Staff Recognition Week: Maintaining transgender health services through Covid-19

Throughout week commencing 21 – 25 September, we are holding a special staff Recognition Week to say thank you to our fabulous staff for everything they have done over the past few difficult months and continue to do during the Coronavirus pandemic.

The Recognition Week will showcase and celebrate the amazing work of our staff and how they have been innovative in adapting their practices to ensure that our patients and service users have continued to get the very best care and treatment possible throughout this time. The commitment of our staff to making a difference in these unprecedented times is truly inspiring.  You can read about our inspiring staff and how they have adapted during the pandemic below. 

The Nottingham Centre for Transgender Health supports people with a range of issues to do with gender identity healthcare. This includes providing transgender healthcare to people who identify as transgender and/or non-binary.  

The Nottingham Centre for Transgender Health team

As part of a national network, the centre faced additional challenges in supporting its patients during the Covid-19 lockdown. As travel was curtailed across the country, the team had to find new ways of supporting its patients remotely, using mobile technologies and adapting its ways of working.

The Nottingham clinic is one of seven such clinics across the country, and pre-Covid the team saw most of its patients face-to-face. As soon as the pandemic hit and the national lockdown was imposed, the team moved its patient interaction initially to telephone consultation, so as not to put people at risk through using public transport or other means of travel. The team then worked with the Trust to move to video consultations from April 2020.

Maintaining activity compared to previous years

Tina Nock, Service Manager, said: “Thanks to the hard work of our brilliant team in embracing the new ways of working, we’ve managed to support as many patients as we would have done if they had still been coming through the door, and we’ve maintained the same level of activity as last year.”

Dr Derek Glidden, Clinical Lead, added: “The hard work and dedication that the team has shown during this time has been truly amazing. We have been able to innovate in the face of adversity and safely maintain our full range of services to our patients, including new patient assessment, recommendations for medical treatment and recommendations for gender affirming surgery.”

Where possible during the lockdown, the admin team and clinicians worked from home, with some of the team still based in the Broad Street clinic so they were there in case of walk in’s from patients.

The service say they have received excellent support from the Trust in setting up video consultations, and the NHS England Programme Board and Clinical Reference Group were keen to hear about and share their experiences nationally. NHS England gave positive feedback on the team keeping assessments on track and avoiding any additional delays for people on their waiting list.

“The team has been working closely together, not just on direct patient care but also all the input that is needed in the background,” added Tina. “For example, the admin team has been scanning documents into the server so that clinicians can see client histories when they carry out online consultations – a significant amount of work grasped well by the clinicians and admin.

“It’s been great to see parts of the team delivering different elements of the whole process to create a virtual clinic, even if that’s not part of their usual role.”

Moving forwards

The team of ten clinicians and eleven admin staff has an active caseload of 1,400 patients and a waiting list of 2,500. Their support isn’t limited to their active list, they also offer information and advice through their website for those waiting to be seen.

During the pandemic they have been responding to emails, publishing online information updates and have even created a number of self-directed videos. They have also commissioned an increased number of hours from the support line provided by third-sector organisation Gendered Intelligence to also support patients and their families whilst on the waiting list.

An evaluation of video consultations with both patients and clinicians has been very positive; while some people have missed having face-to-face contact, they have appreciated not having to travel at this time. Some suspended their treatment as they only wanted face-to-face support and some cohorts will be reinstated for visits from October. The team is also hopeful that gender affirming surgery, which has been postponed during the pandemic, will be restarted as soon as safely possible.

While video consultations will continue to be an important part of the service delivery by the clinic, it requires a level of experience and expertise and won’t replace all face-to-face appointments moving forwards.

Tina said: “I am proud of the way the clinicians and non-clinicians within the team have maintained the clinic, though their positive attitude and hard work; there was a real team spirit. Utilising our building’s separate entrances on both Broad Street and Heathcote Street we hope to welcome patients in again soon while also keeping our staff safe, in a Covid-secure environment.”

Dr Glidden added: “While it has been an achievement to continue to provide our service in such challenging times, our ambition is to continue to utilise video consultations, and other further innovations within our clinical strategy, to further improve patient access to, and experience of, transgender healthcare in the future.”