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Feature Inpatient Care

Mixed sex wards: progress towards elimination is slipping

BMJ 2019; 367 doi: (Published 30 October 2019) Cite this as: BMJ 2019;367:l6107
  1. Emma Wilkinson, freelance journalist, Sheffield, UK
  1. emmalwilkinson{at}

Breaches of rules enforcing separate men’s and women’s accommodation are creeping up again, finds Emma Wilkinson, while patients call for the rules to be made even stronger

Dolly Sen from Norfolk remembers being an inpatient in a bay on a mental health ward and men coming in to ask for sex. She had stayed in mixed sex hospital accommodation many times, and on this occasion a man pushed her against a wall and assaulted her, she told The BMJ.

“You’re feeling vulnerable. A hospital ward should be a safe space. It does not feel safe being around men who don’t have inhibitions,” she said.

Sen’s experience was in the early 2000s, before the government’s 2011 pledge to abolish all mixed sex NHS hospital accommodation in England except in intensive care units and emergency departments. Scotland, Wales, and Northern Ireland had by then already scrapped mixed sex accommodation.

The 2011 pledge was limited to stopping the sexes sharing sleeping areas, bathrooms, and toilets or having to cross mixed sex areas to reach these facilities. To meet the rules hospitals could use single rooms, wards for men or women only, or mixed wards but with separate bays or rooms for men and women. The caveat “except where it is in the overall best interest of the patient” gave trusts wiggle room in emergency situations or when patients need highly specialised treatment in a critical care unit.1 The rules have been suspended in times of peak winter pressure.

But the 2011 rules aren’t always followed, and incidents such as Sen’s persist. And many patients and doctors think that the rules don’t go far enough in the first place.

In 2018, after inspectors found an unnamed trust to be breaching the rules and several patients reported sexual incidents, the English regulator …

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