Hospitals in England broke single-sex hospital ward rules thousands of times in November

Rule breaking was at a record high for November in England, as the NHS is criticised for scrapping fines for hospitals that fail to maintain single-sex sleeping accommodation.

<p>Mixed-sex wards were banned in 2010 in England</p>

Mixed-sex wards were banned in 2010 in England

NHS rules banning mixed-sex hospital wards were broken more times last November than at any point on record for that month in England.

Hospital trusts fell foul of the rules for ensuring single-sex provision 2,586 times in November, the highest number recorded for that month since records began in 2011.

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This was before Omicron’s arrival in the UK led to a rise in the number of Covid patients.

In November 2019, there were 1,968 breaches.

NHS England’s usual monthly report on rule breaches recorded by hospital trusts across the country was paused during Covid, but recently resumed.

A rule breach, otherwise known as ‘unjustified mixing’, is recorded each time a patient is placed in sleeping accommodation with a member of the opposite sex where it cannot be justified by clinical need – for instance if they need to be admitted to critical care.

Sleeping accommodation includes any area where patients are admitted and cared for on beds or trolleys, even if they do not stay overnight.

Mixed-sex wards were banned in England in 2010. There are similar rules in other UK nations, but data on breaches is not proactively published.


Advocates of single-sex wards have long argued the rules are necessary to protect womens’ safety and ensure the dignity and comfort of all patients at their most vulnerable.

They have pointed to the anxiety that patients, particularly elderly ones, may feel if forced to share facilities with people of the opposite sex, while wearing hospital gowns and using bed pans.

Until recently, a flat rate £250-per-breach penalty was built into the contract used to commission NHS services, meaning trusts and private hospitals caring for NHS patients could face steep sanctions for persistent rule flouting.

Hospitals would have been liable for fines of up to £650,000 in November under the rules.

But the penalty was quietly and permanently dropped from the NHS contract in a rewrite last April, alongside sanctions for other quality of care failings.

Rachel Power, chief executive of the Patients Association advocacy group, said she had understood the difficult situation facing the health service during the Covid emergency, and that some providers may have chosen to compromise on rules if it was “a viable route to saving lives”.

“But the NHS must be aiming to restore services to pre-pandemic levels and improve from there,” she continued.

“Mixed sex wards are an affront to patients’ dignity, and outside of emergency conditions the NHS must be renewing efforts to eliminate them, not giving up.”

NationalWorld asked NHS England how it intends to enforce the rules, if hospitals do not face financial sanctions for breaking them, but it did not respond.

The 2,586 breach count recorded in November has been surpassed only twice since reliable records began in April 2011 – once in January 2019 when there were 2,793 breaches, and once in February 2020 when there were 4,929.

While breaches tend to peak in January and February, when the NHS is under the worst winter pressure, the figures for both these previous record months may have been inflated by data errors made by two trusts, which accounted for large chunks of the national totals.

If those trusts’ figures are excluded from the respective months, the number of breaches in November 2021 becomes a record for any month.

The Nuffield Trust, a health think tank, said breaches were “unfortunately very common” in the NHS before Covid and are a symptom of “hospitals running close to capacity”.

“It is not surprising given the dramatic effect of the pandemic and disruption to services that we have seen these breaches increase further,” said director of research Sarah Scobie.

“Being placed onto the wrong sex ward will be distressing for patients, and NHS trusts will certainly be trying to avoid this situation as best they can, but staff have little choice.

“The impact of Covid has seen performance against many targets slip further out of reach. Waiting times for beds once admitted have also increased dramatically themselves so this will also be contributing to the challenge of avoiding these breaches.”

An NHS spokesperson said: “While continuing to treat both covid and non-covid patients safely, trusts across the country are also taking action to reduce or eliminate breaches which remain extremely rare.

“Offering single sex accommodation is a requirement under the NHS Standard Contract.”

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