NHS England has drawn criticism for its refusal to provide a timeline for implementing new guidance aimed at protecting single-sex spaces. Outdated policies that permit individuals identifying as women to be housed in female wards remain in effect, despite new guidance from the Equality and Human Rights Commission (EHRC) that came into force Wednesday.

NHS England stated it would release its own policies and guidance on single-sex spaces "shortly." However, the delay has been described as "insulting" to patients and staff by Fiona McAnena, director of campaigns at the charity Sex Matters. "The NHS has a duty to act now," McAnena said. "It knows the law. This prevarication is insulting to patients and staff alike. NHS leaders should have acted when the law was clarified in April last year, and they have no reason to delay further."

McAnena emphasized the importance of these protections, particularly for vulnerable female patients. "There have been reported cases of men claiming to be women and then behaving extremely inappropriately in a women’s ward," she noted.

An NHS England source suggested the delay was coordinated by the Cabinet Office, which was reportedly managing the government's response to the EHRC guidance. However, a Cabinet Office insider countered this, stating that no entity was prevented from updating its policies and that the government's position has been for all bodies to align with the Supreme Court ruling and the EHRC code of practice.

Since a Supreme Court ruling last year clarified that the terms "woman," "man," and "sex" in the Equality Act 2010 refer to biological sex, NHS England has maintained existing transgender policies pending reviews. Current guidance, "Delivering same-sex accommodation," instructs staff to accommodate transgender individuals "according to their presentation," noting this may not align with physical sex characteristics and is independent of a gender recognition certificate or legal name change. This policy applies to toilet and bathing facilities in most circumstances.

Nurse Bethany Hutchison, who was involved in a successful claim against Darlington Memorial Hospital regarding a male colleague using women's single-sex changing rooms, urged the NHS to establish "practical and legally robust policies" to end uncertainty. "The continued delay in issuing updated guidance is creating uncertainty for frontline NHS staff who are expected to make sensitive accommodation decisions every day," Hutchison stated. "Nurses need clear, practical and legally robust policies that reflect the current position following the Supreme Court ruling and the EHRC code, while ensuring that every patient is treated with dignity, respect and compassion."

One reported incident involved a man identifying as a trans woman who was jailed in June for performing a sex act in front of nurses at the University Hospital of Wales in Cardiff. The individual, described in court proceedings using female pronouns despite their biological sex, was deemed at risk of self-harm during hospitalization.

Existing NHS policy also advises staff to defer to the preferences of teenage patients over their parents regarding gendered accommodation if conflicts arise, stating that "the child’s preference should prevail even if the child is not Gillick-competent."

Some healthcare trusts have begun updating their policies. Cambridgeshire and Peterborough NHS Foundation Trust's transgender policy for staff now mandates that single-sex facilities must adhere to the Equality Act's interpretation of sex as biological sex.

Health Secretary Yvette Cooper affirmed that the NHS would comply with the law, stating in a Times Radio interview, "The law's the law. All of us need to follow the law. The law’s been very clear on this." An NHS spokesperson reiterated that new guidance would be published shortly, but in the interim, hospitals are expected to operate within the EHRC code's principles to ensure patient dignity and respect.