National health service organisations are expected to adhere to core standards in their treatment of all patients, as assessed by the Healthcare Commission (HCC). When the HCC find that services are not meeting core standards, it may refer serious failure to the Secretary of State (or for foundation trusts, Monitor) with a recommendation that special measures may be taken. This option is rarely exercised because trust managers and, where appropriate, the strategic health authority (SHA) are expected to act as soon as a failure to reach a core standard is recognised.
75 per cent. of all inpatients are older people. Many elderly patients find mixed sex accommodation distressing as it reduces their privacy. The 2008-09 Operating Framework sets out an expectation that primary care trusts (PCTs), which are responsible for working with healthcare providers to agree and implement plans for improving services, will set stretching local plans for improvement in performance in reducing mixed sex accommodation. The NHS Institute for Innovation and Improvement published guidance in December 2007 to help NHS healthcare providers adhere to the requirements of their local PCTs. The guidance clarifies that single-sex accommodation can be provided in single-sex wards, single rooms with adjacent single-sex toilet and washing facilities (preferably en-suite), or single-sex bays within mixed wards.
Where patient survey scores are available, monitoring should be based on seeking specific improvements in these scores in the next survey. SHAs are responsible for the assurance of these processes and for the performance management of NHS trusts.