Over 250,000 severely disabled people, including those with profound and multiple learning disabilities in the UK, cannot use standard accessible toilets. This number is set to increase in line with demographic trends (as people with very complex needs are living longer). 

There are currently over 1200 registered Changing Places toilets in the UK but provision on the NHS Estate in England would seem to be limited at present to no more than between 30 and 40 locations (although there may be some unregistered Changing Places toilets).

In December 2018, Caroline Dinenage, Minister of State for Care, announced that up to £2million of capital funding will be available for NHS Trusts to improve the provision of Changing Places in NHS hospitals. This funding is intended to improve the provision of Changing Places on the NHS Estate over the next two years (2019-2021).

There are several drivers for this investment:

  • The Equality Act (2010) sets out duties requiring public authorities to make reasonable adjustments by: altering policies and practices; overcoming barriers caused by physical features of buildings; and providing auxiliary aids. 

  • The Public Sector Equalities Duty, introduced under the Equality Act (2010), requires public bodies to have due regard for advancing equality which includes: removing or minimising disadvantages suffered by disabled people; 4 taking steps to meet the needs of disabled people; and encouraging disabled people to participate in public life and other activities.

  • British Building Standards (BS 8300:2009) and the Health Building Note (HBN 00-02) recommend that hospitals include Changing Places facilities.

  • The Changing Places campaign (launched by the Changing Places Consortium in 2006) calls for government to change building and planning regulations to ensure that Changing Places toilet facilities are provided in all large public buildings (including hospitals) as they are built, redeveloped or refurbished.

  • As a result, the Ministry of Housing, Communities and Local Government (MHCLG) is consulting on whether Building Regulations should be updated to make Changing Places facilities mandatory in some large public buildings, including hospitals.

What funding can be applied for?

This fund is a capital fund and as such, the element of funding bid for from the Department of Health and Social Care can only be used to create assets which score as capital investment in the Trust’s accounts. There is no discretion or ability in the award to pass funding between organisations or to create assets anywhere other than in the Trust’s own accounts. 

This capital funding can only be used for the creation of Changing Places facilities.

This includes items such as installation, building and equipment costs. It may not be used to support improvements in existing facilities. Installation of a Changing Places facility can be part of wider building works, renovations or extensions planned.

Capital funding is only available to be spent on items that can be classified as capital expenditure according to the recipient’s local accounting rules.

Funding is available for the financial years 2019-20 and 2020-21 and all funding awarded must be drawn and expended by 31st March 2021. Funding cannot be drawn in advance of need.

Your bid should clearly show how much expenditure you anticipate undertaking in each quarter of each financial year. This includes a profile for the locally ‘matched’ expenditure (see below).

Where VAT cannot be reclaimed on expenditure, the award can be used to cover this.

The successful applicants will be eligible to draw Public Dividend Capital (PDC) from the Department of Health and Social Care to the value of their award through the usual processes.

The recipient will be liable for any future revenue and capital costs of the investment funded.

The expectation of bids for funding from this award is that that they will be matched on a one to one basis from local funds. The local element can be expenditure of a capital or revenue nature but should be detailed clearly in the application form.

Eligability – Inclusion criteria?

This funding is for NHS Acute (Hospital) Trusts in England only. 

This will ensure that funding available has the greatest possible impact for people who need to use Changing Places facilities, as hospitals are likely to have the greatest footfall of buildings on the NHS Estate. 

Primary care providers, community hospitals and Clinical Commissioning Groups (CCGs) are not eligible to apply. Private providers of health services are also not eligible.

NHS Trusts that already have Changing Places facilities may apply for funding to install further facilities.

The funding must be spent by the end of March 2021

Application process

The application process will run from 1 June 2019 until the capital funding available has been allocated.

Capital bids will be assessed and award decisions made on the following criteria:

  • Expenditure plan

  • Delivery confidence

  • Evidencing impact and sharing learning

     

Please see Annex A for full scoring table. 

The corresponding application form should be completed and returned to: Changing.Places@dhsc.gov.uk

Application process

For general enquiries about the application process please contact: Changing.Places@dhsc.gov.uk

For technical enquiries about installing Changing Places facilities please contact us on 01242 822 979

Changing Places Requirements:

In accordance with the Building Standards BS8300, Changing Places facilities must meet all the requirements below.

Required features of Changing Places facilities:

Height Adjustable Adult Sized Changing Bench: Min. length 1800mm by 800mm wide. Must be height adjustable. Free standing or wall mounted.

Hoist track system: Ceiling track or wall track hoist system, a mobile hoist is not sufficient. Hoist must provide access to the toilet, washbasin, changing bench and transfer space. Individuals must be able to transfer safely between all these areas using the hoisting system Must conform to BS EN ISO10535

Adequate Space in Room: Should be 3m by 4m squared with the equivalent of 12m squared in space Must have a minimum ceiling height of 2.4m

Centrally Placed Toilet: Must be positioned in a peninsular arrangement at least 1m away from the wall on either side. Should be a seat height of 480mm Standard toilet is satisfactory, it does not need to be wash dry. A wash dry toilet can be supplied at the facility’s discretion but is not a requirement. A colostomy shelf should be provided.

Privacy Screen or Curtain: Wall mounted or mobile. May be a telescopic clip together configuration. Can be a sturdy screen or a curtain as long as provides dignity for user.

Washbasin: Standard washbasins are acceptable A height adjustable washbasin should be provided where possible Must have clear knee space below the bowl If not height adjustable, must be installed 720-740mm from the floor.

Tear-Off Paper Roll: Must be provided in a dispenser to the adjacent changing bench

Large Waste Bin: Must be provided for disposable pads in a Large size specifically

Non-Slip Floor: As the room may feature a shower and cleaning procedures Drainage Showers are not a direct requirement for Changing Places A shower/floor drain should be considered for certain installations such as Leisure Centres Signage

Signage and Registration: Must be clearly signposted and have the Changing Places symbol on the door. Must be registered with the Changing Places Consortium so it appears on the toilet map. Should be clear signage inside the Changing Place facility as to where the hoist system needs to be docked to allow charging.

Application scoring:

Applications will be scored according to the criteria outlined in the table below: Heading Criteria Scoring

Expenditure plan: Clear and credible expenditure plan including what expenditure is being funded by the Department of Health and Social Care Capital PDC and what capita and revenue is being covered from local matched funding.
4 – fully meets
3 – mostly meets
2 – partially meets
1 – mostly does not meet

Delivery confidence: Clear and credible implementation plans and costings including key milestones and deliverables.
All Changing Places requirements as set out in Section 5 of the prospectus must be met, including proposed equipment supplier and how local disability organisations and disabled people will be involved.
4 – fully meets
3 – mostly meets
2 – partially meets
1 – mostly does not meet

Evidencing impact and sharing learning: Clear plan of how proof of spend will be provided.
Demonstration of how learning from installing Changing Places will be shared with other Trusts.
4 – fully meets 
3 – mostly meets
2 – partially meets
1 – mostly does not mee

Discover Changing Places with Aveso

Interested in installing a Changing Places for your business? By dealing directly with Aveso you can be assured of cost-effective solutions as well as guidance on obtaining official Changing Places accreditation for the room. Book your consultation today to start the Changing Places conversation.

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