East of England Gender Service

The Nottingham Centre for Transgender Health network (NCTHnet) launched a new national pilot in June 2021 for people who live in the East of England. A new service has been developed that is nurse and GP lead and based in two locations in the East of England. One base is in Cambridge and the second, yet to be identified, will be in Norfolk. The service will see patients who have been waiting on other Gender Clinics waiting lists on a “who has been waiting the longest” basis.

Nurses from Cambridgeshire and Peterborough NHS FT have been seconded to NCTH and are being trained in transgender healthcare and will be joined by soon to be appointed GPs. The pilot is part of the NCTH network and patients will have the same access to support and treatment as they do with a Gender Identity Clinic.  Nottingham will provide the training, clinical governance, and additional support elements of a patient’s pathway.  It will be a single approach of two teams working together as one. 

Patients started to be seen in mid-June and whilst the numbers are ahead of target, with two of the four nurses starting at the end of July, assessment numbers will start to increase. The remaining two nurses are starting at the beginning of September.

The East of England Gender Service has a large geographical area and the use of video consultation, when clinically appropriate, will help reduce the need for patients to travel. Below are some frequently asked questions that may be helpful. Patients are being contacted by letter and/or telephone so please do get back in touch if you are offered an appointment.

 

Frequently Asked Questions

Who will the service see?

Initially the service will see patients aged 17+ who are already on a waiting list at one of the 7 NHS England commissioned Gender Identity Clinics (GIC). Patients will be given a choice to remain where they are, on the original waiting list, or be seen by the new service, which starts from June 2021.

Patients do have a choice and East of England (EOE) patients already held on a gender clinic waiting list will be offered the opportunity to be seen at the new service and transfer to that list or remain where they are. Patients will be contacted to confirm what choice they would like to make. 

 

Which CCG areas does the East of England Service Cover?

  • Basildon and Brentwood CCG
  • Bedfordshire, Luton and Milton Keynes CCG
  • Cambridgeshire and Peterborough CCG
  • Castle Point and Rochford CCG
  • East and North Hertfordshire CCG
  • Herts Valleys CCG
  • Ipswich and East Suffolk CCG
  • Mid Essex CCG
  • Norfolk and Waveney CCG
  • North East Essex CCG
  • Southend CCG
  • Thurrock CCG
  • West Essex CCG
  • West Suffolk CCG

 

If I transfer, what does it mean?

Transferring to the new service will mean that you are seen closer to home in a more regional and timely way, whilst maintaining full access to all the services of a GIC. 

As you are being asked to contact us regarding booking you an appointment, it is anticipated that you will be seen sooner than by remaining on the original list, as the EOE Clinic will only be seeing patients from this region. However, you should check with the original GIC about the length of time to your first and second assessments if you remain with them.   

If you agree to be transferred to the East of England Gender Service, you will be offered a first appointment/assessment to be seen based on your position on the EOE waiting list.

 

How is the waiting list managed?

The waiting list of patients is based on the date of referral by the GP to the original GIC and everyone from each of the 7 GICs has been put into date order on an EOE waiting list. People will be seen based on who has waited the longest, no matter to which clinic they were originally referred. People are unable to be moved higher up the list, as it is based on who has waited the longest time, as this is a fair and equitable approach.

 

Do I have to transfer to the East of England Gender Service?

Patients do not have to transfer to the new service; they can decide to remain on the GIC list that received the referral or transfer to the new service. Each patient will receive a letter giving them a choice to move to the new service or stay where they are. 

If a patient decides not to transfer to the East of England Gender Service, then we will advise the relevant GIC that you want to stay on their list and be seen by them. We will then go to the next person on the list and offer them an appointment.

 

If I do not want to transfer to the new East of England Gender Service now, can I change my mind later?

If you do not transfer at this time, you will need to wait for an appointment at your original GIC. The East of England Gender Service has developed a fair system of transferring patients from the waiting lists who have waited the longest for an appointment, so will not be transferring patients beyond this transfer window, as it would not be fair to other patients waiting for their opportunity to transfer.

 

When and how will patients be seen?

The service will start seeing patients in June 2021 using a blended model of video consultation and face to face appointments, based on clinical need and patient digital access.

 

Where will face to face appointments take place?

Cambridge will be one of the locations with a remote/satellite clinic based in Norfolk. Premises are currently being identified and further information will be provided.

 

Who will I be seen by?

The East of England Gender Service is a new clinic and all the nurses and GPs employed will be trained and supervised by experienced transgender professionals from the Nottingham Centre for Transgender Health Network. It may be a clinician from either service; however, the standard of care and treatment will remain the same.

 

What happens if I need the services available at a GIC?

The benefit of the East of England Gender Service model is that patients can access not only the same Telephone Support Line whilst on the waiting list, but also the same service, expertise and treatment that are available at a GIC. The Nottingham Centre for Transgender Health will provide second surgical recommendations, speech and language therapy, endocrinology, complex assessments and/or support. Patients should experience a seamless transition between the two clinics as if it were a single Gender Service.

 

What is the relationship between the East of England Gender Service and the Nottingham Centre for Transgender Health network (NCTHnet)?

The East of England Gender Service is a partnership by Cambridgeshire and Peterborough NHS Foundation Trust and Nottinghamshire Healthcare NHS Foundation Trust to deliver Transgender Healthcare services through a Nurse and GP led model. This service undertakes the assessment and treatment process and surgical referrals for gender affirming surgery. 

NCTHnet provide the training and clinical oversight for the clinicians at the East of England Gender Service, and provide endocrinological, speech and language therapy, psychological and psychotherapy support. NCTHnet will also undertake any complex assessment or treatment needs a patient may have, along with surgical recommendations for genital surgery.

 

If I need to have a face to face appointment and I am on low income or benefits, can I claim for travel?

NHS Patients who need to travel to be seen, who are on low income or benefits can re-claim travel expenses and more details regarding this are available at https://www.nhs.uk/nhs-services/help-with-health-costs/healthcare-travel-costs-scheme-htcs/ or Help with Health Costs team on Facebook. The clinic is unable to reimburse any costs as it will not have a cashier’s office, so claims will need to be made using the form provided on the NHS.uk website.

 

Will the patient’s GP be informed by the East of England Gender Service?

Yes – When a patient decides they want to be seen by the East of England Gender Service, an appointment letter will be sent to the patient, and after this appointment the GP will receive a copy of the outcome letter which is sent to the patient.

GPs receive copies of most letters sent to the patient to ensure they have the necessary clinical information they may need.

 

Will any advice or help be given to GPs and primary care who may not have experience of transgender patients?

Primary Care Transgender Awareness sessions are being held for GPs. These sessions give an overview of Transgender Health, the patient pathway within a gender service, the role of the clinicians and the service. They will also detail the advice, support and guidance given to patients and GPs while a patient is being seen at the service.

 

What support does a patient get while they are waiting to be seen at the East of England Gender Service?

Patients on the East of England Gender Service waiting list will be able to access a Telephone Support Line commissioned from Gendered Intelligence, a trans-led registered charity. This service is confidential and can provide very bespoke advice to the patient or a member of their family. Details of how to contact the service are below:

Monday, Tuesday, Thursday 2-7pm, Wednesday and Friday 10-3pm.

If there are issues regarding your mental wellbeing, then please contact your GP or local mental health service if you are already been seen by them. If the matter is urgent then contact 111 or your GP.

 

 

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