National Gender Identity Healthcare Reference Group minutes: October 2023

Attendees and apologies

• Dr Ewan Bell, (Co-chair), Associate Medical Director, NHS Dumfries and Galloway
• Adam Black, Nurse Consultant/ Clinical Nurse Manager Sexual & Reproductive Health, Chalmers Gender Identity Clinic, NHS Lothian
• 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
• 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
• Kimberley MacInnes, Service Manager, Raigmore Gender Identity Clinic, NHS Highland
• 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 Alison Poupart, Interim Consultant Clinical Psychologist for the Adult and Young People’s services, Sandyford Gender Identity Clinic, NHS Greater Glasgow and Clyde
• Dr Susan Rooney, Clinical Lead, Sandyford Gender Identity Clinic, NHS Greater Glasgow and Clyde
• Dr Fiona Wardell, Standards and Indicators Team Lead, Healthcare Improvement Scotland
• Lived Experience Coordinator
• Representative, LGBT Health and Wellbeing
• Representative, LGBT Youth Scotland
• Representative, Scottish Trans Alliance
• Representative, TransparentSees
• Scottish Government Secretariat 

Apologies:

• Professor Nicola Steedman, (Co-chair), Deputy Chief Medical Officer, Scottish Government
• Richard Anderson, Deputy Director Centre for Reproductive Health, University of Edinburgh
• Dr Christine Mimnagh, CMAGIC Clinical Lead, Mersey Care NHS Foundation Trust
• Dr Ruth Pearce, Lecturer, University of Glasgow

Items and actions

Welcome and minutes of previous meeting

Ewan Bell (EB) welcomed attendees to the thirteenth 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.

The continuation of future meetings into 2024 being held every eight weeks was agreed by those in attendance. The secretariat will schedule these.

Policy update

The Scottish Government provided an update on current workstreams. No substantive changes or issues were reported, good progress continues to be made across the board.

It was confirmed to the Group that Scottish Government/NHS Scotland have joined NHS England’s announced puberty hormone suppression study in children and young people as a treatment option for gender dysphoria, as an observer. The Group will be updated as this work progresses.

Health Board - progress update and summary

All territorial health boards providing a gender identity clinic were asked to provide an update on improvement work undertaken to date using funding allocated by the Scottish Government. All returns have now been received and a paper will be provided for the next meeting.

It was shared with the Group that due to the volume and variety of ongoing work by special health boards a suggestion had been made it would be useful for a short summary paper to be publicly available describing these workstreams. This would be hosted on gov.scot.

The Group agreed with this proposal and for a paper describing the workstreams underway via special health boards to be published as part of the National Gender Identity Healthcare Reference Group webpage.  

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

A brief update was provided. It was noted substantive work to deliver the Framework is ongoing and keeping to schedule and a consultation is planned for this winter. The Group noted this will be a focused consultation including stakeholders and professional bodies, rather than a public one. This is due to the fact the NES Framework will be for professional rather than public use.

NES is considering how the Framework will be implemented effectively, via its usual processes.

Healthcare Improvement Scotland (HIS) – update on standards

HIS confirmed a draft public consultation on standards is being finalised. This will be circulated to its development group for final sign off, before it is due to go live in December 2023.

It was noted that HIS are working with NES to make sure all work is appropriately aligned.

Public Health Scotland (PHS) – waiting times data update

PHS noted all work is on track and it continues to work with health boards to refine available data from gender identity clinic systems and synthesise these as part of its national commission.

A discussion was held around the best way to define and accurately record ‘total caseload’ of gender identity clinics. It was agreed having a shared understanding of caseload i.e. active or returning patients, would assist the broader data picture in this space. It was agreed PHS will continue to work with Health Boards on this point to refine shared understanding.

University of Glasgow – small projects and PhD

A brief update regarding the call for interest in small research projects and the PhD to be hosted by the University of Glasgow was given. It was confirmed that the first round of calls for projects did not receive sufficient applications. It was also confirmed that no appointments have been made to the PhD place at this point.

A second call for interest for small research projects has been issued and the PhD readvertised. An update will be provided at the next Group meeting.

Evaluation - aims, questions, ethical sensitives

It was confirmed Scottish Government is beginning a procurement process for formal evaluation of work to improve gender identity healthcare provision within NHS Scotland. The Group were requested to provide feedback regarding the proposed approach.

Cass Review attendance – focus for December

The Chair facilitated a short discussion concerning areas the Group would like to include on the agenda for its next meeting (19 December 2023) noting Dr Hilary Cass would be in attendance to speak to their ongoing independent review of gender identity services for children and young people as provided by NHS England.

AOB

It was highlighted that Dr Anna Lamont will be moving on from her current role at the end of January 2024. The Chair thanked Dr Lamont for her substantive contribution to the Group since its establishment, and welcomed her continued interest in this field within NHS Scotland in her new role.

No other business was raised and the meeting was closed.