Sandyford Clinic in Scotland closing doors to new patients

'1.2 What informed the review
The review was based on principles of human rights and person centred care.
It took into account in relation to gender identity healthcare:

• Best practice and developments from across and outwith NHS Scotland
• Different models of care
• Advances in evidence including World Professional Association of Transgender Health (WPATH) Standards of Care
• Updates to the World Health Organisation’s International'

From teh SPATH document. No date on it. Does anyone know when it came out?

www.nss.nhs.scot/publications/foi-000151-unlicensed-eunuch-procedures-and-the-care-of-the-patients/foi-000151-unlicensed-eunuch-procedures-and-the-care-of-the-patients-html/

'On the 15th of June, NHS National Services Scotland’s National Services Division became aware of a third-party document hosted on the National Gender Identity Care Network for Scotland (NGICNS) website. The document has since been removed and the website taken down pending the outcome of an investigation.

NHS Scotland did not author the document, contribute to it or comment on it. The document’s content does not reflect current policy or guidance on standards of care for NHS Scotland.

The document was part of a public consultation led by the World Professional Association for Transgender Health (WPATH) and as such is unrelated to NHS Scotland and the NGICNS. NHS Scotland and WPATH do not have a working relationship, and any concerns about the content should be raised directly with WPATH.'

'The review ... took into account ... Advances in evidence including World Professional Association of Transgender Health (WPATH) Standards of Care'

'The document was part of a public consultation led by the World Professional Association for Transgender Health (WPATH) and as such is unrelated to NHS Scotland and the NGICNS. NHS Scotland and WPATH do not have a working relationship'

Well, these two statements seem to contradict each other.

Yep. As long as the script is signed by a doctor with a EEA license to practise.

The only sticking point is if the high street pharmacist refuses to fill the paper prescription.
This does happen but GGP’s customers just just shop around until they find one who is willing/not paying attention. The GGP ‘fund’ provides the costs of the private medications.

www.gov.uk/guidance/prescriptions-issued-in-the-eea-and-switzerland-guidance-for-pharmacists

Dates:

FOI 21 July 2022

SPATH September 2022, according to the FWS website.

Hmmmm.

www.nss.nhs.scot/publications/foi-000247-correspondence-regarding-the-potential-adoption-of-wpath-new-guidelines/foi-000247-correspondence-regarding-the-potential-adoption-of-wpath-new-guidelines-html/

'V7 of WPATH has not been incorporated into NHS Scotland guidance and nir does NHS Scotland follow all of WPATH. Similarly, there are no plans for v 8 of WPATH to be incorporated or followed either. It is incorrect to state that the gender clinics follow the WPATH guidance.
The WPATH guidance is one reference that is consulted to inform gender clinic guidance'

I see. So they consult the guidance as references, but they don't 'follow' them.

Holy sophistry!

GenderGP will already give a year’s worth of hormones to any kid with unsupportive parents who GGP decides is Gillick Competent

Hm. Yes GenderGP do operate in the UK. Are they allowed to determine Gillick competence for UK kids since their doctors aren't necessarily in the UK? GenderGP (and any other overseas services prescribing hormones to children) might be another scandal waiting to break especially now that Susie Green has joined them.

From the guidance for pharmacists that @CryptoFascistMadameCholet linked

"This does not affect your right to exercise your professional discretion to refuse to dispense a prescription if any of the following apply:
it would not ordinarily be dispensed in the UK
there are doubts over its authenticity
there are concerns about the clinical appropriateness of the medicine(s) for that patient
it would cause any issues of health and safety"

Perhaps there need to be more restrictions on UK pharmacies dispensing hormones to under 16s on an overseas prescription? It's likely to be complicated (contraception etc) but maybe not impossible.

Fingers crossed!
it’ll be the ’counsellors’ who do the ‘information gathering sessions’ who determine the Gillick status - the Romanian doctor who signs the EEA prescriptions is pretty much invisible.

care.gendergp.com/911665-What-happens-during-an-Information-Gathering-Session

Marianne Oaks is the most visible of their (freelance) counsellors: www.gendergp.com/my-story-marianne-oakes/

There are lots of complaints re: UK pharmacists saying no to GenderGP prescriptions in online trans spaces!

Under 18s have to have paper prescriptions in the post after RPS intervened (adults can still use the online pharmacies that partner with GenderGP)
www.pharmacyregulation.org/sites/default/files/document/20210209_response_to_gendergp_.pdf

(apologies for the derail from Sandyford specific chat!)

High time. The sand castle is tumbling down.

Sandyford have said it was misinformation in the press and the waiting list has not been shut:

“We wish to assure you that the gender service for both young people and adults at Sandyford is very much open and we continue to accept referral to our waiting list. We are aware there has been some misinformation circulated in the press.

The service is under significant pressure due to the demand and we are experiencing staffing challenges so it does mean our waiting list will most likely increase. We are at the moment undertaking some recruitment into the service, but that will take several weeks before it will have an impact on our waiting times.

We apologise for an inconvenience or distress this may cause”

www.scottishtrans.org/sandyford-young-persons-gender-service-continuing-to-accept-new-patients/

Just came to post the same link.

All a bit odd.

I don’t think it is particularly odd. The overriding message in internal NHS Scotland (NSS, Sandyford etc) correspondence and reports is that families must be reassured that it is effectively business as usual at Sandyford- eg in the NSS Cass summary document, it is emphasised:

”There is a degree of anxiety already existing with young people and their families, it would be helpful to have some reassuring lines prepared and agreed about the continuation of services in Scotland.”

I suspect Sandyford briefly closed their waiting list as the service is overwhelmed. I suspect they did not expect this to be picked up by the press, but it did and what ensued was misinformation that the service was closed. I suspect their statement and reopening of the waiting list is damage control to reassure families <who are still under the deluded belief that Sandyford operates an evidence based approach>

it’ll be the ’counsellors’ who do the ‘information gathering sessions’ who determine the Gillick status

I wonder who is allowed to decide Gillick status. I can see references to judges, "medical professionals" and "healthcare professionals" and it seems to vary for different procedure. So this is something else that might need to be tightened up for overseas gender treatments. Apparently Marianne Oakes has "qualified as a therapeutic counsellor" but that's not a medical qualification and it doesn't mean necessarily understanding the full physical and medical implications. (sorry if that's a derail)

Gillick has been stretched beyond all meaning due to Stonewall/Mermaids law.

School said they had changed DD’s name /sex on the school register without informing parents due to her ‘Gillick Competency’ - we asked who had made the Gillick assessment and for a copy of the paperwork.
They backed down immediately (of course as soon as DD turned 16 she was able to change her name legally without parental permission so it only delayed it but it was interesting to see school recoil when asked for proof). School is in England, is a Stonewall Bronze Champion and staff have had Mermaids training.

Agree with @rogdmum - that the apparent backtrack re: pausing the waitlist was almost inevitable once the press had run off with it. Bet the TQ orgs of Scotland were furious!

thenational.scot/news/23377189.sandyford-gender-services-staff-scared-due-anti-trans-climate/

'“THE climate we’re in right now, the entire team is scared.”
Staff at the Sandyford sexual health clinic in Glasgow – the only place in Scotland where young people can receive gender-related care – have growing concerns about the rhetoric in the debate around trans rights and the impact it will have on services, a source told The Sunday National.'
...
'One post in the gender team, the source said, has been advertised three times over a year without even a single applicant.
“It’s crazy. There’s just no resource and nobody there,” they said, adding that campaigns against the legitimacy of gender identity care were making the problem worse.
“Imagine if you were to sell it without even knowing what the service was,” they said.
“There’s this massive waiting list and there’s going to be loads of scrutiny on you and people are going to be actively campaigning for your service to close down and there’s 1000 newspaper articles written about your client base every week. When you put it like that, nobody is going to want to do it.”'

That is one possibility. Or another possibility is that people don't buy gender identity theory, or medicalising children, and that's why they're not keen on applying for the job.

'“Gender services is a complex specialty which demands a particular set of clinical skills and other qualities from staff, and it is true that we are facing specific challenges around recruitment in some areas.' - NHS spokesperson.

What are those 'other qualities'?

This ^^

The service needs radical overhauling but to just abandon the service users is an appalling response.

They are so dismissive of Cass.

But then they did have the endocrinologists mark their own homework…

(from the NHS NSS SBAR on the Cass Review)