Many of you have expressed concern about the inappropriate pressure being placed upon you to prescribe outside of your experience( and therefore in contravention of GMC guidelines and without proper specialist support) for gender dysphoria and transgender patients. Disgracefully there are even some specialist centres which refuse to accept referrals unless GPs agree to prescribe, sometimes even for children. It is quite clear that NHS England has failed to properly commission services covering the entire patient pathway or this very vulnerable group of patients and so the current state of affairs is self- evidently discriminatory.
NHS England is now consulting on proposals for these services and it is clear that it’s direction of travel is to further shift all of prescribing onto general practice. The consultation document is at this link:
The online response form is here:
The consultation requires a concerted response from general practice making it clear that 1) this work is not part of core GP services 2) any prescribing in general practice must be appropriately commissioned and fully funded ( in my view ideally through a DES and 3)individual GPs/practices with good reasons to do so must be free to decline this non- core work without fear of any adverse consequences s to them and universal arrangements must be put in place to ensure that patients can obtain prescriptions elsewhere. Anything short of full commissioning for this highly specialist prescribing will continue the appalling discrimination against transgender / gender identity patients.
I shall be responding to the consultation on behalf of the LMC and the BMA/GPC will respond too but I would also urge all GPs to respond as well- you do not need to respond to the entire consultation- just to those questions you feel are relevant to your work, particularly those on prescribing.
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