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Welcome to my third blog as Chair of NHS England’s Gender Identity Services Task & Finish Group. And thanks for the comments I’ve received on my previous blogs.
It was great to see some of you at the sixth meeting of our Transgender and Non-Binary Network in London, where I reiterated my strong personal, and professional, commitment to shaping and improving gender identity services. I know that others who were not in the room were able to watch the meeting via the webcast.
I was really impressed with the wide-ranging nature of the many discussions which took place throughout the day, and the energy, expertise and enthusiasm of all those who took part. Everybody had a contribution to make, and we will be capturing those views and comments in a report, which will be published via a future blog post.
One of the great things about these events is to hear directly from the community about experience of services, and ideas about how we can make things better.
We also had a really useful session with colleagues from the Gender Identity Clinics (GICs) sharing their ideas and plans, on the back of a letter from me requesting their proposals for reducing waiting times to be seen, and how they are going to support people who are waiting for clinic appointments.
This includes access to volunteers and third sector organisations. These proposals from the GICs will be used to decide the level of additional funding from April 2016; and I committed to come back to a future meeting with a detailed breakdown of how much NHS England spends on gender services.
Feedback in the room confirmed that we need to do more as NHS England to understand the variations in assessment processes between clinics, so we can share best practice consistently.
I also heard about the difficulties encountered by people trying to get back into the system, having experienced problems some years after surgery; and the inconsistent information that people receive about the 18 week waiting time target. The target does apply to gender identity services. What we need to do is make sure we implement plans to drive down the current waits. I look forward to sharing progress with you at the next Network event.
One of the speakers was NHS England’s Head of Primary Care, David Geddes. David is a GP in York, and brought his personal experience to discussions about how to improve patient experience in primary care. This is a topic which we have already opened up through our work with a number of national organisations at the Symposium earlier this year.
David talked about the importance of joining up primary, secondary, tertiary and voluntary sector care, and moving away from the traditional notion of the GP as ‘gatekeeper’. He saw the GP’s future as that of a ‘navigator’, helping people to find their way around the system. He saw his role as being able to offer ‘more intelligent support’, making the wait for specialist appointments more manageable for the patient, helping them to live with uncertainty.
David’s attendance at the Network is a tangible demonstration that we are taking a more joined up approach within NHS England to all aspects of NHS care for people with gender dysphoria.
We know that continuity, and access to a familiar GP, are important to you. There was also discussion about the need to improve communications, and, in particular, the development of co-ordinated advice for GPs about referral to GICs.
GP prescribing remains an issue, as does discrimination against transgender patients. David not only made a commitment to attend a future Network meeting, but also to work with me and colleagues to tackle some of the issues which you have raised with us over the past couple of years. This is really welcome.
The overall impression I took away from the event was one of progress being made. Yes, it is slower than we would like, but there can be no doubt that we are making inroads and I see this continued dialogue with the transgender and non-binary community – via the Network – as critical in helping us shape the future.
On a final note, I just want to draw your attention to a couple of documents which we have published on our CRG pages: one looking at patient experience, and the other, setting out the findings of the recent visits to six of the seven specialist clinics.
If you have any feedback on either of these reports, or the Network event, please do not hesitate to get in touch, and I will respond to your comments as quickly as I can. You can also Tweet via #nhsgenderid
I’ve been having problems with my GP surgery in Buckinghamshire. This morning without warning I received a letter from the male practice manager suggesting I go elsewhere and that I am ejected from the GP surgery?. This is not the first time he has sent these kinds of letters. I believe he is bigoted and doesn’t like me because I am Transgendered. He was like this several years ago when I joined the surgery.
This is a result of me contacting NHS England for help because I was unable to get my repeat prescriptions. I have been mentally abused by this GP surgery because of my condition and it has made me feel depressed and suicidal.. .
I’m very sorry to hear of your problems with your GP surgery.
I can’t comment on your specific situation, but if you are unable to resolve your difficulties directly with the practice then you may wish to consider a formal complaint, which should be made to NHS England in its role as commissioner of primary care services. Details of the complaints process may be found at https://www.england.nhs.uk/contact-us/complaint/complaining-to-nhse/
hi just wondering if there is any update to what is happening with the funding for the clinics after April. plus thank you for taking the challenge on for improving the condition we have to face
Thanks for writing, and for your kind words about our working to improve access to services.
I know that the clinics currently do not have capacity to see the increasing numbers of people who are being referred, and we need to address that urgently.
I am meeting with representatives of all of the gender identity clinics on 28 January as part of the process for assessing business plans for April 2016 onwards. NHS England has committed to deploying additional funding in gender identity services from next year, and we will do so where providers are able to demonstrate that waiting lists will be reduced.
I cannot see comments that either I or others have posted here. Is there a problem with my browser?
We apologies for the delay. I can confirm that comments have been posted and Will has been notified of all comments.
There needs to be more work around managing patients cosmetic expectations within specialist services. After people are discharged from the gis they are treated as people born of that sex, however often they are unhappy with Thier appearance. To treat patients who have had gender reassignment different to those who have not would be to discriminate against those who have not. This causes problems where some patients have not been treated to Thier expectations
I’m sorry for the delay in responding.
Thanks for raising these points.
I’ve passed your post to the Clinical Reference for Gender Identity Services which will consider your comments, and others received, in the current work to update a proposed service specification for gender identity services.
I was disappointed to see you put the problems GPs have prescribing into the same sentance as discrimination. Some people might consider that to be inflammatory.
I saw the webcast and there was a clear question for Dr Geddes from Dr Jameel of the GPC about NHSE resourcing GPs for prescribing and monitoring. Dr Geddes said that he disagreed with the GPC and then ducked the question.
Our patients deserve to know what is being done to provide specialist and GP shared care for prescribing and monitoring of their medications.
Dear Dr Luke
Apologies for the delay in responding. There were technical problems with our website that prevented me from receiving posts in December. I’ve since responded to you in the further post you submitted in January.