OK, so a link to the document
http://www.nhscitizen.org.uk/wp-content/uploads/2015/03/Gender-ID.pdf (http://www.nhscitizen.org.uk/wp-content/uploads/2015/03/Gender-ID.pdf)
and some points I found the most interesting (mostly about wait times for GRS)...
"Current waiting times for new referrals are around 22 months*. We estimate that without additional capacity waiting times for new referrals will increase to 42 months by March 2017."
-- Yes that's 42 months/3.5 years from referral! - The times are climbing quickly. Currently they are standing at 102 weeks, but that figure will almost certainly have climbed again by next month.
"... we are committed to deploying additional funding in 2015/16 and subsequent years to reduce waiting times for genital reconstruction surgery to below 18 weeks by March 2017 subject to a consideration of other priority areas in 2015/16, and to the outcome of price negotiation with the providers."
-- If you look at the figures* though , and the "subject to a consideration of other priority areas" escape that is written, it does look like the "18 weeks by March 2017" is pie in the sky.
* see this link for latest published information on incoming and outgoing to the surgery list http://www.imperial.nhs.uk/services/gendersurgery/faqs/index.htm (http://www.imperial.nhs.uk/services/gendersurgery/faqs/index.htm)
"NHS England deployed additional resource to increase surgical capacity at Nuffield Hospital in 2014/15, and this has begun to reduce the number of patients waiting for male-to-female surgery."
-- Though this might at first appear true, considering the reported drop of people waiting from 395 to 393*, firstly this is not a significant decrease and secondly there are issues with their figures in that they don't add up, which has been the case previously also **.
* previous months figures for March http://uktrans.info/attachments/article/252/imperialgrsapril15.pdf (http://uktrans.info/attachments/article/252/imperialgrsapril15.pdf)
** previous noted discrepancies http://uktrans.info/attachments/article/252/Discrepancies%20in%20Imperial%20College%20Healthcare%20NHS%20Trust.pdf (http://uktrans.info/attachments/article/252/Discrepancies%20in%20Imperial%20College%20Healthcare%20NHS%20Trust.pdf)
"Discussions with Imperial Healthcare NHS Trust will focus on the creation of additional capacity by the employment of two additional consultant surgeons and additional theatre time, and possibly earlier reductions in waiting times through a subcontracting model with the independent sector."
-- I do feel more than a little sceptical about them being able to meet the March 17 target, as it will take a good period of time to even recruit and train 2 surgeons and for them begin practising. Even when they do, currently the two surgeons that they do have performed an average of 3.6 operations each over the last 3 months. If that were to continue that would give them a processing capacity of 14.6 surgeries a month, when the number of incoming referrals was 17 last month and climbing each month. The reference to "a subcontracting model with the independent sector" doesn't hold much water either as far as I can see, as they are already using the only practising private surgeon that I know of in the UK, so I don't see this making a great difference either.
The NHS watchdog Healthwatch recently published documents* on the problems with gender services and called on the NHS to answer them. The NHS response is, as far as I can see, quite non-committal with a lack of any sign of direct action **.
* a brief summery and links to further documents http://www.healthwatch.co.uk/news/people-facing-unacceptable-waits-gender-reassignment-surgery?ukti=true (http://www.healthwatch.co.uk/news/people-facing-unacceptable-waits-gender-reassignment-surgery?ukti=true)
** NHS response http://www.healthwatch.co.uk/sites/healthwatch.co.uk/files/gender_identity_correspondence_healthwatch_england_nhs_england_0.pdf (http://www.healthwatch.co.uk/sites/healthwatch.co.uk/files/gender_identity_correspondence_healthwatch_england_nhs_england_0.pdf)
All in all it looks like they are at least accepting that they have an obligation to provide the same service to us as they do to other surgeries, they accept that they are failing in that respect, that the problem is getting worse and are making noises about changes, but I can't see any significant change coming in the next two years, certainly not reducing a 2 year wait to 18 weeks.
I don't like the NHS and there gatekeeping
With respect its a little more complicated than just "gatekeeping."
The problem is twofold - one we have to balance too few resources among vastly different patients - that is very difficult and makes it a no win for everyone. As someone who now sits on the other side of the table I assure you that doctors don't like the situation anymore than you do.
Secondly though the regret rate is small, it does happen, and when it does people have a horrible habit of then blaming the doctor for not trying to stop them. (And of course cis lawyers will readily believe that they should have done!) The worst bit is there is no definitve yes/no answer in advance as to who will have regrets. My best friend who was for many years the leading UK specialist in trans medicine, nearly got struck off because a patient tried to blame him in this way, and as the law stands the only defence that a doctor has is that they have done their best to follow the protocols as laid down.
So I don't think its entirely fair to blame the doctors for the situation. Its more complex than that, and a fair amount of responsibility lies with compensation lawyers, and indeed politicians who set NHS targets and budgets.
Thanks for posting this Kira!
It's all a bit confusing though, I was really worried about there being a long wait for funding but it came through with my referral to Brighton. So I don't know whether its down to different areas or something?
Quote from: Yenneffer on June 11, 2015, 05:31:39 AM
I don't like the NHS and there gatekeeping
This has not been my experience of the people at Leeds at all, they've been great. Everything I read before hand made me feel really nervous and turned out to be wrong.
This is probably why....
Charing Cross, London 21 months
Nuffield Health Hospital, Brighton 12 months
St. Peter's Andrology Centre, London Less than 18 weeks
Ahh!! That makes more sense. I think the Brighton waiting list is shorter than that now. Hopefully! :)