May 18, 2026

INK -v- NHS England (anonymity order)

Administrative Court High Court King's Bench Division Anonymity Order

Case number: AC-2026-LON-000045

In the High Court of Justice
King’s Bench Division
Administrative Court

In the matter of an application for judicial review

15 May 2026

Before:

Richard Wright KC,
sitting as a Deputy High Court Judge

Between:

The King
on the application of
INK

-v-

NHS England

Order

Notification of the Judge’s Decision (CPR 54.11, 54.12)

Following consideration of the documents lodged by the Claimant, the Defendant’s Summary Grounds of Defence and the Claimant’s Reply

ORDER BY RICHARD WRIGHT KC SITTING AS A DEPUTY HIGH COURT JUDGE

Anonymity:

(a) Pursuant to CPR 39.2(4) and/or the Court’s inherent jurisdiction and/or s. 6 of the Human Rights Act 1998:

(i) the Claimant’s name is to be withheld from the public and must not be disclosed in any proceedings in public; and

(ii) the Claimant is to be referred to orally and in writing as INK.

(b) Pursuant to s. 11 of the Contempt of Court Act 1981, there must be no publication of the identity of the Claimant or of any matter likely to lead to the identification of the Claimant in any report of, or otherwise in connection with, these proceedings.

(i) the parties must within 7 days file a redacted copy of any statement of case filed, omitting the name, address and any other information likely to lead to the identification of the Claimant;

(ii) if any statement of case subsequently filed includes information likely to lead to the identification of the Claimant, a redacted copy omitting that information must be filed at the same time;

(iii) unless the Court grants permission under CPR 5.4C(6), no non-party many obtain a copy of any unredacted statement of case.

(d) Any person wishing to vary or discharge this Order must make an application, served on each party.

The Defendant’s application for permission to amend the summary grounds of defence is granted.
Permission to apply for judicial review is refused.
The Claimant must pay the Defendant’s costs of preparing the Acknowledgement of Service and Summary Grounds of Defence, summarily assessed in the sum of £15,000.
Further provision as to costs:

(a) Where the Claimant does not make a valid request for reconsideration of the decision to refuse permission to apply for judicial review (see notes below):

(i) Within 14 days of the date of this Order, the Claimant may file and serve a notice of objection (maximum 3 pages) showing why the order in paragraph 4 should not be made. The notice should include any objections to the principle that costs should be paid and/or as to the amount assessed.

(ii) If the Claimant does not file and serve a notice of objection within that period, paragraph 4 is a final order and the Claimant must pay the sum specified within 14 days of the date of this Order (in accordance with CPR 44.7(1)(a)).

(iii) If the Claimant files and serves a notice of objection in accordance with (i) above:

the other party may, within 14 days after the date on which the notice is served, file and serve submissions in response (maximum 3 pages);
if the other party files and serves on the Claimant submissions in response, the Claimant may, within 7 days after the date on which the other party’s submissions in response are served, file and serve reply submissions (maximum 3 pages);
the Court will determine what costs order to make on the papers;
any costs ordered must be paid within 14 days of the date of the Court’s order (in accordance with CPR 44.7(1)(a)), unless the Court specifies another date.

(b) Where the Claimant makes a valid request for reconsideration (see notes below):

(i) Paragraph 4 does not become final as respects the costs payable to any party unless, insofar as it relates to that party:

the Claimant withdraws the application for permission; or
permission to apply for judicial review is refused on all grounds after a hearing.

(ii) If the Claimant wishes to contend that the order in paragraph 4 should not be made even if permission is refused on all grounds, the Claimant must within 14 days after the date of this Order file and serve (together with the request for reconsideration) a notice of objection (maximum 3 pages). The notice should include any objections to the principle that costs should be paid and/or as to the amount assessed.

If the Claimant files and serves a notice of objection in accordance with (ii) above:

the other party may, within 7 days after the date on which the notice is
served, file and serve submissions in response (maximum 3 pages);
if the other party files and serves on the Claimant submissions in response, the Claimant may, within 7 days after the date on which those submissions are served, file and serve reply submissions (maximum 3 pages);
the Court will determine what costs order to make at or after the
permission hearing;
any costs ordered must be paid within 14 days of the date of the Court’s order (in accordance with CPR 44.7(1)(a)), unless the Court specifies another date.

6. Renewal directions: Where the Claimant makes a valid request for reconsideration (see notes below), the following directions apply:

(c) The permission hearing is to be listed with a time estimate of 30 minutes, including submissions by the parties and an oral judgment by the judge. If the Claimant considers that more time should be allowed, the time estimate must be included with the request for reconsideration of permission.

(d) Within 21 days of the service of this Order, the Claimant must file and serve an electronic copy of the Permission Hearing Bundle, prepared in accordance with the guidance on the Administrative Court website and containing the following documents:

(i) the Claim Form, Statement of Facts and Grounds and any evidence or other documents filed with the Claim Form;

(ii) any Acknowledgment of Service, Summary Grounds of Defence and any accompanying documents served by any Defendant and/or Interested Party;

(iii) any Reply or other document served by any party to the proceedings at the paper permission stage;

(iv) this Order;

(v) the renewed application for permission to apply for judicial review (on Form 86B);

(vi) any other document the Court would be likely to consider material to its decision on permission to apply for judicial review.

(e) If the Claimant fails to comply with sub-paragraph (b), permission will be determined on the basis of the renewal notice and the documents before the Court at the paper stage, unless at the hearing the Court otherwise directs.

(f) At least 7 days before the date listed for the hearing, the Claimant must file and serve:

(i) a skeleton argument, maximum 10 pages;

(ii) an electronic bundle containing any authorities which the Court needs to read at the hearing (the Authorities Bundle: see para. 22.1.2 of the Administrative Court Judicial Review Guide); and

(iii) if requested by the Court, a hard copy version of the Permission Hearing Bundle and Authorities Bundles.

(g) At least 7 days before the date listed for the hearing, any party other than the Claimant intending to participate in the hearing must file and serve any skeleton argument, maximum 10 pages.

(h) If a party fails to comply with sub-paragraph (b), (d) and/or (e), the Court may have regard to the failure when considering any question about costs at the hearing.

REASONS

(1) Anonymity: The claim relies on personal medical information in which the Claimant has a reasonable expectation of privacy. There are accordingly compelling reasons for the limited derogations from the principle of open justice in paragraph 1.

(2) There is no opposition to the Defendants application to amend the Summary Grounds of Defence, and it is a proper application made in a timely fashion.

(3) The Claimant challenges the decision of NHS England taken on 2nd September 2025, to refuse to refer the Claimant to an alternative provider of gender dysphoria services in circumstances where the Claimant was not offered an appointment within 18 weeks at the Tavistock clinic. The Claimant’s refusal was on the basis that no other provider was available. The Grounds of challenge are that first, the Defendant has failed to take reasonable steps to ascertain alternative providers, second the Defendant’s requirement that the total waiting time for new patients at an alternative provider should be considered is wrong and third that that the Defendant acted unlawfully in failing to offer direct referrals to services relevant to gender dysphoria as they could be provided more quickly than a referral to the Tavistock.

(4) I do not consider this claim to be arguable. The Defendant takes a preliminary point in respect of Ground 2, namely that as an attack on the commissioning arrangements made in respect of TransPlus in May 2023 the claim is a very long way out of time. I agree. However the Claimant seeks to dress it up that is exactly what Ground 2 amounts to and I refuse permission on that Ground on that basis.

(5) Ground one is not well founded on the facts. I agree with the Defendant that there is no proper factual basis on which to assert that there were other identifiable and reasonable steps that the Defendant could have taken.

(6) Ground Two is similarly misconceived. The TransPlus policy is not arguably irrational for the reasons set out by the Defendant, all of which I accept are well founded.

(7) Ground Three ignores the wide discretion afforded to NHS England as a commissioner of services. The only challenge to the exercise of that discretion could be on the basis that it was Wednesbury unreasonable. I agree with the Defendant that it is not realistically arguable that ‘the clinical pathway of the service commissioned is irrational and should be fundamentally altered, to permit direct access to specialities that, under that specification, are accessible only following assessment and diagnosis by the MDT, and under the overall supervision of the GDC.’

(8) There is no reason why the Claimant should not bear the reasonable costs of the Defendant.

Signed: Richard Wright KC

Date: 15th May 2026