NHS Constitution change could see trans patients treated in rooms on their own

Hospital patients in England will have the right to request to be treated on single-sex wards under proposed changes to the NHS Constitution, with transgender people placed in rooms on their own.

The update “is about putting patients first”, ministers said, and includes plans to accommodate requests for same-sex intimate care.

But the British Medical Association warned the proposed changes could mean transgender and non-binary patients could “potentially find their access to vital NHS services limited”, while the Royal College of Nursing said changes to health policy should be done with patients “not unto them”.

The changes will also enshrine Martha’s Rule in the NHS Constitution in a bid to bolster patient safety.

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.

In October, former health secretary Steve Barclay said he would look into changing the constitution to address concerns about trans women using wards intended for biologically female patients.

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.”

The new document will also aim 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.

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.”

Maya Forstater, chief executive of Sex Matters, a human rights charity that campaigns for clarity on sex in law, policy and language, said: “Victoria Atkins explicitly referring to biological sex is 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.

“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.”

However, 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.”

Professor Nicola Ranger, chief nursing officer and deputy chief executive of the Royal College of Nursing (RCN), said: “Patients are 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.

“It’s also important to recognise that nursing staff treat all patients with the utmost respect and professionalism, no matter their gender.

“Trans and non-binary patients are deserving of high-quality care like any other patient and changes to health policy should be done with them, not unto them.”

Dr Emma Runswick, deputy chairwoman of the British Medical Association (BMA) council, warned some changes “run the risk of causing more harm than good – with the potential to incite further discrimination, harassment and ostracisation of an already marginalised group”.

“If these proposed changes come into effect, transgender and non-binary patients will potentially find their access to vital NHS services limited,” she added.

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.

The new constitution will also reinforce the health service’s commitment to unpaid carers and will aim to reduce inequalities in access among different groups.

Louise Ansari, chief executive of Healthwatch England, said the constitution “plays a crucial role in shaping the culture of our NHS and helping the public to know their rights”.

“Since the NHS Constitution launched, it has helped to shift the balance of power from services towards patients and their families,” she added.

“But, with only a third of people knowing their rights, there is still a long way to go.

“Given the challenges our NHS faces, a conversation to reaffirm and raise awareness of the most important rights to the public has never been more timely.”

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.”