The Department of Health has recently issued further guidance on mixed sex accommodation. National Health Services organisations are expected to eliminate mixed sex accommodation, except when it is in the overall best interests of the patients or reflects their personal choice. The Operating Framework for the NHS 2011-12 confirms requirements for reporting and sanctioning breaches of national guidance. Organisations providing NHS funded care must agree with their commissioners how they will determine whether a particular episode of mixing is justified. One of the limited number of circumstances in which mixing can be justified, relates to patients who actively choose to share with others the same age or clinical condition rather than gender. One element of the new guidance specifically refers to “patients with long term conditions, including renal dialysis”. Here the guidance states that it can be acceptable for mixing to occur.
The guidance makes clear that dialysis units are not automatically exempt and that common sense should prevail. Clearly in units where acute patients might be dialysed (particularly those dialysed through femoral lines, thigh loop gortex grafts or those who are in inpatient beds) should be managed in single sex accommodation or with appropriate consideration. In the majority of maintenance and satellite units the dialysis floor is essentially an outpatient area and should be managed as such.
Common sense should prevail. There is actually a dialysis example on the Department of Health website and to quote directly from that “staff in these areas will need to make decisions on a day to day basis. For instance in a renal dialysis unit, if all the patients are well established on treatment, wear their own clothes and have formed personal friendships, mixing may be a good thing. By contrast a new dialysis patient, with a femoral catheter, wearing hospital gown, should be able to expect a much higher degree of privacy”.
The publication of the guidance has even led to a question in Houses of Parliament where Mrs Moon asked the Secretary of State if he would make an assessment of the likely effects on renal dialysis patients of imposing financial penalties on dialysis units which provide mixed sex accommodation. In a statement from the Government Simon Burns, Minister of Health, quoted the recent guidance and explained that it was not expected that renal dialysis will prompt a significant number of sanctions. If concerns are raised I would urge common sense to be applied by commissioners, Trust managers and renal unit staff to avoid unnecessary anxiety and confusion on the one hand but also to protect and promote respect and dignity on the other.
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