The People Involved
Institutions can sometimes feel strangely anonymous.
Letters arrive from departments. Emails are signed by teams. Decisions are attributed to committees, policies, procedures and governance processes. But organisations do not make decisions by themselves. People occupy the roles through which those organisations act.
This page introduces some of the people who became directly relevant to my case and to the accountability process that followed.
Where available, I have linked to each individual's public professional profile so that readers can review their publicly stated professional background, positions and career history for themselves.
Why name the people involved?
Because public responsibility should not become anonymous simply because it is exercised through a large institution.
Inclusion on this page does not mean that every person listed personally created the original sterilisation policy or is individually responsible for every failing identified in this case. It means that they held a relevant public or professional role, became involved in the correspondence or accountability process, or carried responsibilities directly relevant to the issues being examined.
Leah Spasova
Patient, Complainant & Author of This Archive
I am the patient who challenged the NHS female sterilisation policy, submitted the complaint that ultimately reached the Parliamentary and Health Service Ombudsman, and continued pursuing the questions of policy, equality, transparency and accountability that followed.
I created this website to preserve and publish the documentary record so that the case can be examined beyond my own interpretation of what happened.
More about Leah →
Dr Nick Broughton
Chief Executive / Senior Accountable Leadership
Professional profile:
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Dr Nick Broughton was Chief Executive of Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board and subsequently held senior Chief Executive responsibility within the reorganised Thames Valley ICB structure.
He is particularly relevant to this case because he sent me the ICB's final formal response to my original complaint - in November 2023. His whole letter described the governance process through which clinical commissioning policies were developed and adopted and claimed that the policy review had included assessment of national guidance, clinical evidence, cost-effectiveness and legal and ethical considerations.
The Parliamentary and Health Service Ombudsman's later investigation found significant failings in precisely those areas, including the balancing of evidence, documentation of decision-making, departure from clinical guidance, consultation and the fair and consistent treatment of female and male sterilisation.
Dr Broughton also subsequently corresponded with me regarding implementation of the Ombudsman's recommendations and the revised female sterilisation policy.
Furthermore, his roles as an Accountability Officer places him in charge of Freedom of Information Requests compliance. The ICB's own governance material places significant responsibility at Accountable-Officer level for organisational compliance, openness and transparency. The Chief Executive also formally delegated approval and adoption of clinical commissioning policy recommendations within the ICB's governance structure. His conduct in both of these roles is questionable and requires investigation.
Why he appears here: Chief Executive responsibility; formal complaint response; clinical commissioning governance; responses following the Ombudsman investigation; and subsequent questions about leadership accountability.
Dr Priya Singh
Chair, NHS Thames Valley Integrated Care Board
Professional profile:
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Dr Priya Singh became directly relevant to the case when I escalated my concerns to her at Board level following the Ombudsman's findings.
By that stage, my concern was no longer simply whether a sterilisation policy had been poorly developed. I was asking what happened to leadership accountability after an independent investigation had established significant failures, particularly where senior assurances given to me during the complaint process appeared difficult to reconcile with the findings that followed.
The Chair has an important governance role in relation to Board leadership and scrutiny. NHS England's Fit and Proper Person Test framework also places ultimate organisational accountability for adherence to that framework with the Chair.
I therefore approached Dr Singh directly asking what Board-level consideration had been given to leadership accountability following the Ombudsman's findings, including whether the findings had triggered consideration of the fitness and propriety requirements applying to senior Board members.
Why she appears here: Chair-level governance; Board accountability; oversight of senior leadership standards; and recipient of my formal escalation concerning what accountability followed the Ombudsman's findings.
Hannah Iqbal
Chief Strategy & Commissioning Officer, NHS Thames Valley ICB
Professional profile:
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Hannah Iqbal became relevant during the transparency and Freedom of Information stage of this case.
NHS Thames Valley ICB's Freedom of Information Policy identifies the Chief Strategy and Commissioning Officer as the directorate responsible for that policy. The policy is intended to support compliance with the Freedom of Information Act and the organisation's responsibilities around access to recorded information.
I escalated matters to Hannah Iqbal after an FOI request seeking evidence about the processes behind the revised female sterilisation policy became substantially overdue.
That request mattered because, following the Ombudsman's findings, I wanted to examine whether the revised policy had actually been developed through the improved governance, evidence and consultation processes that the ICB said would prevent the previous failings from being repeated.
Why she appears here: Executive responsibility connected with strategy and commissioning and, specifically in this part of the case, the directorate responsibility identified in the ICB's own Freedom of Information policy.
Mark Gittins
Information Governance Manager, NHS Thames Valley ICB
Professional profile:
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Mark Gittins became directly involved during my attempts to obtain information about the revised policy-making and governance processes through Freedom of Information legislation.
After delays and my request for an internal review, correspondence concerning FOI-TV-2606-105 was issued under his name in August 2026 in his capacity as Information Governance Manager.
Information governance is particularly relevant to this stage of the case because the questions were no longer only about what the NHS said it had done. I was asking for the records that would allow those statements to be independently checked.
Why he appears here: Information Governance Manager; direct involvement in the FOI and internal-review process; and responsibility connected with the disclosure and handling of information sought as part of this accountability record.
Why Roles & Responsibilities Matter
One of the recurring difficulties throughout this case has been understanding where responsibility actually sits.
A patient may receive an email from a “Complaints Team”, a response from “Information Governance”, a policy produced by a committee, a decision adopted by an ICB, and an assurance signed by a Chief Executive.
When something goes wrong, that structure can make accountability extraordinarily difficult to follow.
Organisations have structures.
Responsibilities still belong to people.
That does not mean that the most senior person personally made every decision below them. Nor does it mean that everybody copied into an email is responsible for the subject of that email.
It does mean that titles such as Chief Executive, Chair, Chief Strategy and Commissioning Officer and Information Governance Manager carry defined responsibilities. When those responsibilities become relevant to a matter of public accountability, I believe it is reasonable for the public record to identify who occupied those roles and how they entered the case.
As this archive develops, additional people may be added where their role becomes materially relevant to understanding the decisions, investigations, governance or accountability processes documented here.
Want to see the correspondence for yourself?
The names on this page are not presented in isolation. The underlying correspondence, policies, investigation findings, Freedom of Information material and other records are being made available through the evidence archive.
Explore the Evidence →
