Health watchdog warns NHS gender service is failing to cope with patient influx

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The independent health regulator has warned that NHS gender identity services are falling short of targets as backlogs and waiting lists grow.

The Care Quality Commission released a report this week after carrying out an inspection of the Gender Identity Clinic at Charing Cross Hospital – a hub for transgender people seeking medical care.

While praising the standard of care available at the clinic, it warned that waiting lists were well in excess of the NHS-wide statutory targets.

The report says: “There were long delays between people being referred to the service and having an assessment and treatment.

“The target timescale was 18 weeks but people were waiting 10-14 months. Action plans had been developed with commissioners but these were still being implemented.”

The CQC inspectors also warned that a number of administrative shortcomings have made things more difficult for trans people accessing the service.

The report continues: “Administrative systems were causing problems for people who used the service. There were delays in
letters being sent to people who used the service and to other professionals.

“Appointments were being cancelled, sometimes at the last minute when people were already travelling to the clinic.

“People using the service were not always told why appointments were cancelled and would sometimes have to wait long periods of time for appointments to be re-arranged.”

The report specifies mandatory actions for the service, which is run by the West London Mental Health NHS Trust.

It states: “The trust must ensure they follow through the action plan agreed with commissioners so that patients are assessed within 18 weeks of being referred to the service. This includes the recruitment of staff.”

Many NHS services relating to gender identity have seen a rapid upswing of people seeking treatment in the past few years as a growing number of trans people seek help.

The only clinic to deal with transgender young people has seen a 500% rise in people seeking treatment, while adult services have seen a similar rise.

Dr John Dean, chair of the National Clinical Reference Group for Gender Identity Services, warned previously that waiting lists must not be allowed to spiral out of control.

He said: “Not treating people is not a neutral act – it will do harm.

“There are a number of studies that report evidence of suicide and self harm among trans people who are unable to access care.

“It is an intensely demeaning and frustrating experience to have to live in a social role in a body that is incompatible with your deepest inner sense of self.”

Parliament’s Women and Equalities Select Committee also sounded the alarm on the issue earlier this year, warning that services with year-long waiting lists were in violation of statutory limits.

The surgeon who previously performed the majority of the NHS’s gender reassignment surgery has also warned that backlogs are ‘spiralling out of control’.