NHS Fife admits it broke the law over allowing trans doctor to use female changing room

The Equality and Human Rights Commission has now told the health board it must now “carry one out immediately”.

This is the latest development in the ongoing employment tribunal between nurse Sandie Peggie and Dr Upton and NHS Fife. Ms Peggie is suing her employer for sexual harassment over being forced to share a changing room with Dr Upton at Victoria Hospital in Kirkcaldy.

Weeks of evidence sessions ended at the tribunal hearing centre in Dundee last month, and the tribunal is due to reconvene on September 1 for closing statements.

The equality watchdog had written to NHS Fife bosses back in February to remind them of their obligations under the Equality Act 2010 on single-sex spaces, including a “duty to assess and review proposed new or revised policies or practices”.

This comes after Ms Peggie’s legal team requested a copy of any relevant assessments in August 2024. When asked “whether an equality impact assessment or risk assessment was undertaken before the decision” to allow Dr Upton to use the female changing room, the health board said there was not one available.

Get daily political analysis - subscribe for free to The Steamie

The EHRC initially said public bodies have “a duty to assess and review proposed new or revised policies or practices” and that any assessment results must be published “within a reasonable period”, but this information was not on the NHS Fife website.

The commission then asked the health board to provide “a copy of any equality impact assessment for any policies or practices relevant to how you’ve kept those under review post-implementation, and details of any steps you are taking to ensure that the rights of different groups are balanced in the application of these policies or practices”.

It wrote to NHS Fife again a month later after receiving no response.

In July, NHS Fife assured the EHRC that it had “taken steps in several areas, including a full review and audit of changing, toilet and locker room facilities”.

Baroness Kishwer Falkner, chair of the EHRC, has now said the health board did not have an equality impact assessment in place and now expects to publish one at the end of September.

She said: “The policies and practices of all Scottish health boards must comply with the Equality Act 2010.

“Earlier this year we asked NHS Fife to provide us with information on the provision of single-sex changing facilities for staff and the rights of different groups in the application of these policies.

“At that point NHS Fife confirmed that no equality impact assessment was available.

“Undertaking an equality impact assessment of relevant policies or practices, and publishing the results, are requirements of the PSED specific duties in Scotland.

“We believe NHS Fife failed to meet these requirements and told them to carry one out immediately.

“NHS Fife has now confirmed that it has commissioned an equality impact assessment and anticipates it will be published by September 30.”

Baroness Falkner added: “Since we first wrote to NHS Fife, the Supreme Court ruled on the definition of ‘sex’ in the Equality Act.

“The EHRC has been clear that all duty-bearers should be following the law, as set out in the judgement handed down on April 16.

“NHS Fife has assured us that it is following our advice to review the implications of the judgement for its policies and procedures, seeking specialist legal advice where necessary.

“We continue to urge NHS Fife to progress the corrective actions we directed without delay.

“These steps are essential to protect NHS Fife staff from discrimination and harassment on the basis of protected characteristics, including sex, religion or belief, and gender reassignment.

“We will continue to engage with NHS Fife and monitor its progress and the outcome of the measures it has committed to taking, to ensure compliance with the Equality Act and public sector equality duty.”

A spokesperson for NHS Fife said: “NHS Fife acknowledges the EHRC’s media release of August 13, 2025, and welcomes its continued engagement and oversight.

“We are committed to working constructively with the EHRC to provide assurance that we fully understand, and are meeting, our obligations under the Equality Act 2010 and the public sector equality duty.

“This includes considering the implications of the recent Supreme Court ruling and the EHRC’s interim guidance.

“A comprehensive review and audit of our facilities has been completed, and an equality impact assessment is underway. This will be concluded and published by September 30, 2025.”

They added: “Our priority is to ensure that all NHS Fife policies and practices protect the rights of our staff and comply fully with equality legislation.”

Tess White MSP, the Scottish Conservatives’ equalities spokeswoman, said this development shows the top team’s positions are “completely untenable”.tess w

She said: “This damning directive from the EHRC confirms that, on top of being negligent, incompetent and biased, NHS Fife broke the law in relation to the Sandie Peggie case.

“It’s just one failure, and one revelation, after another.

“It’s abundantly clear that the positions of the chief executive and senior health board colleagues are completely untenable.

“The shameful admission from the health board confirms that Sandie Peggie was hung out to dry from the very beginning of this tawdry scandal simply for standing up for her rights as a woman.

“Fairness and accountability must prevail. Surely John Swinney and his SNP colleagues can no longer retain confidence in those in charge of this dysfunctional health board.

“The First Minister must clear out those at the top of NHS Fife and finally demand that it, and all other public bodies, upholds the clear and unequivocal Supreme Court ruling entitling women to single-sex spaces.”