Interim NHS England Gender Dysphoria Protocol and Guideline 2013/14

Interim NHS England Gender Dysphoria Protocol and Guideline 2013/14 – CPAG Approved 12th July 2013

“In 2012/13, NHS England’s Clinical Reference Groups (CRGs) were asked to develop a number of draft service specifications and commissioning policies, to support the nationally consistent commissioning of specialised services across the country. These service specifications and commissioning policies were subject to a short public consultation. Feedback received during this consultation was used to further develop the specifications and policies for use in contracting with providers.

NHS England was unable to recommend adoption of the specifications and commissioning policies developed by the former Gender Services CRG (2012-13) because of the volume of feedback received in relation to those documents, in particular relating to equality and equity of access issues. At its March 2013 meeting, the Clinical Priorities Advisory Group (CPAG) supported the recommendation to not adopt the gender identity commissioning policy and specifications.

NHS England has committed to a programme of work, led by Professor Steve Field and the equalities directorate, to address the inequality issues raised during consultation. The development of this protocol, to ensure consistent commissioning, is the first output from this piece of work, and specifically addresses equity of access. NHS England has used the widely consulted Scottish Protocol as the basis of this interim approach. This was to ensure a safe starting point where consensus could be established.

This protocol and guideline document is the culmination of extensive work to adapt the Scottish protocol so that it fits with NHS England structures; to ensure it meets the needs of patients; and establishes the right checks and balances to ensure safe delivery through the NHS commissioned services. Two stakeholder events were held in London in June, involving both patients and non-service related stakeholders, and separately with clinicians and services, in order that facilitated and honest debate could take place on the proposed document. The outputs of those events have been considered and included in the document.

The purpose of the interim protocol and guideline is to bridge the time period between the present, fragmented commissioning and provision of these services and an agreed NHS England policy and service specification that will be developed through the CRG in the coming months in readiness for the 2014/15 contracting round. It will provide interim consistency, equality and equity of access across the country and drive out the significant variation currently experienced by patients.

There will be a financial impact should the interim protocol and guideline be adopted but this relatively small unit cost for a small cohort of patients relates in the main to Facial Hair Reduction for male to female transition.

Document: Interim Gender Dysphoria Protocol and Service Guideline 2013/14 (PDF, 598KB).

As part of the above guidelines patient’s have the right to choose which of the clinics they are referred to, no matter where they live. There are seven adult Gender Identity Clinics (GICs) available in England. You can find details of these clinics on our NHS Gender Identity clinics (England) information page.

Sometimes there can be a barrier where the GP may not be experienced or supportive for the patient when they approach them for the first time to help access Gender Identity Services. Gender GP has created a downloadable guide for professionals and patients.

 This combines best practice from leading centres of excellence worldwide with our  significant experience of providing affirmative care to this patient cohort.