Provision of Non Core Surgery for the purpose of alleviating Gender Dysphoria - Local Policy Documents

SM Collings made this Freedom of Information request to NHS Nottingham City Clinical Commissioning Group

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear NHS Nottingham City Clinical Commissioning Group,

The most up to date guidance for provision of care for patients suffering gender dysphoria is the Interim Gender Dysphoria Protocol and Service Guideline 2013/14 issued by NHS England.

https://www.england.nhs.uk/wp-content/up...

The guidance states that:

"Procedures not exclusive to gender reassignment (“non-core” procedures)
Some patients may require other medical procedures as part of the process of
transforming their body to be more congruent with their gender. Other procedures that are
not considered within the Gender Reassignment Protocol can only be considered by the
patient’s Clinical Commissioning Group (CCG). Examples of such procedures are given in
the table below.

“Non-core” surgical procedures are not routinely commissioned by the NHS and can only
be provided on an exceptional clinical need basis. Patients will only be referred for this
surgery following a clinical assessment by their GIC and where a symptomatic or
functional requirement for surgery has been identified. All cases will be referred to the
patient’s GP’s CCG for consideration and assessment against CCG Policy. Access criteria
will consider age, body mass index (BMI), impairment of function, and psychological
distress. Referral for consideration does not necessarily mean that surgery will be offered.
This must be communicated to the patient."

The non core treatments that the policy states may be requested are Breast augmentation
(augmentation mammoplasty) in the case of clear failure of hormones to develop breast growth, Facial Feminisation Surgery (FFS) an Lipoplasty / Contouring and Gamete storage"

I would like to request a copy of all the appropriate local policies and guidance used in order to facilitate the decision making process when it comes to deciding whether non core procedures are approved or rejected.

Yours faithfully,

SM Collings

Foi (NHS NOTTINGHAM CITY CCG), NHS Nottingham City Clinical Commissioning Group

Dear Requester,

Thank you for your request made under the Freedom of Information Act
2000.                                 

A response will be provided to you no later than 20 working days from the
first working day after the request was received.

 

Kind regards

Freedom of Information lead

Corporate Development Department

Direct line: 0115 883 9442 Internal: 39442 email: [1][email address]

NHS Nottingham City CCG

1 Standard Court, Park Row, Nottingham NG1 6GN

[2]www.nottinghamcity.nhs.uk  [3]www.facebook.com/NHS-Nottingham-City
Twitter: @NHSNottingham

show quoted sections

Foi (NHS NOTTINGHAM CITY CCG), NHS Nottingham City Clinical Commissioning Group

2 Attachments

Dear Requester,

 

RE: FREEDOM OF INFORMATION ACT 2000 - INFORMATION REQUEST (1169/17)

 

We have dealt with your request in accordance with your ‘right to know’
under section 1(1) of the Freedom of Information Act 2000 (FOIA), which
entitles you to be provided with any information ‘held’ by a public
authority, unless the information is not held or an appropriate exemption
applies.

 

I can confirm that NHS Nottingham City Clinical Commissioning Group (CCG)
does hold the information you have requested.

 

The FOI Request (Highlighted below)

The most up to date guidance for provision of care for patients suffering
gender dysphoria is the Interim Gender Dysphoria Protocol and Service
Guideline 2013/14 issued by NHS England.

[1]https://www.england.nhs.uk/wp-content/up...

The guidance states that:

"Procedures not exclusive to gender reassignment (“non-core” procedures)

Some patients may require other medical procedures as part of the process
of

transforming their body to be more congruent with their gender. Other
procedures that are

not considered within the Gender Reassignment Protocol can only be
considered by the

patient’s Clinical Commissioning Group (CCG). Examples of such procedures
are given in

the table below.

“Non-core” surgical procedures are not routinely commissioned by the NHS
and can only

be provided on an exceptional clinical need basis. Patients will only be
referred for this

surgery following a clinical assessment by their GIC and where a
symptomatic or

functional requirement for surgery has been identified. All cases will be
referred to the

patient’s GP’s CCG for consideration and assessment against CCG Policy.
Access criteria

will consider age, body mass index (BMI), impairment of function, and
psychological

distress. Referral for consideration does not necessarily mean that
surgery will be offered.

This must be communicated to the patient."

The non core treatments that the policy states may be requested are Breast
augmentation

(augmentation mammoplasty) in the case of clear failure of hormones to
develop breast growth, Facial Feminisation Surgery (FFS) an Lipoplasty /
Contouring and Gamete storage"

 

I would like to request a copy of all the appropriate local policies and
guidance used in order to facilitate the decision making process when it
comes to deciding whether non core procedures are approved or rejected.

 

 

Our Response

Please find the East Midlands Commissioning Policy for Cosmetic Procedures
and the East Midlands Specialised Commissioning Group policy for Gamete
Cryopreservation which are managed by Mid Nott's (Newark & Sherwood CCG
 and Mansfield & Ashfield CCG) for Cosmetic referrals.

 

I hope that this answers your request. However, if you have any queries or
concerns then please contact me. Please remember to quote the reference
number above in any future communications.

 

If you are unhappy with the way in which your request has been handled,
NHS Nottingham City CCG has an internal review procedure through which you
can raise any concerns you might have.  Further details of this procedure
can be obtained by contacting Lucy Branson, Director of Corporate
Development via [2][email address] or by writing to  NHS Nottingham
City CCG, 1 Standard Court, Park Row, Nottingham, NG1 6GN.

 

If you remain dissatisfied at the conclusion of any review you may contact
the Information Commissioner, who will consider whether NHS Nottingham
City CCG has complied with its obligations under the Act, and can require
NHS Nottingham City CCG to remedy any problems.  You can do this via the
[3]Information Commissioner’s Website, or by writing to the Information
Commissioner's Office, Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9
5AF.

 

Kind Regards,

 

Freedom of Information lead

Corporate Development Department

Direct line: 0115 883 9442 Internal: 39442 email: [4][email address]

 

NHS Nottingham City CCG

1 Standard Court, Park Row, Nottingham NG1 6GN

[5]www.nottinghamcity.nhs.uk  [6]www.facebook.com/NHS-Nottingham-City Twitter:
@NHSNottingham

 

All information we have provided is subject to the provisions of the
Re-use of Public Sector Information Regulations 2015. Accordingly, if the
information has been made available for re-use under the [7]Open
Government Licence (OGL) a request to re-use is not required, but the
licence conditions must be met. You must not re-use any previously
unreleased information without having the consent of NHS Nottingham City
Clinical Commissioning Group. Should you wish to re-use previously
unreleased information then you must make your request in writing (email
will suffice) to the FOI Lead via  [8][email address] . All requests for
re-use will be responded to within 20 working days of receipt.

 

 

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