Rise in NHS mixed-sex accommodation breaches threatens success

Meeting government regulations around the provision of single-sex environments for NHS patients requires more than just improvements to estates and facilities, according to the only strategic health authority in the country to continuously report zero breaches.

For the month of April, NHS North East once again reported no incidents; the only regional NHS body to meet the requirements of the rules on single-sex accommodation, which were brought in by the Government 17 months ago.

Under the regulations, NHS trusts, and any other organisations treating NHS patients, are required to provide sleeping accommodation and bathroom and toilet facilities dedicated to each sex. Each month they must report all unjustified mixing of the sexes and pass these figures onto the Department of Health. Sleeping accommodation includes areas where patients are admitted and cared for on trolleys or beds, even if they do not stay overnight, such as admissions and assessment units and day surgery and endoscopy centres. The rules do not include areas where patients have not been admitted, such as accident and emergency cubicles or where it is in the best interests of the patient, for example in intensive care units.

The small rise in these figures is due to a handful of trusts. It shows why the NHS cannot be complacent about this if we're to continue the great progress made so far

For every breach of the rules, the trust is fined £250. On a four-bed ward, even if there are three men and only one woman, the regulations state the fine must be paid four times over.

In April 2012 the total number of breaches was 559. This is slightly higher than the 461 reported in April and means total fines of £139,750.

While NHS North East topped the league table with no breaches, at the other end was NHS London with 190 reported incidents, followed by NHS South East Coast with 106 and NHS North West with 100.

The primary care trusts worst affected were NHS West Sussex with 56 breaches, NHS Warwickshire with 40 and NHS Sutton and Merton with 37.

All the breaches in April were at acute healthcare facilities, with most at St George’s Hospital in Tooting, south London (54) and the nearby King’s College Hospital (41). Warwick Hospital also reported 43 incidents.

Every patient has the right to receive high-quality care that is safe, effective and respects their privacy and dignity at a time when they are often at their most vulnerable

Commenting on the slight increase in April, Health Minister, Simon Burns, said the NHS had made ‘great strides’ in tackling the issue, reducing incidents by a total of 95% since reporting began.

He added: "The small rise in these figures is due to a handful of trusts. It shows why the NHS cannot be complacent about this if we're to continue the great progress made so far.

"Nobody should have to suffer the indignity of mixed-sex accommodation. Every unjustified breach is one too many and I urge those hospitals that have still to tackle this problem to look at the improvements in other hospitals and follow them. If they don't, they will face fines of £250 for every breach."

Speaking to BBH this week about its success, Teresa Fenech, deputy chief nurse for NHS North East, said: “Every patient has the right to receive high-quality care that is safe, effective and respects their privacy and dignity at a time when they are often at their most vulnerable. This is one of the guiding principles of the NHS Constitution and is at the core of our vision for local NHS services.

“When the Department of Health first outlined its pledge on same-sex accommodation in 2009, the staff in our trusts delivered the necessary changes to their facilities within a tight timescale – installing new toilet and bathroom facilities, as well as extra beds, curtains and signs.

This is about more than buildings and facilities and our staff have continued to show their commitment to ensuring that the privacy and dignity of patients is at the heart of everything that they do

“However, this is about more than buildings and facilities and since then our staff have continued to show their commitment to ensuring that the privacy and dignity of patients is at the heart of everything that they do. The recent reports showing no mixed-sex accommodation breaches demonstrate this commitment and I would like to congratulate the trusts in this region on their successes.”

When the regulations were first mooted three years ago, NHS London published a statement committing to eradicating mixed-sex accommodation by the end of March 2010. Two years later it is still failing to achieve this aim.

At that time it announced more than 100 refurbishment projects at hospitals in the capital, with plans to erect separating walls, increase the number of single rooms, improve non-permanent partitions and increase signage.

Chief nurse, Trish Morris-Thompson, said in the statement: “We know from talking to patients that they find mixed-sex accommodation unsettling, uncomfortable and undignified. By investing this money across London we can ensure the top-quality treatment that is provided across the capital is not undermined by patients feeling uncomfortable in mixed-sex accommodation. By the end of June 2009 we will expect to see a substantial improvement and will continue to work with trusts to ensure that the March 2010 deadline is met.”

Despite approaches this week to NHS London and NHS South East Coast, statements were not provided on why hospitals were failing to meet their goals. However, a report published in 2010 by St George’s Healthcare NHS Trust did refer to difficulties due to ‘the nature of the campus’ at St George’s Hospital, and the SHA has previously pointed to current building improvement works which, when completed, will enable hospitals to provide separate-sex facilities.

Click here for full details of April's breach rates