NHS health check form: who designs them?

[GarlicMetre]

I went for my 'older person health check' today - there was a question about gender 🙄 Putting one foot gently on my soap box (the HCA was nice), I asked to see the options so she swivelled her monitor round.

All the options require the patient to have a 'Gender'. They were, iirc: Male Gender, Female Gender, Nonbinary Gender, then two others which were something like 'In the process of changing gender' and 'Wanting to change gender'. I should have taken a photo.

Anyway, there was no 'Other' choice, let alone space for 'Sex realist' or 'Does not accept gender'.

While I can easily imagine the justifications for this, I object strongly to the question format on both statistical grounds (the question contains implicit bias) and moral (I'm a woman, that should be enough!)

Does anybody know who's responsible for these forms, and to whom I should complain? I'd also be chuffed if any HCA could tell me the exact wording of all the options now.

TBF This is not a bad effort

The law:
characteristic of gender reassignment if the person is proposing
• to undergo,
• is undergoing or
• has undergone
a process (or part of a process) for the purpose of
● reassigning the person's sex by changing physiological or other attributes of sex

Male Gender, ( has undergone)
Female Gender, ( has undergone)
Nonbinary Gender, (data breach by collection as not a sex)
'In the process of changing gender'
'Wanting to change gender'.

But there should have been a not applicable
As most people will not fall within the PC

Similar question thread here:
https://www.mumsnet.com/talk/womens_rights/5374509-gender-id-on-a-housing-allocation-policy-consultation?reply=145726212

You contact the data protection section.

Asking

What was collected and by default if you tick one box yes they collect the no data too.
And why.

You let them explain and then point out the error

The basis of collection will normally be to run analysis of the PC and set policy under the Equality Act 2010
https://www.legislation.gov.uk/ukpga/2010/15/contents

But they have no justification if you have to ID into the PC

Oh, that's interesting, thanks @AnSolas!

For a medical form this is wrong. It will have been designed by some immature incel whose only knowledge of life is the internet!

And not saying it was just me but a hospital I regularly attend used to ask about gender so not just me but must have been others, got them to change the form from gender to sex. (In fact I am sure that somewhere there is a thread about an update on NHS guidance on this.

What is your sex: male / female / not answered

I am not sure there is an medical need to ask about gender identity.

Whether they should collect data on those who have or are undergoing gender re-assignment seems to go against the notion that TRAs support that it is a breach of a person's privacy to ask this.

I think 'gender identity' is still very much a thing. I know the NHS has been through several convoluted processes to correct the issues arising from confusion between sex and gender: practices are now expected to record both as separate fields. However much this may piss me off, it makes sense when trying to deliver sex-specific health services to a gender-obsessed world.

My issue is that the HCA's template made it impossible to reject the notion: every patient interviewed using this template must be allotted a gender identity. Since gender identity is an insubstantial quality amounting to a preference or belief, it's the same as asking me whether I'm Christian, Muslim, Sikh, Jewish or Buddhist with no spaces for 'other' and 'no religion'.

I could claim the form's discriminatory because it doesn't allow me to express my gender identity of 'None' 🙄 I'd really rather not play that game, though.

I've now found out that there isn't an NHS-wide set of templates (for god's sake!). There's a large provider & systems administrator called Arden but, looking at their example screens, I don't think it's the one my GP uses. I'll have to put in a written request for the info and hope they don't take it as some sort of attack or breach of confidentiality. Careful wording needed, and I bloody hope it doesn't turn out they've used a teenager to design their data collection!

Arden is just the company that makes the software, which will bolt on to the surgery’s patient record software, likely either Emis or SystmOne. Could you write to Arden expressing your concerns and bypass the surgery altogether? See if they can tell you why they’ve chosen to use that phrasing and disallow any option to decline.

According to the NHS Data Dictionary the options for Gender Identity should be:

CodeDescription
1
Male (including trans man)
2
Female (including trans woman)
3
Non-binary
4
Other (not listed)
Z
Not Stated (PERSON asked but declined to provide a response)

https://www.datadictionary.nhs.uk/attributes/gender_identity_code.html

I may have been a tad optimistic about the progress NHS has made towards common sense. 'Similar threads' brought up this horrifying one (with link) only two months old!

How on earth did the world's largest health service jettison basic biology so completely, in favour of what amounts to a spiritual belief?!

I'll start by writing to Arden tomorrow.

The second part of Nurse Sandy Peggie’s employment tribunal started today with the hospital’s DEI lead giving evidence; she claimed not to know what sex she is. People like that are how the NHS got where it is.

The software provider has no obligation or need to engage with you they are selling a tool

The data collection issue is with the processor as is the obligation to select the correct tool.

So if the data collection is not for a PC (gender reassignment ) the HCP needs to have a lawful legitimate reason to collect Gender Identity.

And asking for a Faith would be more lawful as some faiths have interactions with treatment pathways eg food rules which medicines break and body management blood / death rites

That the NHS is paying to put that tripe up as a defense when they know the media is watching.🤪

And she is imo stupid as she has proven she is unqualifed to do her job if she cant manage the PC sex. ( that is a rather big one in a Hospital setting where not knowing how to work that out can kill people ) 🤨

I'm floundering around in software maps and data dictionaries, getting nowhere and being ever less surprised that it keeps fucking up. As an aside but an example, I also saw a nurse today about a minor injury. Half an hour after I got home, I received a text from the nurse with an update on my condition. Wow! I thought, that's efficient! It was an update on somebody else's condition - addressed to me, so it could've been worse, but not exactly inspiring confidence in the everyday implementation of all these automated systems.

Somewhere in one of the lists of data codes, I saw that patient sex is ONLY required for maternity care. I thought I must've missed something, so moved along. Now I'm not so sure.

I will get to the bottom of this gender question, if it's all I can manage.

My advice is to email the Department and the Data Protection Officer - you will find their email in the Privacy Policy; usually a link at the bottom of a webpage.

I would refer them to the requirement under GDPR and their privacy policy to ensure they capture and process accurate data. Point out the form is not doing that and they may find this link https://osr.statisticsauthority.gov.uk/our-work-on-data-about-sex-and-gender-identity/ to the Office for Statistics Regulation guidance helpful in redesigning the form.

Note: This guidance was developed due to the very embarrassing new section in the 2021 Census that gathered poor quality data because ONS fucked up.

Well, being something of a multiuser of different parts of the NHS I can say I have never been given those options. So not sure who they were written for and who pays any attention.

The main problem has been, but notices a change that they ask for gender (when they mean sex) and some have recently corrrected this.

Then some convoluted question about identity which is just a reminder of why the census went so wrong.

And I think this is because it is the external providers who come up with this nonsense, and GP surgeries, special clinics etc., just buy them off the shelf.

So in fact I go back to my original opinion that most of this will be the inner workings of the inner life of incels.

Lets face it, if the data actually matter they would by now have had some conformity.

This just proves it is an empty question.

I also received a medical questionnaire recently asking my gender (which I was able to strike through and put sex) and - FFS - my pronouns.

Believe me, no part of the NHS ever buys anything "off the shelf". They are all bespoke and different, which is why much of the IT costs millions and is incompatible across the board.

You could point them to the Sullivan review: https://www.gov.uk/government/publications/independent-review-of-data-statistics-and-research-on-sex-and-gender

My local surgery has.

The blood clinic at my local hospital has.

And not only do that not follow any standard format, both of them contravene the guidelines on web accessibility.