pass through opposite-sex areas to reach their own facilities. Women in mental health units should have access to women-only day spaces.
Sleeping accommodation includes areas where patients are admitted and cared for on beds or trolleys, even when they do not stay in hospital overnight. It therefore includes all admissions and assessment units (including all clinical decision units), plus day surgery and endoscopy. It does not include areas where patients have not been admitted, such as accident and emergency cubicles.
Single-sex accommodation can be provided in:

• single-sex wards (this means the whole ward is occupied by men or women but not both)
• single rooms with adjacent single-sex toilet and washing facilities (preferably en-suite)
• single-sex accommodation within mixed wards (for instance, bays or rooms that accommodate either men or women, not both; with designated single-sex toilet and washing facilities preferably within or adjacent to the bay or room)"

I completely agree and I did look through all of this. I opted to avoid lots of stuff on the over-arching policies because that is probably a whole paper in itself! And maybe not quite sexy enough for a news story? But I am happy to be persauded otherwise...?

Can you sign post it in some way, a short reference and a link maybe?

Yes, to reinforce the point that none of them do offer single sex accommodation in reality despite it being a pledge in the NHS Constitution (reference).

Don't think it would add anything to say any more but gives journos another thread to follow up on. The 2025 Handbook is more recent than most (all?) the Trusts policy / declarations which is potentially also helpful

Morning! While trying to understand the DATIX issues with incident recording, I came across a reference to a Sexual Safety policy which some trusts seem to have. Anyone seen one of those?

Also while searching, this case of a London nurse came up - reported sexual harrassment by a colleague and was victimised/hounded out of her job. Sounds so familiar to SP's case - a male colleague's feelings prioritised over someone else's career. x.com/mothermruss?lang=en

I'm thinking these things link to our dossier because it shows how the NHS is already failing women - so until they can do the basics single sex spaces are even more important?

edited to add x link

I'd say the clear thrust of the story is 'Women are not entitled to single sex spaces in the NHS, but the NHS lies about this to patients'.

The lying is as important as the replacement of sex with gender. It's incredibly deceitful and undermines trust. Also it's clear, given how literally insane these contradictory policies are and how they make no logical sense at all and are completely disconnected from reality, that a lot of time is spent creating this deceit, using word salad and long impenetrable documents to cover up the truth. The staff time spent on squaring a circle must cost a fortune and I expect most people would prefer this money to go on frontline care.

Too late to edit - but I bet most staff would prefer dealing with clear, common sense policies and being able to get on with their jobs. I bet most staff know about biological reality too. I get the sense it's the managerial class that's pushing this, and the TRAs of course. In NHS trusts like Fife it must feel really awful going to work knowing you're walking on eggshells in case recognising the truth of biological sex gets you cancelled and reported. As we saw from SP's case even when you don't speak, as soon as they decide Goody P is a witch, her silence can be used against her just as well as accusations with no evidence let alone anything normal she said or did.

Oh thank you! That hits the nail on the head!

Women are not entitled to single sex spaces in the NHS, but the NHS lies about this to patients'

excellent phrase which I’ll stick at the top - I’m too verbose to be a headline writer 🤣

https://www.england.nhs.uk/publication/sexual-safety-in-healthcare-organisational-charter/

There has been a big push over the past couple of years for acknowledgement and development of sexual safety policies and charters. Some organisations will have separate policies and some have likely embedded it in other wellbeing / speaking up / whistleblowing type policies but I suspect they will mostly be based around the NHSE stuff.

I'd say the clear thrust of the story is 'Women are not entitled to single sex spaces in the NHS, but the NHS lies about this to patients'.

Brilliant summary @thenoisiesttermagant

Suggest put up front that this is a breach of the law. Otherwise a reader quickly glossing it might think that women truly are not entitled to single sex spaces.

i.e. “In a clear breach of the Equality Act 2010, women are not entitled to ….”

It is, in essence, quite intentional deception and misrepresentation to avoid having to comply with the law.

In a way that exclusively favours men over women.

And regards women's bodies as something that men have an entitlement to that entirely bypasses and trumps any issues of consent or humanity of the owner of the woman's body.

After all, as we know: even if he rapes her, the only thing the NHS will be concerned with is that they properly enabled the man.

Good work wims. I suspect our Scottish campaign has been helping in the background of this. Fife are being made an example of… go the vipers!

https://www.scottishdailyexpress.co.uk/news/politics/secretive-nhs-fife-asked-again-34997443#

Going back to Datix - I seem to remember that it isn’t a single system, the company charges for does a bespoke system build for each organisation. I mean I’m sure there is a lot of commonalities but each organisation sets its own requirements. So any omissions are down to the organisation.

This has also reminded me that NHS organisations, and a lot of their subcontractors have to maintain an information asset register and complete a risk assessment for each system and database used. Importantly, the Senior Information Risk Officer (SIRO) who is responsible for managing information risks has to be a registered health professional.

I think we should keep this at the back of our minds. Depending on where this project goes, it might be pertinent at some point to start asking to see some of those risk assessments.

Trawling the audit docs and came across this odd phrase in Barking Havering & Redbridge LGBTQ+ Plan: "strive to be non-heteronormative and non-cisnormative in everything we do"

Which I thought didn't sound balanced or inclusive. But it's a document from 2022 by the NHS Confederation?! What?

https://www.nhsconfed.org/publications/health-and-care-lgbtq-inclusion-framework

On the other hand I do agree with this sound advice - shame they didn't all follow it?!
"Ensure equality impact assessments are being considered during the creation or review of policies and service development, not after"

Me and my “cis heteronormative’ husband mused about what this actually meant.

the best we could come up with was medical staff are required to claim to be gay, non binary and cross dress, from the sex identified at birth at every available opportunity, whilst flogging ones arses off, in operating theatres, on under staffed wards, and in AnE.

And in any spare available time watch Ruples drag race and any other such non offensive content.

If one has children, in a heteronormative family do not under any circumstances mention that your partner is of the opposite sex to you, or who is the mother or father.

i could go on

and on and on and on ………………….

Yes, that framework had my eyebrows in my hairline a number of times. I quoted a bit up thread which I interpreted to mean that some Trusts had given LGBTQI+ employee groups the power to veto policy. I may have misunderstood. I hope I misunderstood. The framework is where I found the claim that LGBTI+ were the most marginalised when it comes to healthcare - thus “justifying” everything that follows