National Gender Identity Healthcare Reference Group minutes: July 2023

Attendees and apologies

• Dr Ewan Bell, (Co-chair), Associate Medical Director, NHS Dumfries and Galloway
• Professor Nicola Steedman, (Co-chair), Deputy Chief Medical Officer, Scottish Government
• Jane Harris, Head of Programme, Postgraduate and Post-registration Education and Continuing Professional Development, NHS Education for Scotland
• Dr Anna Lamont, Medical Director, National Procurement Commissioning and Facilities, NHS National Services Scotland
• Catriona Johnson, Associate Director, NHS National Services Scotland
• David Parker, Senior Educator/Subject Matter Expert, NHS Education for Scotland
• NHS Lothian Chalmers clinic staff
• Jennifer Layden, Healthcare Improvement Scotland
• Linsey Galbraith, Principal Information Analyst, Public Health Scotland
• Rhoda Macleod, Head of Sexual Health, Prison and Police services, Sandyford Gender Identity Clinic, NHS Greater Glasgow and Clyde
• Dr Ruth Pearce, Lecturer, University of Glasgow
• Dr Paul Connelly, Clinical Lecturer in Diabetes & Endocrinology, University of Glasgow
• Lived Experience Coordinator
• Representative, Scottish Trans Alliance
• Representative, LGBT Youth Scotland
• Parent Representative, TransParentSees
• Representative, LGBT Health and Wellbeing
• Scottish Government Secretariat

Apologies

• Adam Black, Nurse Consultant/ Clinical Nurse Manager Sexual & Reproductive Health, Chalmers Gender Identity Clinic, NHS Lothian
• Colin Briggs, Director of Strategic Planning, NHS Lothian
• Kimberley MacInnes, Service Manager, Raigmore Gender Identity Clinic, NHS Highland
• Neil Ferguson, Director, West of Scotland Regional Planning
• Fiona Wardell, Standards and Indicators Team Lead, Healthcare Improvement Scotland
• Kathryn Kinnear, Service Manager, Elmwood Gender Identity Clinic, NHS Grampian
• Dr Sarah Weldon, Consultant Clinical Psychologist, Sandyford Identity Clinic, NHS Greater Glasgow and Clyde
• Dr Louise Melvin, Clinical Lead, Sandyford Gender Identity Clinic NHS Greater Glasgow and Clyde
• Dr Fiona Gibson, Specialty Doctor Gender and Sexual Health Services, NHS Highland
• Dr Michelle Watts, Senior Medical Advisor, Scottish Government

Items and actions

Welcome and minutes of previous meeting

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

Minutes of the previous meeting were approved by those attending and EB noted that these will be published online in due course.

It was noted that the secretariat are looking into plans for a hybrid meeting to be held in October. The opportunity to meet in person was welcomed by the Group. 

Policy update

Scottish Government provided an update on current workstreams.

Progress and completion of previous actions arising from the last meeting were noted.

An update was provided regarding allocation issued to territorial Boards, confirming funding for 2023/24. A more in depth update regarding financial allocations was proposed for the next meeting.

NHS Lothian update

A presentation was given by staff from the Chalmers gender identity clinic (GIC) within NHS Lothian.  This highlighted development of the Chalmers GIC since its establishment, and recent service developments following allocation of Scottish Government funding.

Ongoing improvement work within NHS Lothian included expanding the clinical team attached to the GIC and continuing to embed a larger multi-disciplinary model, to facilitate a more robust clinical service and support a more individualised approach to the provision of care. It was noted the GIC has more than doubled staffing levels in the past 12 months. This has meant significant progress has been made in reducing waiting times to access the service. It was also confirmed NHS Lothian are engaging positively with local primary care partners, to facilitate better care in the community for patients no longer requiring the dedicated support or expertise of the GIC.

It was confirmed local work is underway to make contact with those on the waiting list, to offer or signpost to appropriate support if required. Collaborative working with the 3rd sector organisations continues, particularly in terms of how those services may help support individuals waiting to access the GIC.

A discussion followed regarding the role of primary care in the ongoing treatment of this patient cohort and how GICs can work to support this.

Lived Experience

The Lived Experience Coordinator provided an update on current work and recent workshops they have coordinated. Main themes arising from that engagement  include:

• Support for new ways of working including multidisciplinary teams;
• Interest in NHS England adult pilot programmes and service developments seen elsewhere;
• The role of and expectations placed upon primary care;
• A desire for better communication for those on waiting lists from the health system;

Discussion – 2021 Framework

Secretariat and Co-Chairs facilitated a discussion and feedback session on progress made to date against committed to actions in Scottish Government’s NHS gender identity services: strategic action framework 2022-2024.

This primarily focused on framework commitments not yet completed, whether the Group believed these were still relevant and on track. Members were also given the opportunity to highlight any gaps. 

AOB

No other business was raised and the meeting was closed.