Permission for judicial review refused in ATN v WellBN Partnership over GP hormone prescribing

The High Court has refused permission for judicial review brought by a father seeking to challenge a GP partnership's former practice of prescribing gender-affirming hormones to patients under 18, finding the claim both out of time and academic.

In ATN v WellBN Partnership [2026] EWHC 1567 (Admin), Mr Justice MacDonald considered an application brought by the claimant, ATN, against WellBN Partnership, a GP practice with a particular focus on transgender healthcare. The claimant's daughter, ATT, the first interested party, had been prescribed spironolactone and oestrogen by the practice from October 2024 under what was described as a "bridging prescription" pending referral to specialist services, administered on an informed consent model. The claimant disputed that ATT had been properly diagnosed with gender incongruence, though CAMHS had confirmed a consultant psychiatrist's view that she experienced gender incongruence with bodily related distress.

The claimant had also brought parallel proceedings in the Family Division seeking a best interests declaration, proceedings later withdrawn after ATT accepted an expedited transfer into specialist NHS gender services. By the time of the judicial review hearing, ATT had turned 18 and there was no suggestion she lacked capacity to consent to treatment.

The judicial review challenge concerned two grounds: that gender-affirming hormone treatment was not lawfully commissioned and funded when provided by a GP, and that the defendant's policy misstated relevant legal and professional duties, including the need for caution in prescribing and the discrediting of the informed consent model. The claimant sought declarations that the practice's prescribing approach and informed consent model were unlawful.

The defendant resisted permission on several grounds, including limitation, mootness and standing. It confirmed that, following an instruction from NHS Sussex Integrated Care Board acting on a direction from NHS England in April 2025, it had ceased prescribing gender-affirming hormones to new patients under 18 experiencing gender incongruence or dysphoria, save for those already receiving such treatment, and had no intention of resuming the practice.

Mr Justice MacDonald held that time began running on 19 October 2024, when the claimant first became aware of the prescription, meaning the claim filed on 7 February 2025 fell outside the three month limit prescribed by CPR 54.5(4), with no good reason established for an extension.

The judgement also addressed mootness in detail. Applying the principles in R v Secretary of State for the Home Department, ex parte Salem and subsequent authority including R (MS) v Secretary of State for the Home Department, the court found no public interest justification for hearing an academic claim, noting the absence of evidence that the defendant intended to resume its policy, that other practices were adopting similar approaches, or that further similar claims were anticipated. The court declined to use judicial review as a vehicle for resolving the broader, ongoing societal and medical debate concerning the Cass Review's recommendations, citing warnings in Office of Communications v Floe Telecom and R (Howard League for Penal Reform) v Secretary of State for the Home Department against courts issuing advisory rulings on matters of wider policy controversy.

The court further noted that the claimant had already pursued and obtained an alternative remedy through the Family Division proceedings, and emphasised the public interest in not subjecting ATT to further stress from litigation that had become academic as between the parties.

The judgement also addressed unsolicited post-hearing submissions sent by the claimant's solicitors, finding they breached CPR r.39.8(4) and the guidance in MH (Eritrea) v Secretary of State for the Home Department on unilateral submissions following the conclusion of argument, and confirmed the court had proceeded without regard to them.

Permission for judicial review was refused.