National Gender Identity Healthcare Reference Group minutes: July 2022

Attendees and apologies

• Professor Nicola Steedman, (Co-Chair), Deputy Chief Medical Officer, Scottish Government
• Leanne Baxter (Observer), Assistant Programme Manager, NHS National Services Scotland
• Adam Black, Nurse Consultant/Clinical Nurse Manager, NHS Lothian
• Neil Ferguson, Head of Planning, NHS Greater Glasgow and Clyde
• Dr Fiona Gibson, Clinician, NHS Highland
• Jane Harris, Head of Programme, Postgraduate and Post-registration Education and Continuing Professional Development, NHS Education for Scotland
• Dr Amber Keenan, Clinical Lead, NHS Grampian
• Kathyrn Kinnear, Service manager, NHS Grampian
• Dr. Anna Lamont, Medical Director, Procurement, Commissioning and Facilities, NHS National Services Scotland
• Jennifer Layden (Guest) (part of the meeting), Healthcare Improvement Scotland
• Rhoda Macleod, Head of Sexual Health, Prison and Police Services, NHS Greater Glasgow and Clyde
• Katrina Mitchell, Development Worker, LGBT Health and Wellbeing
• David Parker, Lead Clinician, National Gender Identity Clinical Network for Scotland
• Dr Ruth Pearce, Lecturer,University of Glasgow
• Everlyn Sheerin, Parent Representative, TransparentSees
• Michael Taylor (Part of the meeting), Head of General Practice (GP) Contract Operations, Scottish Government
• Vic Valentine, Manager, Scottish Trans
• Dr Fiona Wardell, Standards and Indicators Team Leader, Healthcare Improvement Scotland
• Mairi Watson, Information Consultant, Public Health Scotland
• Dr Sarah Weldon, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde

Apologies

• Dr Ewan Bell (Co-Chair), Associate Medical Director, NHS Dumfries and Galloway
• Dr Richard Anderson, Deputy Director Centre for Reproductive Health, University of Edinburgh
• Jenny McNicol, Acute Director of Nursing and Midwifery

Items and actions

Welcome and introductions

Nicola Steedman (NS) welcomed attendees to the fourth meeting of the National Gender Identity Healthcare Reference Group (the Group). Apologies were noted, minutes of the previous meeting were approved and completion of previous actions arising from the last meeting were noted.

Members agreed minutes would now be published on the Scottish Government website.

Strategic leads overview

NS invited a strategic lead representative from each gender identity clinic to present to the group on how they are being supported strategically by their boards.

Kathryn Kinnear (KK) described the situation in Grampian, where they were in 2018 and where they are now and how the national work going on is important to them. She explained how engagement with endocrinology has been positive for their future plans for service improvement.

Anna Lamont (AL) commented on how colleagues should be recognised on the running of an unfunded service.

Neil Ferguson (NF) presented on behalf of NHS Greater Glasgow and Clyde and explained the strategic governance in place and the creation of their steering group which includes representation from primary care and the third sector.

A discussion on the pros and cons of payments by case from other boards took place.

Kimberley McInnes (KM) presented for Highland and explained that their service has been funded since 2018 and how the publication of the strategic action framework has highlighted the need for the alignment of services to programme boards.

Fiona Gibson (FG) commented on how this group and sharing good practices is useful and that much of the work done across clinics is through goodwill as there are no service level agreements in place in Highland.

Christine Mimnagh (CM) shared some of the learning that took place setting up the Cheshire and Merseyside Adult Gender Identity Collaborative (CMAGIC) pilot.

NS thanked the clinicians and strategic leads for their presentations. It was agreed that NHS Lothian will present at the next meeting due to other commitments from their strategic lead.

Policy update

An update from Scottish Government was provided, outlining developments relevant to commitments contained within the December 2021 strategic action framework.

Primary care overview

Michael Taylor, Head of GP Contract Operations gave a presentation on the general practice (GP) contract and explained the relationship of GP’s business with NHS boards and how they are funded.

A discussion took place on how this is a difficult landscape to navigate and how it is hoped that the gender reassignment protocol (GRP) review may help.

Ruth Pearce (RP) shared some thoughts on improvement and what is happening in other areas.

Gender reassignment protocol review

David Parker provided an overview of the continued work to review and update the gender reassignment protocol. He explained that the work of the sub groups has now came to a close.

Any other business

The statutory instrument that has been laid by the UK Government in connection with the Cass review was highlighted.

A discussion took place about the frequency of meetings and it was agreed to move to every eight weeks after September meeting.

Close and date of next meeting

No further business was raised. NS closed the meeting.

Next meeting: Friday 19 August 11:30 to 13:30.