UK Government

Department of Health (National): Fewer patients staying in mixed sex accommodation

Press Release   •   Jun 16, 2011 11:29 BST

Reported mixed-sex breaches fall by 83 per cent since December 2010

Fewer patients are suffering the indignity of staying in mixed sex accommodation, according to new figures out today.

Since December 2010, when the monthly collection of mixed sex accommodation was introduced, the number of breaches has dropped from 11,802 to 2,011 – a decrease of 83 per cent.

In May 2011, hospitals reported that 2,011 patients were placed in mixed-sex accommodation without any justification. This compares to 2,660 for April 2011 – a decrease of 24 per cent.

The data, published online at individual hospital level, also shows that:

• 103 Acute Trusts (62 per cent) reported zero sleeping breaches (compared to 59 per cent in April 2011).

• 42 Acute Trusts reported a reduction in the number of breaches in May 2011.

Commenting on the statistics published today, Health Minister Simon Burns said:

“Today’s figures show that the tough action we have taken is having a sustained impact on reducing mixed sex accommodation breaches. Greater transparency has now driven down breaches by more than 80 per cent since December. I’d like to pay tribute to all the NHS staff across the country who have worked so hard to make this happen.

“However, there are still too many breaches. This is why hospitals face fines of £250 for every breach, which can then be reinvested back into patient care.”

Notes to editors

1. A full statistical press notice with further explanatory notes, and detailed tables by provider and commissioner can be found via the following link:

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

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

4. 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.

5. 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.

6. 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 began in April 2011, will simplify and strengthen sanctions further - a flat rate of £250 per patient affected per day will be charged. It will be kept under regular review to ensure it is fair and appropriate.

7. 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.


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