The Ardens TNBI Template allows the clinician to record information about general history and examination findings, sexual health, referrals, prescribing, screening, as well as communication preferences for patients identifying as Trans, Non-Binary, Intersex, Lesbian, Gay Bisexual or Gender Dysphoria.
The TNBI Template includes lots of information, advice and guidance for the clinician, as well as links to various useful and relevant website and documents.
Access the template within the patient record in one of the following ways:
- Click on the Run Template option within the consultation.
- Click on the Add > Data using Template option outside of a consultation.
Clicking on either of the options above will display the Template Picker screen.
Search for the 'TNBI' template using the search box provided or via the navigation pane. Select the template and click OK.
The template has been broken down by pages on the left-hand side. Navigate to the page required.
The Quick entry page is for quickly recording patient information such as biological sex, preferred gender pronoun and title for correspondence. There are also codes to record gender reassignment on the patients record (with consent) which will improve the accuracy of some Ardens searches.
The History page also contains the patient information section, but additionally allows the recording of information such as the impact of their gender identity on their relationships, the perception of others, their future ambitions and fears etc. If there are concerns around safeguarding, safeguarding codes are provided (please follow your local policies relating to safeguarding and refer to the Ardens Adult/Child Safeguarding templates). There is a section for recording additional information for children and young people e.g. bullying:
The Examination page enables recording of basic physical examinations e.g. BP, height and weight.
The Lifestyle page enables the undating of the patients smoking, alcohol and use of Illicit drugs status.
The Sexual Health page enables the clinician to record information such as a patient’s history and examination data around sexual activity. There is also a section to record HIV testing and monitoring, as well as the use of drugs to prevent or reduce the risk of HIV infection:
The Referral page of the template enables the clinician to record that a referral to the gender identity clinic has been done. You also have the opportunity to record a concurrent referral to mental health/psychiatric services.
The Referral page also includes a link to a list of Specialist Gender Identity Services clinics in the U.K. for adults, children and young people, and from that link you can access the individual clinic websites.:
The Prescribing page offers GMC guidance with regard to patients who may be, or have intentions of, self-administering hormone medications from illicit sources. There is advice and guidance regarding bridging prescriptions which the GP may consider in the best interests of the patient, and the opportunity to record such a prescription:
The Screening page offers advice for the clinician when discussing sex-specific screening with Trans patients. Such patients will drop out of automated screening processes (breast, cervical, prostate or abdominal aortic aneurysm) if their gender designation is changed on their electronic patient record. The page also allows you to record that screening was offered or advice given:
The Resources page includes many relevant links to resources for patients, as well as links to websites for healthcare professionals:
Complete the template using the required fields and ensure you save the information, using the Save option.
If using the template via the Run Template option within an open consultation, you will also need to click Save to save the consultation.
Ardens has created a suite of Cancer Screening searches in relation to transgender patients. These searches are located within Ardens Searches > 4.14 Conditions - Cancer > Early Cancer Diagnosis folder.
In this folder you will find:
1. Work done > Clinical Activity - screening searches – identifying transgender patients from the bowel, breast or cervical cancer screening population who have been screened within appropriate timeframes.
2. Work to do searches – identifying transgender patients who have not received screening for bowel, breast or cervical cancer within appropriate timeframes or have not had advice given in the financial year.
Additional transgender searches can be found within the 1.31 Administration - Registration > Gender mismatch searches folder. These are searches to identify patients with potential gender mismatch codes recorded.
If you require any further assistance on the process above, please contact Ardens support on: firstname.lastname@example.org