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Details of the Independent Clinical Review of Referrals for Gender Affirming Surgery – 6th October 2026
The NHS Wales Joint Commissioning Committee (NWJCC) has today published the Terms of Reference for the Independent Clinical Review relating to patients referred for gender affirming surgery through the Welsh Gender Service (WGS).
The Terms of Reference explain what the review will look at, how it will be carried out and how it will be overseen. Read the Terms of Reference.
Cardiff and Vale University Health Board has also published updated Frequently Asked Questions (FAQs), providing further information about the review process, what patients can expect and next steps.
On 24 August 2026, NWJCC took the decision to pause referrals for gender affirming surgery from the Welsh Gender Service, assessments by surgical providers and new surgeries. The pause was introduced as a precautionary measure, on clinical advice, following concerns identified through routine quality, safety and assurance processes.
The overarching responsibility of the NWJCC is to ensure that the services it commissions provide safe, high-quality care for patients and the decision to pause surgery was taken to help ensure those standards are maintained. The NWJCC recognises, however, the uncertainty and worry the pause has caused for patients waiting for surgery and their families.
This remains a pause and is not a permanent change to the service. The NWJCC remains committed to ensuring residents of Wales can access high-quality gender affirming services, including access to appropriate surgery.
Since the announcement of the pause, NWJCC, Cardiff and Vale University Health Board and partner organisations have been working to establish the Independent Clinical Review and the arrangements required to support its implementation.
The Independent Clinical Review will be carried out in phases, with patients reviewed in order of where they are within the surgical pathway.
The review will initially focus on patients whose surgery was due to take place between 26 August 2026 and 31 December 2026. It will then consider patients who have already had a surgical assessment and are awaiting surgery, followed by patients who have been referred for surgery and are waiting for a surgical assessment.
Independent gender clinicians will review relevant clinical records and meet with patients as part of the review process and will consider a range of factors relevant to an individual's care. Where appropriate, surgery will be reinstated as soon as an individual's review is complete.
Patients will be contacted directly regarding any review relating to their individual care and will receive information about any outcomes, next steps or further actions required. The Welsh Gender Service will continue to oversee each patient's ongoing care throughout the process and remain the main point of contact for support.
Alongside individual patient reviews, the independent gender clinicians will identify any common themes, examples of good practice and opportunities for learning. These findings will help inform recommendations for future improvements to the service and its governance arrangements.
The NWJCC will continue to work closely with Cardiff and Vale University Health Board, clinical leaders, stakeholders and service partners as the review progresses.
Further information, including frequently asked questions and support resources, is available on the Cardiff and Vale University Health Board website. The information will be updated as further details become available.