2017: a key year for gender identity services
It has been a busy year and I want to thank all those who have taken the time to work with us in our various initiatives to improve services for transgender and non-binary people.
They include members of the Transgender Network; members of the Clinical Reference Group and its various working groups; the organisations that have joined our symposiums; and the staff who work in the services.
2016 saw publication of the report and recommendations of the Women and Equalities Select Committee on Transgender Equality, and we have used those recommendations to inform our work in developing new service specifications for gender identity services.
I am very pleased about the quality of engagement with partner organisations at our symposiums during the year, which has resulted in a joint initiative with Health Education England to progress training and education, for specialist staff and for others more widely across the health service.
The applicability of the 18 week waiting standard is now established in the transgender pathway. The surgical providers are now required to publish their monthly waiting time data, measuring compliance with the 18 week waiting standard, and Gender Identity Clinics will begin reporting in 2017 – though the requirement to meet the 18 week standard applies to them now.
NHS England invested an additional £6.5m in gender identity services in this financial year, and we will continue to hold the providers to account in demonstrating how that money is being used to tackle long waiting lists.
Looking ahead to 2017, we will be going out to consultation on new service specifications for both the adult gender identity clinics and the gender surgical services by the Spring. I will publicise the consultation in a future blog.
The Clinical Reference Group has been given the challenge of delivering new specifications that will give us an innovation and new models for care, addressing the concerns identified by the Select Committee and Transgender Network.
We have convened a stakeholder testing group on 5 January for registered stakeholders to help shape the specifications for the purpose of consultation. Once the specifications have been agreed, NHS England will begin a process of national procurement to identity providers and agree new contracts for the delivery of services in line with the requirements set out in them.
I reported previously that West London Mental Health NHS Trust, which currently hosts the Charing Cross Gender Identity Clinic, had decided it no longer wished to provide gender identity services in future. Since that time, we have been working closely with the Trust, and with the staff of the GIC, to identify an appropriate organisation to host the service. Our commitment throughout has been to ensure there is no disruption or reduction to the service provided by the GIC.
I am very pleased to report that, following discussions with a number of different organisations, NHS England has agreed the Tavistock and Portman NHS Foundation Trust will host the Charing Cross Clinic from April 2017.
This will be on an interim basis, pending the outcome of the national procurement which NHS England will undertake in 2017. The focus for the Tavistock and Portman will be to assume the service with minimum disruption to patients and staff, combining their expertise with the knowledge, skill and experience of the current Charing Cross staff. The service will continue to be delivered from the same location as now, and there will be continuity in the clinical and non-clinical team. The change will not have any impact on appointments that have already been scheduled or treatment plans.
There are many advantages to the Tavistock and Portman as the new host for the service, given their experience in delivering the children and young people’s gender identity service, and its links with the adult services.
Making the transfer from children to adult services as smooth as possible will be one of the expectations in the specifications to be issued in the new year and, dependent on the outcome of the procurement process, the experience of having both services in a single provider should help us to understand how to do this better, to the benefit of all people seeking support.
I wish you a Merry Christmas and a Happy NewYear, and I look forward to working with you all in a busy 2017.
- Please let me have any observations or questions about this blog via Twitter at #nhsgenderid
Will Huxter
Will Huxter is Regional Director of Specialised Commissioning (London) at NHS England and currently chair of the NHS England Gender Task & Finish Group.
Prior to joining NHS England in June 2014, Will worked in a range of commissioning roles within the NHS, and for five years at an NHS Trust.
He has also spent eight years working in the voluntary sector.
8 comments
Dear Will,
As the NHS is finding it difficult to cope with the numbers of applications soaring for GRS surgery from the GICs, with the current team on the Provider’s list, it is clear the surgeon numbers available is far too low, therefore, could Mr Christopher Inglefield GRS Plastic Surgeon in London LBPS be considered to be put on the Provider’s list please? as this would alleviate and reduce the pressures and suffering for those waiting for their GRS surgery.
I understand that Mr Inglefield is in the application phase at present, but it would help greatly for the people waiting for their surgery for another surgeon as qualified as Mr Inglefield to be on the Provider’s list, as soon as possible to avoid further unnecessary delays.
Yours sincerely,
Diane
Good news, and some would say long overdue.
Consistent good quality and national standards of delivery is what we need and deserve, right now it seems to be us talking with each other, comparing notes, experiences etc.
This is the complete opposite to my cancer care, which is at a small Surrey Hospital, though I understand it’s equally good elsewhere, so perhaps that is one model that could be looked at, no doubt there are others too.
Good luck and thank you
Carrying on from my previous post about FFS:
Providing FFS would ameliorate some of the bottle neck in the chain for the waiting times for surgery and would perhaps allow the NHS to start meeting its target waiting times in a more timely manner.
Also, as FFS is not so radical a surgery as GCS, and would greatly enhance the individuals perception of themselves, this would lessen the degree of dysphoria that each individual suffers from.
As many people remarked in the survey which I did, “When I am walking down the street, nobody can see what is in my knickers, but everybody can see my face”.
I welcome the move of the Charing Cross GIC to the auspices of the Tavistock – provided that the Tavistock do not then see that as a vehicle to promote the Charing Cross GIC above the other adult GIC’s.
Although the extra £6.5 milion in funding is to be welcomed, I see this as a drop in the ocean to the amount that is realistically needed to bring waiting times down and provide a better service to trans people.
For instance, in a survey which I conducted 18 months ago, it was clear that many transgender women (around 50%) would prefer to have Facial Feminisation Surgery over Gender Confirmation Surgery – and yet there will be no provision for this being carried out through the NHS.
I realise that this is a contentious issue and the right wing press would seize upon this with glee – but it is people’s lives that we are dealing with here first and foremost.
Changes to meet demand for NHS England – Gender Services are long over due. Looking forward to providing positive input to help design a ‘new service model’ next year !
GICRG – Member & Stoke – NHS CCG – Patient Congress Member.
Thank you for your comment. We look forward to working with you too!
its good to know the GIC at Charing Cross is in safe hands moving to the tavistock and Portman NHS foundation Trust – two things: Facial Feminisation Surgery included in this service? and Monitoring long standing patients and not forget them?
Dear Stephenie
Just to be clear, it is only the gender identity clinic service that is moving across to the TAVI, not surgery.
I will certainly make sure that we work with the TAVI to look at arrangements for monitoring long-standing patients, and can perhaps update people on that aspect of the service in one of my future blogs.
Best wishes