UK: Former NHS gender reassignment surgeon says backlogs ‘spiralling out of control’

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The surgeon who performed the majority of the NHS’s gender reassignment surgery has warned that backlogs are ‘spiralling out of control’.

James Bellringer, the surgeon who performed the majority of vaginoplasty work for the NHS in the UK, confirmed in February that he would be resigning from the NHS’s Gender Identity Clinic.

However, trans activists raised alarm that waiting lists had increased following his departure, and warned the backlog is set to only get worse, unless the trust begins to refer more people to the private sector

Imperial College Healthcare NHS Trust said in a statement: “To replace [Bellringer] we have appointed Ms Tina Rashid who will be operating a full time list by September.

“This transition has led to a temporary reduction in the number of cases we are carrying out, but by September we expect to be carrying out the same number of surgeries as we did previously.

“We recognise the impact of this on patients and we have therefore arranged for a small number of patients who have waited the longest to be treated in the private sector during this period.

“We are very proud of the quality of care we provide to our gender reassignment patients and of the outcomes and benefits of this life-changing surgery.

“There has been an increase in the number of referrals for this specialist surgery over recent years and we are in discussion with NHS England about whether to expand the service so that we can offer this to more patients.”

Bellringer has today released his own statement raising concerns that the changes will not be enough to tackle the backlog.

He wrote: “I read with interest the news on the ICHNT website (…) that you expect that when Tina Rashid starts to work normally in September, there will be no further need to use any private sector capacity.

“[When I was working] there was an average 5 month wait for a clinic appointment, followed by an average 7 month wait thereafter for surgery.

“The dramatic reduction in capacity which has occurred since I left, (and which could have been completely mitigated if the private sector capacity had been used), has meant that both these times have now at least doubled.

“Given the continuing mismatch between demand and capacity, this will continue to spiral out of control.

“I believe we managed to do about 180 operations in 2013-4, but we received over 300 new referrals. The nature of gender surgery is that the vast majority of these referred patients will go on to GRS. So there was a shortfall in 2013-4 of over 100 cases.

“Had I stayed at Charing Cross, we might possibly have got to 220 operation in the current year. We are, however, on track to receive over 350 referrals.

“Although the projected number of operations would have increased, the gap between capacity and demand was due to widen yet further.

“Even if no further patients are referred, there are sufficient patients currently funded within the Charing Cross system to keep Tina and Phil fully occupied for the next 3 years.

“These patients’ lives are basically ‘on hold’ from the point when they are referred by a GIC to the time they get surgery. The delays currently imposed at that point are causing a huge amount of suffering to this patient group.”