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 once had a colleague from a small town in eastern Scotland who apparently used to play a version of the children’s game where you knock on a door and run away. It was called “shite-alight”.

😳😬🤣

As a light-hearted derail I once asked a Micky what the difference was between Shit and Shite. The answer was "an E".

🤣 Never heard of that one!
Was “Cheeky Nelly” where I grew up.

“Goose Grass” was also known as “Sticky Willy” which caused no end of hilarity amongst the school mums after I said to DD “Don’t get that sticky Willy on me!” 😅

What random kids naming did you all grow up with?!

I’m still working away on the single sex wards guidance on data returns which is proving really tricky to find - will update tomorrow when I’ve done more work - but this guidance from Dec 2007 was so interesting I had to share. It seems to mark the point at which the Dept of Health moved to recommending self ID as good practice.

Page 6 on protecting privacy says ‘’Medical professionals should use names, titles and wherever possible hospital accommodation that the individuals concerned regard as appropriate’..

Think this is Dec 2007 version, from crown copyright date.
<a class="break-all" href="https://webarchive.nationalarchives.gov.uk/ukgwa/20080817221452/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081579?IdcService=GET_FILE&dID=156753&Rendition=Web" rel="nofollow" target="_blank">https://webarchive.nationalarchives.gov.uk/ukgwa/20080817221452/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081579?IdcService=GET_FILE&dID=156753&Rendition=Web

Sorry about the awful link, tried again but it was still bad.

Annoyingly, this particular trust is a merger of three others so it hasn't existed for all that long.

Apologies. I have accidentally double-clicked on part of the Jotform while entering my data for Cambridgeshire and Peterborough NHS Trust and it's been submitted incomplete - will start again and get the completed form to you. sorry again
@KnottyAuty @TwoLoonsAndASprout
There's some good stuff to come though :)

https://www.mumsnet.com/talk/womens_rights/5332492-why-arent-you-getting-changed-man-asks-female-darlington-nurse-this-3-times-in-female-changeroom

This is a powerful reminder of why what we’re doing matters (if there was ever any doubt).

Solidarity with Karen and the rest of the Darlington nurses.

Thanks for the heads-up! We can sort from our side, so don’t worry!

Blimey, I think I found a sensible one!!

"Pg. 8 "6.1.5 Transgender / Transsexual Patients
Transsexual people; those who have proposed, commenced or completed gender reassignment are legally protected against discrimination. Good practice must ensure that clinical responses are service user focused rather than rigidly based on:

Accommodating transgender people according to their presentation and name that they are currently using.

Sensitivity to all patients must be considered in relation to single room allocation. Where practical, the transgender patient should be offered a single room.

Well done PAH!

Holy cow. Which trust is this?

Note it says 'where practical', though.

Meaning, I assume, that no available single room/TIM patient refusing it = in with the women.

That this is still the best we've seen so far is maddening.

Good find @GreenAllOver
Did I miss the bit where the evidence for this was provided?
"Research studies indicate that small parts of the baby’s brain progress along a different pathway from the sex of the rest of its body.
This predisposes the baby to a future mismatch between gender identity and sex appearance."

Oh I am so, so tired of the pseudoscience.

@TwoLoonsAndASprout How are we doing on the trusts? I can pick up another one to do tomorrow if there are any left or if someone is struggling for time?

We have one left on EoE:

• West Suffolk NHS Foundation Trust

It’s all yours - thank you so much!

And if anyone is struggling, do shout on here, there are loads of people who will help!

I have 16 tabs open at the moment, for Hertfordshire Partnership Universities NHS trust😂

Oh that’s giving me flashbacks to NHS Lothian! Make sure you take lots of breaks and stay hydrated 🤣

@TwoLoonsAndASprout From what I can see, the Dept of Health was lobbied strongly and successfully after the GRA was passed, and this ramped up in the run up to the Equality Act. In practice, GIRES and other lobby groups wrote the guidance, and the pseudoscience and incorrect interpretation of the law came from there.

It started in 2004 with adding ‘gender identity’ to their Sexual Orientation Advisory Group at the urging of Press for Change. By 2005 they were writing to all NHS Chief Execs, jointly with Ben Summerskill then CE of Stonewall, to encourage NHS organisations to become members of Stonewall’s Diversity Champions programme, with specific reference to transgender staff.

By March 2006 the updated Essence of Care guidelines no longer include a reference to single sex facilities, though they did in April 2003.

And in December 2006, the Dept’s guidance to NHS Boards said that the GRA means that ‘a male-to-female transsexual person will be legally recognised as a woman in English law’. This is the earliest I’ve found this statement, and it’s particularly interesting in the light of the SC judgement.

The really ‘beyond the law’ stuff starts in February 2007, from what I can see, with the guidance ‘Creating a Gender Equality Scheme: A Practical Guide for the NHS’ (linked) which is clear on current legal requirements but says these may be extended. There is a resource worksheet on transsexual employees, and on p.43-44 it says that it is good practice to allow pre-op trans people to use toilets appropriate to their new gender, and that transsexual employees ‘should be granted access to “men only” or “women only” areas according to the sex in which they permanently present. Under no circumstances should they be expected, after transitioning, to use the facilities of their former gender.’. This is followed by worksheet 2 on single sex services. This is made to sound unlikely in practice, in 2.12 ‘for NHS organisations it s21A, [not clear what this, does anyone know? It is in the context of single sex exemptions] will hardly ever apply’.

After that, the Department of Health published a whole flurry of documents on transgender issues, at least two of which (GP, NHS funding), were branded Dept of Health but written by GIRES. The one on ‘NHS funding processes and waiting times for adult service-users’ is actually purely about how to access treatment for gender dysphoria, and includes advice on threatening legal action. Which is very odd, in a Government document.

<a class="break-all" href="https://webarchive.nationalarchives.gov.uk/ukgwa/20081109082739/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_066068?IdcService=GET_FILE&dID=111181&Rendition=Web" rel="nofollow" target="_blank">https://webarchive.nationalarchives.gov.uk/ukgwa/20081109082739/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_066068?IdcService=GET_FILE&dID=111181&Rendition=Web

Isn’t that a normal amount? 😳 😂

@GreenAllOver, this is really interesting - and kind of outrageous. I don’t understand enough how lobbying groups work, but it seems kind of bonkers to me that a government body would just let a bunch of lobbyists write policy for them.

Am I crazy?

Which area do you all think we should cover next? I’m wondering about NE England in light of the coverage of Karen’s story in MOS today.

The way the capture happened really needs to be studied. Denton's isn't the half of it.

The way people like Whittle were able to position themselves as the unquestioned experts in this very niche area, and persuade those in power that this was a humans rights issue about tiny number of people, and no concern of any else's, so successfully that none of those people in power questioned either the expertise or the claim that it didn't affect anyone other than this tiny minority.

It's incredible really, the psychology of it, oh you'll be making such a difference to this tiny minority, no issues for anyone else, you're such a forward thinker, you'll go down in history as a humans rights advocate, cutting edge of progress etc etc. A lot of the noisy TRAs these days aren't by any means the brightest, but some of these backroom dealers have been extremely clever.

@GreenAllOver It may be this:

See below

In the context of NHS single-sex exemptions, S21A refers to a specific provision under the Equality Act 2010, particularly concerning gender reassignment and single-sex services.
What is Section 21A?
Section 21A of the Equality Act 2010 was added via amendments (notably under the Equality Act 2010 (Gender Reassignment) Regulations 2017). It provides clarity on when trans people (those undergoing, proposing to undergo, or who have undergone gender reassignment) can lawfully be excluded from single-sex services, such as hospital wards, on a case-by-case basis.
Key Points of Section 21A:
It allows lawful exclusion or separate treatment of trans people from single-sex services where it is a proportionate means of achieving a legitimate aim.
The NHS can apply this exemption to balance the rights of trans people with those of others, such as for privacy, dignity, or safety.
The decision to exclude or differentiate must be justifiable, not automatic or blanket, and based on individual circumstances.
NHS Context Example:
In a hospital setting:
A trans woman may be placed in a separate room rather than a women's ward if it is necessary to protect the privacy or dignity of other patients or the trans person.
Such decisions must be based on risk assessment and patient needs, not discrimination.
Would you like a plain-language summary of how this applies to NHS policies or patient rights?
4o

@FarriersGirl Thank you! But that just poses the question, how does guidance from19 Feb 2007 quote section 21a of the Equality Act 2010? I’m wondering if the guidance was updated later, but the original date kept on the document?

It does clearly show that the guidance to the NHS was saying that it was unlikely that the single sex exemptions would ever apply. Which implies that the single sex accommodation that the NHS had worked so hard to achieve was, from at least February 2007, not single sex.

@TwoLoonsAndASprout In my experience it is very unusual for a Government Dept to publish guidance under their logo / brand written by others. Quite usual to publish research papers, or to link to relevant guidance written by charities, but very unusual to have an official policy document writen by a lobby group. In fact, so unusual that my next piece of work is going to be gathering up all the guidance documents from 2006-2008 and working out who wrote them.

At this rate I’m never going to find the single sex accommodation data return guidance from before May 2009…