National Gender Identity Healthcare Reference Group minutes: February 2024

Attendees and apologies

• Dr Ewan Bell, (Co-chair), Associate Medical Director, NHS Dumfries and Galloway 
• Niamh O'Connor, (Interim Co-chair),  Deputy Director, Population Health Strategy & Improvement Division, Scottish Government 
• Dr Paul Connelly, Clinical Lecturer in Diabetes & Endocrinology, University of Glasgow 
• Neil Ferguson, Director, West of Scotland Regional Planning 
• Linsey Galbraith, Principal Information Analyst, Public Health Scotland 
• Dr Fiona Gibson, Specialty Doctor Gender and Sexual Health Services, NHS Highland 
• Sean Harper, Director of Psychology, NHS Grampian 
• Catriona Johnson, Associate Director, NHS National Services Scotland 
• Jennifer Layden, Healthcare Improvement Scotland 
• Rhoda Macleod, Head of Sexual Health, Prison and Police services, Sandyford Gender Identity Clinic, NHS Greater Glasgow and Clyde 
• David Parker, Senior Educator, NHS Education for Scotland 
• Dr Ruth Pearce, Lecturer, University of Glasgow 
• Dr Alison Poupart, Interim Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde 
• Claire Smith, Deputy Service Manager, Gender Identity Clinic, NHS Grampian 
• Dr Fiona Wardell, Standards and Indicators Team Lead, Healthcare Improvement Scotland 
• Dr Craig Wheelans, National Medical Advisor, NHS National Services Scotland 
• Lived Experience Coordinator 
• Representative, * LGBT Health and Wellbeing 
• Representative, * LGBT Youth Scotland 
• Representative, Scottish Trans  
• Representative, TransparentSees 
• Scottish Government Secretariat

 Apologies: 

• Professor Nicola Steedman, Deputy Chief Medical Officer, Scottish Government 
• Colin Briggs, Director of Strategic Planning, NHS Lothian 
• Kerry Cairns, Service Manager, NHS Grampian  
• Jane Harris, NHS Education for Scotland 
• Dr Susan Rooney, Clinical Lead, Sandyford Gender Identity Clinic, NHS Greater Glasgow and Clyde 
• Dr Michelle Watts, Senior Medical Advisor, Scottish Government 

Items and actions

Welcome and minutes of previous meeting 

Ewan Bell (EB) welcomed attendees to the fifteenth meeting of the National Gender Identity Healthcare Reference Group (the Group). Apologies were noted. 

Minutes of the previous meeting were approved, EB noted that the relevant section had been checked for accuracy with the Cass Review team and that the minutes will be published online in due course. 

Actions arising from the previous meeting were reviewed and confirmed ongoing. 

Lived Experience Co-ordinator update 

The Lived Experience Co-ordinator (LEC) provided an update, focusing on feedback themes they are seeing from their ongoing engagement with people with lived experience of accessing or waiting to access NHS gender identity services in Scotland.  

Key themes highlighted were: 

• the need for shorter waiting times
• difference in waiting times across Scotland
• long term vs short term progress, noting that long term progress appears more evident
• access to information, for both individuals accessing gender identity services and healthcare professionals working with trans people
• primary care, variation in services available and desire for specialist GP services
• communication with gender identity clinics
• local services – wanting more services to be available locally

Specific challenges for those with additional needs, older people, those who are unstably housed and those living rurally were also noted.  

A discussion followed around the points raised and the importance of acknowledging and responding to service users. The positive contribution of the work of the LEC was highlighted, particularly in relation to their engagement and support of other ongoing workstreams.  

The need for a detailed response to the points raised at a future meeting was agreed upon.  

Following this discussion an item of AOB was put forward. The Scottish Government policy team sought agreement from the Group to approach NHS Inform and Healthcare Improvement Scotland Right Decision Service to explore development, with the support of members, of online information on services for the public and clinicians. This was agreed by the Group and will be taken forward.  

Third sector input 

LGBT Youth Scotland, TransparenTsees and LGBT Health and Wellbeing representatives each provided a verbal update on the feedback and key points that they have received from people with lived experience that they work with. 

Themes mirrored those highlighted by LEC.  

The Group acknowledged that although this feedback could at times be challenging, it is very important and emphasises the value of the input of feedback from those with lived experience, and the third sector, on the work of the Group.   

Policy update 

The Scottish Government provided an update on progress of current workstreams. 

Financial discussions are ongoing with the Health Boards regarding 2024/25 funding. Scottish Government confirmed it is their intention for the committed funding to be stretched over five years, rather than the initially planned three. 

The updated Gender Identity Healthcare Protocol, previously titled the Gender Reassignment Protocol, is being finalised and will be published in the Spring. A recommendations and suggestions document covering material produced outside the scope of the protocol update will be provided to the Group for views.  

A letter will be sent out to NHS Health Board Chief Executives to confirm that gender identity clinics are not exempt from the updated waiting times standards. 

Public Health Scotland (PHS) – waiting times data update 

PHS provided an update. They continue to work with Health Boards to improve the quality of data received where required. Some previous areas of data quality concern have been resolved, however some issues remain and will need to be resolved prior to publication. 

PHS, with Scottish Government, are taking forward actions to support Health Boards to resolve these issues.

NHS Education for Scotland (NES) – update on Knowledge and Skills Framework 

An update was provided regarding consultation on NES Knowledge and Skills Framework, the deadline for response has been extended to maximise feedback from relevant professional bodies. Feedback already received has been helpful and the extension is not expected to cause a significant delay to this work.  

University of Glasgow – small projects and PhD 

Following from the last update in October, a second call for interest in small research projects and the PhD to be hosted by the University of Glasgow was put out. This has resulted in 6 small projects being funded and a PhD student being appointed. All will focus on different elements of long term health outcomes for those who have accessed gender identity healthcare.  

AOB 

The next meeting of the Group was confirmed for 17 April 2024.

No other business was raised and the meeting was closed.