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GIC Referrals, Appts, Budgets, Staffing 2023/24

Reference: 24-25114

Date response sent: 05/09/2024

Details of enquiry

The questions are as follows for year 2023/24

  1. How many referrals received
  2. How many people were discharged from the service
  3. Number of people on the waiting list at the end of each year.
  4. How many appointments offered in total
  5. How many appointments were not attended
  6. Most common reason for non attendance
  7. How many 1st appointments offered
  8. How many 2nd appointments offered.
  9. Average number of appointments offered per patient.
  10. Average number of appointments attended per patient.
  11. Average wait time between 1st and 2nd appointments in days
  12. Average time between 1st appointment and discharge, where discharge is noted as treated completed, in days.
  13. How many clinical/diagnostic staff (FTE) are employed at the GIC each year.
  14. How may administrative/support staff employed at the GIC each year?
  15. Budget /Spend (total in £) for each year for the GIC.
  16. Breakdown of job roles/titles held by clinical & diagnostic staff at the GIC, including FTE/WTE for each role
  17. Salary Band/Pay Rate for each job role
  18. FTE / WTE of clinical / diagnostic staff trained or capable of delivering diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence
  19. Indication of which job roles / tiles provide diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence
  20. Breakdown of Budget/Spend for each year for the GIC by:

a. Clinical/diagnostic staff

b. Administrative/support staff

c. Administrative Costs

d. Other Costs

Response sent

  1. How many referrals received.
Number of Referrals Received
At Year End
Per Financial Year		 Referrals
2023/24 4,481

 

 

  1. How many people were discharged from the service
Explanatory Notes A:

1   During 2023/24 some discharges related to transfers to the waiting list of new Adult Gender Clinics, where it is anticipated that the patients will receive treatment.

 

Total number of patients discharged during financial year
Financial Year Discharges
2023/24 2,522

 

 

  1. Number of people on the waiting list at the end of each year.
Number of  patients on waiting list for their 1st appointment
At Year End
Per Financial Year		 Patients
2023/24 15,389

 

 

  1. How many appointments offered in total
Total number of appointments offered
Financial Year Appointments
2023/24 12,246

 

 

 

  1. How many appointments were not attended
Explanatory Notes B:

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.

 

Appointments not attended
Financial Year DNA’d
(Patient Did Not Attend)
2023/24 1,080

 

 

  1. Most common reason for non attendance

We do not hold this data.

See Explanatory Note B point 3

 

  1. How many 1st appointments offered.
Total number of 1st appointments booked
Financial Year Appointments
2023/24 875

 

 

  1. How many 2nd appointments offered
Explanatory Notes C:

1   At NHSE’s requests, the GIC has been prioritising surgical update assessments, which are beyond the scope of their initial appointments.

These are booked when a patient reaches the top of the waiting list for their surgical pathway, and only if their last formal assessment of consent and suitability for gender reassignment surgery was more than 2 years ago.

 

Total number of 2nd appointments booked
Financial Year Appointments
2023/24 868

 

 

  1. Average number of appointments offered per patient
Explanatory Notes D:

1   Averages for numbers of appointments booked for patients per annum can only be calculated from appointments occurring within the same financial year (April to March) (Q 9)

 

2   We do not hold the data on any differentials between appointments offered and appointments booked. (Q9)

 

Average number of booked appointments per patient/per year, 
Financial Year Average Booked Appointments
2023/24 2.88

 

  1. Average number of appointments attended per patient
Explanatory Notes E:

1   Averages for numbers of appointments attended for patients per annum can only be calculated for the year in which the 2nd appointment occurred.  (April to March) (Q 10)

 

Average number of  appointments attended per   financial year
Financial Year Appointments
2023/24 2.15

 

  1. Average wait time between 1st and 2nd appts in days
Explanatory Notes E:

1   It is not possible to produce an annual average from data of patients whose 1st and 2nd appointments straddled two or more years, because the resulting average would not be annual, so these have been excluded from data provided at Q11. calculations.

 

Average days wait  between 1st and 2nd appointment, per financial year
Financial Year Appointments
2023/24 321.71

 

  1. Average time between 1st appt and discharge, where discharge is noted as treated 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 set by the ICO under s12 of FOIA for responding to a whole request because any required modelling scenarios are not held.  We are therefore unable to answer this question as we do not hold the requested data.

 

  1. How many clinical/diagnostic staff (FTE) employed at the GIC each year.
  2. How may administrative/support staff employed at the GIC each year

Staff Working at the GIC, in Financial Year 2023/24

(1st  April to 31st  March)

Admin WTE Clinical WTE Total WTE Honorary

Clinicians WTE
2023/24 24 22 46 1.0

(Abbreviation:  WTE:  Whole Time Equivalent)

 

In addition to the above, we have 3 clinicians on honorary, unpaid posts with a total 1.00 WTE

 

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

GIC Total Annual Budget/Spend, by Fiscal Year

(1st April to 31st March

Annual Budget/Spend
Financial Year Budget per Fiscal Year
2023/24 £7,015,683

 

  1. Breakdown of job roles/titles held by clinical & diagnostic staff at the GIC, including FTE/WTE for each role
  2. Salary Band/Pay Rate for each job role
  3. FTE/WTE of clinical / diagnostic staff trained or capable of delivering diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence
  4. Indication of which job roles/titles provide diagnostic initial assessments & follow up assessment appointments for Gender Dysphoria / Gender Incongruence

 

Job roles / titles 2018/19 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
Specialist Nurse – GIC 1 6 No
Specialty Doctor 1 other No
  Total WTE 27.6

 

 

 

 

  1. Breakdown of Budget/Spend foreach year by:
    1. Clinical/diagnostic staff
    2. Administrative/support staff
    3. Administrative Costs
    4. Other Costs

We do not hold our data in this way, and can only report against pay and non pay categories, as shown below.

 

Year Pay Administrative/ Support staff Pay Clinical/ Diagnostic Staff Total Pay Total Non pay Total cost
2023/24 £1,910,359 £2,935,082 £4,845,441 £2,170,242 £7,015,683

 

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