Covid-19: BAGIS position statements
UPDATED RESPONSE – December 2020
The BAGIS supports clinical services returning to safe face-to-face interventions in 2021 following roll out of a national vaccination programme for COVID-19. Following data shared by clinical members of the BAGIS representing services across the British Isles at the webinar event 1st October 2020, benefits have been identified to some contexts of remote (digital) consultation. The BAGIS supports developing a blended approach protocol to client interaction commensurate with clinical judgment and evidence based practice.
UPDATED RESPONSE – July 2020
Covid-19 has had a huge impact on the NHS which prioritised its robust response to the pandemic. Some staff were redeployed to assist on the frontline, and it may take some time for clinics to return to their previous capacity. Gender clinicians have provided some remote consultations via digital platforms and telephone to continue to support trans and gender diverse people accessing services.
Whilst lockdown restrictions are easing, risks of rising COVID-19 infection and the possibility of a ‘second spike’ remain. Significant social distancing and risk management are in place within services. Gender clinicians are continuing to offer some remote consultations as well as planning for the resumption of in person consultations.
Fertility services have largely resumed. The following website lists clinics that have received authorisation to resume licensed treatments: https://www.hfea.gov.uk/treatments/covid-19-and-fertility-treatment/coronavirus-covid-19-guidance-for-patients/fertility-clinics-authorised-to-resume-treatment/
The resumption of routine surgery continues to be reviewed. Further information can be found here: https://www.england.nhs.uk/2020/05/nhs-roadmap/
BAGIS members continue to work together to support best practice during the ongoing challenges posed by the pandemic. Our priority remains to provide safe clinical services of the highest quality to trans and gender diverse people.
INITIAL RESPONSE – April 2020
The Covid-19 pandemic is having a dramatic impact on NHS and independent services across the UK. Routine surgery is not taking place, primary care is under intense pressure, non-urgent bloods are not being taken, and fertility services are unable to offer a full service. BAGIS acknowledges the extraordinary response of NHS services to the crisis, and our members stand in support of frontline health workers and the wider health and social care staff across the UK.
There is substantial impact upon the NHS and independent trans healthcare pathway. Many staff in NHS gender clinics are being temporarily redeployed into other areas of work to support the Covid-19 crisis strategy.
BAGIS recognises that trans and gender diverse people receiving treatment need to continue to access support and healthcare advice as necessary. Gender clinicians are committed to providing the best possible support to trans and gender diverse people through this crisis. BAGIS members are currently working together to share practice and develop robust ways to support trans people in this crisis. It is likely, however, that trans people already receiving treatment may experience delays in treatment due to self-isolation or ability to connect with GP and medical services. BAGIS is mindful to avoid placing additional unnecessary strain upon primary and secondary NHS services at this time.
Broad Summary of Services
BAGIS council has been in liaison with adult and young people’s services in the UK at this time. Not all services were available to comment, but below is a broad summary of what is happening during the crisis:
For the time being face-to-face appointments have been suspended. This is in line with Government advice to restrict travel and enforce social distancing. Gender clinicians are offering support and consultations over the phone and via encrypted video link. Service users will be consented for these ways of consulting. Here is some guidance from the GMC which describes when remote and face-to-face consultations may be preferable: https://www.gmc-uk.org/ethical-guidance/ethical-hub/remote-consultations
Many clinics are not offering new/first appointments until the pandemic eases or resolves.
Trans people receiving treatment may be offered review via telephone and/or encrypted video link, as well as psychological services and voice and communication therapy.
It is not possible to complete gamete storage or obtain routine blood monitoring – therefore initiation or titration of hormones is not possible at this time. Hormone management advice during the COVID-19 crisis (from the London GIC Endocrine Service, Tavistock and Portman NHS Foundation Trust) is available here: https://gic.nhs.uk/gp-support/issues-around-hormone-therapy-due-to-the-coronavirus-situation/
Referrals for surgery have been paused.
Transfers from young people to adult services will continue where possible as agreed by both services.
BAGIS supports the continuation of as comprehensive support as possible during the pandemic in creative, responsible and safe ways. Members will continue to work together for the benefit of trans healthcare in the UK both now and when this crisis has passed.
Links to specific services websites
Please check with individual clinics and services for specific information. The following gave permission to be published; this is not an exhaustive list.
Service users in Scotland should refer to their GIC website for information on the services in their local area. Information regarding all Scottish services is provided by the network, NGICNS: https://www.ngicns.scot.nhs.uk
Information regarding services in Ireland can be found at Transgender Equality Network in Ireland (TENI) https://www.teni.ie
For Northern Ireland go to http://www.belfasttrust.hscni.net/GenderIdentity.htm
For services in Wales go to Cardiff Gender Identity Clinic cav.wgs@wales.nhs.uk
The GIDS service continues to offer first appointments and aims to deliver care as usual, albeit remotely. For further information go to https://gids.nhs.uk