Ending mixed-gender wards

Pressure is mounting for an end to mixed-gender wards in hospitals.  Inconsistent policy is resulting in some patients receiving less dignity and privacy than others. 

The Health Service will focus on ending mixed-gender accommodation in hospitals as far as possible after the health regulator called for the practice to end within one year.

In a review conducted by the Regulation and Quality Improvement Authority (RQIA), patients, relatives and carers reaffirmed that privacy and dignity is compromised when men and women have to share sleeping accommodation, toilets or washing facilities.

At present, Northern Ireland does not have an agreed regional policy although since January 2008 new hospitals and major hospital refurbishments have been fitted out with single rooms.  Two health and social care trusts (Southern and Western) have zero tolerance of mixed-gender care.  However, it occurs daily in the three others (Belfast, Northern and South Eastern) when alternative accommodation is not available.

All trusts have mixed-gender wards but the bays within individual wards are normally occupied by either men or women.  Speaking to agendaNi, Edwin Poots explained that all hospitals aim to accommodate patients in single-gender wards “as far as possible”.  Exact statistics are not available but he expects that the implementation of Michael McGimpsey’s policy of single-gender accommodation in all new builds will facilitate an end to mixed-gender wards.  Poots has also pledged to implement the RQIA’s recommendations “without delay”.  These include:

• a definitive policy statement (by the Department of Health, Social Services and Public Safety);
• regular audits to ensure systematic and uniform reporting of mixed-gender care (by the Public Health Agency and Health and Social Care Board);
• a commitment to whether hospital improvement programmes could have unintended consequences for patients (by the Public Health Agency and Health and Social Care Board);
• ensuring that all ward-based staff are appropriately trained to recognise and protect vulnerable adults (by all health and social care trusts).

Advice at ward level included making sure that patients had no more than two visitors at any one time, that curtains were large enough to be drawn fully around the bed, and that all patients were adequately dressed or covered.

New Labour’s 1997 manifesto promised to “work towards the elimination” of mixed-gender wards although Labour health ministers concluded that this was not possible due to the cost of renovating old Victorian hospitals.

The Coalition Government renewed that pledge, for England, in August 2010 and the Welsh Government concurs.  English hospitals are required to provide men and women with separate toilet and washing facilities, ideally within or next to their ward, bay or room.

Official guidance (in both England and Northern Ireland) recognises that it may be necessary to accommodate men and women together in exceptional circumstances.  This could, for example, happen in A&E or intensive care units where it is not practical to segregate patients by gender.  However, if that occurs, every effort must be made to transfer the patient to a single-gender ward as soon as possible.

Scotland announced an end to mixed-gender wards in 2005 but the practice still continues.  Last year, 12 per cent of Scottish A&E patients reported that they had shared a room or bay with someone from the opposite sex.  The rate was lower (at 6 per cent) among patients on waiting lists or whose admissions were planned.