FOI – 2023-000406 Specialist Surgeries and the Cost (HTML)

Date received – 03/11/2023 | Date responded – 01/12/2023

Request

Please provide any information that you hold answering to any of the following descriptions:

1. How many of the following surgeries have taken place since 2020?

• Masculising chest surgery
• Phalloplasty
• Metoidioplasty/scrotoplasty
• Vaginoplasty

2. What is the total amount of money this is estimated to have cost the NHS?

Response

1. How many of the following surgeries have taken place since 2020?

• Masculising chest surgery
• Phalloplasty
• Metoidioplasty/scrotoplasty
• Vaginoplasty

Under Section 17 of the Freedom of Information Scotland Act, 2002 (FOISA), an organisation does not have to provide that information if it does not hold that information. NHS National Services Scotland (NSS) does not hold this level of information. Gender reassignment surgeries, funded via the National Screening Directorate (NSD) risk share, are categorised by the following 3 broad procedures: Chest reconstruction (masculinising chest only), Masculinising genital surgery and Feminising genital surgery.

Please find attached Appendix 1 - Gender reassignment funding requests approved, for the figures pertaining to the 3 categories above.

Please note the following caveats regarding the data:

• The data represents the number of funding requests approved by NSD for the gender reassignment surgeries, by financial year 2020/21 up to today (15 November 2023).

• The data does not include approved funding requests for revision/unscheduled aftercare.

• The data does not indicate the actual number of referrals as the patient, or their clinician may decide they no longer wish or need to proceed with investigation or treatment. NSD does not keep an end-to-end record of the patient’s journey. The responsibility for the funding of ongoing follow-up falls to the Territorial Health Board of residence.

• The data does not indicate the number of unique patients as an individual may have more than one need/request.

• The data does not capture all funding requests for residents in Scotland who wish for gender reassignment surgeries. The Territorial Health Boards may decide to directly refer to specialised/highly specialist services without seeking NSD risk share funding and are therefore responsible for these costs.

• NSD has no role in the authorisation of funding for planned state healthcare treatment in an EU country or Switzerland. This is funded via either the S2 funding route or the EU directive route (in place prior to 2021) which is managed by Territorial Health Boards in conjunction with the Department of Health.

2. What is the total amount of money this is estimated to have cost the NHS?

Please find attached Appendix 2 – GRS Expenditure, for the total and breakdown of costs for gender reassignment surgeries to NSS NSD.

Please note the following caveat around these figures:

• The financial breakdown is not reflective of the number of approved funding requests reported above. This is because we are not always invoiced within the same financial year due to various reasons (waiting times, patient no longer wishing to proceed).

I trust you will find the information of assistance and if you require any further information, please do not hesitate to contact us.

If you are unhappy with any aspect of how we have dealt with your request, you can make representations to us asking us to review the handling of your request.

If you require any further information, please contact Head of Information and Cyber Security, Digital and Security within 40 working days of the date of this correspondence.

Contact

Address

If after a review you are still unhappy, you also have the right to apply to the Scottish Information Commissioner, who can be contacted at Kinburn Castle, St Andrews, Fife, KY16 9DS, or via their application form.

National Services Scotland (NSS) is committed to publishing all information released in response to Freedom of Information requests. You can view all FOI responses within our FOI Publications repository.