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At your practice, is it easy for your reception team to offer a patient a quiet space to wait? Have you got wall murals in your building? Are the signs to help people around your building easy to understand?

These are just some of the questions being posed by a new toolkit to help GP practices improve their buildings and the physical environment for people with disabilities and conditions such as dementia, neurodiversity and anxiety.

The Designing for Everyone kit – which brings together best practice on design aspects including colour, lighting, acoustics, fixtures and fittings, wayfinding, artwork and use of space – gives primary care sites the chance to self-assess their environments and find small, low-cost actions to make them better for everyone.

The tools can be used by practice managers, premises teams and patient groups to better understand how the design and layout of their health centre building works for people with a range of needs. It’s believed to be the first integrated resource of its kind to focus specifically on design principles to support people living with dementia, learning disabilities and neurodiverse conditions – which can play vital part in patient experiences, engagement with health services and reducing inequality of access to care.

The toolkit was commissioned by primary care building specialists Assura plc and written by the Association for Dementia Studies at the University of Worcester. It draws on research into best practice design for people living with disabilities, dementia and neurodiverse conditions, and earlier studies with Assura by the national charities Dimensions and the Patients Association. It will form part of Dimensions’ suite of training resources for general practice in its #MyGPAndMe campaign, and will also be rolled out by Assura in its approach to designing new primary care buildings and delivering extension and improvement works to existing sites around the country.

The tools allow primary care teams to self-assess their buildings and patient environment on core design features such as lighting and use of colour which apply all over a health centre building, and on specific features for particular areas like consulting rooms. They also offer guidance on additional design issues to consider during a pandemic.

It follows Dimensions’ 2019-20 research with disabled people on their experiences of primary care buildings. It found:

  • Just 22% of disabled people feel independent in health centre environments
  • Less than half of people felt that toilet facilities in health centres met their needs
  • Almost half of all disabled people feel worried in health centre environments – with décor, lighting, noise levels and waiting room layout all highlighted as factors that affect how people feel
  • Increased training, awareness, skills and knowledge are needed on supporting people with disabilities in primary care environments.

It also highlights some of the challenges raised in the government’s National Disability Strategy, which noted ‘visiting the GP surgery’ as a key issue for people living with disabilities: “Of those disabled people who had found difficulty accessing public buildings at least ‘sometimes’, about three quarters had experienced at least some difficulties accessing health services (78%)…Access to healthcare services appears to have been particularly impacted by the COVID-19 pandemic – disabled people more often indicated coronavirus had affected access to healthcare for non-coronavirus related issues than non-disabled people (40% compared with 19%).”

Given the role of primary care in community health through the pandemic, and its position front and centre of the NHS Long Term Plan, the places where we access face-to-face primary care must work for everyone.

Addressing the fact that the design of many older primary care buildings is particularly difficult for people with disabilities, dementia and neurodiverse conditions – and can even impact on whether people who are most in need of local health services access them at all – is an estates challenge which cannot wait. Levelling up access to healthcare and reducing the impact of health inequalities is at the heart of the NHS’s vision, so creating healthcare facilities which are designed to serve everyone who uses them is fundamental for those patient experiences.

Download the Designing for Everyone guide, summary assessment tool and full assessment tool at

Jonathan Murphy, CEO of Assura plc

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