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!

The Rainbow Badge assessment and recommendations are extremely egregious IMO, I can’t see that being a route to change. Better to abolish that scheme altogether and issue a central DoH policy for all Trusts to adopt and embellish as they have done with the 2010/19 ones. Probably safer to do it centrally as so much deliberate obfuscation happened centrally to replace sex with gender. No one was supposed to notice.

They can put back ‘gendered’ language in maternity services while they’re at it

obviously the same would need to happen for Scotland, Wales and NI.

Is this useful?

https://www.womensrights.network/hospital-report

I've submitted Royal Berkshire

Very little on their website - no EDI, trans, single sex accommodation policies. However does say Stonewall diversity champion/rainbow badge.

Single sex accomm. policy (FOI) says may be difficulties with accommodating trans people with some religious people
''We remain aware that members of some religious groups may need to be informed of the application of this policy and the associated legislation in relation to sharing the same ward with our transgender patients who will need to be accommodated. We are also aware that some of our patients will find sharing with transgender patients new to them and they may need to be sufficiently informed in relation to the application of this policy; similarly ordinary members of either sex may also need to be informed on the application of the policy especially when sharing the same ward with transgender patients.''
They will deal with this by training and on a case-by-case basis.

From FOI
'Please specify what analysis has been conducted to ascertain whether these goods or services (Stonewall) meet contractual and/or legal requirements? - no specific analysis undertaken.'

NHS Confed. guidance shared on staff intranet. Didn't mention this doc specifically but I had a look as it's still on the Confed website despite Supreme Court judgement 'Health and Care LGBTQ+ Inclusion Framework':

LGBTQ+ leaders should aim to be visible, bringing their whole selves to work.
Ensure you and your staff understand the specific needs of LGBTQ+ people, the health inequalities they face, and the variance of experience between the L,G,B,T,Q and + identities, particularly that of transgender people
One pilot site had co-produced a package of LGBTQ+ training with children and young service users who were able to articulate a clear understanding around the gender spectrum and their lived experience of gender.
Considering trans service users in particular, several pilot sites had reviewed their policy on admissions to single-sex services, allowing service users to be admitted on gender presentation
Pilot sites ensured they were visibly supportive of LGBTQ+ service users, particularly within services for children and young people, by celebrating Pride events, hanging rainbow flags and creating spaces that did not feel gendered.

Thank goodness, I cannot tell you the relief I felt reading that.

Though it still leaves the option open that the trans persons wants will be put over all the other patient's rights to safety. Given how captured how many NHS managers seem to be, I have no doubt there will still be NHS trusts going ahead with men in women's spaces and denying any sexual assaults that happened. No matter the evidence.

Evening Vipers - just a quick update on the progress as we have had a some trusts completed over the weekend.

Acute trusts in the South East region

Ashford and St Peter’s Hospitals NHS Foundation Trust - Cantunseeit
Buckinghamshire Healthcare NHS Trust -Cantunseeit
Dartford and Gravesham NHS Trust - Theeyeballsinthesky
East Kent Hospitals NHS Foundation Trust - Needmoretinfoil
East Sussex Healthcare NHS Trust - Yellowroom
Frimley Health NHS Foundation Trust - Cantunseeit
Hampshire Hospitals NHS Foundation Trust - Yellowroom
Isle of Wight NHS Trust - Cantunseeit
Maidstone and Tunbridge Wells NHS Trust - socialdilemma
Medway NHS Foundation Trust - Yellowroom
Oxford University Hospitals NHS Trust - thenoisiestteramgant
Portsmouth Hospitals University NHS Trust - bluebootsgreenboots
Queen Victoria Hospital NHS Foundation Trust - cantunseeit
Royal Berkshire Hospital NHS Foundation Trust - Yellowroom
Royal Surrey County Hospital NHS Foundation Trust - cantunseeit
Surrey and Sussex Healthcare NHS Trust
University Hospital Southampton NHS Foundation Trust
University Hospitals Sussex NHS Foundation Trust

Community and mental health trusts in the South East region

Berkshire Healthcare NHS Foundation Trust - withsilverbells
Central Surrey Health - FarriersGirl
First Community Health and Care - FarriersGirl
Kent Community Health NHS Foundation Trust - Cantunseeit
Kent and Medway NHS and Social Care Partnership Trust - Blackmetallic
Medway Community Healthcare - FarriersGirl
Oxford Health NHS Foundation Trust - cantunseeit
Solent NHS Trust - FarriersGirl
Southern Health NHS Foundation Trust
Surrey and Borders Partnership NHS Foundation Trust - teawamutu
Sussex Community NHS Foundation Trust - teawamutu
Sussex Partnership NHS Foundation Trust - teawamutu

Ambulance trusts in the South East region

South East Coast Ambulance Service NHS Foundation Trust - Yellowroom
South Central Ambulance Service NHS Foundation Trust

Well done everyone! I better get my skates on - I was supposed to be checking the East of England but I think the Darlington publicity last week makes me think I will skip to the North first - still nowhere near catching all of you! Thanks so much

Worth a look at this video from the Royal Free about research and the badge scheme which was prompted in part by a complaint from a TW patient in 2012 on an acute mental health ward. See about 3.17m in to miss the intro. K

I can take another please @FarriersGirl

Hi, apologies for asking here, but you are the most knowledgeable people I know about this.

I work for a mental health trust.

Re Supreme Court FWS judgment, they've done the usual - ignored women, offered support to LGBTQ+ colleagues.

They say they will respond as a Trust to the EHRC consultation, and they're seeking input/contributions - via the LGBTQ+ networks, asking us to send contributions to the chair of the LGBTQ+ network. No other contacts given.

I assume many women won't feel comfortable sending responses to this guy (LGBTQ+ chair) - he's made his position pretty clear.

I'm not even sure who to ask about this.

I'd like to know how the Trust includes individual contributions in their Trust response, and who decides what their position is going to be.

Has anyone else come across this, or got any suggestions?

Thank you, as always! xx

So if I understand correctly, your trust wants to respond to the EHRC consultation, and they are soliciting responses from their members, via the LGBTQIA+++ network. I presume these responses will not, therefore, be anonymous within the trust? And that you will have no control over how (or even if) they are used? I can see your concern.

To start with, no matter what anyone responds in the consultation, the EHRC cannot in any way shape or form change the SC ruling. The consultation is rather about how to make the SC ruling clear and understandable to service providers. The things that could possibly change as a result of the consultation would be stuff like the wording of examples that are given to illustrate situations and how people should respond to them. I agree with you that your trust is behaving dodgily, but I’m not sure how much damage they can do.

However, you know that you can also, as an individual, respond to the consultation? And that you can say what you have said above - that your trust (which you could name) is soliciting feedback, but rather than asking people to respond as individuals, is collating responses (and potentially editing them, who knows) via a group which appears to have a particular agenda with respect to the consultation. I think if you’re concerned, that might be a way to go. And if you don’t want to respond to the consultation, you could simply email the EHRC, and/or one of the commissioners (Akua Reindorf is one).

You might be able to take some of this - assuming you want to raise with the Trust that they're risking seeming biassed and potentially falling into error by not consulting with all stakeholders? That's the route I went with my Trust (no reply yet from the EDI lead, who is a transman so very neutral obviously). Alternatively you could try asking the Freedom to Speak Up Guardian to raise it as a concern, if you want to be anonymous, depending on how neutral your FTSUG is

https://www.legalfeminist.org.uk/2025/04/29/where-are-your-values-now/

Also good advice!

This must feel incredibly frustrating but it isn't as bad as it seems. The consultation isn't 'Britain's Got Talent' or Strictly. There is no weight of opinion involved. The EHRC has invited opinion on its draft guidance to ensure that factual errors and gaps are covered off before the final guidance is presented to the SoS.

Hello I don't think I have submitted Kent & Medway NHS & Social Care yet - if I have, it's in error as am still working on the last few bits

How about Surrey and Sussex Healthcare NHS Trust

OK thanks I'll check it

Surrey and Sussex Healthcare submitted

Tricky to find any info at all. I think patients could struggle to find the Privacy and Dignity Policy that covers patient accommodation and I couldn't find anything about staff.

This bit looks promising:
Accommodation for transgender people and gender variant children
Single Occupancy/Side rooms may be the preference of the patient or may be the most appropriate option and this will be the standard approach for all transgender patients. The patient will be asked if they are happy with a single occupancy/side room with ensuite facilities..., but this must be done in discussion with the patient ensuring their consent.
If there is a circumstance where the patient does not wish to have a single occupancy/side room or there are any concerns in relation to the requirements of a patient presenting as transgender these should be discussed initially with the patient in a sensitive manner however if there are still concerns or an agreement cannot be reached these should be escalated...
But then the wrecking-ball which is the NHSE guidance
APPENDIX 4 - National Guidance Delivering same-sex accommodation for trans people and gender variant children (NHSE/I 2019)
P30 Trans people should be accommodated according to their presentation: the way they dress, and the name and pronouns they currently use.
P31 In some instances, parents or those with parental responsibility may have a view that is not consistent with the child’s view. If possible, the child’s preference should prevail even if the child is not Gillick competent.

On a quick look, some of these links might be helpful, at least in shaping an FOI request that will get a useful answer. This is from 2018:
https://www.cqc.org.uk/publications/major-report/sexual-safety-mental-health-wards

And this from a bit later:
https://www.gov.uk/government/publications/rapid-review-into-data-on-mental-health-inpatient-settings-final-report-and-recommendations/rapid-review-into-data-on-mental-health-inpatient-settings-final-report-and-recommendations

I recall an earlier (possibly annual) series of reports on safety on inpatient mental health wards, but could only find these more general ones, but if you’re interested they might have some useful information:
https://www.cqc.org.uk/publications/monitoring-mental-health-act

Saying the quiet parts out loud at Oxford Health NHS Foundation Trust:

"Trans people, who may be male or female of any age, are those people who live all of the time, or part of the time in a way which is not usually associated with the gender which they were assigned at birth. ‘Trans’ is an umbrella term which includes those people who live or wish to live full time in their preferred gender (transsexual people) and those people who live part of the time or on
special occasions for reasons of comfort or sexual pleasure (sometimes called transvestites). Transsexual people sometimes have hormones and surgery to make their bodies more congruent with their internal sense of gender."

When a single room is not available, this will be escalated operationally (to gain relevant support to agree level of risk to all patients requiring a cubicle)

This seems quite a vague statement to me. What risk are we talking about here?

The risk involved in placing a trans-identified patient on the ward of their sex presumably, since the alternative would breach same-sex exemptions.

We should be very wary of vague statements. We've seen what happens when activists start interpreting them.

Agree, it is vague and not water-tight but it is a significant shift away from the 2019 guidelines.

I feel we should be campaigning for a centralised SOP that is extremely clear and not open to mis-interpretation. This would also save Trusts much time and money by not having to develop their own.

I'm sure there would be lots of drawbacks to this approach but it would also speed up and de-risk the implementation

Sorry to spam the thread but sharing these glorious examples while I'm finding them (glorious only for the new heights of batshit that they reach)

"4.4 Summary
The Equality Act 2010 prohibits discrimination against someone who is undergoing gender re assignment. People are not required to have undergone or plan to undergo a surgical or other medical procedure to receive protection.

As part of the process, an individual is required to live ‘in role’, they will therefore need to access facilities relating to their acquired gender.

Once an individual is deemed to have successfully transitioned, they can apply for a Gender Recognition Certificate, giving them legal recognition of their acquired gender. An individual does not have to undergo a surgical procedure to apply for a Gender Recognition Certificate. Once an individual has a Gender Recognition Certificate, it is an offence to disclose their previous gender history."

I agree completely, but we would need to be aware of all of the policies where this has potentially been injected, even if only one or two lines - maternity care, consent, chaperoning…

@KnottyAuty Looking through the timeline, this is how it pans out for each SofS up to 2010:

• Early Blair era SofS’s for Health (Dobson, Milburn, Reid), from what I can see really did preside over an attempt to eliminate mixed sex accommodation.
• Patricia Hewitt presided over the setting up of SOAG (soon SOGIAG) and the first publications in the GIRES series
• Alan Johnson inherited a legacy of work in train (more of the GIRES documents, a joint NHS CE and Stonewall CE letter just after he was appointed) and on his watch the May 2009 CNO letter with the Annex E was published
• Andy Milburn continued what Alan Johnson had started, with Annex B in 2010

OMG

"7.1 Supporting Trans people
Often staff are concerned about the possible risks and vulnerabilities that could arise as a consequence of admitting a trans patient on a ward during transition, but these should be assessed in light of the cause of that concern. Patients may, of course, be moved, but not on the basis they are trans and not to an inappropriate setting. Just as a BAME patient would not be moved to an inappropriate ward due to potential racism by other patients, so too should a trans person not be moved from a ward appropriate to their acquired gender due to prejudice of patients or staff."