SINGLE SEX WARDS - TOMORROW 11.45, House of Lords

[Sicario]

Baroness Nicholson of Winterbourne has issued an invitation to an open discussion on single sex wards.

5-7pm, 17 October, Committee Room 1, House of Lords.

Attendees are asked to arrive at least 30 minutes earlier, so best to be there by 4pm at the Cromwell Green entrance. I cannot get there as I will be at the WPUK Oxford meeting, but I will be writing to Baroness Nicholson.

Please do try to be there if you can, and spread the word.

NO DECISIONS ABOUT US WITHOUT US.

• [Title edited by MNHQ to reflect rescheduled time/date of meeting]

merrymouse I’m absolutely sure about this area.

The single sex accommodation refers to the bay/room and not whole wards. Wards often have male and female bays with shared nurses stations, kitchens, sluices, treatment rooms etc.

The appropriate relays to clinical areas where the small numbers of beds make separate areas challenging- such as critical care and recovery. Interestingly, critical care can breach mixed sex accommodation if there is a delayed discharge for non clinical reasons. A ward fit patient remaining inappropriately on critical care is likely to trigger a mixed sex breach.

It refers to areas where length of stay shouldn’t be extended and so not usually overnight (although a grey area) ie accident and emergency, day surgery, ambulatory care, chemo units. MAUs and other emergency/acute admission units do have to comply with mixed sex accommodation requirements. Short stay clinical decision units are fine to be mixed sex unless they’re using it as a high demand escalation area when planned overnight accommodation means they need separate arrangements.

Lavatories and bathrooms can change sex depending on the balance of numbers on a particular ward. Women shouldn’t have to walk through a men’s bay to use a lavatory or shower but many wards have lavatories and showers outside of the bay in the corridor area so can be used by either sex (but not both) for a given period and changed as balance of men and women changes.

The reason to offer male and female bays on specialist wards rather than put all men on male medical and all women on women’s medical wards (such as mixed wards but separate bays for oncology, cardiology, respiratory, stroke, orthopaedic surgery or renal etc) is about better outcomes.
Patients cared for by staff with specialist skills and experience are more likely to make a better recovery with less complications and reduced length of stay.
Medical outliers have significantly worse outcomes.

I'm not sure what you are disagreeing with Cherry.

The point is that sleeping accommodation is single sex.

Most wards are 'mixed sex' during the day because doctors, nurses, administrators, visitors, catering staff and cleaners are mixed sex.

merrymouse All wards are, using your criteria mixed sex at night too - doctors, nurses, porters, physios. That doesn’t count towards mixed sex accommodation breaches.
My point is that wards do not have to be single sex but theres a common misconception that you can’t have mixed sex wards. Oncology you said you weren’t sure about but the same rules apply that single sex accommodation is required but that means bays not wards.

My point is that wards do not have to be single sex but theres a common misconception that you can’t have mixed sex wards.

There is a very strong common conception that women would like to sleep in single sex accommodation. Whether you call that area a ward, a bay or a room is semantics - the point is who has access.

I imagine that there are also women who would like parts of the hospital to be single sex all the time, but that seems more difficult to achieve.

I'm also sure that many women have a strong opinion about which hospital staff should be able to access sleeping accommodation at night.

CherryPavlova the NHS policy relates to gender not sex, as do all fines for breaches. This has been in place since 2010.

If everyone on a ward was biological female (all same sex) but one identified as a man, ('gender') that would be a breach.
If a man was placed on a female ward (mixed sex) and identified as a 'woman', the 'gender' of all the female patients would be assumed to match their sex and this would not be recorded as a breach.

The original 2010 policy, who gave this directive, and how it came to be such a deception is in the attached article.
The policy may be called 'Eliminating mixed sex Accomodation' but it actually refers to gender, not sex.

medium.com/@anneharperwright/sex-gender-the-nhs-1e8f4e6363a6

Our hospital except maternity is all mixed. The single sex bays don't exist in reality as people are placed in whatever bed comes available. My last admission I kept the ward awake with night terrors because I was in a bay with a man and the nurse in charge of my care was a man. They knew of my past as I'd explained, it was all dismissed as me being silly, even after I ripped the cannula out and tried to run away in my gown. In the end they gave me sedatives to sleep but that didn't work either.

Why? I was raped by a consultant in hospital (not found guilty at the time but found guilty later), assaulted by his nurse and have been sexually and physically abused by a patient in a mental health ward (I was told to put up with it or leave as he was ill and couldn't learn differently - though he managed not to assault anyone else and when I spoke to the police and women's aid they both said they knew him and he always goes for vulnerable women).

I find being in hospital for any reason terrifying and won't go for any treatment. Even if my life is at risk. I'm in urgent need of treatment but won't go near hospital. It takes even my GP ages to get near me as well now.

Before anyone mentions therapy, it was a waste of time, they totally dismissed my fears and made things much worse.

Guidance is single sex not gender. Breaches are mixed sex breaches.
Most recent guidance below.

improvement.nhs.uk/documents/6005/Delivering_same_sex_accommodation_sep2019.pdf

Placing people in mixed sex bays results in fines.
The semantics about wards and bays are quite important. A ward is a more separate area with separate access whereas bays are usually open, without doors and much more readily accessed. I think many believe wards have to be single sex but that is not the case.

I’m not sure in these times when staff shortages are so significant that it would be reasonable to suggest only female staff can access women’s wards.im sure some people would like that but it’s not possible.
Personally, I’d like all new builds or refurbishment to result in single rooms. It solves the problem of mixed sex.

Single rooms are detrimental to patients and staff though. I’ve worked on wards with bays and side rooms, and those in siderooms are often lonelier and harder to keep an eye on when they are acutely unwell... especially if the patients in the bay are task heavy (eg assistance with daily living tasks)

I actually think conflating the terms bays and wards is detrimental to the mission

That guidance is only for England though.
What's the guidance for rhe rest of the U.K.? (I'm Wales which is why I'm asking).

When I was in a room on my own no one did the checks I needed resulting in a diabetic hypo. If I'd been in a bay they would have seen me becoming unwell. They relied on me being well enough to ask for help before becoming too unwell to do so which having just been diagnosed I'd no idea when that was.

i worked in a German hospital. wards contain 2 or 3 beds, single sex. if there were no single sex rooms left, they would mix sexes, but always with a screen between beds. As soon as a single sex space became free, the situation was corrected.

CherryPavlova

You're wrong. Embarrassingly so...
Read the words, highlighted on the image I attached. Slowly.

Better yet. Read the policy you just posted yourself.
And catch up.
Calling something sex when you mean gender does not magically make it sex. It makes it a deception.

The entire, national, NHS breach reporting dataset is predicated upon gender, not sex.

"This data set supports the collection of consistently defined data on
breaches of the Department of Health policy on Mixed-Sex Accommodation. The policy commitment relates to gender, not sex, but to ensure a better public understanding it is referred to as Mixed-Sex
Accommodation (MSA)."

Those words are LITERALLY written at the top of the NHS National "Mixed Sex Accomodation Specification" which is the Information Standards Board document, approved in 2010.

You even posted a link to the recently updated Guidance document, which, for those who can be bothered reading it, confirms without any doubt that ANYONE can self-ID onto a ward of their choosing on the assumption that the other patients on that ward HAVE a gender, and can share on the basis of that assumed gender.

Surefire way to make yourself look like a prat is to continue to argue in the face of all the evidence to the contrary.

You may be able to read the words
"The policy commitment relates to gender, not sex" and continue to assert the opposite, but most people would probably stop embarrassing themselves at that point.

It’s great for the baroness to give us a bit o& her time

But I can’t aftord child care or travel to get to this event

Is she accepting emails ?

Does anyone know ?
I probs will google her and ask her if she hasn’t given an email address

Barracker. If you stay so. The issue about gender identification is a different one to the ruling on mixed sex accommodation. It’s a touch of scaremongering, to be honest.

BeardofZeus Do you have the evidence base that’s because that’s simply not true. Staff worry about single rooms but they do not cause worse outcomes- exactly the opposite. Acutely unwell patients should be monitored properly. Falls, infection and patient experience are all improved by single rooms. The independent sector use single rooms almost exclusively, even for their sickest patients.

Sigh.
It's not me that says so.
It's the department of health and the NHS Information Standards Board, it's every hospital in the country that says so.

The only 'ruling' (I assume you mean policy?) that exists is the one that says segregate all wards by gender, but tell the public it's by sex to make sure they think it's the one thing when it's actually the other.

Obviously the deception works better on some of us than others, even after reading the wording of the policy and understanding that the choice to use the word sex when the segregation and reporting of breaches was by gender was a purposeful directive from the Health Secretary himself.

How did this go? Is there any update available?

The event was postponed and rescheduled for this Tuesday 22nd October. I don't know why it was moved.

Anyone wishing to attend the event was asked to email Baroness Nicholson to request an invitation to the meeting.

Please email [email protected] with "Baroness Nicholson" in the title line, and ask for an invitation if you wish to attend.

There was an article in the Telegraph yesterday about the number of fines being levied against hospitals for breaches in the single-sex ward regulation.

Thanks for the update Sicario

Invitations have now been issued for tomorrow's meeting.

Any updates?

Should it not be single sex bays, and not wards, that we talk about? As cherrypavlova posted about?

I know the main issue is the gender v sex issue, but we do need to be clear.

The policy document very clearly defines the areas, both sleeping, washing and other that are or are not single 'sex' - by which the NHS means single gender.

I can only suggest people read it.
It's entirely irrelevant whether the area is named bay, ward, or room.
What matters is that it WILL end up mixed sex even whilst it declares to the breach report that it is single sex and compliant.
All it takes is a self declaration.

Meanwhile fines will be issued for actual same sex arrangements IF a patient declares they belong elsewhere based upon their 'gender'.

The entire policy is set up to make people believe segregation is by sex, and breaches are by sex (whether room, bay, or ward).

But it is explicitly reported by gender.

"The policy commitment relates to gender, not sex, but to ensure a better public understanding it is referred to as Mixed Sex Accommodation"