akira
It's a matter of playing the system. As El points out, it is top heavy with administrators who seem at least, to have an agenda, though I personally suspect they are simply so busy building their own little empires that proper admin is neglected. It is almost impossible to complain simply because few medical professionals want to risk upsetting their administrators.
I had a surgeon dealing with me in 2000 who was known to be unpopular with her admins. I wrote to her about something and she didn't receive the letter. After about 6 months, I went personally and discovered it had simply been lost in an over complicated system.
It is made the worse for those dealing with any mental health issues, simply because this group are so easy to label as problematic.
As transgender, you have an advantage, firstly, your treatment is predictable, Secondly, other problems associated with mental health are not always so evident.
Now, be polite, persistent and contact people. Pebbles, for example, is waiting for her blood test results. These will have been sent some time ago. She needs to contact the Dr concerned, directly, if possible, and remind them that she is still there.
I appreciate that some might claim this is evidence of the general problems associated with an NHS. The reality is, these are problems associated with British and especially English society. This is clearly evident by looking at other, similar NHS's in other societies. I know of an African country that has a very good NHS, in theory. There are some enormous problems with some quite unpleasant consequences. Only when you look at these in the context of that society can they be understood.
The solutions to all societies problems are found by looking more closely at the actual society and the various local cultures. Political dogma is part of a problem, never a solution.