National Gender Identity Healthcare Reference Group minutes: March 2023

Attendees and apologies

• Professor Nicola Steedman, Co-Chair, Deputy Chief Medical Officer, Scottish Government
• Richard Anderson, Deputy Director Centre for Reproductive Health, University of Edinburgh
• Neil Ferguson, Head of Planning, NHS Greater Glasgow and Clyde
• Linsey Galbraith, Principal Information Analyst, Public Health Scotland
• Jane Harris, Head of Programme, Postgraduate and Post-Registration Education and Continuing Professional Development, NHS Education for Scotland
• Catriona Johnson, Associate Director, NHS National Services Scotland
• Dr Anna Lamont, Medical Director, National Procurement Commissioning and Facilities, NHS National Services Scotland
• Jennifer Layden, Healthcare Improvement Scotland
• Kirstin Leath, Head of Gender Identity Healthcare Access, Scottish Government
• Rhoda Macleod, Head of Sexual Health, Prison and Police Services, NHS Greater Glasgow and Clyde
• Katrina Mitchell, Development Worker, LGBT Health and Wellbeing
• Parent Representative, TransparentSees
• Vic Valentine, Manager, Scottish Trans Alliance
• Dr Fiona Wardell, Standards and Indicators Team Leader, Healthcare Improvement Scotland
• Lived Experience Coordinator
• Scottish Government Secretariat

Apologies

• Dr Ewan Bell, Co-Chair, Associate Medical Director, NHS Dumfries and Galloway
• Adam Black, Nurse Consultant/Clinical Nurse Manager, NHS Lothian
• Colin Briggs, Director of Strategic Planning, NHS Lothian
• Dr Fiona Gibson, Clinician, NHS Highland
• Kathryn Kinnear, Service Manager, NHS Grampian
• Kimberley MacInnes, Service Manager/Lead Nurse, NHS Highland
• Jenny McNicol, Acute Director of Nursing and Midwifery, NHS Grampian
• Dr Louise Melvin, Interim Clinical Lead, NHS Greater Glasgow and Clyde
• Dr Christine Mimnagh, CMAGIC Clinical Lead, Mersey Care NHS Foundation Trust
• David Parker, Lead Clinician, National Gender Identity Clinical Network for Scotland
• Dr Ruth Pearce, Lecturer, University of Glasgow
• Dr Sarah Weldon, Consultant Clinical Psychologist, NHS Greater Glasgow and Clyde
• Dr Michelle Watts, Senior Medical Adviser – Primary Care, Scottish Government

Items and actions

Welcome and minutes of previous meeting

Nicola Steedman (NS) welcomed attendees to the ninth meeting of the National Gender Identity Healthcare Reference Group (the Group). Apologies were noted.

The first anniversary of the Group’s meeting was acknowledged.

Minutes of the previous meeting were approved by those attending and NS noted that these will be published online in due course. Progress and completion of previous actions arising from the last meeting were noted.

Policy update

Scottish Government provided an update on current workstreams including highlighting an updated risk register.

Concern relating to workforce challenge impacting broader service improvement was discussed. Recruitment and retention pressures across NHS Scotland were acknowledged, alongside the unique context of this field of healthcare. The Group noted workforce recruitment opportunities can be impacted by ongoing polarised public, media and political attention. The Group acknowledged recent reports of threats and protests at facilities, and received assurance that Health Boards were taking appropriate steps to safeguard staff.

The status of some of longer term workstreams was considered. It was agreed that discussions around these pieces of work will resume in new financial year and timelines updated accordingly.

Lived experience update

The Lived Experience Coordinator gave an update on their work to date and on main themes arising from engagement.

Discussion followed, with the Group acknowledging that lived experience involvement is essential to gender identity healthcare improvement. This includes the importance of keeping the community informed on the background, processes, and the progress of the work across different workstreams.

Actions for stakeholders to provide information to support the Lived Experience Coordinator with this work were agreed and will be coordinated by the secretariat.

Healthcare Improvement Scotland (HIS) update

HIS updated the Group on its progress on developing standards of care for gender identity healthcare.

HIS outlined the initial results of the consultation on scope of the standards which closed on 13 February. The format of the forthcoming scoping report was outlined. The importance of providing feedback to all contributors’ suggestions and the need for transparency was highlighted.

Initial steps towards the development stage are underway, including the recruitment of a Chair and membership of a standards development group.

Public Health Scotland (PHS) update

PHS gave an update on progress on their work to collect, collate and publicly report standardised waiting times and associated patient cohort information.

PHS outlined initial findings of a pilot on the draft data reporting template and set out next steps. In light of the learning from the pilot, minor revisions and a return have been reissued to Health Boards for development of a quarterly return.

The administrative ask of Boards on top of existing pressures was acknowledged and clinics were thanked for their support.

Young people provision

NHS National Services Scotland (NSS)

NSS provided an overview of NHS Scotland approach to national commissioning of specialist services processes and applicable remits.

A progress update on national commissioning of young people’s clinical provision in this field was given.

Young people’s service

NHS Greater Glasgow and Clyde provided an overview of capacity challenges experienced by the current young people’s gender service, and work underway and action planned by the Board to improve the current offering.

One year Group review and AOB

The Chair thanked members for attending and it was noted the meeting had overrun. NS proposed the meeting be closed and that feedback for the outstanding items be considered via correspondence and finalised at the next meeting. The Group agreed.

Members were reminded to send any additional thoughts or feedback on any of the items to the Gender Identity and Healthcare Access Team who are providing secretariat: genderidentityhealth@gov.scot.