Mixed-sex accommodation breaches

We look at changes in the instances of unjustified mixed-sex sleeping accommodation.


Last updated: 28/06/2018

Patient experience
Hospital care

The Revision to the Operating Framework for the NHS in England 2010/11 stated that "mixed-sex accommodation needs to be eliminated, except where it is clearly in the overall best interests of the patient". Since December 2010, providers of NHS care have submitted monthly data on the number of occurrences of Mixed-Sex Accommodation (MSA) breaches. A mixed-sex accommodation breach is any unjustified mixing of genders in sleeping accommodation.

How has the number of mixed-sex accommodation breaches changed over time? 28/06/2018

Chart QualityWatch

Read more

The number of MSA breaches decreased by over 93% between April 2011 and August 2012. Following this, the number of MSA breaches remained low at less than 500 breaches per month, until 2016 when they began to increase again. In February 2018, the number of MSA breaches reached 2,319, which is the highest reported figure since MSA data collection became mandatory for all NHS providers in April 2011.

In April 2018, there were 1,584 MSA breaches. The MSA breach rate (the number of MSA breaches per 1,000 finished consultant episodes) for England in April 2018 was 1.0 per 1,000 FCEs compared to 0.4 in April 2017.

About this data

MSA breach data is collected monthly from all NHS providers and other organisations that provide NHS-funded care (including Independent and Voluntary Sector organisations). From April 2011, the MSA data return has been mandatory for all NHS Trusts.

“Sleeping accommodation” includes areas where patients are admitted and cared for on beds or trolleys, even where they do not stay overnight. It therefore includes all admissions and assessment units (including clinical decision units), plus day surgery and endoscopy units. It does not include areas where patients have not been admitted, such as accident and emergency cubicles.

From April 2011 MSA data have been mandatory for all NHS providers and flat-rate fines for MSA breaches have been built into organisations’ contracts. Therefore, it is expected that MSA data collection processes are now fully embedded in the NHS and that the data submitted from April 2011 onwards is of a higher quality than in previous months.

The MSA breach rate is the number of breaches of mixed-sex sleeping accommodation per 1,000 Finished Consultant Episodes.

For more information, please see the Department of Health's Methodology for Mixed-Sex Accommodation Breach Rate Indicator.