Helping doctors respond to the needs of transgender people – Will Huxter

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The Chair of the NHS England Gender Task & Finish Group looks at how new guidance and training packages promote best practice in the treatment of transgender people in the NHS:  

I am always pleased to draw attention to examples of good practice from the transgender community, voluntary organisations and other stakeholders in this field.

Attached to this blog is a link to some e-training on gender commissioned by the Royal College of General Practitioners from GIRES.  I have also received from the Men’s Forum a publication called Your Body Your Health:  Health choices made easy for trans men, trans masculine and non-binary people, as well as a shortcut to another useful document,

The Stakeholder Network has consistently brought to our attention many concerns about accessing treatment in primary care – particularly with regard to getting prescriptions for hormonal and other medications – and doctors’ training , and knowledge of, trans health issues.

The regulatory body for doctors in this country, the General Medical Council (GMC), has just published a helpful Guidance for doctors treating transgender patients.

This document reaffirms previous guidance published by NHS England on the responsibilities of GPs in the prescribing and monitoring of hormone treatment for transgender people.

The GMC sought community input to this and this guidance was reviewed by two Network member community representatives and by the Chair of NHS England’s Clinical Reference Group for Gender Identity Service before its publication. Their recommendations helped to shape the final document.

All registered medical practitioners in the UK will receive an email from the GMC advising them of this guidance and encouraging them to read it. I really welcome this approach by the GMC.

I hope this publication will be of assistance to all doctors working in the NHS in responding to the healthcare needs of trans and non-binary people, and to further develop the excellent services that many already provide.

I also hope that it will lead to significant benefits to trans and non-binary people throughout the UK, making it easier for them to get referrals for specialist advice, have appropriate changes made to their medical records, get prescriptions for essential treatments recommended by specialists, and, by reducing delays in treatment, enhance the efficiency and capacity of GICs, and help to reduce waiting times.

I have written in previous blogs about meetings that I have convened with the Gender Identity Clinics to discuss what can be done to increase capacity and reduce waiting times, and to share best practice so that people seeking support receive consistent access to core services, whichever GIC they attend.

Earlier this month, I chaired a meeting with the Imperial, Nuffield and St Peter’s Andrology providers to look together at the volume of surgery undertaken in 2015-16, and plans for 2016-17.

In 2016-17, more surgical procedures will be commissioned by NHS England, including additional work undertaken by Aspen at Parkside Hospital.  We also discussed workforce, and the need to ensure that we have sufficient trained and experienced surgeons available to clear the current backlog of people who have been waiting far too long, and then to meet the maximum 18 week standard consistently after that.

The providers highlighted some differences in the approach to referral between the different GICs, and we agreed that it would be very helpful to convene a joint meeting of the surgical providers and the GICs, to help ensure a joined up approach to service delivery for people across the country.

We held a second symposium meeting in February, focussed specifically on establishing shared ownership among partners for developing clinical workforce in GICs, and starting to develop an initial plan to support delivery of workforce development on a multi-agency basis, including in particular Health Education England.

In a future blog, I will describe the development of a joint plan with Health Education England and, as an example of what can be achieved in terms of service transformation, I will be sharing information on future models for provision of speech and language therapy, which I know is a key service for many transgender people.

Finally, just to remind you that the consultation on the proposed service specification for the children and young people’s Gender Identity Development Service, and proposed clinical commissioning policy on prescribing cross sex hormones for young people, remains open until 20 April 2016.

Thanks for the questions and feedback from my last blog on transgender services and I would welcome any comments on this latest post. Please get in touch via this blog, or Twitter, #NHSgenderid

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