Dear Payton

Freedom of Information Reference: 2023-000099

I refer to your below freedom of information request which we received
today, requesting the following information:

Readable copies of all documents attached to the "SPATH – Sub group
considerations and recommendations v1" document.  For example, "Assessment
example journeys 19 May 2022" attached to page 9 of the document.  In the
currently available PDF form of the v1 document, the attachments are not
included in a readable form.

A copy of the current version of the "SPATH – Sub group considerations and
recommendations" document including all attachments (for example,
"Assessment example journeys") in a readable form.

A copy of the updated gender re-assignment protocol as submitted to the
Scottish Government and/or the Chief Medical Officer, referenced in the
Chief Medical Officer's letter to NGICNS dated 8th July 2021 and in the
National Gender Identity Healthcare Reference Group minutes 23rd November
2022 including all attachments in a readable form.

Any subsequent correspondence between the Chief Medical Officer and NGICNS
in relation to the updated gender re-assignment protocol or
recommendations made in the SPATH document in the period from the issue of
these documents to the CMO/Scottish Government to present date.

I confirm that under the terms of the Freedom of Information (Scotland)
Act 2002, a response to your information request will be sent within 20
working days of receipt, i.e. no later than 12 April 2023

Kind regards & best wishes

Leanne

FOI Support Administrator

Strategy, Performance & Service Transformation

NHS National Services Scotland

Gyle Square

1 South Gyle Crescent

Edinburgh

EH12 9EB

[NHS National Services Scotland request email]

Please consider the environment before printing this email.

NHS National Services Scotland is the common name for the Common Services
Agency for the Scottish Health Service. www.nhsnss.org

show quoted sections

Dear Payton McIntosh, 

Freedom of Information Reference FOI-2023-000099 

I refer to your request of 15^th of March under the Freedom of
Information (Scotland) Act 2002 for information in relation to the
following: 

Readable copies of all documents attached to the "SPATH – Sub group
considerations and recommendations v1" document.  For example, "Assessment
example journeys 19 May 2022" attached to page 9 of the document.  In the
currently available PDF form of the v1 document, the attachments are not
included in a readable form.

A copy of the current version of the "SPATH – Sub group considerations and
recommendations" document including all attachments (for example,
"Assessment example journeys") in a readable form.

A copy of the updated gender re-assignment protocol as submitted to the
Scottish Government and/or the Chief Medical Officer, referenced in the
Chief Medical Officer's letter to NGICNS dated 8th July 2021 and in the
National Gender Identity Healthcare Reference Group minutes 23rd November
2022 including all attachments in a readable form.

Any subsequent correspondence between the Chief Medical Officer and NGICNS
in relation to the updated gender re-assignment protocol or
recommendations made in the SPATH document in the period from the issue of
these documents to the CMO/Scottish Government to present date.

I can advise you that we have now completed the search of our records and
can provide you with the following information:

Readable copies of all documents attached to the "SPATH – Sub group
considerations and recommendations v1" document.  For example, "Assessment
example journeys 19 May 2022" attached to page 9 of the document.  In the
currently available PDF form of the v1 document, the attachments are not
included in a readable form.

A copy of the current version of the "SPATH – Sub group considerations and
recommendations" document including all attachments (for example,
"Assessment example journeys") in a readable form.

The document SPATH – Sub-group updates and recommendations was a working
document providing information to the Oversight Board for consideration.
It is not a guidance document and has not been updated as it reflected the
information at a point in time. The attachments were early iterations of
documents being developed and as such I have provided the most up to date
version of these documents. These are:

• Assessment example journeys (attached)
• GS Prison Model Appendix 1 May 2022 (attached)
• GS Prison Model May 2022 (attached)
• Endocrine and fertility guidance (attached)
• Masculinising Treatment Final (attached)
• Feminising Treatment Final (attached)
• Trans voice and communication leaflet (attached)
• 2022 Facial Hair Removal Guidelines:
[1]https://www.ngicns.scot.nhs.uk/wp-conten...
• Letter re Provision of Wigs (attached)
• YP Gender Service Assessment Proforma (attached)
• GRP Children and YP age and stage (attached)
• Recommendations for GRP YP Subgroup (attached)

The documentation being released includes personal data of third parties,
specifically, names of individuals which have not been released into the
public domain on any previous FOIs or literature regarding this topic.
Where this is the case, these names and contact details have been redacted
in line with exception Section 38 ((1)(b)) of the Freedom of Information
Scotland Act – Personal information.

A copy of the updated gender re-assignment protocol as submitted to the
Scottish Government and/or the Chief Medical Officer, referenced in the
Chief Medical Officer's letter to NGICNS dated 8th July 2021 and in the
National Gender Identity Healthcare Reference Group minutes 23rd November
2022 including all attachments in a readable form.

Under Section 27(1) of FOISA - Information held with a view to publish
this information is currently being withheld.

NSS convened a short life working group to refresh the Gender Reassignment
Protocol and intend to publish the document, retitled as the NHS Scotland
Trans Healthcare Pathway on 6^th June 2023.

Any subsequent correspondence between the Chief Medical Officer and NGICNS
in relation to the updated gender re-assignment protocol or
recommendations made in the SPATH document in the period from the issue of
these documents to the CMO/Scottish Government to present date.

Under Section 17 of the Freedom of Information (Scotland) Act 2002, NHS
National Services Scotland (NSS) does not hold the information that you
have requested.  

If you are unhappy with any aspect of how we have dealt with your request
you can make representations to us asking us to review the handling of
your request.  Please write to the Head of Information and Cyber Security
using the email address [2][NHS National Services Scotland request email] within 40 working days of the
date of this correspondence.                         

If after a review you are still unhappy, you also have the right to apply
to the Scottish Information Commissioner, who can be contacted at Kinburn
Castle, St Andrews, Fife, KY16 9DS, or via their [3]online Appeal
form.           

If you have any queries about this letter, please contact me at the above
address.    

Kind regards,

Faith

Faith Glennon

Information Governance Advisor

NHS National Services Scotland

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Dear Payton McIntosh, 

Freedom of Information Reference FOI-2023-000099 

I refer to your request of 15^th of March under the Freedom of
Information (Scotland) Act 2002 for information in relation to the
following: 

Readable copies of all documents attached to the "SPATH – Sub group
considerations and recommendations v1" document.  For example, "Assessment
example journeys 19 May 2022" attached to page 9 of the document.  In the
currently available PDF form of the v1 document, the attachments are not
included in a readable form.

A copy of the current version of the "SPATH – Sub group considerations and
recommendations" document including all attachments (for example,
"Assessment example journeys") in a readable form.

A copy of the updated gender re-assignment protocol as submitted to the
Scottish Government and/or the Chief Medical Officer, referenced in the
Chief Medical Officer's letter to NGICNS dated 8th July 2021 and in the
National Gender Identity Healthcare Reference Group minutes 23rd November
2022 including all attachments in a readable form.

Any subsequent correspondence between the Chief Medical Officer and NGICNS
in relation to the updated gender re-assignment protocol or
recommendations made in the SPATH document in the period from the issue of
these documents to the CMO/Scottish Government to present date.

I can provide you with the following information in response to your
initial request and your subsequent questions on the 21^st of May: 

A copy of the updated gender re-assignment protocol as submitted to the
Scottish Government and/or the Chief Medical Officer, referenced in the
Chief Medical Officer's letter to NGICNS dated 8th July 2021 and in the
National Gender Identity Healthcare Reference Group minutes 23rd November
2022 including all attachments in a readable form. 

Further to our response to your FOI request on the 12^th of April NHS
National Services Scotland (NSS) previously withheld information under
Section [1]27(1) of the Freedom of Information (Scotland) Act 2002 for
“Information Intended for Future Publication” as the information was
intended to be published on the 6^th of June 2023. 

NSS holds information covered by your request but which it is not
releasing to you as the release of the information would be prejudicial to
the effective conduct of public affairs and is therefore exempt from
disclosure under  [2]Section 30 (b) and (c) - Prejudice to effective
conduct of public affairs of the Freedom of Information (Scotland) Act
2002.

The information requested includes the draft NHS Scotland Pathway for
Trans Healthcare.  This pathway will be released in conjunction with the
Scottish Government, including the Chief Medical Officer.  The Pathway had
been due for publication and had not been released previously for that
reason.  NSS has now had further correspondence with the Scottish
Government that will require review and potential amendment of the
pathway.  If the current draft document were to be released it may inhibit
substantially the free and frank exchange of views for the purposes of
deliberation about the pathway.  In addition, the possibility of a
superseded version of the draft pathway being in public circulation could
more generally prejudice substantially the effective conduct of public
affairs.  In this instance the public affairs being the application of the
pathway to the care of individuals in Scotland and the use of public
resources in that regard.

NSS has considered whether it is nonetheless in the public interest to
release the information (in terms of [3]Section 2(1)(b) of the Act).  The
possibility of a draft version of the pathway being in the public domain
and a subsequent version, which may differ even if only slightly, being
published results in a real risk of unnecessary confusion and uncertainty
for the public about the pathway and delivery of these services.  Given
the potential for controversy in relation to the subject matter of the
pathway, NSS considers that maintaining the exemption outweighs the public
interest in disclosing the pathway.

If you are unhappy with any aspect of how we have dealt with your request,
you can make representations to us asking us to review the handling of
your request.  Please write to the Head of Information and Cyber Security
using the email address [4][NHS National Services Scotland request email] within 40 working days of the
date of this correspondence.                

If after a review you are still unhappy, you also have the right to apply
to the Scottish Information Commissioner, who can be contacted at Kinburn
Castle, St Andrews, Fife, KY16 9DS, or via their [5]online Appeal
form.               

If you have any queries about this letter, please contact me at the above
address.  

Kind regards,

Faith

Faith Glennon

Information Governance Advisor

NHS National Services Scotland

--------------------------------------------------------------------------------------------------------------------------------------------------------
This email is intended for the named recipient only. If you have received
it by mistake,
please (i) contact the sender by email reply; (ii) delete the email from
your system; .
and (iii) do not copy the email or disclose its contents to anyone.

--------------------------------------------------------------------------------------------------------------------------------------------------------

References

Visible links
1. https://www.itspublicknowledge.info/site...
2. https://www.itspublicknowledge.info/site...
3. https://www.legislation.gov.uk/asp/2002/...
4. mailto:[NHS National Services Scotland request email]
5. http://www.itspublicknowledge.info/Appeal