East of England Gender Dysphoria Service for Adults (non-surgical) MSP

The Commissioner is awarding a contract using the Most Suitable Provider (MSP) Process for the delivery of non-surgical interventions for individuals on the NHS pathway of care for the treatment of gender dysphoria within the East of England region. The intention is to award a contract under the Most Suitable Provider process which has identified the most suitable provider that can deliver the provision of an adult gender dysphoria service, covering the population in the East of England region, in line with the NHS England service specification: https://www.england.nhs.uk/publication/service-specificat...

The successful provider is an existing provider who will utilise a multi-disciplinary team of professionals, and the service will be delivered from a primary care setting in the East of England region. The service will provide assessment of individuals for the purpose of diagnosis and will provide (or arrange access to) healthcare interventions for those who receive a diagnosis of gender dysphoria as described in the service specification.

The Commissioner has funded a pilot service in the East of England Region since 2021, and the contract for that pilot ends on 31 March 2026. The Commissioner’s learning from the evaluation of the pilot has informed the future delivery model for the proposed service.

The contract for the service is expected to be operational, providing services from 1 April 2026. It is anticipated that the contract term will be 5 years with an option to extend for up to a further 2 years (at the commissioner's discretion).

The maximum value of this service is £2,100,000 in any financial year. The total contract value over the full potential 7 year contract period is estimated to be £14,700,000.

It is expected that this contract will be managed on an open book basis, meaning that the provider will share detailed financial information with the Commissioner for the duration of the contract and will be reimbursed based on actual cost (within the maximum contract value of £2.1m in any financial year). Exact activity levels for the contract will be determined by the commissioner during the procurement process.

However, for planning purposes, providers are expected to have capacity to receive approximately 400 new referrals per year, and to deliver at least 1,500 first assessments per year, as well as at least one – but possibly multiple – correlating follow up appointments. Providers are also expected to ensure that waiting lists are reduced to manageable levels over the lifetime of the contract, and waiting list reduction targets will be set through the procurement process.

Please note the service specification will change during the life of the contract, and providers will be expected to deliver the new specification. A key feature of the delivery model is the placement of several (~6 at ~0.3WTE) medical professionals with a specialist interest in gender (such as GPs or General Endocrinologists supervised by an Adult Gender Service clinician) across the region.

These professionals will work to a central service hub and be directly employed by the commissioned provider. They will provide support to their local primary care system in the shared care of patients who are under the care of – or discharged from – the specialised gender service.

By involving primary care providers in the long-term management of stabilised patients, the model aims to improve the awareness and understanding of gender care within general practice, reduce unnecessary delays in the provision of medical treatments to individuals and free up clinical time in the commissioned specialised provider. While the medical professionals would not initially assume direct responsibility for prescribing or providing clinical intervention to individual service users, those who wish to further specialise in the assessment, diagnosis and clinical management of gender dysphoria would be supported to attain enhanced competencies through the existing post-graduate credential in gender medicine hosted by the Royal College of Physicians.