Mixed-sex wards used a record 5,000 times in a single month – despite Wes Streeting condemning practice

[IwantToRetire]

Under official guidance that was updated in 2012, patients should not share wards overnight, share bathroom facilities or have to walk through areas occupied by patients of the opposite sex to get to the toilets.
https://www.aol.com/articles/mixed-sex-wards-used-record-121624001.html

The trouble is that the NHS does not record sex accurately for a whole host of factors. It also deliberately hides the fact that wards are de facto mixed sex, by allowing self ID of trans identified people into the wards of their choice. This means that any figures produced are utter nonsense!!!!

See article from the Telegraph - yes this is from KnottyAughty's audit crew.

https://archive.is/BSekm

Ive not read the article but I think it’s interesting that this has surfaced just after our England audit results hit the Telegraph. Im wondering if we will get to “mixed sex happens so often that there’s no need to worry about it” and instead of reinstating single sex spaces, they’ll be removed as much as possible….?

From the article:

A government spokesperson said: “The use of mixed-sex wards soared under the Tories, and are another sign of just how damaged the NHS became under their watch.
“As we look to fix the harm they’ve done, we’ve been clear – the safety, dignity and privacy of patients is crucial, and NHS Trusts are expected to eliminate mixed-sex accommodation.
“Even with high flu cases and demand for services at unprecedented levels, it is not acceptable for patients to share sleeping accommodation with members of the opposite sex, and trusts are reminded robustly on this point."

How can these politicians be so disingenuous? State this but then simultaneously say TWAW and women with penises are free to enter these single sex spaces… how do they reconcile these opposing ideas in their minds?!

I wonder if anyone here more knowledgeable than me can tell me what a single sex ward is actually defined as?

The reason I ask, is the main hospital for my area has 1 'ward' for say Gastro or Cardiac or whatever. That ward consists of a locked door, opening onto a long corridor with a main desk, and off that at 90 degrees are bays - holding 6 or 8 beds. These bays are (supposedly) single sex. The bays have no doors. Just a big hole in the wall. They are male and female bays that change depending on how many of each sex are patients at any one time.
Toilets and bathrooms are generally single occupancy and unisex (often with no working lock!) and on the opposite wall of the long corridor to the bays.

Is that a single sex ward because the bays are single sex? Or are the people - like Streeting - who are telling hospitals that they must have single sex wards envisioning a hospital with 2 completely self contained Cardiac wards?

Because that is physically impossible in the hospital in my area and I expect many others.

Add to that, if single sex bays are what they mean - there is absolutely nothing stopping a male leaving their bay and then entering a female bay. Not even a door. Frankly there's not even enough staff, especially at night, that they would even notice that happening. But that's another subject I suppose!

It is also a problem that the NHS tries to run at too high an occupancy rate, so often runs out of beds. There may therefore be no choice but to put patients in mixed-sex wards.

UK acute care beds run at 80-90% capacity. On average, OECD countries run at 70-75% capacity. England has 2-3 beds per 1000 people, whereas Germany has 7-8 beds per 1000 people.

Ensuring single sex wards in the UK is going to take more than just enforcing the law. But putting people in opposite sex wards should be a last resort, based on clinical need, not on patient preference or staff interpretation. And NHS staff should be honest about it.

The right to a single sex ward is supposedly laid out in the NHS constitution

" if you are admitted to hospital, you will not have to share sleeping accommodation with patients of the opposite sex, except where appropriate, in line with details set out in the Handbook to the NHS Constitution"

The trouble is this document conflates sex with gender. In addition wards may contain single sex bays supposedly with separated WC and washing facilities but in practise this does not always provide the privacy and dignity that most of us expect.

https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england#patients-and-the-public-your-rights-and-the-nhs-pledges-to-you

According to AI

The NHS defines a ward as a group of hospital beds and associated treatment areas managed as a single unit by a senior nurse for staffing and care, with "single-sex" meaning it's exclusively for males or females, providing separate sleeping and washing areas, though it can also mean single rooms or same-sex bays within a larger unit, all designed to ensure privacy and dignity.

Key Aspects of "Single-Sex" Wards:

• Same-Sex Wards: The entire ward is occupied by patients of only one sex (all men or all women).
• Mixed Wards with Segregation: Patients of different sexes are in separate bays or rooms, with their own toilets and washing facilities, and shouldn't have to pass through opposite-sex areas to use them.
• Single Rooms: An individual room with private, lockable en-suite facilities can serve as a single-sex space.
• Core Principle: The goal is to protect patient privacy and dignity, meaning no patient should share sleeping areas or toilet/washing facilities with someone of the opposite sex, except in rare clinical circumstances.

In essence, a "ward" in the NHS context is a functional unit of care, and "single-sex" refers to the accommodation within that unit, ensuring separation by sex for privacy.

That's a different issue, though of course related.

With or without the Supreme Court ruling, since 2012 various governments have not been able to put in to practice a ruling the approved.

Without anything to do with trans, and I thought it more likely to happen in emergency wards, men who kow they are men are being treated within the same area (ward) as women.

I thought that on a number of occasions since 2012 various governments have said lack of finances has meant the maintaining of separate wards for men and women, has made it impossible to implement the ruling.

So it is curious that this is being raised now. I wonder what the motive is. Did the Independent (the aol link in the OP is in fact an Independent article) raise it when the Tories are in power.

I suppose one slight benefit, if that is what you can call it, is that in light of the 2012 ruling they must be recording occassion of men in women's wards.

The second issue of the NHS not acknowledging sex as a biological fact, is an ongoing corcern, that medical practitioners of all people,chose to pretend that sex isn't biological.

More from AI that at least knows the implications of the Supreme Court ruling

" ... The NHS "breaks" the single-sex ward rule in clinically justified instances (like critical care needing specialized equipment), for urgent situations, or when accommodating transgender patients based on their presentation (though this is evolving after recent legal clarity on biological sex). However, "unjustified breaches" also occur frequently due to bed pressures, with thousands of recorded incidents where patients share wards with the opposite sex, often leading to patient distress and dignity concerns.

Instances Where Mixing (Breaching) is Allowed/Occurs

• Clinical Necessity: Highly specialised care, like intensive care units, where specific equipment necessitates mixed-sex arrangements.
• Urgency/Emergency: In emergencies, placing a patient in the nearest available bed might override the single-sex rule.
• Transgender Patients (Historically): Current guidance allowed placement based on gender identity (presentation, name, pronouns), but this is changing following a 2025 Supreme Court ruling clarifying "sex" in the Equality Act as biological sex, leading to new NHS policy development.
• Unjustified Mixing: This happens due to bed shortages, overcrowding, or poor planning, despite the dignity concerns it raises.

The 2012 Rule & Its Application

• The 2010 ban (with 2012 guidance) aimed to end mixed-sex wards, emphasizing dignity, but allowed exceptions for clinical need and specific circumstances.
• Breaches are reported nationally, and while some are justified, many are "unjustified," with thousands occurring monthly, especially post-pandemic.

Recent Developments (2024-2025)

• A significant Supreme Court ruling in April 2025 clarified that "woman" in the Equality Act refers to biological sex, prompting the Equality and Human Rights Commission (EHRC) to warn the NHS to overhaul its transgender patient guidance to align with biological sex, potentially limiting current accommodation practices.

In essence, while exceptions exist, frequent "unjustified breaches" highlight ongoing challenges, and new legal interpretations are forcing a policy shift regarding transgender patients and single-sex spaces

Thank you @IwantToRetire and @FarriersGirl

I'm still not clear (because of the NHS, not your explanations) if the set up at my local hospital is complaint.

I do know their policy has been twaw up until now.

In any ward I've been in there - and unfortunately I've been in a lot of them as due to a long stay and no diagnosis I was was moved around every 3/4 days for 4 weeks - the bay is single sex but you leave the bay and go to a communal corridor to get to toilets and washing facilities. You may even have to walk the whole length of it and past all the male bays to get to the shower or whatever.

The official NHS Policy is here:

https://www.england.nhs.uk/long-read/delivering-same-sex-accommodation/

A few extracts:

All providers of NHS-funded care are expected to prioritise the safety, privacy and dignity of all patients. Adherence to this guidance is an essential part of this.
…
In April 2011, reporting of breaches to same-sex accommodation guidance became mandatory.
…
There are some clinical circumstances where mixed sex accommodation can be justified. These are few, and mainly confined to patients who need highly specialised care, such as that delivered in critical care units. A small number of patients will actively choose to share with others of the same age or clinical condition, rather than sex. Further detail on the circumstances in which mixing is justified (and therefore does not constitute a breach) is provided in Annex A.

Because of the huge variation in ward designs, it is impossible to monitor all aspects of mixing centrally; this is why central reporting concentrates on admitted patients in sleeping accommodation.
…
Link to Annex A which all seems completely fine - until you get to Annex B where you find this:

General key points are that:

• Trans people should be accommodated according to their presentation: the way they dress, and the name and pronouns they currently use.
• This may not always accord with the physical sex appearance of the chest or genitalia.
• It does not depend on their having a gender recognition certificate (GRC) or legal name change.
• It applies to toilet and bathing facilities (except, for instance, that pre- operative trans people should not share open shower facilities).
• Views of family members may not accord with the trans person’s wishes, in which case, the trans person’s view takes priority.

ETA Annex B link

It very much depends on the hospital and how old its accommodation is. As you describe it’s common to have the “bed management” of single sex provision made by “bay”. So yes you’d need to walk along a “corridor” in some instances past other bays but you’d ideally not be walking through a bay or directly past a bed containing someone of the opposite sex. They have to keep the system very flexible to cope with the fluctuating demand of who comes in.

I’m not an NHS Staffer - this is just what Ive gleaned from doing our audit

Too late to add another edit but the 2019 policy above is currently “on hold” following the SC Ruling

the safety, dignity and privacy of patients is crucial

Until it conflicts with the desires of transvestite men. Then it can get to fuck.

Like women's rights and safeguarding children and medical ethics. (Edited to add: I forgot one. Supreme Court judgments.)

It's as mad as the whole 'we're going to defeat VAWG by talking to boys' - when it's a government that believes no one knows what sex they are. Are they going to mouth swab all the kids to identify the right ones for the input?

My 19 yo DD was in hospital for a week last year with a broken leg which involved complex surgery. On 3 separate occasions they put her in mixed sex bays, despite me informing them she had previously been a victim of sexual assault and seeking an assurance she would not be placed in a mixed sex bays. It was very distressing for her (and me) to constantly have to disclose her history to nursing staff, and even then, for it to be ignored. She was completely immobile, reliant on bed pans, and vulnerable due to high pain meds, and it still makes me really angry that they did that. It made an already traumatic experience even worse. Quite apart from her personal history, there was a basic safety and dignity aspect. Imagine using a bed pan with some unknown man just feet away from you only separated by a flimsy curtain? In the end we made such a fuss (and she was a screamer due to the pain) that they put her in a side ward, and even then she got snide comments from staff such as ‘you must be really special getting a room to yourself’. It’s a year on and it still makes my blood boil.

This makes me furious. What do these idiotic (immoral, power abusing, unprofessional) medical personnel think that they were achieving with such comments? Would they be likely to help or hinder their patient’s wellbeing?

Perhaps we need to start recording all interactions with abusive medical personnel either through phones or other recording devices or the presence of independent witnesses to their ‘care’.

I am so sorry that you and your family went through this and it would be my worst nightmare if it happened to me. It is not good enough even in a hard pressed health service and as a PP says some staff don't care enough. 😠

It’s no justification - but from what we know from the audit who cares about the staff? In my experience you can’t give what you’re not getting… im always amazed that anyone wants to work in the NHS

I am not saying its the same but a parallel example is when council's are making cuts because their level of funding has been cut.

So people who make decisions based on finances are allowed to make, and have voted through, cost saving decisions that totally ignore agreed provision of services, etc..

And apart from the fact that those who are part of the decision making process, do not challenge the ethics, those lowere down the pay scale and at the front line of service provision, are left to implement a decision that they have no choice not to.

And as we know, especially if the extra cost of providing services that centre women are put to the vote, women are rarely if ever thought to be worth that financial cost.

Haven't read this but came across it by accident.

Delivering same-sex accommodation

Following the ruling from the Supreme Court in theFor Women Scotland Ltd (Appellant) v The Scottish Ministers (Respondent), case published 16 April 2025, our Delivering same-sex accommodation guidance, published in 2019, is currently being reviewed.

In full at https://www.england.nhs.uk/long-read/delivering-same-sex-accommodation/

I suspect this is NOT about catering to trans identity, but the far larger infrinchment of the committment to single sex wards, etc., ie when men who know they are the male sex and women who know they are the female sex, are put in a mixed sex ward.

ie according to the article this happens by as much as 5,000 times in ONE MONTH.

Add to that, if single sex bays are what they mean - there is absolutely nothing stopping a male leaving their bay and then entering a female bay. Not even a door. Frankly there's not even enough staff, especially at night, that they would even notice that happening. But that's another subject I suppose!

Inwws recently in hospital on just such a ward, where bays are single sex depending on who has been put in the bay. In my case there were doors to each bay which were generally closed at night and open during the day.

However in my case an elderly man with dementia followed one of the nurses into my bay. He was mostly harmless which I knew, having spent some hours in A&E talking to him and his wife. But I felt very vulnerable and was alarmed by his wandering into the female bay. I insisted they shut the doors to stop him but the doors kept being left open. I had to complain to the nurse in charge to say he needed one to one care. It was very unsettling. And I'm someone who is very comfortable in standing up for myself and others.

This is also my understanding.

The NHS is run 'hot' continuously. Bed space is designed to maximise efficiency, and closing smaller hospitals and wards has been a policy since the 1980s.

A few newer hospitals from the noughties onwards have majority single rooms and small bays, but it will take a lot of capital investment to get that rolled out to the whole estate.

Guaranteeing single-sex provision, without causing excess deaths or suffering by turning patients away, requires spare bed capacity. But the NHS is designed to eliminate spare bed capacity. So this will keep happening.

N.B. there are probably arguments in favour of running the NHS like this and investing the money in drugs, specialists and machinery that keep people out of hospital, rather than beds and nurses. But as with the disappearance of convalescent and respite care beds with patchy community care to replace them; there's an argument that this is a neglected priority in the NHS.

But as with the disappearance of convalescent and respite care beds with patchy community care to replace them; there's an argument that this is a neglected priority in the NHS.

It is IMO a reflection of not treating the health service and community care as one and the same thing.

All this talk about bed blockers, somehow making the patient the problem, rather than the system.

@IwantToRetire, try reading Annex B of the document you link to.

As a teaser, I will let you know that, in a document called “Delivering same-sex accommodation,” Annex B is called “Delivering same-sex accommodation for trans people and gender variant children.”

Highlights include “Trans people should be accommodated according to their presentation: the way they dress, and the name and pronouns they currently use,” and “It applies to toilet and bathing facilities.”

How do you all feel about mixed sex intensive care units/critical care units? How is this different from a basic ward in terms of dignity? I dont think it does but it's still justified.