Nurses have been given more freedom to decide whether patients should be treated in single sex wards, along with specific examples of where mixed accommodation will not be tolerated.
Updated Department of Health guidance states mixed sex accommodation must be “eliminated” where it is not in patients’ overall best interests or does not reflect their personal choice - appearing to move away from the previous approach of a deadline for its abolition.
It says patients must not be put in mixed wards: for the convenience of staff; to group patients within a clinical specialty; because of predictable fluctuations in activity or seasonal pressures; or because of a predictable non-clinical incident, such as a ward closure.
In addition, decisions must not be based on staff or bed shortages, poor skill mix or restrictions caused by old buildings.
Patients cannot be placed in mixed sex accommodation while awaiting assessment, treatment or a clinical decision, or for regular - not constant - observation.
Royal College of Nursing adviser on acute and emergency care Alan Dobson said it was the first time such clear examples had been provided, which would help staff who “often felt compromised when faced with competing priorities”.
The guidance also gives clinicians significant leeway to use professional judgement in decisions over where to treat patients.
It says staff can mix patients in the event of a life threatening emergency, where a nurse needs to be present at all times, during close observation, or if there is a risk of an adverse drug reaction.
Janice Stevens, the DH’s national director of healthcare associated infection and mixed sex accommodation programmes, told Nursing Times: “It’s a professional decision, based on the patients’ needs.”
For example, she said, it might be more appropriate for a female stroke patient to be treated in a small specialist unit with male patients for the first 48 hours of admission.
The DH announced in April that 95 per cent of trusts in England had “virtually eliminated” mixed sex accommodation.
From January, trusts will have to report any breaches to the DH and could be fined as a result.
When patients may be placed in mixed sex accommodation
- In the event of a life threatening emergency
- Where a critically ill patient requires constant one to one care
- Where a nurse must be present in the room/bay at all times
- Where a short period of close patient observation is needed
- On the joint admission of couples or family groups