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Improving awareness and understanding of transgender issues – Will Huxter

The Chair of the NHS England Gender Task & Finish Group looks at what NHS England is doing to improve health services for transgender and non-binary people

You may be aware that West London Mental Health NHS Trust recently announced that it will, over time, stop providing gender identity services. The Trust’s statement can be found here. I have been working with the Trust’s management and clinicians to begin the process for agreeing future arrangements for a gender identity service hosted by an appropriate alternative provider, and we will be meeting again to review progress in September.

I appreciate that any potential change can cause anxiety for people who use the services, and for staff who work in the service.  The Trust has given a commitment that it will continue to provide services as normal until such time as a new provider is able to take over, and on our part NHS England will put in place a process that identifies an alternative suitable provider as quickly as possible. I would like to assure you all that there will at no point be any pause in the delivery of services and as commissioner of the service we expect the Trust to continue its initiatives to reduce waiting times. I will keep you updated on future arrangements via my blog and the Trust will post updates on its own website.

I’m sorry that I wasn’t able to make the July meeting of the transgender network, but many thanks to colleagues from NHS England, NHS Choices and the Race Equality Foundation for running the sessions. The agenda can be found here and a video of the event can be found here.

There are some specific actions that workshop members will help us to take forward, including a refresh of the NHS Choices web content about NHS services for transgender people, and a look at ways in which we can begin to share learning and outcomes of the various initiatives that are being pursued in the statutory and voluntary sectors to improve access to transgender services for people from black and minority ethnic groups. The workshop also discussed how NHS England can best engage with the Transgender Network in the future, perhaps moving away from the national events in favour of regional events that are more focused on local networks and local services. Our engagement team is currently considering the feedback and ideas that were offered, including a pilot of a regional event, and I will come back to this in a future blog in the autumn.

A request was made at the workshop that we share more information with the network on the work and progress of the Task & Finish Group, and in my next blog I will post details of our work plan.

One of the themes that is raised regularly with me is about services for non-binary people.  As a commissioner, NHS England is very clear that all GICs are required to offer services for non-binary people.  Until recently, the website for the GIC at Northamptonshire Healthcare NHS Foundation Trust stated that it was not commissioned to provide services for non-binary people.  This is incorrect – we have taken this up with the Trust and the website has been changed as a result.

We also recently published a new clinical commissioning policy for prescribing cross sex hormones to transgender young people, and a new service specification for the Gender Identity Development Service for Children and Young People. These documents were agreed following stakeholder engagement and public consultation earlier in the year, and following recommendations from the independently-chaired Clinical Priorities Advisory Group. The policy and service specification (separate documents) can be found here.

At the multi-agency symposium that we held in March, Gerald Chan, Director of Policy and Public Affairs from the Royal College of Obstetrics and Gynaecology, undertook to lead some work on good practice in relation to trans people.  Gerald has undertaken a number of actions as a result, including updating RCOG’s training curriculum to clarify that transgender is not a sexual issue; began preparations to engage clinicians in the field and with commissioners over the planned revision of the curriculum; and has spread general awareness of trans-issues at meetings and other forums, including the findings and recommendations of the Women and Equalities Select Committee report on Transgender Equality.

I’m pleased that the Royal College of Obstetrics and Gynaecology is considering how to educate its members in supporting trans and non-binary people including competencies for specific clinical procedures (such as hysterectomy and urogynaecology), cultural competence, and screening requirements.

Finally, congratulations to Dr John Dean who has been appointed for a second term as chair of NHS England’s Clinical Reference Group for adult Gender Identity Services, which plays a key role in providing advice to NHS England. We are currently in the process of recruiting three patient and public voice representatives to join him and the confirmed professional representatives, who were appointed following an open recruitment process, and are listed below:

  • Mr James Bellringer, Consultant Urologist, Charing Cross clinic
  • Matthew Mills, Head of Speech Therapy Service, Charing Cross clinic
  • Christina Richards, Senior Specialist Psychology Associate, Nottinghamshire GIC
  • Dr Grainne Coakley, Clinical Lead, Sheffield GIC
  • Dr Helen Greener, Clinical Lead, Newcastle GIC
  • Mr Philip Drew, Consultant Specialist Breast Surgeon, Royal Cornwall Hospital Truro
  • Maria Morris, Clinical Team Leader, Laurels GIC

I look forward to working with them and future PPV representatives on continuing to develop quality services that transgender and non-binary people want and need.

Please feel free to post comments to this blog and I will respond as soon as I can. Or you can take part in the discussion at #nhsgenderid.

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.

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