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Sanitary product provision for inpatients

"Patients in hospitals should expect to have all of their needs met, to allow for a quick and dignified recovery."

– Eleanor Wilson, medical student, ARM 2018

Doctors recognise that reliable access to sanitary products is essential for the health and wellbeing of patients in hospital, and have expressed concern that they are not always readily available for patients who require them.

FOI (freedom of information) requests submitted by the BMA to all trusts and health boards providing inpatient care across the UK reveal that there are shortcomings in the provision of sanitary products for patients:

  • While just over half of respondents indicated that sanitary products are available for inpatients, a significant number of trusts and health boards (42%) either do not supply sanitary products at all or indicated that they would only supply them in case of an emergency, and would then expect a patient to supply their own as soon as possible.
  • In numerous cases sanitary products were only provided on gynaecology or maternity wards, as a clinical item, rather than being available to all inpatients that may need them.
  • No trusts or health boards in the UK have a dedicated policy in place covering the provision of sanitary products to inpatients.
  • The availability of items to purchase – either from an on-site shop or vending machines – is inconsistent. Sanitary products are not available to purchase on any site in 14% of trusts and health boards. This further substantiates the requirement for free and readily accessible provision across all trusts and health boards.
  • Some trusts and health boards reported spending nothing on sanitary products for inpatients. For those trusts and health boards that readily supplied products, the average spend was just £0.71 per bed per year.
  • A number of trusts and health boards listed toiletry items such as razors and shaving foam as being freely provided to patients during their stay, despite only supplying small amounts of sanitary products in case of an emergency, or not supplying them at all.

The findings presented here align with a 2018 investigation by Scottish Labour MSP Monica Lennon, which concluded that none of Scotland’s 14 health boards had a policy for providing sanitary products, with patients generally expected to have products brought in by friends and family, purchase their own from a hospital shop, or rely on hospital staff to make emergency purchases on their behalf.

"Despite it being the 21st century, in some UK hospitals patients do not have access to sanitary protection. It sounds so basic, doesn't it?"

– Shree Datta, consultant obstetrician and gynaecologist, ARM 2018

While the Scottish Government response at the time was that it expected health boards to provide sanitary products to all those in hospital who needed them, the results of our FOI requests suggests that isn’t always the case in practice – although progress has been made in Scotland in other areas (see the ‘recent developments’ tab below for more detail).

There is a clear need for sanitary products to be free and readily available across all trusts and health boards in the UK. They are essential for the health and wellbeing of patients, and it would not be prohibitively expensive to provide them.

 

Recommendations

Sanitary products should be provided for free, readily available to all in-patients and easily accessible by hospital staff. To support this:

  • Trusts and health boards should have a policy in place to ensure that there is adequate and consistent provision of sanitary products, or write this into existing policies concerned with patient care.
  • Trusts and health boards should include clear information to patients on how to access sanitary products in the literature distributed prior to a planned stay in hospital.

View our press release if you are a journalist interested in finding out more.

  • Summary of results

    Out of 223 FOI requests sent, 187 responses were received. This is a response rate of 83.9%.

     

    Sanitary product provision

     

    Does the trust / health board supply sanitary products?

     

    Yes

    Yes - small amounts / emergency only

    No

    Unclear

    Total

     

    104 (56%)

     

    54 (29%)

     

    25 (13%)

     

    4 (2%)

     

    187

     

    The majority of trusts and health boards stated that sanitary products were readily available for patients. However, many respondents explicitly stated that they only held small amounts of sanitary products, available for emergencies, and often with a stated expectation that patients should either purchase or receive their own from family/ friends as soon as possible. For example, responses ranged from:

    “We hold a supply of sanitary products on our female inpatient wards. Staff ensure that patients have the products they need, patients are asked about their own supply and made aware of the availability of ward-supply on admission as part of their welcome. This is to ensure that patients do not run out and any potential distress is minimised.”

    To:

    “All wards would expect patients/families to provide their own, but would have a very small supply of sanitary pads for emergency use.”

    There were also a number of respondents that held sanitary products for patients, but only on gynaecology or maternity wards, which suggests that they are only purchased for clinical need rather than for hygiene and wellbeing. For example:

    "Available and supplied in gynaecology ward and related areas. No other wards have supplies, but are able to request to borrow from Gynae if required."

     

    Policy on the provision of sanitary products

    No trusts or health boards indicated that they had an explicit policy in place to cover the provision of sanitary products. However, one trust did cover sanitary product provision in their Privacy, Dignity and Respect Policy: “Sanitary items will be made available for women patients and women should not be expected to approach a male member of staff to request such items.” And one health board told us that they were in the process of drawing up a policy statement to outline their position on free provision of sanitary products at the time the FOI request was made.

     

    Purchasing sanitary products

    Are sanitary products available to purchase in the trust / health board?

    Yes - but not at all sites

    Yes - but likely to be at restricted times

    Yes - readily available

    No info / refused

    No

    Total

    48 (26%)

    47 (25%)

    37 (20%)

    28 (15%)

    27 (14%)

    187

     

    48 (26%) respondents said that sanitary products were available to purchase at some of the sites within their trust or health board, but not at every site.

    “There are six sites with inpatients beds in the Trust. There is only one site which has a shop with the facility to purchase sanitary products.”

    47 (25%) respondents stated that sites within their trust or health board had shops at which sanitary products could be purchased, but either explicitly stated that there were no vending machines, or didn’t reference the availability of sanitary product vending machines. These items therefore cannot be purchased when hospital shops are closed.

    “These products are not supplied via vending machines but are available to buy in the on-site Boots.”

    37 (20%) trusts and health boards either stated that products could be purchased at all sites in shops and vending machines, or didn’t provide detailed enough information to suggest that products weren’t readily available.

    “One hospital site, sanitary products are available from the retail shop and from vending machines within public female toilets.”

    28 (15) respondents were unable to provide information about the availability of sanitary products to purchase.

    27 (14%) trusts and health boards indicated that there were no facilities to purchase sanitary products at any of their sites.

    “There are no sanitary products available to buy within the in-patient facilities.”

     

    Expenditure on sanitary products

    The quality of the data on expenditure on sanitary products varied across respondents. What the received data suggests, however, is that free sanitary product provision to all in-patients across the NHS would not be prohibitively expensive. The average verifiable expenditure in 2017/18 of all trusts and health boards which readily supplied sanitary products (i.e. the answer to question 1 was ‘yes’) was £0.71 per bed. We therefore estimate that to supply sanitary products at a level equivalent to those trusts and health boards that state that they readily provide them, it would cost each trust or health board £548 per year on average.*

    Whilst there is no guarantee that this would result in a perfect system of provision, it would at least mean that no trusts and health boards would either only be providing small amounts of products in an emergency, or not providing anything at all. The quality of provision could then be individually reviewed by trusts and health boards.

    *There are approximately 172,000 beds in the UK (see here for data for England, Wales, Scotland and Northern Ireland). At £0.71 per year per bed, the total UK annual cost would be £122,120. This is £548 for each of the 223 trusts and health boards to which FOI requests were sent.

     

    Other items provided to patients, and hospital visit information for patients

    A number of trusts and health boards listed toiletry items such as razors and shaving foam as being freely provided to patients during their stay, despite either stating that they didn’t supply sanitary products, or that they only provided them in case of an emergency.

    It is notable that many trusts and health boards did not explicitly list sanitary products as something that patients should bring with them in the literature provided to patients ahead of a pre-planned stay in hospital. There appears to be an expectation that patients would remember to bring these items with them if required.

     

  • Recent developments

    Although there is clear need for progress on the provision of sanitary products in hospitals, there have been recent developments in the free provision of products in other areas around the UK. In Scotland free sanitary products are available in all schools, colleges and universities, and a pilot that began in Aberdeen has since been expanded to provide free products to low income households across the country. In Wales, £1m of government money has been committed to councils to tackle period poverty in the areas of highest need, and a council in Northern Ireland has become the first in the country to consider providing sanitary products for free in some public buildings.

    The BMA has called for an end to period poverty across the UK, alongside calling for the provision of sanitary products to in-patients.

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