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Health leaders have asked the government to not drag the NHS into a pre-election culture wars debate after it published a proposed update to the NHS Constitution for England focusing on biological sex issues.
The NHS Constitution for England is a document outlining the rights of patients and staff. It has to be updated every ten years and was last updated in 2015. A consultation will be the first stage of a review of the constitution and will run for 8 weeks.
Proposed updates will reflect biological needs of patients and empower people to request same-sex wards and care. This includes setting out that placing transgender patients in single-room accommodation is permissible under the Equality Act 2010 when it is appropriate, such as respecting a patient’s wish to be in a single-sex ward.
It says that the government has been clear that biological sex matters and the constitution proposal makes clear what patients can expect from NHS services in meeting their needs, including the different biological needs of the sexes. Illnesses and conditions that we know impact men and women differently should be communicated in a clear and accurate way.
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.”
NHS Constitution should focus on high quality care for all
The NHS Confederation said that the constitution should focus on high quality care for all and energies should not be focused NHS on dragging into a pre-election culture wars debate.
Matthew Taylor, chief executive of the NHS Confederation said: “This is especially true when health leaders and their staff already work hard every day to show fairness and compassion towards all their patients and colleagues regardless of their characteristics or needs. They recognise that everyone has the right to be treated with dignity and respect and to be protected from abuse and neglect.
“In particular, groups of people, including trans and non-binary patients, continue to receive some of the worst health outcomes of any group in our society and NHS leaders and staff will want to do all they can to support these patients, as well as their trans and non-binary staff to reduce inequalities. Whatever changes are eventually introduced following the consultation need to be clear and workable for NHS staff, who should not expect to have to interpret ambiguous guidance at a local level.”
The consultation also plans to embed the right for patients’ and their loved ones’ access to a rapid review from outside the care team if the patient is deteriorating. The importance of this pledge has been made clear by the tragic story of Martha Mills. This aims to put patients and their families, carers and advocates at the heart of decision making, and strengthening links between NHS services.
Additional updates the government is proposing include:
- ensuring the health system works together to understand the needs of different groups within each community and reduce disparities in access, experience and outcomes for all
- strengthening responsibilities on patients to cancel or reschedule appointments and on the NHS to communicate appointment information clearly
- making clear that patients can expect their physical and mental health care to be person-centred, co-ordinated and tailored to their needs
- reinforcing the NHS’s commitment to unpaid carers.
Matthew Taylor added: “The opportunity to update the NHS Constitution should not be about grabbing headlines, but to strive to reach a consensus around upholding these core values and closing the gap between the waiting time standards it mandates and where performance levels are currently. This should include facing up to the reality that the government has overseen an NHS budget that has not kept pace with demand and demographic changes.
“For example, the current NHS Constitution advocates a maximum wait of four hours in A&E from arrival to admission, transfer or discharge. When the constitution first published in March 2012, 7.5% of patients were waiting longer than this time yet in March 2024, this had increased to 25.8%. When it comes to elective care, in March 2012 there were 2.33m entries on the waiting list, but in February 2023 there were 7.54m. There is absolutely no chance of recovering this or the other constitutional standards without further capital investment and delivering the NHS Long Term Workforce Plan.
“Our members support the introduction of new ways to improve patient safety and they have welcomed the piloting of Martha’s Rule. If the scheme is to be extended, questions will need to be answered about what resources hospitals and other providers will be given to ensure it can be delivered.”
