Referral information

Cumbria, Northumberland, Tyne and Wear (CNTW) NHS Foundation Trust have had to make the difficult decision that, effective 23rd August 2023, we have temporarily paused all new referrals and transfers to the Northern Region Gender Dysphoria Service (NRGDS) service.

Referrals to the NRGDS have increased significantly year-on-year with the service struggling to respond to increases in demand and blockages in the pathway. Over recent years NRGDS have worked closely with NHS England to develop new roles in line with service development. This includes recruiting peer support workers which allows service users access to support whilst awaiting treatment.

We want to ensure that our future service users will not have to wait as long as they do now to be seen by one of our team members. We need to pause new referrals into the service so waiting lists do not continue to increase, while we work with our partners on the future development needs of the service and ensure we maintain our standards for access to responsive services from a quality and safety perspective.

Although new referrals are paused, the NRGDS will remain open to support our existing service users and those already accepted onto the waiting list. Though this situation is far from ideal, taking this action is necessary to work towards an improved and sustainable service.

Where to find support

As the Gender Dysphoria service is a national service, you can click here for information on other Gender Dysphoria Clinics.

We have also put together a webpage listing mental health services and helplines, and a leaflet of local, national and online support for transgender and non-binary people.

FAQs about the pause in referrals

These FAQs will be regularly updated, and were last updated on 25 August 2023.

Is the NRGDS closing?

No, the NRGDS is not closing. Referrals to our waiting list are being temporarily paused.

Why are you pausing referrals to the waiting list?

We have seen a continuous increase in referrals to the service, which has resulted in extremely long waiting times for people to be seen. This situation is not sustainable, and we continue to work with NHS England to explore ways to reduce waiting times for the service.

How much has demand increased?

Demand has continued to rise with an increase in referrals meaning the service is referred around 50 people per month, with around 40 of those people accepted into the service (average between January 2022 and April 2023). This means the service accepts around 480 people in a 12-month period.

Also, national changes in young people’s gender services mean NRGDS will be expected to accept a substantial number of new referrals in the near future.

You can find up-to-date information on our waiting times on our website.

How long will referrals to the waiting list be paused?

We hope to re-open to referrals as soon as possible, but at this time we are unable to say when this will be.

To re-open to referrals and transfers, we need to reduce the current length of time people have to wait for assessment and treatment, to make sure that people can access the Northern Region Gender Dysphoria Service in a timely manner going forward.

Does this mean other Gender Dysphoria services in the country will be closing their waiting lists too?

We cannot comment on the situation for other specialist gender services. All gender clinics have seen a significant increase in demand and all will be working towards meeting the needs of service users. This situation is not unique to the Northern Region Gender Dysphoria Service, however we have made this decision to ensure wait times reduce, and that patient safety is our priority.

Will this decision increase waiting lists and waiting times at other gender dysphoria services elsewhere in the country?

Potentially, but we will be working with the network of other providers and NHS England and Improvement to manage this in the coming months.

Will current service users still be receiving the same level of support from NRGDS?


What are you doing to see people on the current waiting list more quickly?

We have already been able to recruit a small number of new staff to increase capacity in the service; this combined with the action we are taking today will help in our goal to reduce waits for those on our waiting list already. We continue to work with NHS England on future service development.

Have you engaged with transgender people about this decision?

No. As a Trust we would usually consult with service users about decisions we make, however, this has not been possible on this occasion. This decision and its impact has been carefully considered, but has been driven by the need to maintain safety and quality for service users.

If people refer to another Gender Dysphoria service, will they be able to transfer back if referrals reopen?

It may be possible for people to transfer back to the Northern Region Gender Dysphoria Service when we re-open for referrals and transfers. Each transfer case will need to be reviewed and decisions will be made on a case-by-case basis.

How many staff does the service currently have?

The Northern Region Gender Dysphoria Service is budgeted for 35.78 ‘whole time equivalent’ (WTE) staff. As of 25th August 2023, the service has 33.27 WTE staff. We have vacancies for 3.51 WTE staff.