We would like to confirm our position on prescribing gender-affirming hormone therapy (e.g. oestrogen, testosterone, hormone blockers) at Deddington Health Centre.
Our current NHS system does not provide a clearly commissioned local pathway for prescribing or monitoring hormone therapy for transgender and gender diverse patients.
While specialist Gender Identity Clinics (GICs) exist, they often discharge patients back to primary care without structured follow-up, and shared care arrangements are often unclear or incomplete.
We are not specialists in transgender medicine. However, we recognise the importance of continuity and safety in hormone prescribing. For that reason, we will continue to prescribe for patients who:
- Have previously been under the care of an NHS Gender Identity Clinic or NHS specialist; and
- Have a clear, documented treatment plan; and
- Are stable on hormone therapy.
We are not able to take over prescribing responsibility for patients whose care has been initiated and managed solely by private providers, or where no NHS specialist treatment plan is available.
In such cases, patients will need to be referred back to either their private provider or, if eligible, to an NHS Gender Identity Clinic.
To support continuity of care during this transition, we may offer a bridging prescription for a limited period — typically up to three months — while referral is arranged, or specialist review is sought. After that, prescribing will only continue if an appropriate
NHS specialist plan is in place and monitoring can be safely delivered.
We will also not initiate new treatment for gender-affirming hormone therapy. We are not commissioned, trained, or indemnified to provide this service in a primary care setting.
This situation highlights a genuine commissioning gap. Neither NHS England (which commissions specialist services) nor the local Integrated Care Board (BOB ICB) currently commissions the necessary support services in primary or secondary care.
If you would like to raise your concerns about access to care, we would encourage you to contact the BOB ICB, which is responsible for local NHS commissioning decisions.
We are guided by national and international clinical guidance (e.g. WPATH and the Endocrine Society) to ensure prescribing is as safe as possible. Hormones can affect liver function, blood counts, and cardiovascular health, so monitoring is essential.
Therefore, we will continue prescribing your hormone medication if you meet the aforementioned criteria and also agree to the following:
- You will attend for regular monitoring blood tests and/or blood pressure checks, typically every 6–12 months depending on treatment stage.
- You understand that we are prescribing in your best interest, but we do not have specialist training in gender medicine.
- If your blood tests show levels significantly outside of safe or expected ranges, we may need to reduce or pause your treatment and will discuss this with you.
- If you develop any new medical conditions or are prescribed new medication elsewhere, you will inform those healthcare providers about your hormone treatment so they can ensure safe prescribing.
- If you experience side effects or are considering stopping or adjusting your hormones, you will book a GP appointment to discuss this.
- You agree to ongoing review, including weight, blood pressure and blood tests, to ensure treatment remains safe.
We are committed to treating all patients fairly and respectfully and want to support you in accessing appropriate care safely. If national or local guidance changes, we may need to revise our policy and will let you know.