<p>In August, NHS England published a service specification for the National Referral Support Service for Specialist Services for Children and Young People with Gender Incongruence. Now referrals can only be made by a National Health Service-commissioned, secondary care-level paediatric service, or a Children and Young Person mental health service. This will ensure that healthcare professionals with the relevant expertise conduct the assessment and help determine any co-existing mental health or other health needs of these children and their onward care, ultimately ensuring a holistic approach to care for these children and young people.</p><p>The impacts of the new arrangements for referral into the NHS Children and Young People's Gender Services were considered in detail by NHS England through a process of public consultation, which included publication of an impact assessment. The impact assessment concluded that the new access arrangements are unlikely to increase the waiting time into the NHS Children and Young People's Gender Services for the majority of individuals, as the referral date from primary care to the secondary care service will be honoured for determining an individual’s place on the waiting list for the NHS Children and Young People's Gender Service, and waiting times for local mental health services and paediatric services are likely to be lower for the majority of individuals than the current waiting time for the first appointment with the NHS Children and Young People's Gender Service. NHS England expects waiting times into the NHS Children and Young People's Service to fall as clinical capacity is increased through the establishment of new regional providers, in line with the recommendations of the Cass Review. The consultation materials and the impact assessment are available at the following link:</p><p><a href="https://www.england.nhs.uk/publication/referral-pathway-for-specialist-service-for-children-and-young-people-with-gender-incongruence/" target="_blank">https://www.england.nhs.uk/publication/referral-pathway-for-specialist-service-for-children-and-young-people-with-gender-incongruence/</a></p>