Gender Dysphoria Epilation Pathway

Management and administration of the gender dysphoria epilation pathway:

Arrange timely facial hair and surgical site epilation at suitable epilation providers for all patients with valid referrals (via NHS-commissioned Gender Dysphoria Clinics) from the service start date onwards. The assumption is that the service will process 950 referrals per year.

Provide information and support on epilation to patients as needed, including on epilation modality and provider choice.

Make timely payments to epilation providers, maintaining close financial control to ensure only valid invoices are paid.

Record data on epilation referrals and treatment.

Provide a central point of contact regarding epilation for patients, surgical providers, Gender Dysphoria Clinics and Pilots and epilation providers.

Epilation is commissioned by NHS England for the alleviation of gender dysphoria, as described in the Gender Identity Services for Adults (Non-Surgical Interventions) service specification. Epilation referrals, for both facial hair reduction and surgical preparation hair removal, are currently managed by NHS England regional commissioners. This business case proposes that this function is moved to the Gender Dysphoria National Referral Support Service (GDNRSS). This is a service provided by Arden and GEM CSU and commissioned by NHS England to manage referrals for gender dysphoria surgery, including giving advice to patients and providing detailed reporting to NHS England.

The national epilation referral service to be provided by GDNRSS would:

· Arrange timely facial hair and surgical site epilation at suitable epilation providers for all patients with valid referrals (via NHS-commissioned Gender Dysphoria Clinics) from the service start date onwards. The assumption is that the service will process 950 referrals per year.

· Provide information and support on epilation to patients as needed, including on epilation modality and provider choice.

· Make timely payments to epilation providers, maintaining close financial control to ensure only valid invoices are paid.

· Record data on epilation referrals and treatment.

· Provide a central point of contact regarding epilation for patients, surgical providers, Gender Dysphoria Clinics and Pilots and epilation providers.

Note: This business case was approved through Commercial Panel on 3rd February 2022 (Reference NHS-CSU-2021-615). Due to a change in the method of paying the invoices of epilation providers, the CSU is now planned to pay the invoices directly for efficiency and be reimbursed by NHS England, which has added £1.2 million to the business case (bringing it over the £1m threshold). However, it should be noted that the £1.2 million is currently paid to epilation providers by NHS England regions and under the current proposal would be paid to epilation providers via the CSU, reimbursed by NHS England on a pass-through basis, funded by top-slicing from regions.