University of Worcester Authors First-of-its-Kind Toolkit to Improve Healthcare Access

The ‘Designing for Everyone’ kit was commissioned by primary care building specialists Assura and written by the the University’s Association for Dementia Studies .

Sarah Waller CBE, from the Association for Dementia Studies, 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.”

Bringing together best practice on building design aspects including colour, lighting, acoustics, fixtures and fittings, wayfinding, artwork and use of space, the toolkit gives primary care sites the means with which to assess their environments and implement small, low-cost actions to improve accessibility for the most vulnerable.

The launch of the toolkit follows 2019-20 research by Dimensions, one of the UK’s largest organisations supporting people with learning disabilities and autistic people, which found that:

  • Just 22% of respondents feel independent in health centre environments
  • Less than half of respondents feel that toilet facilities in health centres meet 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

The suggestions and actions outlined in the toolkit can be used by GPs, 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. This toolkit is the first integrated resource of its kind to focus specifically on how design principles can support people living with dementia, neurodiversity and conditions like anxiety and will play a vital part in improving patient experience, promoting engagement with health services and reducing inequality of access to care.

Building on expertise provided by the ADS, the toolkit is aligned with national dementia policy and to ADS’ values. It aims to help people with dementia live well in their homes and communities’ post-diagnosis and recognises the need for skilled care and dementia friendly person-centred design while drawing on research into best practice design for people living with dementia, neurodiversity and conditions like anxiety and earlier studies with Assura by Dimensions and the Patients Association

‘Designing for Everyone’ 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.

The kit also addresses some of the challenges raised in the government’s National Disability Strategy, which highlighted ‘visiting the GP surgery’ as a key issue for people living with disabilities, with over three-quarters experiencing some difficult accessing health services. A further 40% indicated that the pandemic had affected access to healthcare for non-coronavirus related issues, whereas just 19% of non-disabled people had encountered the same barrier.

Rachael Dodgson, Chief Executive of Dimensions, said: “It’s crucial that people with learning disabilities and autistic people 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. The Designing for Everyone kit will address this situation and allow health centres to care for every patient in an inclusive, welcoming atmosphere.”

Jonathan Murphy, CEO of Assura, 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’ 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: