"Access to gender identity services"

About: Nottinghamshire Healthcare NHS Foundation Trust / Gender dysphoria services

(as the patient),

My GP originally sent off my referral to Nottingham centre for gender dysphoria in November 2015. I was advised that there would be a 12 month wait for my intial appointment. I have now been advised by the gender clinic that this has risen to 16 months due to a lack of clinicians.

Given that the NHS rules state I've a right to be seen within 18 weeks of referral and that information about the waiting list seems to be changing for the worse all the time, this isn't acceptable. It is detrimental to my mental health and I feel that it is extremely unfair to not have clear communication about the waits I will face when trying to access these services.

I'd like to know what the gender clinic is doing in order to meet the 18 week rule and why the waiting times for those already on the list are rising so dramatically? I have been forced to seek interim private healthcare in the meantime in order to safeguard my health - given that this is as a direct result of NHS failure to adhere to waiting list rules, can I expect my private fees to be refunded?

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Response from Angie Jackson, Interim Community Service Manager, Mental Health Services for Older People, Nottinghamshire Healthcare NHS Foundation Trust

I am sorry to hear that you are experiencing a long wait to be seen by the gender clinic.

There has been a significant increase in demand for gender services and as a consequence of this the waiting times for assessment have increased as the clinic does not have enough resources to meet the demand.

Gender services are comissioned and funded by NHS England; The Nottingham Clinic is working closely with them in order to try and secure the extra clinicians it needs to address the waiting times & has put forward a business case for increased funding.

Currently the 18 week assessment to treatment target does not apply to gender services.

I have established that the wait for new patients is around 16 months however if the waiting time was 12 months when you were referred then this should still be the case for you, I apologise if this has not been made clear.

I am unable to comment as to whether you can seek a refund on any fees you have paid to be seen privately as this would be a matter for the comissioners.

I appreciate that this does not change the situation in which you find yourself, but I hope that I have asnwered your questions.

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Update posted by Frustrated trans male (the patient)

Hi, thank you for your very prompt response.

I'm confused by your assertion that the 18 week limit doesn't apply to gender identity services as this letter from NHS England confirms that they do: http://uktrans.info/attachments/article/366/GIresponsetoHWE08-01-15.pdf can you please tell me if this has changed?

Thank you for letting me know that I shouldn't have a wait longer than 12 months for my initial appointment. I know many people whose initial wait has been extended far beyond the time period referred to in their referral letter and am pleased that this will not happen to me. Please can you confirm that I will definitely have my first appointment in November 2016?

Many thanks for your help.

Response from Angie Jackson, Interim Community Service Manager, Mental Health Services for Older People, Nottinghamshire Healthcare NHS Foundation Trust

Thank you for your response.

The 18 week target is not applied to our Gender services at present, I am unable to comment further on how it is applied nationally.

We are however about to engage in dicussions with the comissioners to look at what we can do to start to work to get closer to that target as we all accept that waiting times are too long.

I'm afraid that I cannot confirm that you will receive your first appointment in November, there are many issues which affect the waiting time and any given time is still only an estimate.

If you havent heard anything by November then I would advise that you contact the clinic directly and ask them if they can give you any further information.

Kind Regards:
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