NHS Leaked Emails Raise Concern.

Leaked emails have revealed how senior bosses have shared concerns about the closure of the NHS Gender Identity Clinic for Young People at the Tavistock and Portman NHS Foundation Trust.

Executives at the hospital raised concerns about the cancellation of appoinments, the lack of information, and poor communciation with the new services. In one email, the Service Director, Dr Polly Carmichael, said cancellations could potentially put patients at risk. However, NHS England have insisted patients can have "continuity of care".

The Gender Identity Development Service (GIDS), which is the sole NHS Gender Indentity SErvice for children in England and Wales is due to close later this week. The closure was announced in July 2022 after an independent review said that a "fundamentally different" model of care was needed for young people with gender-related distress. The service was rated as "inadequate" by inspectors in 2022.

The Service will initially be replaced by two new regional hubs, one in London and another in the north, with additional hubs expected to open in coming years. Yet staff have been unable to answer basic questions from patients about the future of their care, just days before the closure.

They say they still do not have enough details about how the new services will operate or when some provisions will be fully operational in the new clinics.

Emails have also shown how staff at the new services complain about a lack of information, with serveral sources saying that, for several months, they have asked NHS England for help to set up channels of communication between the teams to assit with a smooth handover.

NHS England says it has now organised a meeting between the new and old teams, but this meeting has only occured in that past few weeks which has impacted the organisation and capabilites of both teams to adjust.

In an email sent earlier this month, Dr Carmichael informed staff about the "unexpected" cancellation of appointments at endocrinology clinics. In the email, send on the 08th March, she said that the cancellations could create a "risk" to some and that the service had become "poorly managed, as [they] did not know in advance". She added "I know this is upsetting but [I] hope we can contain and support any families who make contact".

In November, clinicians wrote to Dr Michael Holland as Chief Executive of the Tavistock and Portman NHS Foundation Trust, to raise concerns that they had "insufficient information" for patients. They wrote that the "situation is now having a significant impact on the safety and well-being of the families we are supporting".

Dr Holland replied: "Your concerns are extremely important, and these are concerns that [the senior leadership team] share. We are in dialogue with [NHS England] on these very points as we are extremely worried that we need clarity. It is far from an ideal situation."

One family explained how they were still "completely in the dark" about their child's future care, saying that they had heard more through various News sources than they had from the NHS, suggesting that there is little continuation of care.

Patients and their families have now received letters explaining that the oversight of their care will transfer from Gids to the new service. However, many say they still do not have basic information, such as names or contact details of the doctors taking over their children's care. Instead, the letters advise that those with urgent concerns or queries should contact their GP, local mental health crisis teams, or Child and Adolescent Mental Health Services (CAMHS).

One of the most controversial elements of care provided by GIDS was the use of puberty blockers - drugs that NHS England said were a way to "delay" the physical changes of puberty.

The NHS recently said that more research was needed as there is not enough evidence about whether these were "safe or effective", saying that they would not routinely prescribe these to 'gender-distressed' children.

Sources have said they fear part of the new service that gives psychological support to children taking this medication will not be fully operational during the service transfer period.

This includes a team at Nottinghamshire Healthcare NHS Foundation Trust, which will take over the support of children who are currently approved for puberty blockers or cross-sex hormones

A spokesperson for the Nottinghamshire Healthcare NHS Foundation Trust said they had hired some some staff and were still actively recruiting more. It said the new service would open on 2 April but would not provide details on when they will be able to see patients.

An NHS England Representative commented, to say: "In line with the Cass Review, NHS England took the decision to close Gids at the Tavistock and set up a fundamentally different and improved approach to children and young people's gender services.

Patients will see continuity of care when the new services come online from April, and all patients waiting will be offered a local mental health assessment if they want it, with extra national resource provided to ensure the best possible support".

Outside the Tavistock Centre