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GPC guidance tells GPs to ignore GMC advice on prescribing for gender dysphoria

The GPC has issued guidance on treating gender dysphoria, which states that GPs should not be obliged to prescribe 'bridging prescriptions’.

It has issued a new report in response to controversial GMC’s guidance that said GPs should prescribe so-called ‘bridging prescription’ hormones for patients before and after they get specialist care.

The BMA’s new report says that the GMC’s guidance ’fails to address the resulting significant medicolegal implications for GPs, and neglects the non-pharmacological needs of these patients.’

This is the latest in the long running row between the GPC and GMC/NHS England over GPs being told to offer specialist treatment which is in many cases beyond their competence.

The GPC acknowledges that all GPs will provide services to patients with gender identity problems at some stage and wants ‘to ensure high quality service provision is made for this particular group of patients.’

In April, the GPC said there were 'significant concerns’ about NHS England and GMC guidance on prescribing advice, and discussions over the guidance are still ongoing.

The GPC’s new report advises: 'While awaiting specialist assessment, GPs should attend to their patients’ general mental and physical health needs in the same way as they would for other patients, but are not obliged to prescribe bridging prescriptions.’

It has called on NHS England to make proper commissioning arrangements to avoid patient self-medicating 'rather than by GP-prescribing before initial assessment and diagnosis.’

The guidance added that GPs need to understand the issues to ensure they provide quality care and make appropriate referrals to specialist services.

It said: 'In our view, there is however a need for a balance between what can justifiably be expected of GPs in providing Primary Medical Services to patients with gender incongruence, those enhanced services which can be provided in primary care, and the knowledge and expertise which should rightly remain within the remit of specialist services.’

It also advised GPs to:

  • Refer early and quickly to a reputable gender service;
  • Support recommended treatment;
  • Get pronouns right and ask discreetly if in doubt;
  • Take care over medical confidentiality and never divulge a patient’s gender past without their consent;
  • Avoid misattributing commonplace health problems to gender.

The GPC also called on CCGs to refrain from blocking appropriate direct referrals to the eight gender identity clinics (GIC) in England from GPs.

 

Readers' comments (8)

  • I wasn't aware of the GMC guidance but WHY is the GMC issuing clinical guidance like this in the first place? Enough with all the guidance already.

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  • GMC were going to issue this guidance as special note to all Drs. It looks like they backed away from this because there advice runs counter to all other GMC guidance.
    Expect more of this as they get leaned on by pressure groups

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  • Because GMC is a branch of HMG like NHSE and HMG want to cut the costs of it/not commision properly so are using GMC to bully GPs into disregarding the guidance on prescribing and shared cares.
    Same as GMC have bullied juniors about strike action.
    Expect more of the same from GMC around any challenges we as Drs make.

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  • Perhaps we should get to vote on who runs our register and training.
    Everyone better make sure they are anonymous on this thread

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  • This comment has been moderated.

  • The GMC has erred in this matter.
    As others have commented above, the GMC should not,and must not be seen to,
    disseminate guidance on clinical practice.It is,reportedly admitted by the GMC, not part of its remit, see below.


    http://www.bailii.org/uk/cases/UKICO/2016/FS50619386.pdf

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  • Bridging prescriptions of diamorphine to heroin addicts whilst waiting for specialist drug rehab.

    Bridging prescriptions of anabolic steroids to reduce the risk of patients purchasing at the gym.

    Bridging prescriptions of amphetamines for ADHD whilst waiting years for specialist review.

    Nice to know the GMC will now back me up with all of these as well!

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  • Yet another example of this organisation operating outside of its range and fields of competence.
    Fit for practice?

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  • anon 10:44, beautiful piece of work here is a snippet from the judgement
    11. In its response to the complainant of 16 December 2015, the GMC had confirmed that disseminating guidance on clinical practice is not the GMC’s function and therefore it does not hold the information he requested.
    lets see how they backtrack from this one

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