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Are we going back to the future on mixed-sex wards?


My Wednesday started with a radio interview on an issue I thought the NHS had seen the back of, namely breaches of the rules on mixed-sex wards.

A decade ago, stories about patients of different genders being cared for on the same ward were rife in the media.

“It is an indicator of a bigger problem – the increasing pressure faced by the NHS and its workforce”

Successive governments had tried to tackle the problem but in 2010 it was made a key policy objective to eradicate so-called mixed-sex ward breaches by the end of the year.

Fines were to be imposed on trusts – £250 per patient per day – and the chief nursing officer for England, Dame Christine Beasley, was given responsibility for pushing through the policy.

A quick trawl of the Nursing Times archive reveals that we wrote about mixed sex wards a lot in the years up to 2011 but then not so much.

It seemed to be a success story, the number of breaches went down and the problem disappeared from the headlines.

I was, therefore, a bit surprised to be asked to give my views on a sudden spike in breaches by hospital trusts in Kent – but perhaps I shouldn’t have been.

An investigation by BBC Radio Kent had found a near tripling of the number of breaches in the county’s hospitals compared to last year – from 420 to 1,186 (see box below).

”If we are getting more breaches, then it is yet another indicator that the ‘conveyor belt’ is broken”

In addition, three of Kent’s four hospital trusts were revealed to be responsible for a third of all acute breaches across the country, with Medway alone responsible for 13.8% of them.

A quick search of the internet also revealed that, by coincidence, the Daily Mail – a dogged follower of the mixed-sex accommodation issue in the past – had published a story earlier in the week on the problem at a national level.

It reported that nearly 4,500 people had to share hospital facilities with the opposite sex in the last 12 months – a 70% rise on the previous year.

I was however somewhat amused to read the stern criticism meted out by Labour to the government in the Mail article over the issue. I noted that it followed similar criticism of the last Labour government by Andrew Lansley before he became health secretary and prior to that the comments made by Tony Blair when he first called for the abolition of mixed wards way back in 1996 when still in opposition.

Generic mixed sex

It demonstrated nicely the cyclical nature of politics surrounding the health service – but that’s very much a side issue.

The real point I want to make is that the return of media stories about breaches of the mixed-sex ward regulations represents a warning.

While often uncomfortable for patients and unhelpful for staff, it is an indicator of a bigger problem – the increasing pressure faced by the NHS and its workforce over the last 12 months.

If we are getting more breaches, then it is yet another indicator that the “conveyor belt” is broken. More patients are coming in because of rising demand for services – especially via A&E – but well patients are not necessarily going home due to the lack of a community bed or social care package.

One could argue that the numbers involved in mixed-sex breaches at present are small in comparison to the number of patients treated in the country’s hospitals each week, but they should not be brushed under the carpet.

Yes, there are many problems facing the NHS at the moment – many a matter of life and death – but the factors that prevent mixed-sex breaches are also those that will reduce delayed discharge and A&E overcrowding, namely resources targeted at the right places and patients targeted at the right places.

For me, this morning’s interview warranted an unwelcome return to talking about mixed sex wards. I had (perhaps naively) hoped we had consigned the box marked mixed-sex wards to history – but alas it seems not yet.

Bed managers and nursing staff will do their best to fit patients in and treat them where they can, but they should not be the brunt of complaints or pick up the blame for something that is a symptom of a systemic problem.

Total mixed sex breaches across Kent hospital trusts in 2015-16

  • Medway NHS Foundation Trust: 504
  • East Kent Hospitals University NHS Foundation Trust: 301
  • Maidstone and Tunbridge Wells NHS Trust: 6
  • Dartford and Gravesham NHS Trust: 375

Kent total: 1,186

National total: 3,639


Total mixed sex breaches across Kent hospital trusts in 2014-15

  • Medway NHS Foundation Trust: 324
  • East Kent Hospitals University NHS Foundation Trust: 31
  • Maidstone and Tunbridge Wells NHS Trust: 68
  • Dartford and Gravesham NHS Trust: 0

Kent total: 420

Source: BBC Radio Kent


Readers' comments (2)

  • I was a nurse who ended up in a male ward with c diff when there was a bad outbreak in 2006. It was incredibly embarrassing to be sitting on a commode with severe and offensive diarrhoea, surrounded by men with only a curtain between us. I was being catheterised and a male nurse opened the curtain in the middle of the procedure so other male patients could see. That was Kent & Sussex Hospital. Nothing seems to have changed.

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  • Anonymous 25/2@ 9.45pm, that should never ever happen. However, one of my concerns is the erosion of humanised expressions, so no wonder patients are not treated as such. One example, we have bed blockers - wooden blocks to raise furniture. Now, I see above, 'conveyor belt' a term used in industry (e.g. car manufacture), supermarkets, mostly referring to metal objects, commodities, and not forgetting the cuddly toy!

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