AC-2024-LON-001142 - [2025] EWHC 2015 (Admin)

For IP1, it was emphasised that the process of assessment by Kelly Psychology is rigorous and closely aligned to that current within the NHS, with a MDT structure common across NHS child and adolescent mental health services, including a mechanism for peer review and quality control; although the NHS MDT also includes a paediatrician, that would be required as the NHS gender services include much younger children (within the NHS, those age 16 and over would be referred to adult services). As for the relationship between Kelly Psychology and IP1, the degree of integration (whilst still maintaining independence) was both transparent and consistent with the Cass Review final report (paragraph 18.3); the criticism made by the claimants suggested a potential conflict of interest but that would be inconsistent with professional obligations and IP1 was run at a loss. Accepting that IP1, as a private provider, would not have input from a range of providers, it nevertheless ensured there was input from a range of professionals from different disciplines, including a wholly independent member of IP1’s MDT.

Commenting on the statistical data regarding patient referrals, it was notable that around one third of those assessed by Kelly Psychology had not been recommended for treatment; the fact that most of those recommended had then been accepted by IP1 reflected the rigorous assessment process. Given differences in patient profiles (NHS will see a far broader pool, with no minimum age), and NHS waiting lists, it was not possible to make a meaningful comparison of IP1 and NHS figures.

As for the views expressed by Dr Kelly/others, to the extent these related to PBs, that had no relevance to the service IP1 was offering; more generally, the selected quotes had to be seen in context, and there had been no expression of disagreement with the requirement for caution and care when prescribing the hormone treatment.