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Open Door

To help local healthcare facilities meet new equal access legislation, six companies have joined to form Build for Health, a complete design specification service for doorsets About 90 per cent of patient contact with the NHS is through general practice. But in many of the country's most deprived urban areas a disproportionately high number of primary healthcare premises are substandard. Typically, they 'fail to meet patient expectations' in terms of quality and accessibility. The NHS LIFT (Local Improvement Finance Trust) initiative promises to address this problem at 42 sites across the country by establishing long-term partnering agreements between the private sector, local health bodies and local government to deliver investment and services in local healthcare facilities. It will, says the Department of Health, make a significant contribution to the government's commitment, under the NHS Plan, to provide 3,000 new or refurbished doctors' surgeries and 500 new one-stop primary care centres by December 2004.

The first tranche of NHS LIFT schemes, representing an investment of about £1 billion over the next three years, is a sizeable opportunity for the construction industry, but one that is not without challenges. Evolving legislation, particularly the enforcement of Part III of the Disability Discrimination Act (DDA) in October 2004, dictates that primary-care premises must be equipped (in many cases adapted) to enable disabled and able-bodied visitors and staff to access and move around within them safely.

Setting an example of how suppliers can address the requirements of such legislation, six companies from the UK's door industry have joined forces to offer a complete design specification service for doors and doorsets. Build for Health comprises doorset manufacturer LS Leaderflush Shapland, smoke sealing and acoustic containment specialist Lorient Polyproducts, hinge manufacturer Royde & Tucker, Hewi hardware supplier Turnquest UK (formerly Hewi UK), doorclosing device supplier Dorma, and Kaba (UK), supplier of door entry systems. It was established 16 months ago by Turnquest UK director Julie Batters and Paul Lewis, sales director of Royde & Tucker.

'We'd both read a lot about LIFT and realised that, because of the DDA, the government would have to bring doctors' surgeries, many of them converted houses or shops, up to their own high standards, ' says Batters. 'We realised, too, that as individual products ours are not particularly useful in this context, so we joined forces with four firms of similar stature, offering complementary products and created a range of doorsets that meet, and in many cases exceed, LIFT requirements.'

It is a natural partnership, Batters asserts: 'We all use the same testing facility and test our products on each other's, so we know these products work in synergy.' A 70-strong combined sales force, accessible on one telephone number, provides 'a seamless transfer' to associate companies, she adds. Build for Health sets out its integrated product specifications in a series of straightforward data sheets. It also provides specialist information and detailed regulatory advice from JMU Access Partnership (a pan-disability access consultancy) and relevant information on companies that 'encompass the Build for Health philosophy', such as Contacta Hearing Loops and Polyflor flooring.

'We shared ideas with a network of skilled and passionate people at the onset of the project, ' explains Batters. These included architect and specialist in healthcare design Steve Isaacs, independent project and cost-management consultant Derek Barnsley, and Helen Allen, senior access consultant with JMU Access Partnership. Barnsley believes passionately in the longevity of buildings and the importance of whole-life costing, says Batters. 'Users want their buildings to work for them and, having recognised that where Private Finance Initiative projects currently fail is in their quality, we are only too happy to commit to whole life-cycle costing.'

Something Build for Health is equally committed to, she adds, is the concept of inclusivity: 'It is no longer sufficient to specify fijust the basicsfl, allowing for a unisex WC cubicle with a 1,000mm-wide door and a few support rails, for example. Simply because a new building satisfies the regulations and the current Part M [of the Building Regulations], it cannot be assumed that all the specifier's duties to the disabled have been met.'

The DDA and BS8300: 2001 form the backbone of the soonto-be-implemented Approved Document M. Together, these dictate that buildings meet the needs of the able-bodied and disabled alike.

So while the approach to a building and its entrance width may comply with regulations, the weight of a door may not, Batters warns, 'nor may the colour contrast of the door handles', as BS8300: 2001 suggests that, in terms of colour and luminance, handrails should contrast with their surroundings, without being highly reflective.

Quantifying visual contrasts was the subject of Project Rainbow, research conducted by Reading University, the JMU and ICI Paints.

The project, which formed part of the basis for the DDA, found that a 30 per cent difference in colour, tonal contrast and luminance is needed to meet the needs of the 90 per cent of people registered as blind who are actually partially sighted. Build for Health consulted with Reading University on the practicalities of gauging such contrasts and complying with this '30 per cent rule', prior to drawing up its specifications.

Build for Health also acknowledges the BS8300: 2001 requirement that handrails should be easy and comfortable to grip, with no sharp edges, and that they must be smooth and not cold to the touch.

The standard suggests the use of wood or coatings such as powdered nylon rather than bare metal. It also recommends, wherever possible, the use of lever-action door-opening furniture, stating that door furniture with a spherical, circular or similar design can be difficult to use by people with a weak grip - such as those with arthritis.

Furthermore, door-opening furniture should be operable with one hand, without the need for tight grasping or twisting the wrist.

'We'll certainly be looking for guidance from suppliers on items such as doors and windows, ' says Rob Waters, associate director of Hunter & Partners and architect to the East London and City LIFT partnership. Announced this June, the £55 million East London and City LIFT project is the first of six schemes comprising the preliminary wave of NHS LIFT projects. Another two, in the London boroughs of Camden and Islington, have gone to Community Solutions for Primary Care, which includes Sprunt as architect, and work is expected to have started on all six in three to four months.

Architectural ironmongery is the last thing to go on buildings, so Build for Health does not expect to see the fruits of its labour for another four to five months. And while companies with low turnovers might be able to argue against making changes to their premises on the grounds of what is 'reasonable', Batters warns that ignorance of the DDA's wide-ranging scope will not afford immunity from prosecution when designing hospitals, GPs' surgeries, clinics or hospices.

'The DDA is only the catalyst, ' she says. 'Inclusive design should be embraced by all. It is not just a flash in the pan'.

For more information on Build for Health, call 01634 269588, email enq@buildforhealth. co. uk or visit www. buildforhealth. co. uk

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