NHS Policy Audit - working party -Thread #3

[KnottyAuty]

NHS Policy Audit - working party -Thread #3

Original thread #1 here:
https://www.mumsnet.com/talk/womens_rights/5291237-nhs-policy-audit-working-party?page=1
Thread #2:
https://www.mumsnet.com/talk/womens_rights/5322494-nhs-policy-audit-working-party-thread-2

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!

@KnottyAuty I will post an update for Wales tomorrow but we [mainly @Mipe ] are chomping through them quite quickly. Are we doing to do Northern Ireland? Not actually part of the NHS but part of the UK.

Haha I’m enjoying this Viper stuff 😁

Oh wowsers! Well done everyone you are whipping through them...
Maybe we can get the UK done before mid august after all?!

Yes please to Northern Ireland I think Ermine has sorted the FOIs...

Submitted Hywel Dda University Health Board, usual story wrt staff policy, Stonewall Silver Champion at one stage but disillusioned with Stonewall and did not consider it offered value for money by 2024.

No policies on single sex accommodation or transgender patients but shared a pretty garbled statement as part of its FOI response:

"‘In general terms, there is national work taking place around single sex accommodation in NHS Wales led by the Chief Nursing Officer for Wales. Within Hywel Dda University Health Board, patients are, where possible, assigned to same sex ward areas. However, there are exceptions whereby this may not be possible. These include clinical areas such as assessment units, coronary care units and other areas where a higher level of care is required.

With regard to transgender patients, staff should remember that, under the Equalities Act 2010 and the Public Sector Equality Duty, it is a legal requirement to ensure that trans people are not discriminated against.

It should be noted that, previously, transgender and non-binary people were accommodated in line with their stated gender identity. In all cases, staff communicated to all patients and/or their carers when such a situation arose, ensuring sensitivity to all views and acting accordingly to protect the privacy and dignity of all patients.

Following the recent Supreme Court ruling on the definition of sex within the Equality Act 2010 being biological sex only, the Equality and Human Rights Commission have been consulting on their Code of Practice for services, public functions and associations. Within the proposed guidance, when considering whether providing a single-sex service is proportionate, there needs to be a fair balance between:

• The benefits of offering the service as a separate or single-sex service, and
• The needs of those who are access it, and
• The impact on those who are excluded from accessing it.

The service provider should consider whether the disadvantage to trans people, and any other people who may be disadvantaged, outweighs the benefits of providing a single-sex service. They should also consider whether there is a less intrusive option than excluding trans people which would be proportionate. Therefore, any decision should be based on:

• An objective and evidence-based assessment of the circumstances and relevant information
• Respecting the rights and needs of transgender people and the detriment to them if they are denied access and balancing that against the needs of other service users and any detriment to them if the transgender person is admitted."

@FarriersGirl Walton (NE) is done - happy to head to Wales if any left?

That is great thank you that is another region NW 100% completed @TwoLoonsAndASprout . Wales is fully allocated but I will send you a Northern Ireland trust when I get that posted up tomorrow.

Quick update on Wales

NHS Wales

Aneurin Bevan University Health Board - Mipe
Betsi Cadwaladr University Health Board - Mipe
Cardiff and Vale University Health Board - FarriersGirl
Cwm Taf Morgannwg University Health Board - Yellowroom
Hywel Dda University Health Board - cantunseeit
Powys Teaching Health Board - NCembarrassed
Swansea Bay University Health Board - Mipe
Velindre University NHS Trust - Mipe
Welsh Ambulances Services NHS Trust - Withsilverbells

Woot woot! Thank you vipers!

I'll take a N. Ireland one when you're ready

Brilliant!

Last, but not least in our sojourn around the UK is Northern Ireland. Not formally part of the NHS, the health and social care trusts also provide social care services as well as front line health care. @teawamutu and @YellowRoom I have already allocated a trust on the list below. New link to follow.

Northern Ireland

Belfast Health and Social Care Trust - teawamutu
Northern Health and Social Care Trust - yellowroom
South Eastern Health and Social Care Trust
Southern Health and Social Care Trust
Western Health and Social Care Trust
Northern Ireland Ambulance Service Health and Social Care Trust

Please can I have one too?

Thank you! Will try to get that done today as tomorrow will be bedlam.

@FarriersGirl I would be happy to take a Northern Ireland one

That is great thank you please can you do the Southern Health and Social Care Trust. I'll DM the link in a mo.

Having been on the audit team since the start I thought I had read it all but it seems not. Cardiff and the Vale have left me feeling quite disturbed. The policies in themselves are full of usual stuff but they heavily reference a couple of new [to me] docs that are really quite extreme. One is the LGBTQ+ Action Plan for Wales, a government policy that aims to embed trans into every area of Welsh life [education, sport etc.] and get devolved powers for self id laws.

The other gem is a guide for employers from GIRES written in 2019. This makes it clear that anyone undergoing a medical pathway for transition must be given extra time off work because it would be illegal under the Equality Act to refuse it.

Another paragraph in the GIRES doc I have copied below comes from advice on changing rooms etc.

A person’s religion or belief must, of course, be respected, but it must not be used to discriminate against another person because of that person’s protected characteristic. Anyone making such an objection may not understand that although they have a right to their views (no matter how objectionable these may be to others), they do not have the right to act on those views if this results in discrimination against another person. It is not acceptable to move either the trans person, or the person making the complaint, to another work area, so that they do not have to work together. Further training should be offered but, ultimately, a person refusing to work alongside a trans person will have to undergo the employer’s disciplinary procedure which may lead to dismissal.

Further training should be offered but, ultimately, a person refusing to work alongside a trans person will have to undergo the employer’s disciplinary procedure which may lead to dismissal.

In which case the authority concerned will be leaving themselves wide open to a constructive dismissal case. Bring them on, I say.

Re. Northern Ireland - for info. some links to Equality Commission for Northern Ireland docs. as they have some differences to Britain:
https://www.equalityni.org/legislation Sex and gender reassignment come under 'gender'. There's a maternity and parental leave bit, an equal pay bit and this:
https://www.legislation.gov.uk/nisi/1976/1042/contents Sex Discrimination (Northern Ireland) Order 1976

Response to FWS https://www.equalityni.org/ECNI/media/ECNI/Publications/Delivering%20Equality/ECNI-Legal-Paper-and-Information-June-2025_1.pdf
For Women Scotland Ltd v The Scottish Ministers (“FWS”) is a case which defines the meaning of “sex” in Great Britain in its equality legislation.
• In FWS the Supreme Court concluded that “sex” means biological sex. It follows that any reference to a woman in Great Britain’s equality legislation is a reference to biological women only.
• Whether a person has a Gender Recognition Certificate or not is irrelevant in terms of identifying women under equality legislation in Great Britain.
• Northern Ireland has different equality laws to Great Britain which were not considered by the Supreme Court. An added complication is that Northern Ireland is subject to Article 2 of the Windsor Framework which the Supreme Court also did not consider.
• There is allied legislation in Northern Ireland which uses terms like “woman”. The Supreme Court did not consider the meaning of “sex” in this allied legislation either.
• All of this means that FWS does not provide all the answers to difficult legal questions about “sex” and “gender” in Northern Ireland

P52 .It is recognised that there may be some circumstances in which there is the potential for a “clash of rights”, for example, between biological women and transwomen in relation to matters like separate sex and single sex services. In these circumstances, it is recommended that, in so far as is possible, a public authority considers the impacts that their proposed decisions may have on (a) men and women generally, and (b) on transgender people compared to non- SCJ: Legal paper and information June 2025 51 transgender people. There must always be due regard given to the need to promote equality of opportunity between men and women generally.

Wow those are very explicit compared to other regions!

“a person refusing to work alongside a trans person will have to undergo the employer’s disciplinary procedure which may lead to dismissal”

Actually I think if someone refused to work near a trans person just because they were trans, then that would be genuinely transphobic and not OK imo. However if there’s a genuine concern regarding a reasonable disagreement or smelly feet or whatever then that should be proper dealt with without any involvement of “trans”. There’s also the issue of just not getting on with someone which is just life and how things are at work. Usually an employer will try to move people to avoid friction and that’s OK too. Obviously the issue of how to deal with SSS will be resolved by SP’s tribunal…

@FarriersGirl could you allocate me a NI Trust when you get a minute? Thanks

My pleasure - Western Health and Social Care Trust

I've submitted Northern Health and Social Care Trust.

Interesting in that some NI legislation is different to Britain. Gender Reassignment counts only if a person is under medical supervision, though the Trust says trans-identified people don't have to be under medical supervision to use the facilities of the opposite sex.

Gender is used a lot eg 'Mixed Gender Accommodation in Inpatient Areas' is the policy title

Current consultation on sex and gender following Supreme Court clarification - open until 19 Sept. https://www.equalityni.org/SCJConsultation

Risks of mixed-sex spaces acknowledged a number of times but trans people can still use opposite sex facilities.
eg On review of Datix incidents, we identified that when some patients were acutely unwell, there was an increased risk they may display inappropriate behaviour which, on a mixed gender ward, could potentially compromise their dignity. We saw evidence that staff reconfigured the ward area to protect patient’s dignity by ensuring the allocation and location of male/female beds better meets the ratio of male: female patients. We suggested that the Trust give consideration to undertaking a scoping exercise to understand the risks associated with mixed gender patient population.

Welsh ambulance services university NHS trust submitted. No staff policy found but ambulance staff attending Pride in uniform with rainbow epaulettes. Rainbow or transgender star pin badges encouraged

@FarriersGirl I have just submitted Swansea Bay University Health Board and
Velindre University NHS Trust, happy to take on a few more if you have any left 😀

That is fantastic - We are onto Northern Ireland and I have just one left to allocate which is the Northern Ireland Ambulance Health and Social Care Trust!