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

I'll have a look after I've walked the dog.

Good morning - i'm finishing off East of England Ambulance and will have time for to look at Stonewall/Rainbow stuff for Shropshire Community today

Sorry have cross-posted with FarriersGirl! I'll leave it with you and I can pick up a free Trust if any available.

@WithSilverBells, if you’re up for it I’ve got

Hertfordshire Partnership University NHS Foundation Trust

for you. Many thanks!

Morning! I can give you:

West Hertfordshire Hospitals NHS Trust

Thank you!

@KnottyAuty I have had a trawl for Shropshire Community Trust. I can't see anything specific, there is a LGBT network that is involved in the local Pride. The trust itself does not seem to be signed up for Rainbow Badges or Stonewall, I found an FOI from Jan 2024 stating that they had had no correspondence with Stonewall. The local hospital is a member of rainbow badges but that is a different trust. Hope this helps.

Thanks! I’d got to the same point…. But I’d not found the LGBTQ network. Can you point me to that link please?

ETA I’d usually be delighted to find a trust which wasn’t affiliated but given the level of NHS capture I’m suspiciously assuming they are self ID in practice but just haven’t written it into any of the policies?! Do we know anyone who works there?!

Here you go @KnottyAuty

www.shropshiretelfordandwrekin.nhs.uk/shropshire-community-health-nhs-trust-pride-month/

Ooh thanks.
i can see that this ST&W are very close to the Shropshire Community Trust.
Does anyone understand the overlap and can explain it to me?

Shropshire Telford and Wrekin are the ICB Integrated Care Board for the area. They don't provide patient services directly but they plan, commission and buy services. They replaced clinical commissioning groups a few years ago.

It seems like The Liverpool School of Tropical Medicine is fully captured. I'll do some investigaton to see if they have updated their policies or aproach in the light of the supreme. court ruling. ( The Brownlow Medical Practice is up the road from the LSTM and is where Dr Adrian Harrop is employed)

"We are here to support you during your time at LSTM and to help create an engaged and representative LGBTQ+ network by listening to your ideas and working with our institute to make positive changes – whether that be through creating inclusive policies, supporting local events, creating more inclusive toilets or ensuring LGBTQ+ visibility across the school"

"We are seeking folks for three new roles without our team: bisexual rep, transgender rep, and LGBTQ+ overseas rep. These roles are to ensure that all our activities and events are fully inclusive. The positions are open to all identities; however, we are actively encouraging volunteers with lived experiences of these identities to get involved"

( I really dislike this 'folksy' language..so American)

www.lstmed.ac.uk/about/equity-inclusion-at-lstm/lgbtq-network

Mersey NHS Trust are currently reviewing their policies around single sex accommodation ( they refere to it as 'Same Sex') though the previous guidance provides exceptions for trans identified patients:

6.2 Support for Transgender

6.2.1 Accommodation and Sensitivity:
• To support transgender individuals, their accommodation should align with their presentation, considering room allocation with sensitivity. Best practices prioritise patient- centred, respectful, and adaptable clinical responses.

6.2.2 Key Steps Include:
Reviewing Past Admissions:
• Examine the individual's previous inpatient stays to better understand their needs and preferences.
Assessing Forensic History:
• Evaluate any history of sexual offending, domestic violence, or abuse of the opposite sex.
Risk-Based Allocation:
• Determine the appropriate ward allocation based on both risk assessment and the patient's input. If an agreement cannot be reached, an escalation process may be necessary via senior nurse/manager in charge.
Documentation:
• Record all decisions in clinical notes, inform admitting notes, and create a care plan accordingly.
Enhanced Observations:
• As a best practice, transgender individuals admitted may receive increased observations. Avoid using terms like "placed on 1:1 observation." Instead, use terminology such as "a chaperone has been allocated."
Privacy and Dignity:
• Ensure that privacy and dignity are always maintained. This includes providing access to appropriate toilet and bathing facilities and ensuring personal preferences for privacy are respected.
Training and Awareness for Staff:
• Provide training for all staff on transgender issues: including the importance of using correct pronouns; using the name the person wants to be known by; understanding gender identity; and addressing specific health needs sensitively.
Support Systems:
• Establish support systems such as access to counselling services, peer support groups, and liaison with LGBTQ+ advocacy groups to provide comprehensive support for transgender individuals during their stay.
Feedback Mechanism:
• Implement a feedback mechanism to allow transgender individuals to provide input on their care and accommodations, ensuring continuous improvement in meeting their needs.
Ward Allocation review
• Ward allocation for transgender patients will need to be reviewed regularly as there may
be factors that change which will affect where the patient is placed for example who else is admitted onto the ward. If it is viewed best that a service user is moved to another ward (for example for their safety) this may be for the this needs to be documented and also sensitively explained to the patient. As the dynamics can change this will be reviewed regularly.

If the patient is unconscious:
• If the patient is unconscious when they arrive at the ward, ward allocation will be based
on the person’s gender presentation. Document this. When the person is conscious review the decision and document this.

https://yourspace.merseycare.nhs.uk/application/files/9017/2372/1891/SA47-DeliveringSameSexAccomodation-up15Aug2024revJune2027.pdf

It goes on to add:

The Equality Act (2010) has brought a Public Sector Equality Duty to all public authorities. This Equality Relevance Assessment provides assurance of the steps that Mersey Care NHS Foundation Trust is taking in meeting its statutory obligation to pay due regard to: Eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act.
Advance equality of opportunity between people who share a protected characteristic and those who do not.

Sex:

Positive Impact: Ensures that all patients, regardless of sex, have access to accommodation that respects their privacy and dignity.
Neutral/Negative Impact: None identified

Gender Reassignment:

Positive Impact: Policy includes provisions to ensure transgender patients are accommodated in a manner consistent with their gender identity,
promoting their rights to privacy and dignity.
Neutral/Negative Impact: Efforts will be made to place a person on the ward that they identify with, however, due to the complexity of the conditions
people on the ward will have and the changing dynamics; a patient may need to be placed onto a same sex ward they do not identify with but it reflects their birth gender. All ward allocations for transgender patients will be reviewed regularly, documented, and reasons explained to the patient. This is to make sure the ward allocation is most appropriate for the individual and other patients.

It's crazy that given Mersey NHS policies on 'Breaches' and guarding against them that they should permit individuals to self identify into 'same sex' accommodation;

"There are no exemptions from the need to provide high standards of privacy and dignity.

Males and females should not have to sleep in the same room, unless sharing can be justified by the need for treatment, or by patient/service user choice.

Males and females should not have to share mixed bathing and WC facilities, unless they need specialised equipment such as hoists or specialist baths.

Patients/Service users should not have to pass directly through opposite-sex areas to reach their own facilities.

In exceptional circumstances, mixing of the sexes can be justified. Decisions should be based on the needs of each individual patient/service user, not the constraints of the environment, or the convenience of staff.

Where mixing of sexes does occur, it must be acceptable and appropriate for all the patients/service users affected.

This guidance includes:
In General Ward Areas
Specialist Units
Mental Health and Learning Disability accommodation.
Children’s and young people’s services

A breach is defined as occurring when males and females are required to:

Share sleeping accommodation.
Share toilets or bathrooms.
Pass through an area of opposite sex accommodation to access
toilets/bathrooms or their own sleeping accommodation. (DH, 2010c)"

When a breach occurs the organisational escalation policy should be implemented. This should quickly escalate the breach to an executive level"

Will do!

I've submitted East of England Ambulance.

Tricky to find info on their website.
Ermine had to dig deep to get info from them on their Rainbow Badge involvement.
In 2021 had to sign a legal agreement to protect staff from sexual harassment. Also press about sexual assault of female patients.
Had a transgender ambulance care assistant/discharge co-ordinator and LGBT+ network secretary who wrote about transgender day of remembrance, '...there are hundreds of trans people being driven to suicide by discrimination, intimidation and bullying.' Also provided written evidence to the Transgender Equality Inquiry in 2015. Much of it relates to hair.

I'll start on West Hertfordshire Hospitals NHS Trust

Good work, you lovely women.

It drives me up the wall seeing equality impact assessments that mix up sex and gender, use gender not sex and/or are some variety of "sex including transgender" ignoring the impact on women, on people who know sex is real (gender critical = protected belief), on those from traditional religions, and the disabled who may want same sex care. It took nearly 4 years to get one of my local trusts to correctly state the protected characteristics in their equality policy and then amend their EIAs.

I think it would be worth catching worst EIAs you see for a separate article - about how the real impact of these policies was ignored.

Good call on the EqIAs - some are appalling.

It is window dressing at its worst.

Hiya @TwoLoonsAndASprout have you allocated all the Trusts now? I think I can squeeze in another one if any are still going begging

I'm going down so many rabbit holes here with Cambridge University Hospitals. Have just been looking at workforce equality monitoring information and they use the wrong pcs - replacing sex with gender.

So there is no reliable information on applicant success rates by sex, starters and leavers by sex nor disciplinaries by sex. Women as a sex class are just disappeared throughout with this trust. It's horrific dystopian stuff.

I will have to draw a line under it at some point.

Oh you are brilliant! Yes, two left - how about:

East Suffolk and North East Essex NHS Foundation Trust

Many, many thanks!

Great. I’m on it 😀

The NHS constitution does this (while referencing the Equality Act!). It’s coming from the top - not surprisingly most Trusts following blindly. Some also conflate gender and gender reassignment, so double whammy

CUH has no record of their staffs' actual sex. ESR, the system they use, only records gender.

Do not ask me how I know this.