Transgender patients could be treated in their own room if other patients ask to be on single-sex wards, under plans by the government to update the NHS Constitution.
The proposed revisions will reaffirm the right of patients to request treatment in single-sex wards, as well as the right to request a person of the same biological sex delivers intimate care.
In both cases, the rights are currently available only where possible and, in the case of same-sex wards, can be breached if there is a clinically urgent need.
It comes after former health secretary Steve Barclay put forward plans in October last year to ban transgender women being treated in female-only hospital wards in England.
Ministers say the changes – which will stress the importance of biological sex for the first time in the NHS Constitution – are “about putting patients first”.
The changes have been welcomed by sex-based rights groups, who have described them as a “return to common sense”.
However, the British Medical Association – the registered trade union for doctors in the UK – has warned they could mean transgender and non-binary patients “potentially find their access to vital NHS services limited”.
Meanwhile, the Royal College of Nursing (RCN) says trans and non-binary patients “are deserving of high-quality care like any other patient” and that changes to health policy “should be done with them, not unto them”.
Announcing the plans, Health and Social Care Secretary Victoria Atkins said: “We want to make it abundantly clear that if a patient wants same-sex care they should have access to it wherever reasonably possible.
“We have always been clear that sex matters and our services should respect that.
“By putting this in the NHS Constitution we’re highlighting the importance of balancing the rights and needs of all patients to make a healthcare system that is faster, simpler and fairer for all.”
Under the planned revisions, transgender people could be placed in a room on their own if another patient requests to be in a single-sex ward.
This would be permitted under the Equality Act 2010 when appropriate, “such as respecting a patient’s wish to be in a single-sex ward”, according to the Department of Health and Social Care.
The new document also aims to ensure different biological needs are met, and that illnesses and conditions that impact men and women in different ways are communicated clearly to patients.
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Health minister Maria Caulfield said: “Updating the NHS Constitution is crucial to ensuring the principles underpinning our NHS work for everyone.
“This is about putting patients first, giving them the dignity and respect that they deserve when they are at their most vulnerable.”
However, Professor Nicola Ranger, chief nursing officer at the RCN, said patients were already able to request intimate care from a staff member of the same sex.
“But in an NHS missing tens of thousands of nursing staff it is nigh-on impossible to accommodate with any consistency,” she said.
Meanwhile, Labour’s shadow health secretary, Wes Streeting, said “rights on paper are worthless unless they are delivered in practice”.
“The NHS Constitution already pledges that no patient will have to share an overnight ward with patients of the opposite sex, but that is not the case for too many patients,” he added.
“Labour supports single-sex wards and will provide the staff, investment and reform the NHS needs to make sure every patient can be cared for safely.”
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Maya Forstater, chief executive of Sex Matters, a human rights charity that campaigns for clarity on sex in law, policy and language, said Ms Atkins’s reference to biological sex was “very significant”.
“It will benefit anyone who needs same-sex intimate care in the NHS in England, or who may do so in the future,” she said.
“We can expect an outraged response from trans rights activists, but this is simply a return to common sense, and an overdue recognition that women’s wellbeing and safety matter.”
The NHS Constitution outlines the rights of patients and staff and is updated every 10 years.
Other proposed changes, which are subject to an eight-week consultation, include committing to providing families with a second opinion when a patient’s condition is deteriorating.
The rollout of the escalation process, also known as Martha’s Rule, started earlier this month and follows the death of 13-year-old Martha Mills in 2021.
She developed sepsis after suffering a pancreatic injury following a fall from her bike.
Martha’s parents, Merope Mills and Paul Laity, raised concerns about their daughter’s health a number of times but these were brushed aside.
A coroner ruled she would most likely have survived if doctors had identified the warning signs of her rapidly deteriorating condition and transferred her to intensive care earlier.
Sir Julian Hartley, chief executive at NHS Providers, said: “This consultation marks a once-in-a-decade opportunity to review and reset the NHS’s relationship with patients.
“Trust leaders are committed to creating a responsive and effective NHS which meets the current and future health needs of all the patients and communities they serve.”
