Q and A on the new model of care

Regional model for gender care for children and young people

Last year, referrals to our Gender Identity Development Service stood at over 3,500. In addition, the referral support service set up by NHS England for GP referrals recorded over 1,500 referrals. This is another doubling in demand for support with gender identity. This level of need cannot and should not be met by a single highly specialist national service. It is crucial that gender-diverse children and young people can access care and support in a timely fashion within a joined-up system.

The announcement by NHS England, about a new model to support young people, which once fully operational, should increase capacity and improve access to care. Dr Cass has recommended new regional centres be led by specialist children’s hospitals. As a first step, NHS England are establishing two new Early Adopter Services – one in London and one in the North West. It is hoped these services will be operational in 2023 to serve all patients across England. Once operational, these services will take over clinical responsibility for all GIDS patients and those on the waiting list, with the current GIDS contract being brought to a managed close.

Answers to common questions

Last updated: Wednesday 10 August 2022. We will continue to update this page as we learn more.

What change will this mean for me as a current patient at GIDS?

There will be no immediate changes or interruption to your current care. The early adopters will be established in 2023 and all parties are committed to achieving a smooth and seamless transfer for all patients, minimising any disruption. Endocrine care will continue under the current protocols.

Will I need to wait for a research protocol to start hormone blockers?

The proposed research is likely to take some time to design and implement. In the meantime, referrals into endocrine services can continue under current arrangements, which includes the need for assurance by the Multi-Professional Review Group (MPRG) in regard to children under 16.

Will the Multi Professional Review Group that reviews referrals for puberty blockers be disbanded?

Until the research protocol is operational the MPRG will continue to review the process followed by GIDS and by the Early Adopters once operational. This will still only apply to patients under the age of 16.

I am / my child is on the waiting list for GIDS; what will happen to my / their referral?

Once established, the new Early Adopter services will take a share of the national waiting list currently held by GIDS. The new services will then begin to review the waiting list to determine what the most appropriate care pathway is for each young person at that point.

What does that mean for my place on the waiting list?

Current waiting list positions will be honoured by the new services.

How do patients get referred into this new children’s gender service?

The changes will not happen until the new services launch in 2023. Until that time, new referrals can be made using the information here. Once the Early Adopters are established, new referrals and patients on the waiting list for GIDS will be held by one of the Early Adopter services.

How will the Early Adopters operate differently to GIDS?

The Early Adopter services will have a multi-disciplinary team (MDT) of specialist clinicians so that assessment and care planning is delivered in an integrated way. These MDTs will include gender specialists, specialists in paediatric medicine, mental health, autism and neuro-disability so that a young person’s overall health needs are met holistically. There will also be more support offered to local services so that children and young people can receive care more locally where this is clinically appropriate.

Will this change reduce waiting times, and how quickly?

By increasing both the number of providers and clinical capacity within the service, we expect to see waiting lists and waiting times reduce over time once the Early Adopter services are fully up and running in 2023. These are just the first steps of a major transformation programme that will ultimately result in a network of specialist centres of expertise being established in every region of the country which will further increase capacity and bring down wait times over the coming years.