Can the NHS, as it currently operates, actually abide by Equality law?

[JellySaurus]

We have almost the lowest hospital beds per capita of the developed nations, while our hospitals run at nearly maximum occupancy, resulting in corridor care for patients admitted via A&E. Increasing the number of beds (and HCPs too, of course) would benefit everybody. Currently, is it actually possible for the NHS to provide single sex wards?

If they physically/financially cannot, I'd prefer them to be up front about it. "Regrettably we've had no choice but to make this a mixed sex ward" is far preferable to "This is a single sex ward and we're not going to warn you about the bloke in the next bed to you."

It may not be. But if it isn't, they need to be open about that, and a single sex ward needs to be exactly that. It's the lying that is the issue for me, as if you know you need to have your guard up, that is safer than believing you don't.

In extreme cases, mixed sex wards may be unavoidable and patients should be able to express their discomfort and feelings about loss of privacy and dignity without retribution. Staff should be look for ways to minimise the impact of this on both sexes, and should alter practice to be as respectful as possible and take account of this less than ideal arrangement.

What should never, ever happen is that women should go into hospital believing that they're going onto a single sex ward, only to find the bed next to them has a bloke in it.

You seem to be confusing two different things. The Supreme Court judgement ruled that provision that includes both men and women cannot be single sex.

That is not the same as saying that there can be no mixed sex wards.

I did not say that. For years, the NHS has been saying one thing to patients (single sex wards) and another thing internally (a mixture of single ‘gender’ wards and wedge ‘em in any which ways).

Are single sex wards actually possible?

Corridor care seems to be the norm in some places now, so I don't know if this is even possible. Some of the newer wards at our main hospital seem to have a lot of individual rooms, which is obviously the best thing, for safety, hygiene and privacy. Actually being able to relax and sleep at night will no doubt help people recover and save money long-term, plus the single-sex aspect becomes irrelevant. Is it realistic to have these everywhere?

My own experience of having a major operation a couple of years ago:

Pre-op I was in a room with 6 beds. I was the only woman, with five men.

Intensive care and high dependency. Mixed sex.

Back on an ordinary ward: room for four, all of us were women.

I don't know what labels, if any, were given to the wards in terms of sex. The small rooms may have counted as only part of a larger ward, I don't know.

The point is that NHS policy on mixed sex/single sex wards is dictated by their Constitution and standards, not equality law.

My experience of in-patient cancer wards is that they are single sex.

The NHS Constitution and standards have to follow the law.

Do they say anything about single sex wards or services? Or were they written when doctors were men and nurses were women living under guard in nurses’ hostels, and not only was the concept of equal rights virtually non-existent, but the concept of mixed-sex wards and LARPing men were entirely non-existent?

My experience of working in the NHS is that wards (not admissions units, ED, HDU or ICU) are advertised as single sex but due to DEI policies that actually means they operate as single gender.

And now thanks to JKR, they're going to find themselves paying out large sums of money to anyone adversely affected by these policies.

High dependency and intensive care wards have always been mixed sex, they are allocated based on medical need and sometimes by medical condition. Makes no sense to have empty female high dependency cardiac beds empty because there’s less females needing them currently with male operations cancelled because there’s no male bed!

there are single sex bays on many wards, particularly in certain areas of the hospital where the patients have increased vulnerability, but for your typical 1-2 night surgical stay i personally don’t care who I’m sharing with

NHS hospitals are expected to provide single sex sleeping accommodation. They are required to report every breech and report on this monthly.

Wards can be mixed sex, but bays need to be singles sex, as do toilets and bathrooms (which are usually situated within bays.

I presume sleeping in corridors constitutes a breech of single sex sleeping accommodation. Unless they arrange the beds to be parked in different corridors!

Having said the above- pre FWS (and maybe post) I think lots of trusts were not recording ‘inclusion’ of trans people as breeches of single sex accommodation

High dependency and intensive care wards have always been mixed sex, they are allocated based on medical need and sometimes by medical condition. Makes no sense to have empty female high dependency cardiac beds empty because there’s less females needing them currently with male operations cancelled because there’s no male bed!

Absolutely. But in areas where patients are ambulant this is not relevant. Though this is part of my question: the law is that if a service is declared to be single sex, then the provider must provide the single sex service - can the NHS actually do this at current capacity without cancelling ops etc?

As to you not being bothered - irrelevant. You don't get to give consent for other women (or men, either) and you don't get to chose which parts of the law the NHS obeys.

Re toilets on wards: I have never been in, or visited, a hospital where the toilets were actually on the bays. In every case the toilets were either in the central section that the bays wrapped around, or on a corridor. It's all very well having single sex bays on a mixed sex ward, but not if ambulant patients walk around between the bays. There have been plenty of cases where confused patients got back into the wrong bed, or male patients went to watch female patients.

Back in the days when everyone knew what single sex meant, it was easy. You divided by sex, in wards or bays within wards, and used side rooms or mixed bays occasionally, and temporarily, when demand exceeded supply. Always with appropriate apologies and explanations.

I am something of a dinosaur with nearly 40 years of healthcare experience. Once upon a time, it was also normal to run each ward with 1 or 2 empty beds most of the time so that there was extra capacity when required.

The Thatcher government decided that was inefficient and closed a lot of beds. Mixed sex wards became common as hospitals started to struggle with capacity. Then in the inevitable backlash, single sex wards were introduced again. Except that as we all know, they actually weren’t.

Looking back, I want to say the reasons policies went with gender and not sex, were out of kindness, naivety and misguided attempts at inclusion. But reflecting now on conversations and directives about not telling parents about their children’s gender preferences, because they might be bigoted, it’s hard not to reach the conclusion that the people who were the real safeguarding risks, weren’t simply a long way ahead.

But to answer the point in the OP, it’s a problem of both political will and lack of bed capacity.

Re toilets on wards: I have never been in, or visited, a hospital where the toilets were actually on the bays. In every case the toilets were either in the central section that the bays wrapped around, or on a corridor. It's all very well having single sex bays on a mixed sex ward, but not if ambulant patients walk around between the bays. There have been plenty of cases where confused patients got back into the wrong bed, or male patients went to watch female patients.

This is not my experience of working in five different hospitals in East Anglia over ten years. I was an A&E consultant until I retired nearly 3 years ago but at least on the acute medical, surgical & orthopaedic wards that I have visited he four bed or six bed bays always had a toilet & shower facilities for that bay. There is no reason for an ambulatory patient to be wandering about the ward looking for the loo.

There is no genuine reason for an ambulatory patient to be wandering about the ward looking for the loo.

I’ve had overnight stays on a short stay surgical unit. I’ve had a very confused elderly woman with dementia straying from the bay I was in. It was at the end of a corridor and we only saw nurses for observations etc. The young woman in the bed opposite me was more mobile and took on rounding her up and tucking her back into bed. If a male patient had strayed our way, I doubt the nurses would have spotted him.

I think there are regional differences. Scotland seems to regularly have breaches of single sec accommodation. Not sure about the other regions.

But they all claim to offer single sex…
https://seeninhealth.org/nhs-foi-map/

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https://www.podbean.com/ew/pb-n79cb-1af9d67