An end to mixed sex accommodation in hospitals

Labour Health Secretary Alan Johnson MP last week announced the final phase of funding to make sure that virtually all hospital accommodation for patients will become single-sex by the end of 2009.

This is one of those issues that people understandably feel very strongly about: it's about feeling safe, respecting each others' privacy and dignity - and let's face it: it's something we should be able to expect in any 21st century health service.

So I'm delighted at the announcement of £100million to complete the work we've been doing on this since Labour was first elected. Here's a Q&A about the changes:

Why do I say "virtually all" and not "all" accommodation will be single-sex?

Mixed sex accommodation can never be fully eliminated; there will always be some emergency cases where fast, effective treatment will take priority over ensuring separate accommodation. But it must be reduced to an absolute minimum. Examples might be:

• A patient needing very high-tech care, with one-to-one nursing, such as Intensive Care Units
• A patient needing very specialised care, where one nurse might be caring for a small number of patients; or
• A patient needing very urgent care (e.g. rapid admission following heart attack) when a bed - any bed - has to be found and one in a single sex area may not be available.

Where mixing does occur, it must be justifiable for all the patients affected. When a patient is no longer in a condition that clinically justifies mixing we would expect segregation.

What type of changes are being implemented by the trusts?

A large majority of the works funded are capital improvements such as adding new bathroom and toilet facilities, screening and new buildings.


Is the funding provided sufficient for Strategic Health Authorities to carry out the improvement works that needs to be made, what if costs overrun?

Each SHA has submitted costed plans that in some cases exceed their allocation from the £100m.

Funds have been agreed on the basis that improvements will be achieved by the end of June. There may be some minor overrun in a small number of exceptional cases, but all Strategic Health Authorities have confirmed that they expect their trusts to be able to deliver their plans on time. Strategic Health Authorities are monitoring progress fortnightly to ensure they stay on track.

When will the proposed changes to Mixed Sex Accommodation be completed?

The vast majority of developments carried out as a result of the £100m challenge fund will be implemented by the end of June 2009. However some trusts have long term plans in place which the funding will assist them with, so in some cases action will continue beyond this date. We want to be sure that improvements are well-established and sustainable in the long term.

What happens if the trusts do not meet the deadline of their own proposals?

Tough financial penalties will be imposed from 2010/2011 to the trusts that do continue to treat patients in mixed sex accommodation - unless it can be clinically justified.

What do we mean by single sex accommodation?

Single-sex accommodation can be provided in:

• Single-sex wards (i.e. the whole ward is occupied by men or women but not both)
• Single rooms with adjacent single-sex toilet and washing facilities (preferably en-suite)
• Single-sex accommodation within mixed wards (i.e. bays or rooms which accommodate either men or women, not both; with designated single-sex toilet and washing facilities preferably within or adjacent to the bay or room).

In addition, patients should not need to pass through opposite sex accommodation or toilet and washing facilitates to access their own.

Haven't the Conservatives come up with a better plan?

The Conservatives have announced a policy of giving every NHS patient the opportunity to choose a single room when booking an operation in hospital. But they estimated that this would cost £1.57 billion - and that was before the economic downturn. Unfortunately, they got this figure completely wrong ? in fact, it would cost £9.51 billion.

They got their figures wrong because they based their figures on just 80 existing conversions, where the work had been the easiest to carry out. All of them were in NHS Trusts which already had space suitable for conversion, and all are small in relation to each trust's total number of beds.

They also failed to take into account the need to find extra space while the work on the old mixed sex wards is being undertaken.

And the Tories ignored the land costs of increasing NHS single room capacity. Some hospitals would be able to build additional capacity on existing sites but others, particularly in London, would incur significant extra capital costs. And this extra cost is not part of the £9.51bn costing - so the true cost of the Tory plans will be substantially higher.