Read standard 5: Access to gender identity healthcare

Gender identity healthcare: Adults and young people
Healthcare Improvement Scotland

Standard statement

People have timely, equitable, consistent and person-centred access to gender identity healthcare.

Rationale

Evidence highlights a number of barriers for people accessing gender identity healthcare.5 Barriers can lead to poor wellbeing, disengagement from services and an increase in people seeking care that may be considered high risk and unsafe. The presence of these barriers can contribute to apprehension and low levels of confidence when accessing general and specialist gender identity healthcare services.5, 44

People will often initially contact primary care services when looking for information, support and treatment related to their gender identity.40, 45 People may present with multiple and/or complex needs, including co-occurring conditions. People accessing gender identity care may or may not wish medical treatments or interventions. Primary care and community services have a role in providing information and ongoing gender identity healthcare as well as referring people to specialist services.40 Referrals should be timely and in line with national waiting time targets.29 As people wait for referrals, services should continue to provide support with updates on waiting lists, where appropriate (see standard 7 for more about referrals).

It is important that all services work together to deliver person-centred care that is high-quality, evidence based, timely, and provides continuity and consistency of care across pathways. As part of collaborative and multidisciplinary working, there should be arrangements in place, particularly in remote, rural and island settings to support people to access care that is right for them. This might include the use of digital tools to support people’s access services.37

Who is responsible for meeting this standard?

All organisations and staff in line with their roles, responsibilities and workplace setting.

Criteria

5.1

People can access healthcare, including support and advice:

  • in a primary care or community setting
  • from knowledgeable and well-informed professionals
  • that is timely29
  • that is based on current evidence and best practice
  • as close to home as possible, where appropriate.
5.2

Where specialist services are not available locally, organisations ensure robust pathways are in place to provide access to a regional or national service.

5.3

Organisations have systems in place to provide people accessing gender identity health care with:

  • information about services, including who to contact and how to arrange appointments
  • coordinated appointments across services
  • access to remote (including digital options) or in-person consultations or appointments
  • opportunities for extended consultations
  • updates on anticipated waiting times
  • information on what services are available (locally, regionally and nationally)
  • which services the person is being referred to.
5.4

Organisations work in partnership with other services and providers to:

  • ensure that support and advice is available, accurate and up to date
  • support referrals to specialist services from primary care and other community based services
  • raise awareness about local and specialist services.

What does this standard mean for...

What does the standard mean for people?

  • You will be able to access support and advice from your GP or community based service.
  • Staff will help you by sharing information and signposting you to other services, if that is what you need.

What does the standard mean for staff?

Staff, in line with their roles, responsibilities and workplace setting:

  • support people to access information and services on a fair and equitable basis
  • have a comprehensive understanding of access pathways and explain them clearly to people seeking access to gender identity services
  • help people to access gender identity services locally where possible
  • take a person-centred approach to people’s care and reduce barriers to access for them where possible
  • will be supported to address and minimise waiting lists where possible.

What does the standard mean for the organisation?

Organisations:

  • demonstrate partnership working with primary care and community services in providing equitable access to specialist gender identity services
  • have systems and policies in place to support appointment attendance, including coordination across services, remote services as appropriate.

Examples of what meeting this standard might look like

  • Evidence of supporting people in local, community based services.
  • Evidence of the fair and equitable provision of services for people regardless of personal circumstances, geographical location or other factors.
  • Coordination of appointments to support the person.
  • Use of text reminders for appointments, online consultations and other technology to remove service barriers where appropriate.
  • Expense and reasonable cost reimbursement policies.
  • Evidence of clear policies on a fair, person-centred and supportive response when people cancel or do not attend for appointments.
  • Demonstration of partnership working in supporting access to specialist services.