All information regarding the administrative requirements for processing a change of gender and title for a patient. Specifically:
- What evidence is required before a request for change of gender can be processed.
- What process must be followed by the GP in order to change the gender and title of a patient.
- Who can the patient contact if the GP is unwilling to change the gender and title.
- Any information related to the issuing of a new CHI number for patients who have changed gender and how this will be updated throughout the NHS.
This response is based on the based on how the Community Health Index (CHI) is updated and the link to NHS Screening systems which NHS National Services Scotland is responsible.
None of the following information is dependent on the patient changing their gender formally under the Gender Recognition Act 2004.
No evidence is required; the patient simply needs to advise either their GP practice or Practitioner Services (a business unit within NHS National Services Scotland) that they wish to change their gender. This is often accompanied by a change of name being requested by the patient.
The GP practice will amend their data held on their practice management computer system which will be received electronically by Practitioner Services. Whilst any name change can be processed automatically by CHI, a change of gender requires manual intervention by one of our trained staff to update CHI.
Most of our computer systems do not hold a title field rather it is the gender and marital status which determine title.
As GP practices are independent primary care contractors any dissatisfaction by a patient may be raised as a complaint and should be referred to the practice in the first instance and then the NHS Board in the area the practice is contracted to, if the complaint is not resolved by the practice.
In order to provide a better understanding of the context, it would be helpful to explain the current challenges within NHS National Services Scotland in relation to change of gender. Many of NHS Scotland's health screening programmes are gender specific e.g., breast and cervical for females and AAA (Abdominal Aortic Aneurysm) screening for male patients.
Whilst there is an enhancement to CHI which has been developed to allow for patients' CHI records to be marked to be included for screening if their gender does not match the gender usually associated with that particular programme e.g. a trans male who had previously had cervical screening in their former gender, the CHI record in the future will be able to record that the patient should be included in the screening programmes - the enhancement is not yet ready to be implemented.
When a patient asks Practitioner Services to change their gender, we alert them to the current clinical risks if they are undergoing a gender specific screening programme or follow-up treatment as a result of this we also advise the patient to discuss the clinical risks with their GP practice.
Practitioner Services will contact the patient to establish if they want a new CHI number and possibly a new NHS number. The new CHI number is communicated electronically to the registered GP practice.
All changes to CHI, including the issuing of a new CHI, number are notified to computer systems within NHS Boards who hold the previous CHI number for that patient to advise them to update - this previous medical records with reference to gender reassignment treatment and subsequent medication cannot be deleted.