Women and men are being treated together in hospital wards across Belfast despite concern for their privacy and dignity, a report has said.
Elderly women are often uncomfortable when asked to share a mixed-sex ward, an investigation by medical care experts said.
There should be a regional policy adopted after significant variations were noted across hospital trusts, the Regulation and Quality Improvement Authority (RQIA) added.
There is zero tolerance of mixed gender care in the southern and western health trusts but daily occurrences were reported in the rest.
RQIA chief executive Glenn Houston said: "While these trusts reported that this happens only where single accommodation is not available, RQIA is calling on the Department of Health, Social Services and Public Safety to develop a clear regional policy statement on care in mixed gender accommodation."
He said the Public Health Agency and Health and Social Care Board should consider unintended consequences on the quality of patient experience when improving performance targets.
During the review, patients, their relatives and carers identified mixed gender accommodation as an issue that has a significant impact on maintaining their privacy and dignity while in hospital.
In the absence of an agreed regional policy on this issue, RQIA examined current practice in hospitals across the five health and social care trusts in Northern Ireland.
While in England there is zero tolerance in respect to care in mixed gender accommodation, the situation in Northern Ireland is much less clear, with individual trusts developing local policies and procedures.
The design of some hospitals makes it difficult to ensure privacy while the pressure of patients coming from emergency departments can force the temporary housing of men and women together until more suitable accommodation is found.
In the majority of cases where mixed gender accommodation was being provided, it was being appropriately managed. There was good support from the senior nursing staff and good liaison with patient flow managers in the Belfast and Northern trusts, the review said.
Senior managers in the South Eastern Trust said they were doing all within their power to manage mixed gender occurrences to ensure the privacy and dignity of patients.
However, those were not always resolved within reasonable timescales; patients were not being transferred into uni-gender accommodation within 24 hours, in line with locally developed trust policies.
Patients who spoke with reviewers reported that they had been consulted prior to admission to the mixed gender bays and were, in the main, satisfied with their care. They spoke of their preference to be in single gender bays, but appeared to accept the reasons provided to them by staff for their admission to mixed gender accommodation.
Members of staff across all hospital wards were very clear about administering the complaints procedure, should a patient wish to make a formal complaint about their care in mixed gender accommodation.
The Belfast Trust was unable to provide specific information on complaints about mixed gender accommodation, citing coding anomalies in their complaints database.
The Northern Trust reported that since 2007 nine complaints were recorded in respect of patients having to be accommodated in mixed gender bays. The South Eastern Trust recorded a total of six complaints within the same timeframe.
PA