First-of-its-kind toolkit helps primary care centre improve accessibility

By Jo Makosinski | Published: 9-Nov-2022

Assura launches toolkit to support health centres adapt to the needs of people with disabilities and conditions such as dementia, neurodiversity, and anxiety

A toolkit to help GP practices improve buildings and the physical environment for people with disabilities and conditions such as dementia, neurodiversity, and anxiety, has been launched this week.

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 operators the chance to assess their environments and find small, low-cost actions to make them better for everyone.

The tools can be used by practice managers and patient groups to better understand how the design and layout of health centres works for people with a range of needs.

We cannot simply shrug our shoulders at the fact that the design of many older primary care buildings can be 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

And it is believed to be the first integrated resource of its kind to focus specifically on design principles to support people living with dementia, neurodiversity, and conditions like anxiety.  

The toolkit was commissioned by primary care building specialist, Assura, and was written by the Association for Dementia Studies at the University of Worcester.

It draws on research into best practice design for people living with dementia, neurodiversity, and conditions like anxiety and earlier studies with Assura by the national charities Dimensions and the Patients Association and will form part of Dimensions suite of training resources for general practice in its #MyGPAndMe campaign.

Core design features

It 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 toolkit allows primary care teams to assess their buildings and patient environment on core design features such as lighting and use of colour, which apply to all aspects of a health centre building; and on specific design features for particular areas, such as the need for adjustable lighting levels in consulting rooms.

It also offers 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 which found:

  • Just 22% of respondents feel independent in health centre environments
  • Less than half of respondents felt that toilet facilities in health centres met their needs
  • Almost half of all respondents 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 to support 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.

It stated: “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%).” 

Lead researcher and author of the guide and assessment tools, Sarah Waller CBE, said: “Health centres are where the most patient contact in the NHS takes place.

Designing for Everyone will enable the physical environment to be more supportive of all patients who attend clinics and will support staff in delivering high-quality, patient-centred care.”

Hindering accessibility 

Chief executive of Dimensions, Rachael Dodgson, added: “It’s crucial that people with learning disabilities and/or autism have the opportunity to access effective healthcare while maintaining their independence, dignity, and comfort. But, at the moment, inadequate building designs and patient environments are hindering this accessibility.

Designing for Everyone will enable the physical environment to be more supportive of all patients who attend clinics and will support staff in delivering high-quality, patient-centred care

The Designing for Everyone kit will address this situation and allow health centres to care for every patient in an inclusive, welcoming atmosphere.”

And Assura chief executive, Jonathan Murphy, said: “Given everything we have all seen about 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. 

“We cannot simply shrug our shoulders at the fact that the design of many older primary care buildings can be 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.

“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.”

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