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New support for GPs referring young people to gender identity services


By Jess Hacker
13 July 2021

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GPs who have referred young patients to the gender identity development service (GIDS) will soon be signposted to other services available to help patients manage long waiting times, NHS England has announced.

Confirmed this week, NHSE said that it is establishing a service to process referrals from primary care, while it sets up a more robust ‘interim service’.

This service will ensure referrals sent to GIDS contain all the necessary information to free up clinical time for specialist staff without impacting patients’ waiting times.

It comes after a recent study found that GPs were working ‘without clear guidance’ from their local CCG on trans health, or information for care pathways.

This referral management service will be set up to bridge the few-month-gap while NHSE builds its ‘interim regional professional support services’: a more cohesive plan to support patients on the GIDS waiting list.

The interim service will similarly see referring clinicians supported to provide the necessary information to GIDS, albeit in a more comprehensive manner. It will include:

  • Earlier consultation between the professional making a referral and the regional professional support services.
  • Liaison between GPs, young people’s mental health services, paediatrics and education services.
  • Identifying more complex cases which may require more urgent intervention.
  • Coordinating psychological support according to a patient’s needs.
  • Coordinating transfer to adult services within six months of their 18th birthday to prevent delays to treatment.

NHSE said more information will become available via the GIDS website, including the date when these arrangements take effect.

The interim regional services are being set in place in response to initial findings from Dr Hilary Cass’ independent review into the Tavistock and Portman NHS Foundation Trust’s GIDS: the only gender identity service in the UK for people under 18.

Dr Cass, former president of the Royal College of Paediatrics and Child Health, recently wrote to NHSE identifying the opportunity to enhance the identification, differentiation and support for the needs of those on the waiting list.

This would grant GIDS better information about a patient’s healthcare needs when they reach the service, she said.

In her letter, Dr Cass outlined concerns around ‘the increasing number of children on the waiting list’, with difficulties managing their risk exacerbated by staff vacancies.

While the exact waiting time for GIDS is unknown, the waiting list for the equivalent adult services can reach up to five years for an initial assessment.

The new interim service will be reviewed in light of these final recommendations, NHSE said.

Mermaids, a UK charity supporting transgender children, young people and their families, welcomed the extra interim support but said ‘more needs to be done to alleviate the GIDS’ waiting times’.

In an interview with Healthcare Leader in April, the chair of the NHS Confederation’s LGBTQ+ Leaders Network flagged the impact Covid-19 lockdowns may have had on young LGBTQ+ patients’ mental health, adding that these needs must be responded to ‘properly’.

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