Gender Plus Hormone Clinic Also known as Gender Plus Healthcare Limited

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

The managers and all the staff ensured patients were truly valued as individuals and were empowered as partners in their treatment. The nurse was fully committed to treating patients as individuals and providing them with treatment tailored to their needs. Feedback from patients was highly positive. Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. Patients felt they really mattered to staff and valued the amount of time, care and support staff offered to them.

This service scored 95 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We had overwhelmingly positive feedback from all patients and family members that we spoke to. Patients felt so valued and cared for. They felt the staff really listened, understood, and supported them throughout their treatment. One parent told us they felt the nurse took a very cautious and detailed approach which came across as genuinely caring. We had a high number of very positive comments about the service including: “As a mum, I will be forever grateful for what they have done for my daughter because gender affirming care is lifesaving care.”, “The experience has been amazing, and I have felt genuinely cared for by people whose only goal is for me to make a safe and healthy transition” and “We cannot be positive enough, it is such careful, thoughtful, considered and reflective care at every stage”.

There was a culture of kindness and respect between the staff. Staff felt supported by their colleagues as well as managers. Staff followed policy to keep patient care and treatment confidential. Staff understood and respected the personal, cultural, and social needs of patients and how they may relate to care needs. They always asked the patient what their pronouns were and what name they would like to be called. We observed that patients and their families were at ease and comfortable in the presence of staff. Staff’s interaction with people was characterised by warmth and mutual respect. Staff spoke about patients using the service in a respectful, affectionate and positive way and it was evident they were committed to the patients and families they were caring for. Compliments were discussed in team meetings. We listened to a team meeting and heard compliments from patients including “I have a happy child who is now crying happy tears. Thank you for your empathy and understanding on our journey.” And “you have saved my daughter’s life”.

We spoke to Gender Plus partners who told us the staff at GPHC cared for families and patients in a holistic, safe and responsive way.

Our observations of people, and their relaxed body language with staff, assured us they felt comfortable and safe. We observed a consultation, and the nurse asked the patient several times if they needed any time to process the information or a break; they always ensured the patient felt comfortable. The nurse consultant was also respectful of how patients felt during their appointments. For example, they asked patients if they wanted to have a private conversation instead of discussing sexual function and genital changes in front of parents and other staff members. We observed all staff treating patients with kindness and compassion.

All patients we spoke to were so enthusiastic about the service they had received. Patients consistently described feeling respected and valued as individuals and were empowered as partners in their care, practically and emotionally, by this service. They all felt it was so caring, so compassionate and they were all treated as individuals. One parent told us they felt so valued as a whole family. For example, the patient’s sister struggled with ‘losing’ their brother and did not want another sister. The team had a session with her and explained this was a normal feeling and how to deal with it. They also had sessions as a family together to fully understand the process. We were told that information was pitched at the right level over several appointments with all family members; the family felt informed and cared for. Another family told us they were passionate about the excellent personalised care they had received, and they feel it had saved their child’s life. We saw in June 2024 meeting minutes, a patient was discussed who had become emotional in clinic with the nurse, as they had never felt anyone had listened to them before. We saw a few examples of this within the team meeting minutes and when we interviewed patients. All patients felt listened to where they had not been before and felt they were treated as an individual.

Staff made sure patients and those close to them understood their care and treatment. Staff talked to patients in a way they could understand, using communication aids where necessary. Staff told us they had different ways to communicate with patients who had different communication needs. For example, they had a patient who was autistic and communicated best using a laptop. The patient brought their laptop and used this to conduct the consultation to ensure they felt comfortable. The service had thought about the needs of the patients. They had put a few initiatives in place to meet patients’ personalised needs, including fidget toys available, pens and paper to distract patients during a consultation if needed, and a quiet space for service users who may require this.

We observed interactions between staff, patients and their families and they constantly thought about the needs of the patients. All patients and their families were treated as individuals. We observed 3 initial consultations where the nurse spent time with the patient and their family members and addressed any fears or misconceptions. They offered advice and solutions to any issues that were raised. All interactions were wholly positive, and patients and their families left the consultations in high spirits and fully informed.

All patients were in control of their own care. They each had an individualised care plan when they were referred by Gender Plus and this was used to create the treatment within GPHC. The service conducted 6 monthly reviews of the feedback received in the clinic via a questionnaire. We looked at September 2024 report which showed 98% of patients felt listened to, 91% of patients would recommend GPHC, 98% of patients said people at GPHC knew how to help them and 98% of patients felt people were working together to help them. Where scores were not 100%, the managers reviewed the questionnaires and created actions where needed to make improvements.

Patients told us they were fully informed of all the treatment options available to them including the potential positives and negatives. They understood they had control over their treatment and could make changes and discuss things further at any time. All patients and families we spoke to were passionate about the choice they were given and the impact having this treatment had made. One family told us they were “passionate about the excellent care they had received especially in the current climate where there was wide lack of public understanding of what these young patients have to go through and transphobia in general.” The clinic worked hard to ensure patients felt safe and empowered in their environment.

Patients accessing the service for treatment had chosen to do so. The nurse explained patients had the option to change their minds and make decisions about whether to proceed with the treatment offered. Patients were supported to have choice and control over their own treatment and wellbeing. We observed the nurse talk through all the treatment options with 3 different patients and allowed them choice, for example using testosterone gel or injections. They described the differences between the topical application and injection, the potential side effects of each and what might work best for them. This allowed patients to choose an option that suited them.

Patients were supported to have choice and control over their own care. All patients had to attend a face-to-face appointment initially but following that, they had a choice of face-to-face or virtual appointments. The staff understood potential barriers around cost of prescriptions. We observed staff talking to patients about this and trying to find solutions for them to ensure the treatment plan suited them best. They wrote to every person’s GP to ask for shared care. They ensured patients were given all the relevant information before deciding on their treatment.

The treatment and care offered by the service took a whole person approach and considered the emotional needs of patients along with and integral to their physical needs. Medical treatment was supplemented by complementary therapy, if required, to boost wellbeing along with the hormone treatments. Patients could speak to the team and ask for further appointments with the nurse, mental health nurse or psychologists from Gender Plus without further cost throughout their 2-year pathway.

Patients told us the staff were very responsive to their needs. For example, a patient told us they had been highly supportive in some of the non-clinical aspects of transitioning, such as trying to find a more supportive GP, applying for passports in my new name and gender and getting a gender recognition certificate. We were told about a patient who had autism, and they felt overwhelmed during their initial appointment as a lot of information is given. The nurse gave them a 10-minute break during the appointment and then they came back and felt able to process the information. One patient told us “Having a service like this, people you feel you can just relax with, it’s so helpful. When you’re fighting everywhere, when you’re fighting with your GP about treatment, it just makes you uncomfortable going to them for anything else. Whereas with GPHC I don’t have to justify contacting them, I don’t feel silly and I feel safe to say anything to them, it’s easy.”

Staff understood patients’ personal, cultural and social needs. They displayed an understanding and non-judgmental attitude to all patients. Patients told us they felt safe at this service. Patients said the nurse took a full history before treatment so they could understand their immediate needs and their expectations of treatment outcomes. There was a patient and parent involvement (PPI) group. We looked at the minutes for July 2024 meeting and found 3 parents had attended and they had a meaningful discussion about what could further enhance the service. The managers were keen to understand the patient and parent voices and ensure the service worked for them. They shared ideas such as creating a support group for parents, welcome or end packs for parents and sharing practical tips together. These meetings were held once a month. We saw the welcome packs were discussed in the team meeting and they were looking at how they could bring these in. There were leaflets for joining the PPI group within the waiting area. We saw evidence that patients were reviewed in a holistic way. A comprehensive assessment was undertaken to determine their needs, wants and treatment goals. The clinic created bespoke treatment plans for all patients and adjusted treatment to suit the patient.

We observed all staff, both clinical and non-clinical, offered patients a personalised welcome and were always fully briefed on the needs and expectations of patients prior to all contacts. For example, staff knew a patient required a quiet space prior to their appointment and were able to offer this environment to them.

The service sought feedback from patients using a feedback survey. This was audited on a 6 monthly basis and discussed in team and leadership meetings.

Managers ensured staff wellbeing was important within their culture. The leaders looked after each other and took time to discuss wellbeing. They had a shared meeting with Gender Plus and they always started their meetings with a wellbeing check-in and catching up as individuals. There was also a standing agenda item where they discussed compliments and achievements. We saw in July 2024 staff complimenting each other and thanking them for their prompt work on a policy or for their positive attitude. As a small service they knew each other very well and were able to work to each person’s strengths while being aware of any wellbeing issues which could come up both professionally and personally.

The managers recognised that staff were upset following the release of the Cass Review 2024. They arranged a team away day to offer support and to go through the report and create an action plan for any improvements that needed to be made. They ensured the staff felt empowered together as a team.