'Serious' concerns raised over NHS Fife's handling of freedom of information requests

The health board faces an intervention following what have been described as “serious and systemic” concerns about the way it handled freedom of information requests in the trans doctor case.

Nurse Sandie Peggie brought legal action against the health board after her complaint about sharing a changing room with transgender medic Dr Beth Upton led to her being suspended.

NHS Fife is only the second body in Scotland to face a ‘level four’ intervention by the information commissioner.

The intervention aims to address a number of “significant issues” that came to light during the commissioner’s investigation of FOI appeals made about the health board.

NHS Fife received three separate requests for the cost to date of the legal action involving nurse Sandy Peggie in March 2025.

The board rejected all three FOI requests, stating that the information requested was exempt under the FOI Act’s exemption which protects personal information

However, an investigation by the SIC revealed that when responding to the FOI requests, the health board did not actually have the information on which it based its reply.

The concerns identified by the commissioner include the health board’s interpretation of FOI requests, its handling of requests relating to high profile issues, and its handling of requests involving personal data.

There are also concerns around the health board’s co-operation with the commissioner’s staff during the investigatory process, and the governance of its FOI function.

Scottish Information Commissioner (SIC) David Hamilton said: “Level 4 interventions are extremely rare, but the serious and systemic nature of the concerns that have come to light mean that this is the only route through which these issues can be appropriately addressed and resolved.

“While the board is undoubtedly facing challenges, the failure to get its FOI response right has only served to compound those challenges – and is eroding trust between it and the public it serves.

“These issues need to be urgently addressed if NHS Fife is to meet its legal duties, and I will work constructively with the board to help get its FOI function back on track, for the benefit of all.”

In the letter to the health board announcing the intervention, which was sent on Wednesday, Mr Hamilton wrote: “The aim of this intervention is to support Fife Health Board to improve its FOI performance although, at this stage, I anticipate that this will require substantial reforms to your FOI function.”

In launching the intervention, the commissioner has asked NHS Fife to designate a member of staff to take the improvement work forward by January 14, 2026.

A spokesperson for NHS Fife said: “NHS Fife can confirm that we have received a level four intervention notice from the SIC in relation to our handling of freedom of information requests.

“This follows constructive engagement with the commissioner earlier this year, alongside our own internal audit, which identified the need for improvement in our FOI processes.

“The findings and requirements set out in the notice will now form part of our ongoing organisational improvement plan.

“We take our statutory responsibilities seriously and recognise that this level of intervention reflects the scale of change required.

“We will work closely and constructively with the SIC to provide assurance, deliver the necessary improvements, and ensure full compliance with the notice.”