NHS trust ordered to pay social worker £20,000 over whistleblowing on gender identity service

    Employment tribunal rules that children’s safeguarding lead suffered disadvantage after raising public interest concerns about practice at Tavistock’s Gender Identity Development Service

    Sonia Appleby

    An NHS trust has been ordered to pay one of its social workers £20,000 after an employment tribunal ruled she had suffered “injury to “feelings” after blowing the whistle on practice concerns.

    Sonia Appleby reported several concerns to managers at Tavistock and Portman NHS Foundation Trust about practice at the Gender Identity Development Service (GIDS), a specialist national service for children needing support with their gender identity.

    The tribunal found Appleby suffered “detriment” in response to making five “protected disclosures” – issues raised by workers in the public interest – which is contrary to the Employment Rights Act 1996.

    The GIDS assesses young people who have difficulties with their gender identity, provides therapeutic support and, in some cases, refers them to other hospitals for treatment with puberty blockers to give them more time to reflect on their gender identity. They may then receive cross-sex hormones as part of a gender transition.

    Rising caseloads

    Appleby, a social worker and psychoanalytical psychotherapist, has been the trust’s named safeguarding lead for children since 2004, a role that involves advising the board on child protection, strategically and in relation to day-to-day practice. She first reported concerns about GIDS in 2016, highlighting deficiencies in case recording and warning that rising referrals were having a distressing impact. GIDS’s caseloads had been rising since it became a specialised NHS service in 2009, a trend that accelerated when it became a national service in 2016.

    Appleby made her first two protected disclosures in October and November 2017, respectively, in emails to her then manager – trust medical director Dr Rob Senior. These reported concerns from GIDS staff including a culture that made it difficult to report safeguarding concerns for fear of being labelled transphobic, and that some young children were “being actively encouraged to be transgender without effective scrutiny of their circumstances”. She also cited reports of the service’s director, Dr Polly Carmichael, being unwilling to listen to the concerns.

    However, Senior did not respond, leading Appleby to forward both messages to him in January 2018, on return from a period of sick leave.

    This led to a meeting with Carmichael in February – which constituted the third protected disclosure – at which they discussed her emails to Senior. Appleby subsequently emailed Carmichael with a record of the meeting and proposed actions, including that she would talk to GIDS’ safeguarding lead, Garry Richardson, on strengthening safeguarding leadership at the service. However, Carmichael did not respond.

    ‘Jimmy Savile’ remark

    In a subsequent conversation with Richarsdson, Appleby warned that “if they were not careful a Jimmy Savile type situation could arise”, in terms of “an institution turning a blind eye to what was in front of them”. This was a reference Appleby routinely used in training sessions to illustrate the importance of staff vigilance regarding child safeguarding. Richardson, however, interpreted this as an attack on colleagues as being complicit in abuse.

    Through the rest of 2018, Appleby raised further safeguarding concerns reported to her by staff, with Senior, Richardson and the Tavistock’s then director of children, young adults and families, Sally Hodges. These included concerns about children’s ability to give informed consent to medication, premature use of puberty blockers, high caseloads and staff feeling unable to raise concerns. Analysis by Appleby also found low levels of safeguarding supervision at GIDS, and of safeguarding referrals from it to other agencies.

    Also that year, Dr David Bell, an adult psychiatrist and Tavistock staff governor, wrote a report to his fellow trust governors saying the GIDS “as it now functions and children’s needs are being met in a woeful (sic) inadequate manner and some will live on with the damaging consequences”.

    Appleby asked Bell to remove the opening paragraph of the report, which said that she had “been closely involved throughout preparation and has read and discuss with me this final version to which she has made a number of very important contributions”, but he had already submitted it.

    The tribunal found that, while Appleby agreed safeguarding was not being properly handled at GIDS, she disagreed with the tone of the report, which came across as an attack on the service’s management.

    Dr Dinesh Sinha replaced Senior in 2018 as trust medical director and conducted a review of GIDS, during which Appleby made her fifth protected disclosure, details of an exit interview in which a staff member referred to a “climate of fear” at GIDS. Appleby’s reference to Jimmy Savile was raised with Sinha twice, by Richardson and another member of staff, during his review.

    In July 2019, after Appleby’s return to work following another period of ill-health, she was asked to attend an informal meeting with Sinha regarding GIDS. However, an HR staff member was present and Sinha told her she would be receiving a letter about the Savile comment that would remain on her file, but without providing context as the remarks were made in confidence. The letter said that the comparison had made a colleague feel “very disrespected” and that, though this was not a formal procedure, Sinha warned he may need to investigate Appleby formally if there were further such reports.

     ‘The sense of injustice is obvious’

    The tribunal ruled that this constituted a detriment to Appleby, for which the trust must pay her £12,500 in compensation.

    Despite Sinha saying it was an informal meeting, the tribunal found Appleby was right to have seen it as a disciplinary process, and the outcome was, in some ways, “worse than a disciplinary warning”, as it was not time-limited and there was no right of appeal. There had also been no investigation; had there been one, Sinha would have found that the Savile example was one Appleby used routinely in training.

    “The letter on her file contained an explicit threat that it would be taken into account later if there was a recurrence of an obscure event,” said the judgment.

    “She had no opportunity to clear her name or get another view, as would happen if there was an appeal, and it was to remain on her file indefinitely, and it still is on her file. The resulting sense of injustice is obvious. Anyone would lose sleep over this.”

    The tribunal said Dr Sinha’s treatment of Appleby “can only be explained as materially influenced by her disclosures, which were viewed by him (and others) as unwarranted interference, overstepping her proper role”.

    The second area in which the tribunal found detriment to Appleby was in relation to staff being discouraged from referring safeguarding matters to her, despite her being the trust safeguarding children lead. Though nothing was put in writing, the tribunal found “there was a message being communicated to GIDS staff by Dr Carmichael at the time of the Sinha review, that they should not take safeguarding issues to the claimant, not because she was not a clinician familiar with the complexities (as had been suggested to some staff when they took concerns to the speak up champion) but because she was hostile to GIDS”.

    “That must have been hurtful, and must have made carrying on with her duties painful and difficult, especially when the trust denied that had occurred, and was asserting that she bore the responsibility for any difficulty,” said the tribunal, who ordered the trust to pay Appleby another £7,500 for this detriment.

    Trust to learn from ‘difficult situation’

    In response to the ruling,  the trust said it “wholeheartedly supports staff raising concerns and has strengthened its mechanisms for doing so in recent years”.

    “It is important that all staff can raise concerns without fear of detriment and have them properly addressed,” a spokesperson said.

    “There is always room for improvement and learning from these difficult situations and we are looking carefully at what this decision means for us and what we should take from it going forward, including how we best support our staff and protect our patients.”

    ‘Last two years were brutal’

    Appleby opened a crowdfunding page to help cover the legal costs of her case and posted a response to the ruling on the website last week.

    She said the decision to instigate proceedings against her employer was a “nearly overwhelming experience” but that she was “very pleased with the outcome”.

    “I want to thank you, my witnesses, my legal team and all of the very many people who have supported me during the tribunal process,” she said.

    “The last two years, as a claimant and employee, have been increasingly brutal.

    “However, I want to focus on you and to express my sincere thanks for your humanity and your financial support, without which I would never have been able to bring my case.

    “Standing by me as you all did, supported the primacy of childhood, keeping our children safe, and hopefully sending a message that those who strive to do their jobs are not miscreants.”

    , ,

    More from Community Care

    34 Responses to NHS trust ordered to pay social worker £20,000 over whistleblowing on gender identity service

    1. Natalie September 14, 2021 at 11:07 am #

      Care to comment SWE? Content to remain silent on how black social workers are marginalised BASW? Still have confidence in the Case Managers of your Regulator social workers? Anything to say PSW Network?

    2. Rich September 14, 2021 at 11:19 am #

      If I publicly declare that I contributed to the crowd fund will I be investigated and face censure SWE?

      • Rebecca September 14, 2021 at 8:44 pm #

        I also contributed to the crowd funder for this case.

        • Callum September 15, 2021 at 9:47 am #

          Me and my boyfriend too. Both registered social workers if interested SWE.

          • Lauren September 15, 2021 at 9:46 pm #

            Me too. Also a registered social worker.

    3. Karanuts September 14, 2021 at 1:20 pm #

      Will anyone discipline the directors of this Trust?

    4. Celeste Corrigan September 14, 2021 at 2:14 pm #

      It’s all too easy for Health Trusts to make a decision on a social worker’s career and erroneously condemn a social Worker member of a multidisciplinary team for stepping outside the crowd and raising concerns! Congrats to this social worker for doing what is right and rowing against the status quo. We are ALL responsible for safeguarding – not just social workers. However, in a culture of silence, why is it only social workers who have the balls to question dodgy practice & why is it only social workers that are impacted by the “disciplinary” in a multi-disciplinary team environment???

    5. Tom J September 14, 2021 at 2:21 pm #

      Lucky she could find the money to stand up for herself. In Britain you are innocent until proven poor.

      Why should it cost £121,265 in legal fees to get justice?

    6. Oluwatoyin Adenugba-Okpaje September 14, 2021 at 4:18 pm #

      Fair play to Appleby! I can imagine it must have been a traumatic experience for her and her family. The ability of management to get away with underhand threats because a social worker raised concerns is not in anyway good for the optics, however, the truth is this situation is not in anyway unique.

    7. Andy September 16, 2021 at 8:33 am #

      The reputation of the Tavistock’s GIDS seems to be in tatters. This surely cannot bode well for its current appeal against the Bell judgement.

      • Samm September 17, 2021 at 9:15 am #

        Not amongst social work ‘leaders’ though. Telling that for all their self trumpeting, Northern version, of being the vanguard of proactive anti-racism, BASW remian silent on the victimisation of a black social worker. All well and good to berate SWE for their miserable persecution of black workers, but where’s the vision on this?

        • Andy September 18, 2021 at 11:03 am #

          In the light of the actual appeal decision, it looks like I was totally wrong in my above comment.
          There seems to be a huge and erroneous focus on the ethnicity of the whistleblower and very little on the children’s safeguarding issues she sought to highlight.
          The hope must be that with the weight of all the legal, regulatory and tribunal scrutiny, the still highly questionable (massive understatement) interventions offered to children by this service will now be subject to the most intense oversight imaginable.

        • William Teller September 19, 2021 at 12:19 pm #

          A vitriolic diatribe Samm, that says more about you than your targets.

          • Samm September 20, 2021 at 9:59 am #

            Diatribe maybe, vitriolic not. Do tell what BASW has said about the treatment of a black social worker whose actions have been vindicated by an ET? I am always willing to be educated and corrected William Teller, but are you willing to condsider the possibility of collusive selectivity from BASW regarding racism? I can recognise that self defined professional associations can be fallable and compromised by their establishment status.Ever have your own doubts William Teller?

          • Harri September 20, 2021 at 10:18 am #

            I only see one “target” William. Please say why BASW should not be challenged by a social worker?

      • Kendra September 18, 2021 at 9:41 am #

        Tavistock won their appeal.

    8. Anon September 17, 2021 at 2:56 pm #

      The Tavi is going to regret fighting this and we applaud her going forward under such extreme pressure . Open reporting has implications for all NHS Trusts. Partcularly in MH. Long standing criticisms of the Tavi go back decades. And as a lifelong Camden resident ( where the Tavi is located and reputation is well known) I mean decades. For adult and children services. It has always staggered many how it is held as a bastion of excellence that should be immune to scrutiny or criticism.

      For so long this was , and to a significant degree remains an all white middle class institution which to many looked like it had forgotten it was actually a fully funded NHS Trust. The total lack of diversity or cultural difference which failed to reflect the make up of it’s referral catchment areas and especially London where most pts came from, was staggering.

      Many people were concerned that against this background it was commissioned to provide GIDS and then referred to as ‘ experts’. The power that comes with being a sole provider should never be underestimated. It has aggressively hung on to that position . And such a culture is closed to outsiders.

      My entire family of 3 generations Camden residents contributed to the crowdfunding because as POC we had no doubt at all what was behind this. None. Safeguarding children core to good practice yet the Tavi chose – and I mean chose – to arrogantly decide this incredibly vulnerable group should be excluded from safety? And ignore the black lead on safeguarding .

      We all applaud her actions and thank her on so many fronts. And we dont underestimate how hard her position was and what she then had to face for doing the right thing. Like others have said what sanctions for those in this Trust who thought they were above the law?

    9. Nene Obibi-Mordi September 18, 2021 at 7:56 am #

      Her concerns and reservations about the service were commonsense. I am glad the children are still at the centre of the service.

    10. Millie September 18, 2021 at 9:23 am #

      Well done to this brave woman. I cannot imagine the emotional pressure and stress..you took on the giants and won..one in the eye for Tavistock. Shame on you Tavistock..shame!
      Just how far were they prepared to go? The threat level was real.
      My view is that those responsible should face the might of the justice system for this level of systematic bullying.
      £20,000 is nothing as an award..so glad her name is cleared but the fight back for her is just beginning. Hopefully she can find peace. I applaud her for her courage.
      And yes where is SWE and BASW in protecting our SW! The sound of silence is deafening!

    11. Jaime September 18, 2021 at 3:02 pm #

      And how many of these people commenting “yeah good for her woo” actually understand the whole gender part of this. Because, I’m not gonna lie, this whole thing kinda comes across a little transphobic.

      For example, the article says about the ‘premature use of puberty blockers’. Said puberty blockers are used for non trans kids who start puberty too early as well, for kids as young as 8. With pretty much no supervision. And they do not do any long term damage. So how can you use them prematurely?

      I could rant about this all day, and yes, good for her for standing up, they did fail her. But… Yeah, the attitude towards the trans part isn’t great.

      • Rich September 22, 2021 at 8:08 am #

        Really? When did highlighting detrimental pressures of large caseloads, poor recording, staff feeling intimidated to express their professional opinions, querying whether children are giving informed consent to life changing medical treatment, practitioners being told not to communicate with a senior professional lead, imadequate safeguarding supervision, staff not taking a holistic approach to children’s circumstances, entrapping a social worker into a de facto disciplinary hearing so denying her the protection she would have under a formal process become the definition of transphobia? If ideology over professional principles matter more just say it.

    12. Karla September 18, 2021 at 6:57 pm #

      Funny, cos service users at Tavi say it’s actually always been incredibly difficult to get blockers prescribed, they always take way too long to do so, they regularly misgender children, the tone and attitudes of staff are transphobic throughout the entire organisation. Doesn’t fit at all with this social workers “concerns”. An awful lot of people want to think they are safeguarding when they are actually being transphobic. They mostly don’t even realise their own bias is what is making them make that assessment. When it come to this issue, the social worker clearly has her own set of beliefs and has allowed that to influence her doing her job. If I was transphobic I’d most likely think blockers for kids was abuse too. I’m going to go with believing the service users here and not the clearly anti trans social worker.

      • Susi September 20, 2021 at 9:00 am #

        But Karla you are doing the thing you accuse others of. Evidence and vindication doesn’t matter to you then? Ideology versus a legal process is the new social work now is it what? What was that about evidence practice again? Please share with us the special.power you possess that allows you to determine what’s in the mind of a person you haven’t met?

      • Harri September 20, 2021 at 9:06 am #

        Mermaids claim that. They are hardly “everybody.” Honesty matters. If you are going to malign someone in the face of a legal ruling own your ideology. Good for the soul and makes for for better dialogue.

      • Isla September 22, 2021 at 12:10 am #

        If social workers want to be wanna be medics, they should study endocrinology. Saying something someone said to someone else who told it to someone who convinced someone else who than tweeted something does not make it so. However much Mermaids claims it is. Integrity demands an enquiring mind not collusive validation of “it’s true because I say it is true” claims. If “people” are not aware of their bias, might that not apply to you too Jaime and Karla? It’s a big claim to assert personal purity while ignoring objective evidence tested in an ET.

      • Natalie September 22, 2021 at 10:00 am #

        By Keira Bell too Karla?

    13. Andrew September 19, 2021 at 11:19 pm #

      Where has this brave woman been transphobic? Easy to slur her by innuendo rather than look at her highlighting GIDS offering ideologically not medically directed treatment. She stood up and she won Jaime. Questioning her motives is just continuing to tarnish her. Justice means something.

    14. Morrisey September 20, 2021 at 10:49 am #

      That was vitriolic diatribe? You should attend one of our reflective practice sessions for a proper rant. And that’s just from the facilitator. But this? William it was really nothing.

    15. June September 20, 2021 at 10:59 am #

      I am a BASW member and I would be appalledif they commented on this. I am very disappointed by the tribunals decision. Those of you hiding behind made up griviences about racism, sexism and the supposed marginalisation in this case just need to stop hiding your transphobia. An entire world renowned therapy service aren’t wrong against one person whatever the outcome here. I trust GIDS to do right by children. That is true safeguarding.

      • Natalie September 22, 2021 at 9:58 am #

        Keira Bell might disagree.

    16. Olu September 20, 2021 at 6:02 pm #

      A better exposition of what BASW are about would be hard to find. Made up griviences indeed. Good to know that there is good and a bad definition of the right kind of racism, sexism and marginalisation we should be combating. Good to know that some of us are misguided in our understanding of who is the right kind of black female deserving of our support. Proactive anti-racism indeed.

    17. Terri September 21, 2021 at 11:00 am #

      Uploaded my CPD, paid my fee and went to bed feeling miserable at the whole pointless exercise. But today I have my optimism back. The Smiths lyric as a response restores my confidence that whatever the bureaucracy and intolerant orthodoxy inflicts on us, the wit and forbearance of the humble social worker restores something positive to our practice. Thank you.

    18. Stephan September 25, 2021 at 11:41 am #

      Now they’ve overturned the Bell judgement, GIDS should appeal against this Tribunal decision too.

    19. Natalie September 26, 2021 at 9:16 am #

      No Isla, science hurts my head. Better to nod along. Biology is just a man(!) made pseudo empirical opinion. ‘Facts’ are there to be disproven by metaphysical dreams.