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GIC 2024/25: Referrals, Appts, Discharges and Staff, Budget, Waiting List

Reference: 25-26040

Date response sent: 22/05/2025

Details of enquiry

  1. Referrals, Discharges & Waiting List

a. How many referrals received

b. How many people were discharged from the service

c. Number of people on the waiting list at the end of the financial year

2. Appointments

a. How many appointments offered in total

b. How many appointments were not attended

c. Most common reason for non-attendance

d. How many 1st appointments offered

e. How many 2nd appointments offered

f. Average number of appointments offered per patient

g. Average number of appointments attended per patient

h. Average wait time between 1st and 2nd appointment in days

i. Average time between 1st appointment and discharge, where discharge is noted as treatment completed, in days.

3. Staff

a. How many clinical / diagnostic staff (FTE) employed at the GIC each year

b. How many administrative / support staff employed at the GIC each year

c. Breakdown of job roles / titles held by clinical & diagnostic staff at the GIC, including FTE / WTE for each role

d. Salary Band / Pay Rate for each job role

e. FTE / WTE of clinical / diagnostic staff trained or capable of delivering diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence

f. Indication of which job roles / tiles provide diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence

4. Budget

a. Budget / Spend (total in £) for each year for the GIC

b. Breakdown of Budget / Spend for the year by :

c. Clinical / diagnostic staff

d. Administrative / Support staff

e. Administrative Costs

f. Other Costs

5. Service User Transfers data

a. For each financial year between 2018/2019 to 2024/2025

b. How many people were transferred from other adult clinics

c. How many people were transferred from the GIDS service to the adult service

d. Whether these transfers were counted as referrals in referrals data above

e. Whether these transfers were included in the waiting list data above

6. Waiting Time Calculations & Guidance

a. Please provide copies of any algorithms, spreadsheets, formulae used by the clinic to calculate waiting time information published by your clinic

b. Please provide copies of any guidance or processes issued to staff on the production of waiting time information published by your clinic

Response sent

  1. Referrals, Discharges & Waiting List

a. How many referrals received

4,457

b. How many people were discharged from the service

3,807

c. Number of people on the waiting list at the end of the financial year

16,506

  1. Appointments

a. How many appointments offered in total

11,629

b. How many appointments were not attended

1077

c. Most common reason for non-attendance

We do not hold this data.  This is because:

  1. The term ‘cancelled’ applies to both:
  • Booked appointments cancelled without being rescheduled.
  • Booked appointments moved to a different date/time.

2  The EPR system (electronic patient record) only reports cancelled appointments and booked appointments.  There is no automated field to complete to indicate change of booking/s to alternative date/s.

3  The ERP system captures instances of DNA by patient but has no dedicated data fields to capture their reasons and cannot automate reports on DNA reasons. These reasons are only occasionally narrated within the patient’s file notes.

d. How many 1st appointments offered

1,393

e. How many 2nd appointments offered

631

f. Average number of appointments offered per patient

The average number of appointments offered per patient during  2024/25 was 2.75.

The average number of total appointments offered per patient referral for patients discharged during 2024/25 was 9.37

g. Average number of appointments attended per patient

The average number of appointments attended per patient during 2024/25 was 2.05

The average number of total appointments attended per patient referral for patients discharged during 2024/25 was 7.21

h. Average wait time between 1st and 2nd appointment in days

244

i. Average time between 1st appointment and discharge, where discharge is noted as treatment completed, in days.

The Trust confirms that it does not hold this data.

Average time between 1st appt and discharge can vary enormously and does depend on the pathway and patients’ chosen outcomes. For example;

  • Patients cannot be discharged until they have completed their last episode of planned surgery.
    • If this is phalloplasty it is complex, multistage surgery and can be over several years.
    • If that surgery is stand-alone hysterectomy, then this is not part of NHSE Specialised Commissioning and would be provided by local services.
  • We often are not informed when surgery has taken place, and without this information we cannot discharge the patient.

Any calculation of average LoS (Length of Stay), cannot be calculated without an operating model of fixed parameters, which we cannot define, as the GIC patient’s pathway is not linear and patients’ needs are heterogeneous.

More examples of variable data which prevents us from performing simple calculations for average LoS are listed below.  These lists are not intended to be exhaustive, but to provide you, the requester, with an increased awareness of the range of options and variances which occur.

  • a patient assigned female at birth seeking the full pathway will stay in the service and pathway for longer than a patient that does not wish to pursue the genital surgical pathway.
  • types of procedures and interventions sought vary in number of appointments required,
  • the presence of unique co-occuring needs vary in nature and number of appointments required,
  • the impact of slotting in GIDS patients to continue their treatment at GIC affects availability of appointments,
  • the impact of slotting in current patients requiring urgent surgical reassessments, as mandated by NHSE, when the date of their surgery is close, and it is than 2 years since last assessed.
  • whether patients require further appointments post-surgery. NHSE requires us to keep patients open on our systems whilst they complete their surgical pathway, (which we are neither responsible for nor commissioned to deliver), we cannot know how long these patients will be with us, nor how many appointments they would require.

As you can see from the above, extrapolation of the average GIC LoS would require creation of a multitude of modelling scenario’s, which would be out of scope of the Freedom of Information Act 2000 (FOIA) which applies only to recorded information (data) held at the time of the request and does not require us to answer questions where this would involve the creation of new information.

Furthermore, as well as being out of scope for FOIA, as explained above, this question would take, far longer to answer that the 18 hours/£450 resources limit  provisioned under s12 of FOIA for responding to a whole request because none required modelling scenarios are held.  We are therefore unable to answer this question and we do not hold the requested data.

 

  1. Staff

a. How many clinical / diagnostic staff (FTE) employed at the GIC each year

b. Breakdown of job roles / titles held by clinical & diagnostic staff at the GIC, including FTE / WTE for each role

c. Salary Band / Pay Rate for each job role

d. FTE / WTE of clinical / diagnostic staff trained or capable of delivering diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence

e. Indication of which job roles / tiles provide diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence

 

GIC Clinical & Diagnostic

Staff 2024/25

FTE Pay Band Conducts assessments Y/N
Lead Consultant Speech and Language Therapist 1 8c No
Highly Specialist Psychologist 0.8 8a Yes
Highly Specialist Clinical Psychologist 1 8a Yes
Advanced Specialist Speech & Lang Therapist (Voice & Comms) 0.6 7 no
Lead Consultant Psychologist – GIC 1 8c Yes
Speech and Language Therapist 1 8a No
Highly Specialist Applied Psych/Deputy Head of Psychology 1 8b Yes
Trainee Counselling Psychologist 0.6 N/A

Honorary Contract

Yes
Advanced Specialist Speech & Lang Therapist (Voice & Comms) 1 7 No
Trainee Counselling Psychologist 0.6 6 Yes
Clinical Lead Consultant 1   Yes
Consultant 0.6 other Yes
Consultant 1 other Yes
Consultant Psychiatrist 1 other Yes
Professor of Diabetes and Endocrinology 0.4 other No
Doctor in Gender Identity 0.2 other No
Consultant 1 other Yes
Consultant Psychiatrist 1 other Yes
Consultant Adult Psychiatrist 0.6 other Yes
Specialty Doctor 0.2 N/A

Honorary Contract

Yes
Specialty Doctor in Gender Identity 0.4 other Yes
Specialty Doctor 1 other No
Specialty Doctor in Gender Identity 0.6 other No
Specialty Doctor 1 other Yes
Specialty Doctor in Gender Identity 1 other Yes
Specialty Doctor 0.75 N/A

Honorary Contract

Yes
Specialty Doctor in Gender Identity 1 other Yes
Specialty Doctor 0.2 other Yes
Clinical Nurse Specialist (CNS) Endocrinology GIC 1 7 No
Clinical Nurse Specialist (CNS) Endocrinology GIC 1 7 No
Clinical Nurse Specialist (CNS) Endocrinology GIC 1 7 No
Specialist Nurse – GIC 0.8 6 No
Specialist Nurse – GIC 1 6 No
Specialty Doctor 1 other No
Clinical Nurse Lead 1 8a No
Clinical Nurse Lead 1 8a No
Clinical Nurse Specialist 1 7 No
Clinical Nurse Specialist 1 7 No
  Total WTE 31.35

 

d. How many administrative / support staff employed at the GIC each year

30.7 FTE

  1. Budget

a. Budget / Spend (total in £) for each year for the GIC

b. Breakdown of Budget / Spend for the year by :

i. Clinical / diagnostic staff

£2,909,721

ii. Administrative / Support staff

£1,538,668

iii. Administrative Costs

Other Costs

Non Pay costs £2,783,606

 

  1. Service User Transfers data. For each financial year between 2018/2019 to 2024/2025

a. How many people were transferred from other adult clinics

We do not hold this data.

b. How many people were transferred from the GIDS service to the adult service

 

GIDS to GIC Patient Transfers
Financial Year No of Patients
2018/19 294
2019/20 405
2020/21 446
2021/22 544
2022/23 292
2023/24 387
2024/25 3

 

c. Whether these transfers were counted as referrals in referrals data above

Yes, they were counted as referrals.

d. Whether these transfers were included in the waiting list data above

Yes, provided the patient was still in the waiting list at the end of 2024/25

  1. Waiting Time Calculations & Guidance

a. Please provide copies of any algorithms, spreadsheets, formulae used by the clinic to calculate waiting time information published by your clinic

We do not use these.

b. Please provide copies of any guidance or processes issued to staff on the production of waiting time information published by your clinic

The Trust does not hold this data.  We do not hold any documentation, guidance or SOPs on how to pull wait