In his latest blog the chair of the NHS England Gender Task & Finish Group looks at the work being done to help improve people’s experience of NHS gender identity services:
We know we can’t do this on our own, and it is a really key part of our approach that we want to work in partnership with the community, with providers of gender identity services, and with colleagues in other parts of the NHS, including Health Education England and the General Medical Council.
Through working together, we can achieve real improvement more quickly.
Firstly, I wanted to draw attention to some great work on transgender issues that has been done in Brighton. A new online guide for supporting trans patients in GP surgeries has been launched by NHS Brighton and Hove Clinical Commissioning Group (CCG). According to estimates, at least 2,760 trans people live in the city, with many more going there to study and work.
The guide’s introduction follows a recent Women and Equalities Select Committee report into Transgender Equality in the UK. The CCG’s guide has been developed with input from local transgender people and aims to help GPs and other clinical staff in General Practice support patients accessing NHS Specialist Gender Identity Services.
Last week we had the latest meeting of NHS England’s Gender Task & Finish Group and I’m pleased to say we now have CCG representation on the group from Brighton & Hove. We focussed in particular on our analysis of waiting lists for the seven Gender Identity Clinics (GICs); what we are doing to increase capacity in the GICs so that they can see people more quickly after referral; the rules in relation to recording and reporting how long people have been waiting to be seen; and preparation for the symposium meeting on 3 March.
In response to concerns we have heard about the inconsistent approach across the providers in the interpretation and application of the 18 week Referral to Treatment standard, we have been working to update the waiting time guidance. I will return to this in a future blog.
Our analysis of the waiting time data from all the clinics shows that as of December 2015 there were 4,075 patients waiting for a first appointment with a clinic, with 15% of those people already having waited more than a year for an initial appointment.
Age profiling of the clinic waiting lists shows a similar profile across all clinics, with almost half of all people waiting being between 18 and 24 years old. 75% of patients have been referred by GPs, with almost all of the remainder having been referred by another clinical speciality within secondary (hospital-based) care. I have asked the GICs to validate the data by 1 March and I will report on the outcome in a future blog.
This is the first time NHS England has looked consistently at the waiting list data for all seven clinics. The analysis will inform what data we require clinics to supply to commissioners on a regular basis in future.
I have written and spoken before about what we are doing to invest more in the GICs to reduce waiting times by increasing capacity; we also need to look increasingly at the ways in which we can make the best use of current capacity, and offer people a consistent high quality assessment, diagnosis and treatment service whichever GIC they attend.
I chaired a meeting with all of the GICs at the end of January, when we met together with local commissioning leads and colleagues from the national specialised commissioning team. At that meeting, the GICs shared information on examples of innovation that they have developed, and we discussed how the benefits from these can be achieved across the country, so that individuals receive support that is appropriate for them as quickly as possible. These included a new four-week assessment process at Exeter, a preparation group for people on the waiting list in Sheffield, a triage system in London, and one day courses for patients and families in Nottingham.
Local commissioners from NHS England are now working with each of the GICs to agree the additional investment for the clinics from April 2016. This will vary depending on the size of the clinic’s caseload, and the robustness of the plans to reduce waiting times. I will share details of what is agreed once it has been finalised.
I am also meeting with representatives of the surgical providers in March to agree the future application and reporting of the 18 week Referral to Treatment Standard, and the additional investment that is needed to stabilise and then reduce waiting times for surgery.
One of the enduring challenges for all the clinics is recruitment of suitably trained and experienced staff, including in particular medical staff. Ahead of this week’s symposium, we have been in discussion with Health Education England (HEE), the General Medical Council (GMC) and the Royal College of Physicians about what can be done in both the short and the longer term to develop gender identity as a specialism supported by appropriate curricula and recognition. We will be discussing this further at the symposium, and I will provide feedback in my next blog.
The Minister for Public Health has provided a formal Department of Health response to the recommendations for the NHS set out in the Women and Equalities Select Committee report. Within NHS England, the Task & Finish Group will monitor progress against the recommendations, including the work being done to develop the service specification for adult services. The draft service specification for the children and young people’s service is currently out for stakeholder engagement, and wider public consultation is planned.
Finally, I was proud that NHS England was recently nominated as a Public Sector Partner of the Year in the recent LGBT Foundation Heroes Awards. Congratulations to Police with Pride North West for winning this category and for all the good work that they are doing.
I hope that this information is useful, and I look forward to receiving any questions or comments via this blog.