52

14 comments

I hate how this is being framed in the media-that they've been rated inadequate because of the long wait times. They've actually been rated inadequate because they're so useless, they couldn't be trusted to run a bath, never mind a clinic!

I hope the judges will accept new evidence in the appeal, because this could likely be a killer blow for their case, especially if it's true that they're appealing against the consent/Gillick point of the first judgement:

'Staff had only recently begun to record consent and capacity or competence clearly for young people who might have impaired mental capacity or competence. The records of young people who began medical treatment before January 2020 did not include a record of their capacity, competency and consent. When staff identified records without a written capacity assessment, they did not seek to address this or record it as an incident'.

Here is the full report on the gender identity services from the CQC website. You've really got to read it in full. It's pretty fucking bad.

Our rating of this service went down. We rated it as inadequate because:

• The service was difficult to access. There were over 4600 young people on the waiting list. Young people waited over two years for their first appointment.

Staff did not always assess and manage risk well. Many of the young people waiting for or receiving a service were vulnerable and at risk of self-harm. The size of the waiting list meant that staff were unable to proactively manage the risks to patients waiting for a first appointment. For those young people receiving a service, individual risk assessments were not always in place with plans for how to manage these risks. The number of patients on the caseload of the teams, and of individual members of staff, were high making caseloads difficult to manage and placing pressure on staff.

Staff did not develop holistic care plans for young people. Records of clinical sessions did not include any structured plans for care or further action. Staff did not sufficiently record the reasons for their clinical decisions in case notes. There were significant variations in the clinical approach of professionals in the team and it was not possible to clearly understand from the records why these decisions had been made.

Staff had not consistently recorded the competency, capacity and consent of patients referred for medical treatment before January 2020. However, since this date these decisions had been recorded.

• The teams did not always include the full range of specialists required to meet the individual needs of the patients. Staff did not always work well together as a multidisciplinary team.

• Staff did not always feel respected, supported and valued. Some said they felt unable to raise concerns without fear of retribution.

• The service was not consistently well-led. Whilst areas for improvement had been identified and some areas improved, the improvements had not been implemented fully and consistently where needed.

There's a lot but this also stuck out to me too...

Our rating of effective went down. We rated it as requires improvement because:

Staff’s assessments of patients were unstructured, inconsistent and poorly recorded. Staff did not sufficiently record their reasoning in reaching clinical decisions. There were significant variations in the clinical approach of professionals in the team and it was not possible to clearly understand from the records why these decisions had been made.

• Staff did not develop care plans for young people. Many records provided insufficient evidence of staff considering the specific needs of young people, such as autistic spectrum disorders.

[–] Les 5 points

Thank you for sharing. This is bleak.

How can anyone look at this and think that it's okay? How is this not negligent? How is this not malpractice?

Staff did not sufficiently record their reasoning in reaching clinical decisions.

Ridiculous!

I hope, I really hope, that some kids at least have time to grow out of this social disease in the time it takes these quacks to make their first appointment.

Truth. Unintentionally instituting a period of waiting (which they say will kill these kids) and, instead, it causes desistance.

There’s a very good Twitter thread by @hannahsbee (the Newsnight journalist cited in the report) which makes it clear that the issues go far beyond waiting list problems, which is the slant given by the BBC News report.

One criticism made by the inspectors is “Records of sessions with young people and their parents were often simply descriptions of discussions that had taken place. They did not include any analysis, structured assessment, professional curiosity or clinical decision making.”

I can hardly think of a more damning indictment of professionals than that. And it is all the more enraging when we remember that this is the “treatment” being given to mentally ill children. I am furious that the Tavistock has been given permission to appeal in the Keira Bell case, and I hope the Court of Appeal shoots them down completely.

I am furious that the Tavistock has been given permission to appeal in the Keira Bell case, and I hope the Court of Appeal shoots them down completely.

Appeals are granted because of either a)realistic prospect of success or b)some other compelling reason. Tavistock's appeal has been granted for b)some other compelling reason.

Someone asked RadFemLawyer on Twitter: "So effectively they (the court) want to explore and perhaps bring clarity, if required, to interpretations of Gillick competency as that is in the public interest?''

Radfemlawyer answered "Likely!"

So they may have accepted to clear up some misconceptions! I'm trying not to get my hopes too high, but I'd be shitting myself a lot harder if they'd been granted an appeal because they have a realistic prospect of success.

[–] Astraea1284 8 points Edited

Yes - I'm not familiar with the UK system, but higher courts will often accept appeals in cases of major public significance because the implications of the original decision may be far reaching and therefore the issue requires appellate consideration. Appellate decisions are binding on other courts, while a decision of a lower court is not. Leave to appeal just means the court will hear your arguments; it's no guarantee of success.

I keep hearing staff feared “retribution”, and saw that some of the staff indeed got it.

I’ve never heard any names, or job titles to see who was the driving force behind that. Who were the decision makers? What were their job titles? Who stood to lose out from the David Bell report?

I watched one guy interviewed on Triggernometry, but it was all a vague “they”.

Does anyone have a breakdown of the job titles, responsibilities and hierarchy?

It can’t just be a case of a complete clusterfuck that is no one person’s fault anymore than each raindrop is responsible for the flood. There was active silencing.

Who was in charge? Because it seemed to me that the whistleblowers were actually fairly senior and should have had more weight to swing.

Another day, another instance of the BBC being deliberately disingenuous regarding facts on trans matters.