Gender Reassignment Service Specification

[James]

I have been asked by a colleague, who is writing up a service spec for the care pathway, for ideas for service specs. His work will feed into specialised services, possibly nationally.

Given that I'm a commissioner, ex-clinician and ally but not trans gender, it seems to me that I am no expert in this.

I haven't been on this site for a while but I've always thought that its content was pretty grounded and sensible, with some really good ideas.

Please post up anything you would want to be in a service spec, including quality standards. Use your own or others' experiences or be imaginative. Any suggestions welcome!

The spec should cover:
identification
referral
assessment including acceptance and refusal-with evidence as to why
Location of service? Accessibility? Ethnic minorities, disability?
preparation for treatment
hormone treatment
surgery
post surgery medical support
post surgery psychological & practical support
outcomes including reports, satisfaction etc
any further things that should be in there-create a wish list if you want. Not promising anything, mind.

Any responses will be forwarded on with many thanks to posters.

[Pollik]

Hi James and welcome back.

I am away for a few days, but will have a look at this when I get back. Interestingly, I am working on a similar project with Hereford PCT, but my initial optimism is waning, as is that of others (including clinicians) in the group tasked with the project.

The two main barriers are firstly the PCT's notion that it can have a commissioning policy (which,, in this instance, is a highly restrictive policy) on treatment without having a notion of what the recommended treatment entails. The second, the labyrinthine administrative structure of the organisation is an effective impediment to communication...decisions and judgements are being made at some distance from the group which has been trying to act in almost total isolation and without any feedback, whatsoever, to its input. The group is losing the will to live!

Are you able to say more about how your colleague's work will feed into specialised services, possibly nationally? I do get a sense of the same battle being fought over and over again in many parts of the country.

[James]

Thanks Polly. My fairly limited experience of commissioning in all areas is that evrything takes an immensely long time to complete and nothing ends up as you think it will.

My colleague is completing a service spec, and it will be the national one. It will form the basis for all future commissioning plans. I guess it will take some months to complete, as it needs to go out for consultation, criticism etc.

I'll see if he is happy for a draft to be posted up here (don't see why not!).

James