NHS England has recorded more than 120,000 breaches of its mixed-sex hospital accommodation guidance in the past six years, a 257% increase. Guidance added to the NHS constitution in 2012 states that hospital patients will not share sleeping accommodation with members of the opposite sex “except where appropriate”. Exemptions include critical care wards or patients receiving treatment, such as chemotherapy, where they “may derive comfort from the presence of other patients with similar conditions”. The guidance also says patients should not share toilet or bathroom facilities with members of the opposite sex and should not “have to walk through an area occupied by patients of the opposite sex to reach toilets or bathrooms”. However, data from NHS England analysed by the Observer shows thousands of breaches every month, with patient dignity and safety put at risk. Between July 2017 and July 2023, 126,404 mixed-sex accommodation breaches were reported. The monthly figure for July 2017 was 899, and 3,211 in July this year. The true number may be higher. Data collection was suspended from March 2020 to September 2021, to increase NHS capacity during the pandemic. Caitlin (not her real name) worked on an acute mental health ward in a private hospital which switched from 12 women-only beds to 15 mixed beds. “Women on our ward often had a history of sexual or domestic abuse,” she said. “Some had tried to end their life in the wake of this, and a lot of them felt intimidated by the level of aggression shown by some men on the ward.” Women and men had separate wings but shared a communal area. “A lot of the women were really fearful of the men,” she added. Caitlin said the use of mixed-sex accommodation had a negative impact on some women’s recovery. “Women would stay in their rooms, not even coming out to watch TV,” she says. “Some acutely unwell women would display sexually disinhibited behaviour in the communal areas, which is a symptom of their diagnosis. They were put in a position where their dignity could not be protected.” Breaches reached 41,182 in 2022/23, and in the first four months of this financial year NHS England recorded 13,654 breaches. Since October 2017, the number of monthly breaches has not dropped below 1,000. The month with the fewest breaches since recording began was June 2014, with 110. “Women make hundreds of conscious and unconscious decisions to keep ourselves safe from men,” said Karen Ingala-Smith, author of Defending Women’s Spaces. “Women should not have to be on their guard like this when they are in hospital.” Earlier this month, health secretary Steve Barclay announced a ban on transgender patients being accommodated in female-only and male-only NHS wards, telling Tory conference delegates in Manchester: “We know what a woman is.” The move was criticised by LGBTQ+ rights advocates. Paul Martin, chief executive of LGBT Foundation, and Alex Matheson, its deputy director of education, said: “The UK government’s plan to stop trans people from using healthcare wards that match their gender is morally wrong and ethically indefensible.” An NHS spokesperson said trusts were taking action to reduce breaches of the accommodation guidance and that they remained rare.