An ICB has called on NHS England to ‘urgently’ clarify the role of primary care in adult gender dysphoria services, highlighting that responsibility for treatment and medicines should not lie with GPs.
In a recent letter to NHSE, Hertfordshire and West Essex ICB highlighted the consequences of this service provision gap for both patients and local GPs.
The local commissioner said that a specialist provider should manage treatment, with GPs only being involved once a patient’s treatment is ‘stable’.
A spokesperson for Hertfordshire and West Essex ICB told Pulse: ‘We believe that it is in patients’ best interests for their treatment and medicines to be initiated and led by a specialist provider with the knowledge and experience to provide care safely, not an individual’s GP.
‘We have written to NHS England to outline the concerns that we and our GPs share. We have asked NHS England to urgently bring forward plans to set out the role of primary care in supporting patients with gender dysphoria only at a point when a person’s treatment is stable and where there is an individual shared care agreement in place.’
Bedfordshire and Hertfordshire LMC welcomed the letter, saying the ICB listened to feedback from local GPs and understood that ‘pressuring GPs to prescribe isn’t the solution’.
The LMC’s recent update for members said: ‘For the last two years we have been raising the unacceptable provision of services for the management of gender dysphoria in primary care, with our local commissioners, and regional NHS England.
‘The responsibility for commissioning currently sits with NHSE, not the ICB, and it is clear that there is a commissioning gap when it comes to the prescribing for, and monitoring of, these vulnerable patients.’
Kent and Medway ICB recently agreed to start the commissioning process for a gender incongruence service following ‘concerted and concurrent’ pressure from local GPs via the LMC.
There are eight NHS gender dysphoria clinics in England which are commissioned nationally and to which a GP can refer adult patients directly – but patients face long waits as these services experience high demand.
GPs in Kent called for a local service that includes the appropriate set of specialists who can safely manage prescription and monitoring for these patients.
In September, a survey by the LGBT Foundation found that less than half (47%) of transgender people believe their GP meets their needs, compared to 61% of cisgender people.