Shared Care Prescribing Policy for Transgender Patients

We at Hyde Park Surgery are supportive of patients seeking or receiving care for gender related matters. We are happy to discuss issues and make referrals within the NHS and advise of referral in the private sector for assessment and treatment.

Policy Objective:
To ensure the safe and effective management of transgender patients requiring hormone therapy through shared care agreements, this policy outlines the criteria under Hyde Park Surgery will accept shared care prescribing responsibilities. This policy should be shared with a specialist provider before they start any treatment and request a shared care agreement.

 

  1. Scope

This policy applies to all healthcare providers and transgender patients seeking shared care prescribing services within the practice.

  1. Policy Statement

The practice is committed to providing high-quality, safe, and ethical care for transgender patients. To uphold clinical standards and ensure patient safety, the practice will only accept shared care prescribing arrangements from providers that meet the following criteria:

  1. Provider Requirements (NHS and private)
  1. Consultant-Led Care:
    • The provider must be led by a current GMC registered Consultant with relevant expertise in transgender healthcare, including endocrinology, gender dysphoria, or another appropriate specialty.
    • The consultant must have direct responsibility for the patient’s care plan and medication recommendations.
    • Treatment provided by private providers must align with NHS treatment guidelines.
  2. Care Quality Commission (CQC) Registration:
    • The provider must be registered with the Care Quality Commission (CQC) and adhere to its standards for safe, effective, compassionate, and high-quality care.
    • Providers must supply evidence of their CQC registration upon request.

 

 

  1. Provision of Clear and Comprehensive Care Plans:
    • Providers must supply a detailed care plan, including medication regimen, monitoring requirements, and any anticipated changes.
    • The care plan must specify the shared responsibilities between the provider and the GP practice.
  2. Ongoing Communication and Support:
    • Providers must be readily available to offer guidance and support to the GP practice regarding the management of the patient’s care (even after discharge).
    • Any clinical concerns or complications must be addressed promptly by the provider.
  3. Bridging prescriptions
  • Bridging prescriptions are prescriptions done by a GP whilst a patient is waiting to see a specialist.
  • Patients arriving in the UK from abroad, who have had assessment and treatment initiated outside the UK will be referred to a UK based service for review. We may be able to provide a bridging prescription only if there is relevant and adequate documentation from the specialist abroad outlining the current diagnosis, treatment regime, monitoring and dosing.
  • We are not able to provide bridging prescriptions for patients who have initiated treatment themselves, or through non-CQC regulated clinics. We may offer to do blood tests in this situation but cannot advise on dosing on any type of medication that has been bought illegally.
  • Current GMC guidance is outlined below. Leeds GIS currently provide a policy but will not provide specialist advice for specific patients who are not under their care yet. GPs in Leeds are therefore not permitted to initiate (give the first prescription) of these specialist drugs.
  1. Monitoring and Review

The GP practice will:

  • Review the shared care arrangement annually or as required.
  • Monitor compliance with this policy to ensure patient safety and clinical appropriateness.
  • Reassess the agreement if concerns arise about the provider’s competence, CQC status, or compliance with consultant-led care requirements.
  • Continue medication supply following treatment initiation and stabilisation by a specialised Gender service who have provided suitable and clear instructions about treatment and monitoring. This is subject to the appropriate ongoing monitoring taking place.
  • Changes to medication or treatment can only be done with the advice and guidance of the Gender service.
  • Following discharge from a gender clinic, we will continue to issue ongoing treatment, with appropriate monitoring, for as long as it is required
  • If treatment is ceased for more than three months, it can only be restarted by the specialist.

 

  1. Exemptions

The practice reserves the right to decline shared care arrangements that do not meet the above criteria or where concerns exist about the quality or safety of care.

 

  1. Responsibilities

GP Practice:

  • Ensure safe prescribing practices within the scope of the shared care agreement.
  • Conduct regular patient reviews in line with the care plan.
  • Communicate with the provider regarding any deviations, side effects, or clinical concerns.

Provider:

  • Provide expert-led, comprehensive care and oversight of the patient’s treatment.
  • Maintain CQC registration and adhere to its standards.
  • Respond promptly to requests for information or support from the GP practice.

Patient

  • To have an agreed understanding of this transgender policy and the shared care policy provided by the gender services.

 

  • To engage with the appropriate medication monitoring and requirements set out by the shared care policy.

 

 

  1. Communication and Training

This policy will be communicated to all staff involved in prescribing and managing shared care arrangements. Regular training sessions will be held to ensure understanding and compliance.

 

  1. Policy Review

This policy will be reviewed every two years or sooner if regulatory, clinical, or service delivery changes occur.

Version: Review date: Edited by: Approved by: Comments:
1 24/3/27 MP MP