New gender clinic being investigated by CQC

[Clymene]

This is the one that's been set up by former Tavistock employees. 8 of them claim to be doctors but none are registered with the GMC.

www.dailymail.co.uk/news/article-12254933/Now-health-watchdog-probes-private-gender-clinic-set-staff-scandal-hit-Tavistock-unit.html

They need to shut this down.

That didn't take long.

So grifters.

@Signalbox
That is what is supposed to happen with non medical prescribers- they prescribe within their field/scope of practice. So for example, my practice nurses can both prescribe but they limit it to their knowledge area- prescribing for infected leg ulcers they’re seeing, utis, asthma inhalers etc. They don’t start prescribing anti-depressants for example.

But that requires the practitioner and their employer to both recognise their competencies and the limits of it. Just as i as a GP don’t start certain drugs because I know they need to be initiated by a specialist. If that insight into their own practice isn’t there or the person employing them or their regulatory body isn’t enforcing it then we end up with a situation of inappropriate and unsafe prescribing.

Psychology is a very different discipline to psychiatry and the whole reason for that is because it is not just a medical model. I absolutely value the work of my colleagues in psychology but I don’t think they should start prescribing MH drugs. And the only professional who should be prescribing hormones to a child is an paediatric endocrinology consultant (and IMHO that should be confined to cases of precocious puberty and similar).

It's a general course for any nurse prescriber, so I doubt it covers anything as specialised as cross-sex hormones. However, all nurses are restricted to practising within their areas of competency and knowledge. Same for doctors - legally, I can prescribe almost anything, but I would be in breach of GMC rules if I suddenly started prescribing drugs for which I don't have an adequate knowledge base.

I can't see the tweet (I'm not on twitter and it no longer seems to be available without logging in), but is there any evidence of a connection between this man who wrote a book called 'Gender Plus' and the clinic of the same name?

Thanks Faffertea That’s how I imagined it works. And presumably there’s a whole extra level of training and caution required when prescribing to children.

The Twitter poster claims he owns the clinic. I don't know what evidence e there is for that. Would be concerning if so given what the section quoted says

Well, it was probably naive to think that just closing down the Tavistock would fix this problem. Close that place and all those gender woo doctors and therapists and whatnot are out of a job. So what are they going to do? They're going to go and find another job doing the same thing somewhere else, because there's still loads of demand for their services and they need to make a living.

Gender plus is Kelly Psychology trading as gender plus, according to the website. Dr Aiden Kelly is the sole director.

https://find-and-update.company-information.service.gov.uk/company/12874978/officers

From the DM article - which of course may be incorrect - the issue is that they do not believe that they are carrying on a Regulated Activity. If that is correct, that will mean they cannot be registered by CQC and are not within their remit to regulate. If that is the case, CQC cannot ‘close them down’. If they ARE in fact carrying on a Regulated Activity and have not registered then that is a criminal offence - and according to the article, that is what CQC’s unregistered provider team is looking into. If so, that would enable CQC to take action against the fact that they have been operating without registration, and then of course actually register and regulate them.

Am i missing something here?

I don't understand why their statement says that the mental health care, autism assessments and psycho-social services they are offering don't count as health care provision for the purpose of CQC regulation?

These appear to be regulated activities according to the CQC website and the Health and Social Care Act 2008, so why are they saying that these aren't regulated activities?

If they were relying on a legal regulatory exemption, like the GMC registration or individual staff members already being regulated separately, then why didn't they say that in their statement?

Why would they say that it's because the activities themselves aren't regulated activities and therefore aren't under the CQC's remit? Surely they would say they're relying on a valid exemption and not "leave us alone, we're only offering mental health services"?

The only explanation I can think of is that they told the CQC that their website is for future marketing purposes and that they are lying to the public about their current professional offering, but then why contradict that in their statement?

Can anyone shed any light on why they would say that the mental health services and autism assessments aren't regulated by the CQC?

This is their statement in response to the Daily Mail article.

“Gender Plus is a multi-disciplinary and independent gender service that accepts referrals for children, adolescents and adults. Our staff team consists of experts in the field of gender healthcare, mental health, and neurodevelopment. We take a developmental approach to deliver an accessible, holistic and comprehensive service that goes some way towards meeting the huge level of unmet need that exists currently.

Our service management have previously clarified with the CQC that the holistic psycho-social service we provide, which includes gender, mental health and neurodevelopmental assessment and support, does not fall under their remit and as such is not eligible for CQC registration. If in the future we do provide services which will require CQC registration then of course we will seek registration.”

https://www.genderplus.com/statement

Interesting that they say that their "staff team consists of experts in the field of gender healthcare, mental health, and neurodevelopment", and yet they don't have a single medical doctor on their staff.

Why would they need experts in 'gender healthcare' on their staff if they're not providing healthcare and what sort of person should be considered an expert in any field of healthcare if they're not a doctor?

"We're experts in healthcare, so we can charge £££ for our services, but we're not providing healthcare so we don't need to be registered with the CQC."

If in CQC’s scope, it I think would be under Treatment of Disease, Disorder and Injury. This requires treatment to be given by, or under the supervision of, a healthcare professional, a healthcare professional. What a healthcare professional is, is defined in the legislation(see 4(4)(a)). If they a re not employing staff with those protected titles then they wouldn’t be able to register for this activity. https://www.legislation.gov.uk/ukdsi/2014/9780111117613/schedule/1

Yeah the idea is that it would be a specific qualification for an area of practice, like a nurse practitioner. Possibilities include chronic pain management, mental health, gender medicine. It would have to be more comprehensive training as psychologists don’t have basic biomedical training unlike other health professionals who gain prescribing rights.

I do think the push for this change is coming almost entirely from the gender clinicians. There are other areas where it might make sense but the political pressure on the BPS in recent years is from psychologists who want to be able to directly prescribe hormones.

As @Overrunwithlego says, it must hinge on what exactly they are doing. The CQC can only regulate services covered by the HSCA 2008. This does not cover all counselling services.

However, I cannot explain the prescribing nurse. The only loophole I can think of is if the nurse is set up separately, as a provider with CQC registration, and the idea is that Gender Plus works alongside the nurse's provider organisation, but as two separate organisations.

Looking at their website currently, it states that hormone clinics will start in “Autumn 2023”. It might be that at that time they will need to register with CQC, although it’s not clear, as they use the terminology “associated endocrine clinic” whether they will be responsible for that clinic - it might be managed by another provider (who would require CQC registration).

The Gender plus nurse consultant is on this series of podcasts https://www.leedsth.nhs.uk/about-us/podcast-voices-lgbt-community/ interviewing people.

Thanks Overrunwithlego and MissLucyEyelesbarrow for clarifying.

Its awful that parents of distressed and/or ND children are being failed by CAMHS and their families, then forced by long waiting lists to find private ‘alternatives’ which could be entirely dodgy, not even just un-evidenced.
The private sector milking these families and their kids as cash cows for all they are worth is completely unethical when they are providing something with no proven benefit. Setting up as an unregulated provider seems like a new low though. Why should distressed kids who think they’re trans gave to settle for a lower standard of protection? That’s actually transphobic.

Looks like it. Companies House has Kritzinger listed as Director of two companies, the gender clinic and Kritzinger Anaesthetic Services. The other director listed for both companies is his wife, Samantha, who is described as an anaesthetist (and is on the GMC register as such)

Both companies appear to have been in existence for several years

Actually, I don't know that they are husband and wife.

There's an existing thread about this clinic, and its a shame that there are now 2 threads, as it would help for the future have developments about this practice all in one place. :(
https://www.mumsnet.com/talk/womens_rights/4832529-former-staff-from-controversial-tavistock-facility-set-up-private-gender-clinic?page=1

There seems to be Gender Plus Healthcare Ltd which is new and is only Kelly.

Also Gender Plus Ltd which has been a dormant company for over 10 years which is directed by Kizinger and Samantha.

These seem to be completely separate companies run by different people which just happen to have similar names.

Yes it looks like the Gender plus name had already been taken by the book writer, so Gender Plus Healthcare was opened.