NHS Fife has been accused of breaking the law by the equalities watchdog amid the ongoing Sandie Peggie tribunal.
The Herald reports that the Equality and Human Rights Commission (EHRC) has told the health board to carry out an equality impact assessment, after it emerged one had not been carried out ahead of NHS Fife allowing a transgender doctor to use female changing facilities.
Peggie, a nurse, was suspended after she complained about having to share a changing room with transgender medic Dr Beth Upton at Victoria Hospital in Kirkcaldy, Fife, on Christmas Eve 2023.
She was placed on special leave after Dr Upton made an allegation of bullying and harassment, and cited concerns about “patient care”.
Peggie then lodged a claim against NHS Fife and Dr Upton, citing the Equality Act 2010, including sexual harassment; harassment related to a protected belief; indirect discrimination; and victimisation.
The tribunal has become a flash point for gender-critical campaigners and anti-trans groups, with For Women Scotland, which took the case regarding the definition of a woman to the Supreme Court, being permitted to lodge a written intervention to the tribunal.
Peggie’s legal team requested a copy of any relevant impact assessments undertaken by the health board in August 2024. According to the Herald, the health board responded that it had not.
This led to the EHRC writing to NHS Fife on multiple occasions. They said that under the Equality Act 2010, the health board had a “duty to assess and review proposed new or revised policies or practices” and to publish them within a “reasonable period”.
The Supreme Court ruling on the definition of a woman as “biological sex” was handed down on April 16 2025, after the EHRC first wrote to NHS Fife.
The judgment led to the EHRC to release interim guidance – which banned transgender people from using the facilities of their acquired gender.
It also made it compulsory for workplaces to provide single-sex facilities, a statement it would later retract. A consultation is currently underway, before the EHRC releases its full guidance.
Prior to the Supreme Court ruling, the Equality Act had been seen as including transgender women with a Gender Recognition Certificate (GRC) as women.
Baroness Kishwer Falkner, EHRC chair, said: “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.
“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 judgment handed down on April 16. NHS Fife has assured us that it is following our advice to review the implications of the judgment 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.”
In response, a spokesperson for the health board said: “NHS Fife acknowledges the Equality and Human Rights Commission’s media release of 13 August 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 30 September 2025.
“Our priority is to ensure that all NHS Fife policies and practices protect the rights of our staff and comply fully with equality legislation.”
