Mohamed Abdisamad

Parliamentary Under-Secretary of State 

39 Victoria Street  
London  
SW1H 0EU  

Dr Anton van Dellen 
HM Assistant Coroner, for the coroner area of West London  

23 March 2026 

Dear Dr Anton van Dellen,  

Thank you for the Regulation 28 report of 28th December 2025 sent to the Department 
of Health and Social Care about the death of Mohamed Abdisamad. I am replying as 
the  Minister  with  responsibility  for  professional  regulation  and  I  am  grateful  for  the 
extended deadline for the response. 

Firstly,  I  would  like  to  say  how  saddened  I  was  to  read  of  the  circumstances  of 
Mohamed Abdisamad’s death, and I offer my sincere condolences to their family and 
loved ones. The circumstances your report describes are concerning and I am grateful 
to you for bringing these matters to my attention.  

The report raises concerns that: 

1.  Any  individual  may  conduct  a  Non-Therapeutic  Male  Circumcision  (NTMC) 

without any prior training or any continuing professional development 

2.  There is no system of external accreditation and/or registration for individuals 

who conduct an NTMC 

3.  There is no requirement for any record keeping for individuals who undergo an 

NTMC 

4.  There is no system for consent to be taken prior to an NTMC 
5.  There is no requirement for any infection control measures for an NTMC 
6.  There  are  no  requirements  for  any  aftercare  for  an  NTMC,  including  but  not 

limited to dressing the wound, analgesia and/or worsening care advice. 

In preparing this response, my officials have made enquiries with NHS England, the 
Care  Quality  Commission  and  the  UK  Health  Security  Agency  to  ensure  we 
adequately address your concerns. 

The practice of male circumcision is legal in the UK. NTMC is usually performed by 
members  of  the  faith  community,  who  are  not  subject  to  oversight  by  the  General 
Medical  Council  (GMC)  or  the  Nursing  and  Midwifery  Council  (NMC)  or  other 
professional  regulatory  oversight.  There  is  no  requirement  in  law  for  a  practitioner 
performing NTMC to be medically trained.  

If an NMTC procedure is carried out by a regulated healthcare professional, they will 
be  subject  to  oversight  by  the  relevant  professional  regulator  such  as  the  GMC  for 

 
 
 
 
 
 
 
 
 
 
 
 
 
  
  
 
  
 
 
 doctors or the NMC for nurses and midwives. If a regulated healthcare professional is 
acting  in  a  religious  or  spiritual  role,  they  cannot  ‘opt  out’  of  their  core  duties  and 
responsibilities and therefore any registered healthcare professional wishing to carry 
out NTMC must be registered with the Care Quality Commission (CQC) to carry out 
the regulated activity of surgical procedures. As with other areas of clinical practice, 
doctors  and  nurses  may  have  professional  obligations  to  notify  authorities  if  they 
become  aware  of  medical  or  non-medical  practitioners  falling  below  the  expected 
standards of care when performing NTMC.  

The CQC provides oversight of services provided by registered health professionals 
performing male circumcision, ensuring consistent standards of safety and quality in 
those cases. This includes both therapeutic and non-therapeutic male circumcision. 
Circumcision  carried  out  by 
individuals  who  are  not  registered  healthcare 
professionals  remain  outside  of  CQC  regulatory  scope.  This  includes  any  non-
the 
therapeutic  circumcision,  regardless  of 
circumcision.   

for  carrying  out 

the  purposes 

The  majority  of  male  circumcisions  are  carried  out  for  non-therapeutic  reasons.  All 
medical  procedures  carry  some  level  of  risk.  Considering  the  number  of  male 
circumcisions that occur in the UK, it is rare that a death occurs. It is essential that 
every NTMC is carried out in sterile and hygienic conditions, in an appropriate setting 
by an experienced individual. The Government would advise anyone accessing NTMC 
services (or the parent in the case of a child), to inform their GP so the procedure can 
be recorded on their medical record.  

It is a general legal and ethical principle that valid consent must be obtained from an 
individual before starting a treatment or physical intervention.  For consent to be valid 
it must be given voluntarily by an appropriately informed person who has the capacity 
to consent to the intervention in question. If children have the capacity to give consent 
for  themselves,  consent  should  be  sought  directly  from  them.  Once  young  people 
reach the age of 16, they are presumed in law to be competent to give consent for 
themselves  for  their  own  surgical,  medical  or  dental  treatment,  and  any  associated 
procedures,  such  as  investigations,  anaesthesia  or  nursing  care.  If  a  child  is  not 
competent to give consent for themselves, consent should be sought from a person 
with  parental  responsibility.  This  will  often,  but  not  always,  be  the  child’s  parent. 
Legally, consent is only needed from one person with parental responsibility.    

Because  of  the  importance  and  irreversibility  of  the  decision,  the  British  Medical 
Association  (BMA)  and  the  GMC  have  long  recommended  that  consent  for  non-
therapeutic circumcision should be sought from both parents. If parents disagree about 
having  their  child  circumcised,  the  parent  seeking  circumcision  could  seek  a  court 
order authorising the procedure. A competent child may decide for himself whether to 
undergo non-therapeutic male circumcision. 

Like any other surgical procedure, circumcision must be performed in such a way as 
to safeguard the child’s health. The welfare of the patient should be paramount, and 
any  actions  should  act  in  the  patient’s  best  interest.  The  government  would  urge 
anyone  performing  NTMC,  who  may  be  non-medically  trained  representatives  from 
faith  communities,  carrying  out  the  procedure  in  the  community,  in  line  with  their 

 
 
 
 
 
 
 
 
 
 
 
 
 beliefs, to ensure they have the relevant training, proven experience and competence 
in the practice. 

In the absence of regulation for those not medically qualified, several organisations 
publish material relating to carrying out NTMC which non-medical professionals may 
find helpful.  

The BMA has published a toolkit providing practical guidance for individuals, including 
on parental consent and the best interests of the patient, which includes consideration 
of social and cultural circumstances, and should be followed by anyone carrying out 
this  procedure.  Further  detail  is  available  in  the  link:  core-ethics-guidance-updated-
feb-2025.pdf  

The GMC also recognises that male circumcision can be carried out for religious and 
cultural reasons and provides guidance for doctors on personal beliefs and medical 
practice. The GMC has published guidance relating to male circumcision and includes 
specific advice on dealing with requests from parents for procedures, how to assess 
the best interests of the child and who you need consent from. Further information is 
available in this link: Personal beliefs and medical practice - professional standards - 
GMC 

Also, the British Association of Paediatric Surgeons (BAPS) has published guidance 
on  religious  circumcision.  Further  information  is  available  in  this  link:  Religious 
circumcision | British Association of Paediatric Surgeons. The British Association of 
Urological  Surgeons has  also  published  information  relating  to  circumcision  and 
NTMC, including complications arising from community performed circumcisions, and 
refers to the guidance published by BAPS. Further detail is available in the link: Non-
Therapeutic Circumcision | The British Association of Urological Surgeons Limited and 
Circumcision.pdf 

The UK Health Security Agency has published guidance on Preventing and controlling 
infections that provides general guidance on the prevention and control of infections 
in settings. A proactive and preventive approach is advised, including the promotion 
of available immunisations. 

References to the guidance and toolkits mentioned above are publicly available and 
non-medically  trained  practitioners  may  find  them  useful,  for  example  in  relation  to 
consent,  sterile  techniques,  infection  control  and  aftercare  when  performing  male 
circumcision. I am also aware of organisations that support NTMC practitioners, such 
as  the  British  Initiation  Society  (BRIS)  and  the  British  Islamic  Medical  Association 
(BIMA).  

NTMC  is  a  complex  and  sensitive  policy  area  and  cuts  across  several  other 
government  departments,  including  Ministry  of  Housing,  Communities  and  Local 
Government  regarding  faith  and  community  relations;  Department  for  Education 
regarding children’s rights; and Ministry of Justice regarding Article 2 of the European 
Convention on Human Rights on right to life. Departmental officials are in the process 
of liaising with other relevant government officials prior to engaging with stakeholders, 
particularly in Muslim and Jewish communities, regarding non-statutory measures to 
improve patient safety in this area. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 I hope this response is helpful. Thank you for bringing these concerns to my 
attention.   

Yours sincerely,  

PARLIAMENTARY UNDER-SECRETARY OF STATE  
FOR HEALTH INNOVATION AND SAFETY

OFFICIAL

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Ministry of Housing,
Communities &
Local Government

Deputy Director, Local
Government Capacity &
Improvement

Ministry of Housing,
Communities &
Local Government
2"4 Floor, Fry Building
2 Marsham Street
London SW1P 4DF

www.gov.uk/mhelq

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| note that

23 March 2026

Dear Dr van Dellen

Dr Anton van Dellen,
HM Assistant Coroner
West London Coroners Court

On behalf of MHCLG may | offer my sincere condolences to the family and loved ones of
Mohamed Abdisamad.

REGULATION 28 REPORT FOLLOWING THE INQUEST INTO THE DEATH OF MOHAMED
ABDISAMAD

MHCLG will liaise with DHSC around non-statutor measures to improve patient safety in this
area, but we have nothing further to add to

Thank you for the Regulation 28 report of 28" December 2025 sent to the Ministry of Housing,
Communities and Local Government (MHCLG), in which you expressed your concerns following
the inquest into the death of Mohamed Abdisamad.

The issues raised within your Regulation 28 report come under the remit of the Department of
Health and Social Care (DHSC).
the Parliamentary Under-Secretary
of State for Health Innovation and Safety has today sent to you a comprehensive response on
behalf of the government to the issues raised in your report. | have had the opportunity to read
and consider that response.

MHCLG is responsible for the overall stewardship of the local government sector, but we are not
responsible for all the services that councils deliver. Councils deliver a very wide range of services
to residents, within a national legislative framework. Decisions around management are often
taken locally, but the lead Government department for any particular issue delivered by a local
authority is responsible for working with councils to ensure effective delivery.

OFFICIAL 

comprehensive response.

Yours sincerely