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
http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performance
3. Detailed tables by provider and commissioner can be found via
the following link:
http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/MixedSexAccommodation/index.htm
4. Hospital site-level data is also available on the NHS Choices
website (www.nhs.uk).
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.
Contacts:
Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk