GIDS staff have published an open letter outlining their concerns about the closure of the GIDS clinic.
You can read the whole thing here:
medium.com/@GidsStaffGroup/an-open-letter-to-nhs-england-from-concerned-gids-staff-4e075dd574d2
Two bits that jumped out at me:
- Adverse events involving GIDS users:
In December 2020, GIDS clinicians wrote to NHS England and the Trust to advise that their decision to suspend Endocrine Pathways following the initial judicial review (Bell vs. Tavistock, December 2020) would increase clinical risk for our client group. It is the view of many clinical staff that NHS England and the Trust did not take heed of those warnings. In the 2 year time period following this, clinicians saw a significant increase in risks for our client group. And more widely, there was an increase in deaths related to the GIDS service. Many of these individual events have not yet been addressed through the Coroner’s Court and legal processes and therefore no further clarification can be made in relation to those events. And we would note that these events cannot be directly linked to decisions made by NHSE and the Trust; however, the culture of hostility and removal of clinical care pathways cannot be ruled out and in our clinical opinion these are contributing factors to the increase in harm in the patient group.
That sounds bad. I don't think it's an argument for keeping the service open.
- Data and research processes and expertise:
The GIDS has been publishing research articles on ethics, theory, practice, retrospective audits, interventions, the service model, updates to practice, instrument generation, letters to editors, and countless other topics of importance since 1999. GIDS staff and researchers have published over 83 research articles in peer reviewed journals in this time, with more in review. We have contributed to building evidence in the field of transgender mental health by attending and presenting at national and international conferences for over 10 years. We have systematically collected data about gender distress, psychological and behavioural wellbeing, traits associated with social communication difficulties, and feelings about the body, alongside other recognised quantitative service metrics. This data is used by clinicians in their assessment and support of young people as well as in published work. We regularly provide our clinicians with updates on the newest research in the field to keep them updated and conduct countless literature reviews on topics requested by them. We also provide them with research inductions to ensure data is collected consistently, and to give them the governance framework, tools, and support to carry out their own research in the service.
And yet, in their evidence during the Keira Bell Judicial review they could not produce the most basic of statistics about their clients.
Oh and one more thing ... On data governance:
Nevertheless, we developed governance structures and practices inspired by academia; our own standardised research proposal form, a research panel meeting, grant collaboration meetings with the government and with universities, supported research processes for trainee psychologists, further discussions of updates to data analysis with colleagues internationally and regular attendance to Trust research governance meetings. Our research team has a dedicated training manual to ensure consistency across team members. It takes over a month of induction training events to skill up new research assistants through a carefully considered programme; and even longer to start to grasp the uniqueness and nuance of this field of research.
The service was absolutely slammed by the CQC for its lack of standardisation of assessment processes, failure to record informed consent, lack of data process. So whatever month long trainings they are clearly not that effective!