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Hospitals to pay the price for mixed sex accommodation in the NHS

Hospitals to pay the price for mixed sex accommodation in the NHS

News Release issued by the COI News Distribution Service on 20 January 2011

Hospitals found in breach will be fined £250 per patient from April

More than eleven thousand patients were placed in mixed sex accommodation in hospitals providing NHS services in December, according to new data published today by Health Secretary, Andrew Lansley.

The figures come as the Health Secretary announces that hospitals found in breach from April will be fined £250 for each patient affected and each day that they stay in mixed sex accommodation.

This is the first time that verified data on mixed sex accommodation breaches - where a patient is placed in mixed accommodation without any justification - has been collected and published, revealing the nature of the problem in English hospitals. The data, published online at individual hospital level, show that:

• 11,362 patients were placed in mixed sex accommodation in December (out of an estimated 1.4m ‘Finished Consultant Episodes’)
• Over half (52 per cent) of hospitals who submitted data reported no breaches
• 92 per cent of all breaches reported took place in acute hospital trusts
• Across England, the ‘breach rate’ is 8.1- meaning that there were 8.1 breaches per 1,000 ‘Finished Consultant Episodes’, or hospital stays
• The SHA with the highest breach rate, 13, is NHS North West. The SHA with the lowest breach rate, 1.2, is NHS Yorkshire and Humber

Commenting on the statistics published today, Health Secretary Andrew Lansley said:

"Today, for the first time we are publishing information that exposes the true state of mixed-sex accommodation in the NHS. The figures show an unacceptable level of breaches in which patient dignity has been compromised.

"Publishing these figures in itself revolutionises accountability to patients but that's just the start. By April, we expect every hospital to be capable of meeting the single sex accommodation standard. And so from 1st April we are introducing £250 fines for every time a hospital has concerns that a patient's dignity is not respected in this way. And we are increasing the number of single rooms in the NHS to ensure no patient suffers this indignity when it is unjustified."

The majority of hospitals are now compliant in eliminating mixed sex accommodation and remaining hospitals have until 1 April 2010 to declare their compliance. After this date, they will be fined £250 per patient affected per day. Fines will be reviewed regularly to ensure that they are fair and produce the required results - eliminating mixed sex accommodation except where it is in the patient’s best interest. The money will be reinvested into patient care.

Patients can use the data published today to help them decide which hospital they choose and can use a new feedback option on the NHS Choices website to share their experiences.

Notes to Editors

1. There are an estimated 1.4 million Finished Consultant Episodes (FCEs), or hospital stays, across the NHS per month

2. A full statistical press notice, with further explanatory notes is available at

3. Detailed tables by provider and commissioner can be found via the following link:

4. Hospital site-level data is also available on the NHS Choices website (

5. A breach of the policy occurs each time an admitted patient is placed in MSA outside the terms of the policy, ie it is not in their overall best interests and/or does not reflect their personal choice.

6. Central reporting covers MSA breaches in respect of sleeping accommodation only. The NHS is also required to monitor locally all mixed-sex sharing of bathroom / toilet facilities (including passing through accommodation or toilet/bathroom facilities used by the opposite gender), and all mixed provision of day space in mental health units at a local level.

7. These figures have been reported directly by provider organisations and will now be scrutinised by PCTs to ensure that mixing genuinely takes place only when it is in the patient’s best interests.

8. Mixed sex accommodation data were submitted by a total of 269 provider organisations, made up of 75 (out of 75) Acute Non-Foundation Trusts, 72 (out of 92) Acute Foundation Trusts, 74 Community, PCT and Care Trust providers, 39 Mental Health providers and 9 Independent Sector providers._

9. Background on fines for the NHS regarding Mixed Sex Accommodation

Fines are set through the contracts between commissioning (PCTs) and provider organisations (acute, community and mental health trusts). Prior to June 2010, the contract requirements stipulated that any breaches would incur a fine however short the breach, equivalent to the cost of the service or treatment for the procedure in question - for example, a patient in hospital for a hip operation would incur a fine of £5600, but a patient in hospital for a hernia operation, would incur a fine of £959. Under this system fines could varying dramatically and there is little evidence of them being applied where breaches occurred.

In the period from August to January, the Department worked to strengthen the system within the current contract, so that commissioners would have the discretion on the level of fine they could impose to take into account for example the length of time of the breach - strengthening the system by ensuring there were no longer excuses for more proportionate fines not being applied.

The new contract, which begins in April 2011, will simplify and strengthen sanctions further - a flat rate of £250 per patient affected per day will be charged, as announced today. It will be kept under regular review to ensure it is fair and appropriate.

10. MSA breach rate indicator

The MSA breach rate is the number of breaches of mixed-sex accommodation sleeping accommodation per 1,000 Finished Consultant Episodes.

An MSA breach rate indicator was developed because a simple count of the number of MSA breaches does not provide a fair comparison across healthcare providers. Raw numbers alone do not take into account the size of an organisation and it would be unfair to classify large acute providers as “worst performing” compared to other, smaller providers, as they handle larger volumes of admitted patients and therefore the possibility of mixing patients is greater. The MSA breach rate indicator gives us the ability to compare healthcare providers with others, or to compare change over time. It can tell us how a provider is “performing” in relation to other similar organisations, or the national average, and whether they are improving or getting worse.


Department of Health
Phone: 020 7210 5221

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