Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, with reference to pages 18 and 19 of the Government response to the First Report from the Women and Equalities Committee, Session 2015-16, on Transgender Equality, Cm 9301, published in July 2016, what steps NHS England has taken to strengthen governance arrangements to review within six months NHS compliance with the Equality Act 2010 in respect of services for transgender people.

NHS England agrees with the Women and Equalities Committee’s recommendations that the requirement to undergo real-life experience prior to surgery must not entail conforming to externally imposed preconceptions about gender identity. The proposed new service specifications for adult gender identity services will be clear that this requirement is not about qualifying for surgery, but rather preparing the patient to cope with the profound consequences of surgery. NHS England has convened a stakeholder engagement event on 5 January 2017 where stakeholders will have an opportunity to shape draft service specifications before they go out for wider public consultation.

The final service specification for the children and young people's Gender Identity Development Service and the final clinical commissioning policy for prescribing cross-sex hormones to young people were agreed and published in August 2016. Both documents were informed by a process of stakeholder engagement and public consultation.

At the most recent multi-agency symposium in October 2016, Health Education England presented an outline plan for the development of a programme of work which will make recommendations for the training and development of the future workforce in this field. It was agreed with stakeholders that this work will focus on new core competencies for staff working in gender identity services; professional standards for Continuing Professional Development; establishing new trainee placements within gender identity services; and recommendations for general awareness raising amongst National Health Service staff. It will also include engagement with patient groups and people who use gender identity services. Health Education England aims to deliver recommendations in the new year.

Following stakeholder engagement earlier in the year, NHS England implemented a new governance framework for its Clinical Reference Groups (CRFs), which exist to provide expert advice to NHS England on specialised services. A new CRF for adult gender identity services was established in September 2016. Membership of the group includes those using NHS services for transgender people and clinicians and the Chair was appointed following an open recruitment process. The CRF has been asked to deliver draft service specifications for adult gender identity services in January 2017. These will be informed by a consideration of the Women and Equalities Committee’s findings and recommendations and by a process of stakeholder engagement and public consultation. In October 2016, NHS England gave notice to all current providers of gender identity services in England that their contracts would be terminated in 2017 and that they will run an open national procurement process to identify providers to deliver against new contracts. Prospective bidders will be required to demonstrate compliance with the new service specifications, once agreed.