EOI: Care and management of adult patients with Gender Dysphoria / Gender Incongruence in Primary Care

Description

This notice is placed as a Prior Information Notice (PIN) to inform the market of Derby & Derbyshire Integrated Care Board (ICB) intention to commission Care and management of adult patients with Gender Dysphoria / Gender Incongruence in Primary Care. The Commissioner would like to understand the level of provider interest in delivering these services.<br/><br/>*Service Overview*<br/><br/>This service is initially a pilot with plans to then further develop and expand this service. <br/>For the pilot, then expressions of interest are requested from existing primary and/or community care providers in Derby and Derbyshire ICB.<br/><br/>During the initial pilot phase, the successful provider will enable a new model of care through a GP(s) with Extended Role (GPwER) to be commissioned. This will allow general practices in NHS Derby and Derbyshire ICB to refer patients into this service to support and care and management of adult patients with gender dysphoria / gender incongruence in primary care. This supports equality of access to care and management for patients within this cohort whilst enabling further understanding of the need for this service across Joined Up Care Derbyshire.<br/><br/>This service will provide a specialist support service within the community to general practice <br/>where a GP and/or other healthcare professionals with additional interest / education and specialism in gender dysphoria / gender incongruence will be able to support decision making.<br/>This service would also offer, where deemed clinically necessary and at the discretion of the service, patients to receive face to face and telephone / online consultations to support them with gender dysphoria / gender incongruence. This service will (if required) also address the care and management of those patients discharged from the Gender Identity Clinic and stable to provide long term support for patients (as such could be known as a 'step down' approach in managing their care within the community) and could provide advice, guidance and support to practices that are managing these patients. <br/><br/>The service will also be able to support with the prescribing and monitoring, with support from Nottinghamshire Gender Identity Clinic (GIC) of:<br/><br/>For Transmen:<br/>• Testosterone (IM or transdermal)<br/>• GnRH analogues (Leuprorelin or triptorelin sub cut)<br/>For Transwomen<br/><br/>• Estradiol (oral or transdermal)<br/>• GnRH analogues (Leuprorelin sub cut)<br/>• Anti-androgen treatments (oral – Finasteride, Cyproterone and Spironolactone)<br/>The service provider will need:<br/><br/>• Expertise and experience in GD<br/>• Strong links with a GIC <br/>• Track record of delivery / engagement <br/><br/>For copies of the draft service specification please contact the Commissioner using the email address provided and a copy of the specification will be issued to you.<br/><br/>The service is a pilot, and the initial contract is for 5 years with a 6 month notice period included with effect from 01st October 2025. Annual contract value is £46,795.64. Total contract value over 5 years £233,975.00.<br/><br/>Interested providers should formally register their interest by emailing the ICB Primary Care team on the following email - ddicb.lcsf@nhs.net , no later than 5pm on Thursday 7th August 2025 Lot 1: This is a Prior Information Notice (PIN) to help ascertain market interest and capability to help shape the procurement strategy going forward. Service details are provided below. Interested providers should formally register their interest by emailing the ICB Primary Care team on the following email - ddicb.lcsf@nhs.net, no later than 5pm on Thursday 7th August 2025.<br/><br/>*Aims and objectives of the service*<br/>The aim of this service is to ensure safe and appropriate care and management of adult patients (aged 18 years and over) with gender dysphoria / gender incongruence who are registered with a Derby and Derbyshire General Practice. The service also aims to:<br/>• Enhance the knowledge / experience of general practices supporting patients with gender dysphoria / gender incongruence care within the Derby and Derbyshire. <br/>• Enhance the care and management of patients with gender dysphoria / gender incongruence in partnership with the patients' own GP and GIC.<br/>• Deliver a service closer to home which is convenient and meets the needs of patients.<br/>• Improve the use of shared clinical records between primary care, GIC, Adult & Social Care, Mental Health etc to promote a collaborative and joined up care approach and overall providing holistic patient care.<br/>• Enable general practice patients to have access to a GPwER service to seek advice, guidance and support regarding the care and management of patients with gender dysphoria / gender incongruence.<br/><br/>*Service description / care pathway*<br/>The service will involve the commissioning of General Practitioner(s) with Extended Role (GPwER) model across Derby and Derbyshire which general practice can refer into to support the care and management of adult patients with gender dysphoria / gender incongruence in primary care. <br/><br/>This service will provide a support service within the community to general practice where a GP and/or other healthcare professionals with additional interest / education and specialism in gender dysphoria / gender incongruence will be able to support decision making. In so this supports equality of access to care and management for patients within this cohort whilst enabling further understanding of the need for this service across Joined Up Care Derbyshire. <br/><br/>This service would also offer, where deemed clinically necessary and at the discretion of the service, patients to receive face to face and telephone / online consultations to support them with gender dysphoria / gender incongruence.<br/><br/>This service could also address the care and management of those patients discharged from the GIC and stable to provide long term support for patients (as such could be known as a 'step down' approach in managing their care within the community) and could provide advice, guidance and support to practices that are managing these patients. <br/><br/>The service will also be able to support with the prescribing and monitoring, with support from Nottinghamshire Gender Identity Clinic (GIC) of:<br/><br/>For Transmen:<br/>• Testosterone (IM or transdermal)<br/>• GnRH analogues (Leuprorelin or triptorelin sub cut)<br/><br/>For Transwomen<br/>• Estradiol (oral or transdermal)<br/>• GnRH analogues (Leuprorelin sub cut)<br/>• Anti-androgen treatments (oral – Finasteride, Cyproterone and Spironolactone)<br/>This would be supported by training and regular supervision i.e. multi-disciplinary team meetings provided by Nottinghamshire Gender Identity Clinic (GIC).<br/><br/>*Local defined outcomes*<br/>• Patient receiving advice, guidance and support closer to home.<br/>• Enhance the knowledge / experience of gender dysphoria / gender incongruence care in primary care within the Derby and Derbyshire. <br/>• Reduction in travel to specialist clinic supports greener and sustainable NHS.<br/>• Efficient use of National Health Service resources; and<br/>• Patients being jointly managed by secondary and primary care, so they can be treated in the community with the support from the specialist as required.<br/><br/>Please see Additional Information section below for key requirements. Additional information: By expressing an interest providers are confirming:<br/>• that you can meet all of the requirements of the service specification.<br/>• that you can provide the service to all of the registered patients in Derby and Derbyshire ICB.<br/>• that you will provide prescribing and monitoring (as required) for all patients referred from a Derby and Derbyshire GP Practice<br/>• that the lead practice/provider is CQC registered and has a minimum of Good overall rating.<br/>• the provider will be able to set up and offer the service by the 1st October 2025 at the latest.<br/>• the GPwER has a track record and experience in working with Gender Identity Clinics<br/>• the GPwER has attended an education and training session hosted by an approved GIC and can provide evidence to ensure ongoing training and education is provided by Nottinghamshire Gender Identity Clinic.