“We have cut the number of times a patient has been placed in mixed-sex accommodation without justification by half.” David Cameron, 16 May 2011.

David Cameron today delivered a speech outlining the Governments position on the NHS. In drawing attention to successes of the Coalition so far in their management of the NHS, Mr Cameron pointed to a large decline in the numbers of patients being placed in mixed-sex accommodation.

Whilst not a Coalition Government policy pledge, the ending of mixed-sex wards was in the Conservative party 2010 manifesto.

The policy has since been adopted in the NHS Operating Framework, which states that NHS organisations are expected to eliminate mixed sex accommodation, saving for cases cases where it is in the best interest of the patient, or reflects a patient's personal choice.

Since December, monthly data has been published on the number of breaches in England of cases of mixing in wards, with the figures showing the marked declines indicated by David Cameron.

The number of unjustified cases decreased from 11,802 in December to 5,446 in March – a decline of 53.8 per cent. Over the same period, the number of breaches per 1,000 cases declined from 8.4 to 3.6.

On the question of what is a justified case of mixing, the NHS guidance says that: “These are few, and are mainly confined to patients who need highly specialised care, such as that delivered in critical care units. A small number of patients (especially children and young people) will actively choose to share with others of the same age or clinical condition, rather than gender.”

While these figures do show a marked decline in the number of cases of mixing in wards, the Department of Health does advice caution in the use of this data, because this is only the fourth month for which data has been collected and published on a standardised basis.

Guidelines accompanying the data state: “During the early months of this collection, published figures should be treated with caution. With time, data quality is expected to improve as healthcare providers implement and embed data collection procedures... Therefore, figures published during the early months of the collection should be treated with a degree of caution, are subject to change and are not directly comparable with previously released figures.”

The need for caution is confirmed in the January statistics, which were revised in March from 8,160 to 8,7089. Likewise, it has been reported that Oxford hospitalshad some of the worst results for unjustified mixing because they had misunderstood the distinction between justified and unjustified cases of mixing.

Conclusion

While caution is required in using the figures, which could be revised upwards or downwards in the coming months, David Cameron can justifiably point towards big falls in the number of patients being housed in mixed sex wards since December.

However, few conclusions can be drawn on the longer-term trend in declining use of mixed sex wards. While the Labour government originally pledged to end this practice in 1997, no offical standardised data was released during their period in government. The Department of Health first published ad hoc figures in August 2010, noting at the time that data collection and classification of mixed sex wards varied between hospitals and health authorities. A Full Fact article looked at the figures released in August, focusing on the problem of inconsistant and non-seasonally adjusted data. 

Therefore while the figures cited by Mr Cameron are accurate, the limited amount of data leads to problems when assessing the full significance of the claims.