The Equalities Act 2010 does not place any obligations on people as private citizens and service users, so we still have the right to ask the carer and their employer under the The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Section 10, 2 (c)
Dignity and respect
10.—(1) Service users must be treated with dignity and respect.
(2) Without limiting paragraph (1), the things which a registered person is required to do to comply with paragraph (1) include in particular—
(a) ensuring the privacy of the service user;
(b) supporting the autonomy, independence and involvement in the community of the service user;
(c) having due regard to any relevant protected characteristics (as defined in section 149(7) of the Equality Act 2010) of the service user.
https://www.legislation.gov.uk/uksi/2014/2936/regulation/10
However, there are currently problems when organisations do not record the sex of staff and/or service users, so maintain that because of this that they are unable to provide same-sex services. They are therefore in breach of the The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Section 10, 2 (c).
The CQC is wooly on the issue - creating a sex/gender loophole in CQC Guidance. Obviously, this is misleading and if it went to court then then it is the Legislation, not the CQC Guidance, that would be relied on. (I wonder if the CQC has been challenged on this . . . I feel a visit to "What Do They Know" and an FOI search coming on).
CQC Guidance
Regulation 10: Dignity and respect
10(1) Service users must be treated with dignity and respect.
When providing intimate or personal care, provider must make every reasonable effort to make sure that they respect people's preferences about who delivers their care and treatment, such as requesting staff of a specified gender/sex
https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-10
This is at odds with protecting service users from sexual abuse:
Regulation 13: Safeguarding service users from abuse and improper treatment
https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-13
Example of what has been happening in practice:
"On 30th April 2024 the Caring about Dignity team went to parliament to present a report on their campaign for same-sex care to parliamentarians"
1) Speakers included Sam, one of our founders whose non verbal highly autistic daughter, Helen, has been denied same-sex care provision. Sam's council does not collect data on sex."
https://www.caringaboutdignity.org/our-news-and-reports/
Extracts from Sam's speech that you can download from that page:
For the last three and a half years, my husband and I have been asking our local authority to collect data on the protected characteristic of sex, not just gender. Additionally, we have been asking for a commitment from them to commission same sex services.
We believe:
- Firstly, that Helen, and all those like her, have necessary and intrinsic rights to safeguarding and dignity: her intimate care takes place behind closed doors on a 1:1 , lone working basis and she cannot bear witness
- Secondly, we believe that Helen does not have the mental capacity to choose or ‘feel’ her gender – the only thing we can fairly and truly ascertain is her biological sex
- And thirdly, we believe that Helen’s sex-based rights cannot be honoured unless the sex of all parties involved in her care is known and recorded.
Our local authority does not collect data on the sex of its disabled adults in adult social care.
Their justification for this includes (and these are direct quotes from correspondence):
- 'forcing individuals to disclose their sex assigned at birth would potentially be a violation of their human rights’
- ‘we have no intention to facilitate or support the commissioning of single sex services in the current market’
The Caring About Dignity Report from their House of Lords Event on 28 April 2024 has lots more information and references:
https://storage.ghost.io/c/3c/6e/3c6ee750-2b6c-443e-8a48-6d1261eabfa8/content/files/2024/05/Caring-about-Dignity-HoL-event-April-2024-FINAL.pdf
Slight tangent as this next bit is about same-sex accommodation.
When I was checking NHS updates on single-sex and same-sex provision for this post I came across this.
I wonder if the revised guidance on NHS same-sex accommodation was put on hold pending issue of the EHRC Code of Practice? Not that a delay for that reason would be justified.
Delivering same-sex accommodation
Document first published: 14 September 2019
Page updated: 24 April 2025
Following the ruling from the Supreme Court in the For 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.
All providers of NHS-funded care continue to be expected to provide high quality care that meets all patients’ clinical needs, safeguards them from the risk of harm and ensures their privacy and dignity when they are admitted to hospital.
Providers should continue to measure and report breaches of the NHS Constitution pledge on same sex accommodation.
Revised guidance which supports privacy, dignity and safety for all patients in hospital accommodation will be published as soon as possible.
https://www.england.nhs.uk/publication/delivering-same-sex-accommodation/
and
https://www.england.nhs.uk/long-read/delivering-same-sex-accommodation/
That was published under the Topic "Gender Identity" and there have been no other relevant updates in the "Gender Identity" Topic since April 2025.