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NHS Highland keeping pace with referrals to gender identity services better than any other health board in Scotland, new data shows

By Andrew Henderson

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NHS Highland is keeping up with referrals to gender identity clinics better than anywhere else in Scotland, it has been revealed – and the situation for trans people could only be set to improve.

NHS Highland are keeping pace better than other health boards – but the wait for a first appointment is still well over two years.
NHS Highland are keeping pace better than other health boards – but the wait for a first appointment is still well over two years.

Data obtained under Freedom of Information shows that the waiting list for a first appointment for the gender clinic based in Inverness is 90 people, with the current longest wait being just under two-and-a-half years.

In Inverness, patients being offered first appointments in November 2023 were first referred in May 2021.

That is a long time, but it is ahead of NHS Grampian's number, which sits at around 33 months – and streets ahead of the busier Sandyford clinic in Glasgow, where adults are waiting five years and five months (65 months) and young people are waiting four years and six months (54 months).

In fact, the only health board performing better than NHS Highland is NHS Lothian, whose longest wait for a first appointment sits at 23 months with far greater resources.

In NHS Lothian, first appointments are currently being offered to those referred in January 2022, but in Glasgow patients being seen for their first appointment in November 2023 were referred in October 2018.

NHS Lothian has a whole time equivalent of 4.2 staff members who can conduct first appointments – although that is not the entirety of their role.

NHS Greater Glasgow and Clyde have a whole time equivalent (WTE) of 0.5 staff who can conduct first appointments – though again much of their time is spent on returning appointments – while NHS Grampian, who do not keep records of the number of referrals or first appointments they offer per year, have one psychiatrist available one afternoon per week.

The latter situation is most similar to NHS Highland, who have 0.92 WTE staff capable of delivering first appointments – of which just 0.2 is allocated clinic time.

However, NHS Highland confirmed that they recently added extra staff who will see the rate of first appointments being offered pick up.

Although an average of 32.8 people are being referred to the gender identity service in NHS Highland per year over the last five years, an average of 21.6 first appointments have been offered per year over the same period, meaning the waiting list has only grown.

See the yearly breakdown across health boards who record such data in the graphs below

Proportionally, the NHS Highland service is keeping up with demand far better than their counterparts elsewhere in the country.

The rate of first appointments offered in Inverness sits at around 66 per cent of the number of referrals, compared to around 53 per cent in NHS Lothian and just 12 per cent in NHS Greater Glasgow and Clyde.

There are some caveats that mean Sandyford in Glasgow is busier than the others. It is the only clinic with a specialist service for young people as well as adults, and they are the only clinic where patients can self-refer, or be referred by other health and social care providers.

That is significant, as in the 2023/24 year to date it is a fairly even split between GP referrals and other referrals – 55 per cent coming from GPs, 42 per cent being self-referrals and three per cent coming from other services.

It is rare for any medical treatment to begin from a first appointment, which is usually something of a fact-finding meeting to establish what the patient is looking for from the process and what the next steps should be.

Therefore, although the waiting times for a first appointment are already long, it is even longer before trans people begin medically transitioning.

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