NHS Policy Audit - working party - thread #2

[KnottyAuty]

This is a thread about “keeping the receipts” on NHS Policies prior to the Supreme Court ruling on 16th April 2025.

Our working theory is that there were no single sex spaces for NHS Staff or Patients in the entire country before that date, having all been removed by stealth. We are aiming to prove this by auditing websites and policies for all the UK trusts and using the results to raise public awareness. As well as recording what has happened historically, the information will form a baseline so we can check which Trusts comply or defy the judgement in due course.

We are working around the country region by region. If you fancy getting involved in a bit of grassroots feminism then please do join in to help!? Each trust takes about an hour to research and you can upload online without giving any personal details away. Comment below and we can give you the link to an online survey - it changes for each region.

Thanks soooo much to all the vipers who have helped so far and @ Twoloons for doing a great job with the thread wrangling!

Here are the press articles we’ve managed to generate so far:

Scotland:
25th March: The Telegraph
https://archive.is/dTUhY
26th March: Scottish Daily Express
https://archive.is/kaLCB
26th March: The Telegraph
https://archive.is/iSD9m

London:
21st April: The Telegraph
https://archive.is/awGuz
23rd April: The Telegraph (in conjunction with another thread by NHS mumsnetters)
https://archive.is/1DO8d

Original thread #1 here:
https://www.mumsnet.com/talk/womens_rights/5291237-nhs-policy-audit-working-party?page=1

This is a particular bug-bear of mine. The overlap with the autistic community is huge and with boring old autism it is impossible to get any meaningful support. But wave the magic trans wand.... et voila! I'm sorry you had that experience it is really upsetting when this happens. I hope you find somewhere else that can meet need

Oh thanks so much! We are researching East of England now. I will DM you the link to the online form and @TwoLoonsAndASprout will appear shortly to say which Trust is available for research. Thanks!

I’ve been doing some digging on Annex B (which originally was Annex E). I’ve got as far back as 2009 (attached - its a CNO letter including Annex E, which in practice created a self ID exemption to the mixed sex accommodation rules), and have hit a bit of a brick wall on anything earlier. The guidance definitely predates Andrew Lansley, who was SofS for Health 6 May 2010 to 4 Sept 2012.

Could anyone with the right sort of expertise in digging out information from archived websites help? Logins for HSJ, Nursing Times and other related publications would also help, given what I’ve found on google but not been able to read.

@KnottyAuty has very kindly set up a jotform, so it’s a question of digging out the relevant documents and adding them, and then using them to analyse what we need next.

At the moment, the things I’m struggling to find are

• all the versions of the Mixed Sex Accommodation statistical return guidance and FAQs, dating back to the start of the collection in January 2004 (as referenced in the CNO bulletin for that month).
• Any earlier data collections on the mixed sex accommodation (earlier ones may say ‘wards’), as that should lead us to the data definitions.
• A copy of “Delivering same-sex accommodation – the story so far” published in Dec 2009.
• A copy of the Nov 2008 NHS Institute for Innovation and Improvement guidance on implementing Chief Nurse report May 2007 on eliminating mixed sex accommodation

https://assets.publishing.service.gov.uk/media/5a7cd02ced915d6b29fa8d19/CNO_note_dh_098893.pdf

Hello, hello! Sorry, have been offline all afternoon! Can I offer you:

Royal Papworth Hospital NHS Foundation Trust

to investigate? I believe @KnottyAuty DMed you with a link to the form. Shout on the thread if you have any questions or issues and someone will almost certainly be able to help!

Yes I have the form, Royal Papworth is fine. I will see what I can dig up (probably tomorrow as will be heading for bed fairly soon).

Don’t rush! We’re still crunching data on the Midlands data here! And thank you!

Not what you were after but this was turned up as part of the Midlands audit alongside policies being referred to. This is the only copy I can find which is out on the internet: https://facialteam.eu/wp-content/uploads/2017/09/Trans.-A-practical-guide-for-the-NHS.pdf
Dates from 2008

That guide from 2008 was written by Christine Burns (TW), interviewed here: https://www.mancunianmatters.co.uk/lgbt/04042015-we-gained-a-place-in-society-ten-years-since-trans-people-won-right-to-change-legal-gender/

I don't want to interfere with your work but I stumbled upon this earlier on Macmillan's website. It surprised me slightly that it's been in such plain sight that most hospitals don't really have single sex wards.

"If you need to stay in hospital, your team should talk to you about where you will stay. Hospital wards may be single sex or mixed. Some rooms may have beds for several patients and shared bathrooms. Others may have single rooms with private bathrooms.

Where you stay should give you privacy and keep you safe. If the hospital has single sex wards, you will usually be able to stay in a ward that matches the gender you identify with. Sometimes the hospital will not be able to offer this. For example, it may depend on the type of treatment you need and where it can be given. Tell your team what option or ward you prefer, and what feels comfortable and right for you." [Emphasis added]

https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/transgender

Everybody should have safety and privacy in hospital.

@GreenAllOver I found the 2009 report on the "UK government web archive"
<a class="break-all" href="https://webarchive.nationalarchives.gov.uk/ukgwa/20130123201003/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_110047" rel="nofollow" target="_blank">https://webarchive.nationalarchives.gov.uk/ukgwa/20130123201003/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH110047

This is amazing work - thank you! I’m going to pop this on a couple other threads, just to get some more eyes on it.

Thanks for posting. This is pretty much the default we are seeing across the NHS - although most people are unaware.

Just in case anyone missed this, this is from
one of the threads on male mammographers:

LonginesPrime · Today 04:25

Wasn’t this motion triggered by the fact they were already allowing males with a GRC to be recruited as “female” based on the confusion over how the GRA interacts with the EA for the purpose of the single-sex exemptions?
For example, this 2023 article in Radiography, the official peer-reviewed journal of the Society and College of Radiographers, written by professionals with NHS affiliations states:
However, current legislation, specifically Part 1 of Schedule 9 of the Equality Act 2010, allows employers to exclude certain protected characteristics (in this case, gender and gender reassignment) based on occupational requirements, permitting the restriction of mammography roles to females only. Furthermore, the Act sanctions the dismissal of existing employees if they no longer meet these requirements, such as a female transitioning to male. Thus, while transgender men and non-binary individuals are encouraged to participate in screening, they are effectively barred from working in breast screening roles based solely on their gender identification.
My interpretation of this (notably the second and third sentences) is that up until the SC ruling, the NHS and the Soc of Radiographers were classing transwomen with a GRC as legally female and transmen with a GRC as legally male, for the purposes of who could be employed as a mammographer in the NHS.
This would also explain the curious timing of this motion, i.e. while other medical orgs are coming out with statements about trans inclusion in light of the SC ruling, why else would one of the few professions restricted to female practitioners suddenly decide that their priority is letting males perform the role? Because they’re already doing it, but their sex in the eyes of the law has been confirmed by the SC as being based on biology instead of a certificate.

Right, here is what our East of England list is looking like:

[italics = claimed]

Bedfordshire, Luton and Milton Keynes

• Bedfordshire Hospitals NHS Foundation Trust - Cantunseeit
• Milton Keynes University Hospital NHS Foundation Trust - Cantunseeit

Cambridgeshire and Peterborough

• Cambridge University Hospitals NHS Foundation Trust - noisiesttermagant
• Cambridgeshire & Peterborough NHS Foundation Trust - Blackmetallic
• Cambridgeshire Community Services NHS Trust
• North West Anglia NHS Foundation Trust - Faffertea
• Royal Papworth Hospital NHS Foundation Trust - NeedMoreTinfoil

Hertfordshire and West Essex

• East and North Hertfordshire NHS Trust - FarriersGirl
• Hertfordshire Community NHS Trust - FarriersGirl
• Hertfordshire Partnership University NHS Foundation Trust
• Princess Alexandra Hospital NHS Trust - umbel
• West Hertfordshire Hospitals NHS Trust

Mid and South Essex

• Essex Partnership University NHS Foundation Trust
• Mid and South Essex NHS Foundation Trust - teawamutu

Norfolk and Waveney

• James Paget University Hospitals NHS Foundation Trust - YellowRoom
• Norfolk Community Health & Care NHS Trust
• Norfolk and Norwich University Hospitals NHS Foundation Trust
• Norfolk and Suffolk NHS Foundation Trust
• Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust

Suffolk and North East Essex

• East of England Ambulance Service NHS Trust
• East Suffolk and North East Essex NHS Foundation Trust
• West Suffolk NHS Foundation Trust

I wasn't clear enough @TwoLoonsAndASprout - I'll take Essex Partnership University NHS Foundation Trust too.

Oops! No problem, I shall amend the list!

Latest East of England list:

[italics = claimed]

Bedfordshire, Luton and Milton Keynes

• Bedfordshire Hospitals NHS Foundation Trust - Cantunseeit
• Milton Keynes University Hospital NHS Foundation Trust - Cantunseeit

Cambridgeshire and Peterborough

• Cambridge University Hospitals NHS Foundation Trust - noisiesttermagant
• Cambridgeshire & Peterborough NHS Foundation Trust - Blackmetallic
• Cambridgeshire Community Services NHS Trust
• North West Anglia NHS Foundation Trust - Faffertea
• Royal Papworth Hospital NHS Foundation Trust - NeedMoreTinfoil

Hertfordshire and West Essex

• East and North Hertfordshire NHS Trust - FarriersGirl
• Hertfordshire Community NHS Trust - FarriersGirl
• Hertfordshire Partnership University NHS Foundation Trust
• Princess Alexandra Hospital NHS Trust - umbel
• West Hertfordshire Hospitals NHS Trust

Mid and South Essex

• Essex Partnership University NHS Foundation Trust - teawamutu
• Mid and South Essex NHS Foundation Trust - teawamutu

Norfolk and Waveney

• James Paget University Hospitals NHS Foundation Trust - YellowRoom
• Norfolk Community Health & Care NHS Trust
• Norfolk and Norwich University Hospitals NHS Foundation Trust
• Norfolk and Suffolk NHS Foundation Trust
• Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust

Suffolk and North East Essex

• East of England Ambulance Service NHS Trust
• East Suffolk and North East Essex NHS Foundation Trust
• West Suffolk NHS Foundation Trust

Very interesting - thank you! It’s the first official guidance I’ve seen that explicitly tells people (multiple times)that they should ‘go beyond the law’. And it has an annex with lots of useful looking documents to chase down.

It doesn’t mention the single sex accommodation policy explicitly, but it does have an interesting summary on the law on service provision for trans people which mentions ‘proportionate means of achieving a legitimate aim’ but says it doesn’t mean all transsexual (sic) people should be assigned to wards of their birth assigned gender (sic) but says here are few cases where they might need to be placed in a side ward.

Thanks, but the full document doesn’t download for me - I only get the cover page. Does it work for you?

If anyone is interested, this is the story so far (still got lots of gaps to fill) on mixed sex accommodation in the NHS.

NHS accommodation has been mixed sex since (at least) May 2009.

Blair came to power in 1997 promising to eliminate mixed sex wards. By January 2004 the target to eliminate mixed sex accommodation (not wards) in 95% of trusts had been met. The Government wanted 100% compliance, and set up annual monitoring. All seemed to be going well.

In May 2007 the Chief Nurse published a report on privacy and dignity, which didn’t mention single sex accommodation. In November 2008, the NHS Institute for Innovation and Improvement published guidance on implementing this report, focusing on mixed sex accommodation. This could be where the guidance changed from biological sex to self identified gender (I’ve not yet found a copy). The month before DH had published a guide to trans healthcare written by a Christine Buns (TW), which told the NHS to go ‘beyond the law’, including guidance on including trans people in wards that suit their gender.

In January 2009, the then Secretary of State (Alan Johnson) announced a new push on eliminating mixed sex accommodation, possibly with the upcoming election in mind. In May of that year, guidance was published which gave trans patients to right to choose the accommodation that matched their gender identity. The data collected would not classify this as a ‘breach’, in the same way as a mixed sex ICU ward would not be a breach. At this point (if not before) NHS accommodation became mixed sex again. But nobody knew, because all the data returns showed the opposite.

This is stunning work! Thank you so much for this digging - I am so impressed.

I’ve already shared your other post on the “this is how my MHD trust responded” thread, and the NHS v Peggie thread. Are you ok if I share this one too? And maybe on the recent mammography one? I’m thinking of threads that might have a fair number of NHS employees reading. Anywhere else?

@TwoLoonsAndASprout Thank you! Do share as you wish, I need to do some real life stuff now but hopefully can spend another few hours on it later today.

@GreenAllOver is this the 2008 guidance ? https://www.dignityincare.org.uk/_assets/Resources/Dignity/CSIPComment/PrivacyAndDignity_final_pdf_as_published.pdf

@GreenAllOver if your list of publications are governmental then can you FOI them from whatever the current department is now called? You’d have to wait 20 days but it might turn up useful stuff. That or join the British Library?

Brilliant work! Thanks so much

@GreenAllOver worth a look at this thread/post:

https://www.mumsnet.com/talk/womens_rights/5318518-nhs-fife-tries-to-silence-nurse-sandie-peggie-vs-nhs-fife-health-board-and-dr-beth-upton-thread-25?reply=144063326&utm_campaign=thread&utm_medium=share