Report Date


Case Against

Cwm Taf Morgannwg University Health Board


Clinical treatment outside hospital; GP

Case Reference Number



Early resolution

Ms X complained about the service received when she registered with the Practice, having moved to the area from outside Wales. In March 2022, Ms X, a transgender patient, requested a repeat prescription for various medication, including Hormone Replacement Therapy (HRT) medication. The Practice declined to prescribe the HRT medication and instead made a referral to the Wales Gender Service.

The Ombudsman found that the Practice had broadly acted in accordance with referral and prescribing guidance in place with the Welsh Gender Service. However, in taking a cautious approach and making a new referral, Ms X was left without the medication required for her to maintain a healthy hormone balance for several weeks. There was some poor communication with Ms X as to the reasons for the referral being necessary, which caused upset and distress. The Ombudsman found that the Practice could have contacted the Welsh Gender Service for advice on prescribing to clarify the position by email, and could have done so sooner, which may have avoided Ms X being without medication or at least minimised any delay.

The Ombudsman decided to settle the complaint without an investigation and gained the Practice’s agreement to, within 20 working days, apologise to Ms X for the delay in clarifying matters with the Welsh Gender Service and issuing a prescription, arrange to meet with Ms X to discuss her concerns and experience with a view to reinstating her as a patient with the Practice and discuss the matter in a clinical meeting and inform all GPs of the informal facility to seek advice on prescribing from the Welsh Gender Service by email.