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Found 45 results
  1. Content Article
    The NHS Confederation has published a new report, 'The unequal impact of COVID-19: investigating the effect on people with certain protected characteristics', which maps existing research into COVID-19 inequalities onto some of these protected characteristics, showing how the pandemic has interacted with them. The report then showcases four case studies of how different health and care systems have put in place interventions to respond to these inequalities when designing their COVID-19 response. It focuses on a number of key areas including the impact of COVID-19 on: BAME communities people with disabilities older and younger people. The report concludes with a series of recommendations for health and care systems across the UK.
  2. Content Article
    The Arthritis and Musculoskeletal Alliance (ARMA) has compiled relevant and useful resources and information specifically about musculoskeletal health inequalities. The resources include research studies, reports and reviews, and cover these areas: Social deprivation Ethnicity Sex, gender and sexual orientation Health literacy and education level Multiple factors Children and young people Webinars
  3. News Article
    A retired consultant gastroenterologist has been struck off the UK medical register for “wide ranging failings” in treating young transgender patients and in prescribing testosterone for men. Michael Webberley, who was charged with failing to provide good care to 24 patients, acted outside the limits of his expertise, a medical practitioners tribunal concluded. Through the private online clinic GenderGP, which he ran with his wife Helen, a GP, Webberley prescribed puberty blockers to a child of nine and cross sex hormones to a teenager who died by suicide a few months later. He faced charges over his care of seven transgender patients, and the tribunal found that he had provided treatment that was not clinically indicated or that had been prescribed without adequate tests, assessments, or examinations. Read full story (paywalled) Source: BMJ, 30 May 2022
  4. Content Article
    This Healthcare Safety Investigation Branch (HSIB) investigation explores the care of patients who present to child and adolescent mental health services (CAMHS) with questions about their gender identity and are referred to specialised gender dysphoria services. Gender dysphoria is a sense of unease, distress or discomfort that a person may have because of a mismatch between their biological sex and their gender identity. For example, a child who is registered as male at birth might feel or say that they are a girl, or feel that neither ‘boy’ nor ‘girl’ are the right word to describe how they feel about themselves. Gender dysphoria is not identified as a mental illness by the NHS, but some people may develop mental health problems because of gender dysphoria.
  5. News Article
    The only NHS gender identity service for children in England and Wales is under unsustainable pressure as the demand for the service outstrips capacity, a review has found. The interim report of the Cass Review, commissioned by NHS England in 2020, recommends that a network of regional hubs be created to provide care and support to young people with gender incongruence or dysphoria, arguing their care is “everyone’s business”. Led by the paediatrician Hilary Cass, the interim report explains that the significant rise in referrals to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London has resulted in overwhelmed staff and waiting lists of up to two years that leave young people “at considerable risk” of distress and deteriorating mental health. Last spring, the Care Quality Commission demanded monthly updates on numbers on waiting lists and actions to reduce them in a highly critical report on GIDS. Differing views and lack of open discussion about the nature of gender incongruence in childhood and adolescence – and whether transition is always the best option – means that patients can experience a “clinician lottery”, says the new review, which carried out extensive interviews with professionals and those with lived experience. It notes that the clinical approach used by GIDS “has not been subjected to some of the usual control measures” typically applied with new treatments. Another significant issue raised with the review team was that of “diagnostic overshadowing”, whereby once a young person is identified as having gender-related distress, other complex needs – such as neurodiversity or a mental health problem that would normally be managed by local services – can be overlooked. Read full story Source: The Guardian, 10 March 2022
  6. Content Article
    At present there is a single specialist service providing gender identity services for children and young people – the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust. In recent years GIDS has experienced a significant increase in referrals which has contributed to long waiting lists and growing concern about how the NHS should most appropriately assess, diagnose and care for this population of children and young people. The Cass Review has submitted an interim report to NHS England, which sets out their work to date, what has been learnt so far and the approach going forward. The report does not set out final recommendations at this stage.
  7. Content Article
    In this blog for BJGP Life, GP and Public Health Specialty Registrar Richard Armitage looks at the patient safety implications of changes made to gender markers on patient records. Patients in the UK are able to change the gender marker on their NHS patient record on request at any time. This action triggers the creation of a new NHS number and imports the patient’s medical information into a new patient record, without any reference to the patient's previous gender identity or original NHS number. The author highlights that failure to transfer this information could inhibit high quality care for trans patients, especially with regard to population screening programmes which invite patients according to age and gender markers on their patient record. He argues that public health officials, in collaboration with their primary care colleagues, should: respectfully communicate sex-specific health risks with their trans patients encourage them to consider requesting and accessing the appropriate population screening programmes support them in accessing screening in a dignified manner.
  8. News Article
    The death of a "vulnerable" transgender teenager who struggled to get help was preventable, a coroner has said. Daniel France, 17, was known to Cambridgeshire County Council and Cambridgeshire and Peterborough Foundation Trust (CPFT) when he took his own life on 3 April 2020. The coroner said his death showed a "dangerous gap" between services. When he died, Mr France was in the process of being transferred from children and adolescent mental health services (CAMHS) in Suffolk to adult services in Cambridgeshire. The First Response Service, which provides help for people experiencing a mental health crisis, also assessed Mr France but he had been considered not in need of urgent intervention, the coroner's report said. Cambridgeshire County Council had received two safeguarding referrals for Daniel, in October 2019 and January 2020, but had closed both. "It was accepted that the decision to close both referrals was incorrect", Mr Barlow said in his report. Mr Barlow wrote in his report, sent to both the council and CPFT: "My concern in this case is that a vulnerable young person can be known to the county council and [the] mental health trust and yet not receive the support they need pending substantive treatment." He highlighted Daniel was "repeatedly assessed as not meeting the criteria for urgent intervention" but that waiting lists for phycological therapy could mean more than a year between asking for help and being given it. "That gap between urgent and non-urgent services is potentially dangerous for a vulnerable young person, where there is a chronic risk of an impulsive act," Mr Barlow said. Read full story Source: BBC News, 25 February 2022
  9. Content Article
    On 8 April 2020 the coroner commenced an investigation into the death of Daniel France, age 17. Danny was 17 years old and was living at a YMCA hostel. He was on medication for depression and had been referred to secondary mental health services. He had made previous suicide attempts. On 3 April 2020 he took his own life. The medical cause of death was asphyxiation by hanging and the conclusion was suicide.  Danny was a vulnerable teenager: he had left home and was living in hostel accommodation; he had changed his GP practice; he was trans, had changed his name and had been referred to the Gender Identity Clinic; he had recently been discharged from secondary mental health services in Suffolk and had been referred to mental health services in Cambridge; he had previously been under CAMHS and was now being referred to adult mental health services; he had diagnoses of anxiety and depression and had been prescribed medication; he had made previous suicide attempts and had long term suicidal thoughts He had been assessed by First Response Service but had been considered as not requiring urgent intervention. Safeguarding referrals about Danny were made to Cambridgeshire County Council in October 2019 and January 2020. Both referrals were closed and it was accepted that the decision to close both referrals was incorrect. In December 2019 Danny’s new GP referred him to Cambridgeshire & Peterborough NHS Foundation Trust (CPFT). He had been seen by the Primary Care Mental Health Services but was still awaiting assessment by the Adult Locality Team at the time of his death. 
  10. Content Article
    Movements change the world. Throughout history, loosely organised networks of individuals and organisations have sought changes to societies – and won. From the abolitionist struggle and campaigns for voting rights to #MeToo and #BlackLivesMatter, the impact of movements can be seen everywhere.
  11. Content Article
    In this blog for the website Cysters, Kiran Chalke and Hayle Davis share their experiences of accessing gynaecology and reproductive services as a lesbian couple. They describe the barriers they have faced to accessing IVF and highlight disparities in the treatment of heterosexual and same-sex couples on the NHS. They also discuss the impact that bias in the system and from individual healthcare workers has had on both of their experiences of gynaecology treatment. The attitudes of staff and failure to read their notes fully has resulted in the couple feeling uncomfortable in healthcare settings and in treatment delays that have had a real impact on their quality of life.
  12. Content Article
    Despite recent discussions and campaigns to widen nursing’s appeal to people of diverse gender identities, it continues to be perceived as a largely female profession. In the context of an ageing workforce, and alongside recruitment and retention challenges, efforts should be directed at developing a more inclusive profession rather than focusing on why people other than women do not become nurses. To attract more men, transgender people and those who identify as nonbinary, as well as women, the approach to nursing recruitment needs to change. The profession must develop a more inclusive culture and examine and promote the advantages that gender diversity can bring to nursing. This article from Quinn et al. explores the lack of gender diversity in contemporary nursing, briefly examines the history of gender in nursing, and considers how the profession might evolve into a more gender-diverse and inclusive workforce.
  13. Content Article
    People who identify as LGBTQ+ experience disproportionately worse health outcomes and have poorer experiences when accessing health services. In this King's Fund podcast, Helen McKenna sits down with Dr Michael Brady, National Advisor for LGBT Health at NHS England, and Michelle Ross, Co-Founder and Director of Holistic Wellbeing services at cliniQ to explore the health inequalities LGBTQ+ people face and what needs to happen to make sure health services are inclusive.
  14. News Article
    Many dread being invited for their cervical smear test - but Laurie Hodierne found it exhausting to have to keep asking for appointments, and trying to chase up the result. He is one of a number of transgender men who still have a cervix but are no longer registered as female at their GP surgery. Laurie was re-registered as male without requesting it, he says. And this means he could miss out on potentially life-saving cervical smear tests because he is not automatically called up for screenings. As a doctor, Laurie worries others who might be less able to navigate the health system will simply give up trying to get their smear test. "I understand how the systems work and the language - and despite all of that I find it exhausting," he says. "You keep coming up against a brick wall. It's a healthcare inequality in the sense that you aren't able to get access to the screening programme in the same way." NHS patients registered as female are invited to a cervical-cancer screening every three years between the ages of 25 and 50, and then every five years until they are 65. But anyone who has a cervix can develop cervical cancer. The disease often has no symptoms in its early stages and can be fatal. Read full story Source: BBC News, 17 May 2021
  15. Content Article
    Leaders from across the healthcare system agree that for the LGBTQ+ population to recover and thrive after the COVID-19 pandemic, the way services are designed and delivered, and the workforce environments they are delivered in, must change.
  16. News Article
    A transgender boy is taking NHS England to court over delays in accessing gender identity treatment. The 14-year-old, who was referred to the UK’s only youth gender identity clinic in October 2019, has been told he may have to wait at least another year to be seen. He said he was experiencing “fear and terror” while he waits for treatment. Young people are currently facing “extensive waits” to see a therapist, with the average delay being 18 months or more, according to the Good Law Project, which is representing the boy. The not-for-profit organisation said the health service was legally required to ensure patients referred to gender identity development services (GIDS) are seen within 18 weeks. Gender clinics for adults across the country have reported similar delays, with the Devon Partnership NHS Trust reporting “lengthy waiting times” while the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust said patients were facing delays “in excess of 32 months” for an initial appointment and 62 months from referral to treatment. Trusts have blamed a surge in demand as well as reduced capacity, including staffing problems. The teenager involved in the case said in a statement: “The length of the NHS waiting list means the treatments which are essential for my well being are not available to me." “By the time I get to the top of the list it will be too late, and in the meantime I suffer the fear and terror that gender dysphoria causes, every day.” Read full story Source: The Independent, 23 November 2020
  17. Content Article
    In recognition of Transgender awareness week, The King's Fund has created this reading list, which pulls together useful articles, reports and online resources on transgender health.
  18. News Article
    The NHS has announced that Dr Hilary Cass OBE, former President of the Royal College of Paediatrics and Child Health, will lead an independent review into gender identity services for children and young people. The review will be wide-ranging in scope looking into several aspects of gender identity services, with a focus on how care can be improved for children and young people including key aspects of care such as how and when they are referred to specialist services, and clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria. It will also set out workforce recommendations for specialist healthcare professionals and examine the recent rise in the number of children seeking treatment. Dr Cass will then make clear recommendations for children and young people’s gender identity services reporting back next year. The Gender Identity Development Service for Children and Adolescents is managed by the Tavistock and Portman NHS Foundation Trust. The Care Quality Commission (CQC) is due to carry out a focused inspection of The Tavistock and Portman NHS Foundation Trust, Gender Identity Services for children and young people, during the autumn. The inspection will cover parts of the safe, effective, caring, responsive and well-led key questions and will include feedback from people using the service, parents, relatives, carers, and staff. Separately, Dr Cass will also review the service’s clinical practice with the support of the Royal College of Paediatrics and Child Health and engagement of other professional bodies to provide multi-professional insight working closely with the CQC. The review includes an examination of the issues surrounding children and young people who are prescribed puberty blocking and cross sex hormone drugs. Dr Hilary Cass OBE, independent chair, said: “It is absolutely right that children and young people, who may be dealing with a complexity of issues around their gender identity, get the best possible support and expertise throughout their care.” “This will be an inclusive process in which everyone will have the opportunity to make their views known. In particular I am looking forward to hearing from young people and their families to understand their experiences. “This review provides an opportunity to explore the most appropriate treatment and services required.” Read full story Source: NHS England, 22 September 2020
  19. News Article
    The coronavirus lockdown has provoked a mental health crisis among the LGBTQ community, with younger people confined with bigoted relatives the most depressed, researchers found. A study of LGBTQ people’s experience during the pandemic, by University College London (UCL) and Sussex University, found 69% of respondents suffered depressive symptoms, rising to about 90% of those who had experienced homophobia or transphobia. Almost 10% of people reported they felt unsafe in their homes. The study called for more government support for LGBTQ charities, which have experienced significant rises in demand since the start of the pandemic. It warned: “Poor LGBTQ+ mental health may remain unchecked without a substantial policy commitment and funding directed to ameliorating health inequalities exacerbated by the pandemic.” Read full story Source: The Guardian, 5 August 2020
  20. News Article
    There has been a significant rise during lockdown in the UK in the number of LGBT people seeking suicide-prevention support. Support group LGBT Hero reports 11,000 people have accessed its suicide-prevention web pages - up over 44% on the first three months of the year. The government considers LGBT people to be at higher risk of suicide but no national data on LGBT suicides is kept. In total, eight charities told BBC News they had seen an increase in LGBT people accessing their support for suicide prevention. The LGBT Foundation has received more calls about suicide "than ever before". Gavin Boyd, of The Rainbow Project, based in Northern Ireland, said: "In just the last three weeks, we know of three LGBT people who have ended their lives." And another chief executive of a charity, in the south of England, who did not want to be named in case it affected its funding, said: "We know of two young LGBT people in the past two weeks. We're under more pressure to deliver than ever before. The government has done absolutely nothing to help regional LGBT charities cope with the demand from our already struggling service users." Read full story Source: BBC News, 2 July 2020
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