Children, Young People and Maternity Services: Health Building Note 09-02: Maternity Care Facilities

Children, young people and
maternity services
Health Building Note 09-02:
Maternity care facilities
Health Building Note 09-02
Maternity care facilities
Health Building Note 09-02 – Maternity care facilities
© Crown copyright 2013

Terms of use for this guidance can be found at http://www.nationalarchives.gov.uk/doc/open-government-licence/
ii
Preface
About Health Building Notes Care-group-based Health Building Notes provide
information about a specific care group or pathway but
Health Building Notes give “best practice” guidance on cross-refer to Health Building Notes on generic (clinical)
the design and planning of new healthcare buildings and activities or support systems as appropriate.
on the adaptation/extension of existing facilities.
Core subjects are subdivided into specific topics and
They provide information to support the briefing and classified by a two-digit suffix (-01, -02 etc), and may be
design processes for individual projects in the NHS further subdivided into Supplements A, B etc.
building programme.
All Health Building Notes are supported by the
The Health Building Note suite overarching Health Building Note 00 in which the key
areas of design and building are dealt with.
Healthcare delivery is constantly changing, and so too are
the boundaries between primary, secondary and tertiary Example
care. The focus now is on delivering healthcare closer to
people’s homes. The Health Building Note on accommodation for
adult in-patients is represented as follows:
The Health Building Note framework (shown below) is
based on the patient’s experience across the spectrum of “Health Building Note 04-01: Adult in-patient
care from home to healthcare setting and back, using the facilities”
national service frameworks (NSFs) as a model. The supplement to Health Building Note 04-01 on
isolation facilities is represented as follows:
Health Building Note structure “Health Building Note 04-01: Supplement 1 –
The Health Building Notes have been organised into a Isolation facilities for infectious patients in acute
suite of 17 core subjects. settings”
Health Building Note number and series title Type of Health Building Note
Health Building Note 00 – Core elements Support-system-based
Health Building Note 01 – Cardiac care Care-group-based
Health Building Note 02 – Cancer care Care-group-based
Health Building Note 03 – Mental health Care-group-based
Health Building Note 04 – In-patient care Generic-activity-based
Health Building Note 05 – Older people Care-group-based
Health Building Note 06 – Diagnostics Generic-activity-based
Health Building Note 07 – Renal care Care-group-based
Health Building Note 08 – Long-term conditions/long-stay care Care-group-based
Health Building Note 09 – Children, young people and maternity services Care-group-based
Health Building Note 10 – Surgery Generic-activity-based
Health Building Note 11 – Community care Generic-activity-based
Health Building Note 12 – Out-patient care Generic-activity-based
Health Building Note 13 – Decontamination Support-system-based
Health Building Note 14 – Medicines management Support-system-based
Health Building Note 15 – Emergency care Care-group-based
Health Building Note 16 – Pathology Support-system-based
iii
Other resources in the DH Estates and Activity DataBase (ADB)

Facilities knowledge series The Activity DataBase (ADB) data and software
assists project teams with the briefing and design of the
Health Technical Memoranda healthcare environment. Data is based on guidance given
Health Technical Memoranda give comprehensive advice in the Health Building Notes, Health Technical
and guidance on the design, installation and operation of Memoranda and Health Technical Memorandum
specialised building and engineering technology used in Building Component series.
the delivery of healthcare (for example medical gas 1. Room data sheets provide an activity-based approach
pipeline systems, and ventilation systems). to building design and include data on personnel,
They are applicable to new and existing sites, and are planning relationships, environmental considerations,
for use at various stages during the inception, design, design character, space requirements and graphical
construction, refurbishment and maintenance of a layouts.
building. 2. Schedules of equipment/components are included for
All Health Building Notes should be read in conjunction each room, which may be grouped into ergonomically
with the relevant parts of the Health Technical arranged assemblies.
Memorandum series. 3. Schedules of equipment can also be obtained at
department and project level.
4. Fully loaded drawings may be produced from the
database.
5. Reference data is supplied with ADB that may be
adapted and modified to suit the users’ project-specific
needs.
Note
The sequence of numbering within each subject area does not necessarily indicate the order in which the Health Building
Notes were or will be published/printed. However, the overall structure/number format will be maintained as described.
iv
Executive summary
This Health Building Note covers the policy and service It covers facilities provided in:
context, and planning and design considerations for
1 midwife-led units, often known as birth centres –
maternity care facilities.
which may be located alongside a consultant-led
It covers the following: unit on an acute hospital site, co-located with a
community healthcare facility, or exist as a stand-
1 antenatal clinics, early pregnancy assessment units,
alone centre;
pregnancy (fetal and maternal) assessment units;
2 consultant-led units.
2 birthing facilities and in-patient areas, including the
requirements for the routine care of neonates; The guidance recognises that the services and facilities
provision will be different between CLUs and MLUs. It
3 obstetric theatres.
also recognises that MLUs located alongside a CLU may
have differences in provision to those that are separate.
v
vi
Contents
Preface
About Health Building Notes
The Health Building Note suite
Health Building Note structure
Other resources in the DH Estates and Facilities knowledge series
Health Technical Memoranda
Health Technical Memorandum Building Component series
Activity DataBase (ADB)
How to obtain publications
Executive summary
1 Policy context 1
Key policy and standards
2 Service context 2
Midwifery-led units (MLUs)
Consultant-led units (CLUs)
Antenatal care
Antenatal out-patient care
Ultrasound services
Early pregnancy care
Pregnancy (fetal and maternal) assessment
Antenatal in-patient care
Birth
Surgical procedures
Postnatal/neonatal care
Postnatal care
Newborn care
Transitional care
Adult high dependency/critical care
Bereavement support
3 Whole maternity unit considerations 6
Location of birthing facilities
Design considerations
Inclusivity
Security
Infection control
Records
Storage
4 Antenatal clinic 10
Scope and size of provision
Functional relationships
Spaces
Reception and waiting
Consulting/examination rooms
Pregnancy assessment room (MLUs only)
vii
Interview rooms
Preparation for parenthood room/relaxation classes
Preparation for parenthood store (optional)
Treatment room (optional)
Support spaces
5 Ultrasound suite 14
Spaces
Reception/waiting
Ultrasound rooms
Interview rooms
WCs
Support spaces
6 Early pregnancy assessment unit 16
Spaces
Touchdown base
Ultrasound rooms
Interview rooms
Sitting area
Support spaces
7 Pregnancy (fetal and maternal) assessment unit 19
Spaces
Reception/sitting
Pregnancy assessment room/bays
Ultrasound rooms
Interview rooms
Staff communications base
Support spaces
8 Birthing facilities (and associated in-patient facilities) 22
CLU functional relationships
MLU functional relationships
Front of house spaces
Triage room
Induction suite
Birthing spaces
Birthing rooms
En-suite
Birthing pool areas (optional)
Assisted bathroom(s)
Birthing room layouts and ergonomic evidence
In-patient spaces
Antenatal and postnatal bed spaces
Multi-bed spaces
viii
Contents
Isolation facilities
High dependency area
Support spaces
Bereavement suite
Day room(s)/transfer lounge
Private rooms for expressing milk
Milk kitchen/store/training room
Interview rooms
Other support spaces
Staff facilities
9 Obstetric operating theatre suite 37
Spaces
Anaesthetic room
Obstetric theatres
Recovery spaces
10 Whole maternity unit staff accommodation 39
11 Specific engineering considerations 40
General engineering
Sustainability and energy efficiency
Ventilation
Hot and cold water systems
Medical gases
Electrical services
Bedhead services
Acoustics
12 Schedule and cost information 44
Maternity schedules of accommodation
Health Premises Cost Guides (HPCGs)
Costing the example briefing schedules
Engineering space allowance
13 References 71
Department of Health
ix
x
1 Policy context
1.1 Maternity care is provided in several different Key policy and standards
healthcare settings, decided on a local basis by
commissioning bodies. This can be either on a 1.5 This guidance takes account in particular of the
hospital site, in the community or at home. There following key standards and reports:
is an increasing call for woman-centred, user- • National Screening Committee Report
friendly services offering choice and continuity of
care. • Standards for Maternity Care: Report of a
Working Party
1.2 Each setting should be designed so it is appropriate
for use by the family and the staff who are • Towards Better Births: A Review of Maternity
providing care. Whatever the setting and model of Services in England
care, the main objective is to provide for the safe • Intrapartum care: management and delivery of
care of both mother and baby in a comfortable, care to women in labour
relaxing environment that facilitates what is a
• National Service Framework for Children,
normal physiological process, enabling self-
Young People and Maternity Services
management in privacy whenever possible, and
enhances the family’s enjoyment of an important • British Association of Perinatal Medicine
life event. guidance: Obstetric standards for the provision
of perinatal care
1.3 In all units, rooms should be designed to give
women choice and control over their labour and • Standards for hospitals providing neonatal
birth, to normalise the process and welcome family intensive and high dependency care and
participation. Categories of babies requiring neonatal care
1.4 The “normality” of the experience is a key driver, • Creating a Better Birth Environment: An audit
but appropriate facilities are needed for toolkit
intervention when complications occur.
• Are women getting the birth environment they
need?
1
2 Service context
Time
ANTENATAL CARE BIRTH POST-NATAL/NEONATAL CARE
PARENTHOOD & HEALTH ED

MLU –LED POST-PARTUM
HOME
HOME HOME BIRTH AND
ANTENATAL ANTENATAL TRIAGE ROUTINE
SCREENING SCREENING NEONATAL CARE
CLU-LED
INDUCTION BIRTH TRANSITIONAL
CARE
NEONATAL
CARE
EARLY FETAL AND EMERGENCY

PREGNANCY MATERNAL C-SECTION
ASSESSMENT ASSESSMENT
NEONATAL
SURGERY
PLANNED
C-SECTION
ANTENATAL IN-PATIENT CARE

INCLUDING HIGH-DEPENDENCY CARE
Figure 1 CareOUT-PATIENT
ANTENATAL pathwayFACILITIES BIRTHING UNIT (MLU cf CLU) POST-NATAL FACILITIES
Primary care/stand-alone MLU Triage suite: 4-bed bay Post-natal single and multi-bed accommodation
Consult/exam rooms (with mobile ultrasound scanning??) Induction suite: ??? 4-bed bay
Sep Interview/counselling rooms?
Birthing rooms
Pregnancy assessment room
Midwifery-led units (MLUs)
Acute (CLU)
Consult/exam rooms
Consultant-ledNEONATAL
Day room/transfer lounge
Bereavement suite etc. units UNIT (CLUs)
Cot accommodation
Ultrasound scanning facilities
2.1 These units are managed and staffed by midwives
Interview/counselling rooms 2.3 These are secondary-level units, providing team-
OBSTETRIC SURGICAL FACILITIES
and
EARLY are sometimes
PREGNANCY known as “birth centres”.Anaesthetic
ASSESSMENT FACILITIES They
Theatres
rooms
based care. They STAFFare located on a hospital site and
FACILITIES???
Consulting/exam rooms
may be located
Ultrasound scanning facilitiesalongside a consultant-led unit on
Recovery area provide antenatal out-patient and in-patient
an acute hospital site (see ‘Consultant-ledDraft
Interview counselling rooms
units’), services,
note: purple shows the routine birthing and postnatal care, with facilities
care pathway;
white boxes show a deviation from this
be part of a community healthcare facility, or exist
FETAL AND MATERNAL ASSESSMENT FACILITIES
Rooms/bays for cardiotocography (reclining chairs/beds)
for neonatal care and access to adult critical care
as a stand-alone
Interview/counselling facility. They are suitableDraft
rooms (post-scanning) for note: Birthing rooms, antenatal beds and
facilities.
postnatal beds are co-located ie we need to bear in
Ultrasound facilities
women expected
Access to lab facilities to have an uncomplicated mind birth.
that functional clusters do not necessarily map
2.4 Also,
directly to the care pathway. CLUs withcare
post-partum perinatal centres provide team-based
Women can give birth in these units with little or
ANTENATAL IN-PATIENT UNIT care for mothers
can take place in the birthing room so this and birth
with fetal or maternal
no intervention.
antenatal single and multi-bedIf complications
accommodation, arise they
including high- aremap to the same facilities ie birthing rooms
will both
dependency care beds complications. They will provide the same range of
transferred to a CLU. Transfer to an acute hospital
Creatediswith novaPDF
services and require the same facilities as CLUs,
a key issuePrinter (www.novaPDF.com).
for MLUs Please register
that are separate fromtoan remove this message.
with the addition of facilities for neonatal high-
acute hospital site. For MLUs adjacent to a CLU,
dependency and intensive care. Many of these units
their protocols for accepting mothers may be
will be professorial/medical schools.
influenced by the proximity of the more specialist
facilities and staff.
Antenatal care
2.2 The services provided within an MLU will vary
depending on its location. If co-located with Antenatal out-patient care
another healthcare facility, the MLU may use their
2.5 In the antenatal period, a pregnant woman usually
antenatal and out-patient clinics. If stand-alone, it
attends for antenatal care and screening tests at a
may include these and other diagnostic services.
site that is as local and convenient as possible. This
Antenatal and outreach services will also be
may be at a GP surgery/community health centre,
provided in the community, in line with the
local birth centre, children’s centre, or an antenatal
National Service Framework (NSF) for Children,
clinic in an acute hospital. She may also attend for
Young People and Maternity Services (DH, 2003).
parenthood and health education sessions in any of
2
2 Service context
these settings. If she requires more specialist required to laboratory facilities for biochemistry
antenatal care, she will be referred from the and haematology and urgent laboratory results. See
community to an antenatal clinic in a CLU. Chapter 7, ‘Pregnancy (fetal and maternal)
See Chapter 4, ‘Antenatal clinic’. assessment unit’.
Ultrasound services Antenatal in-patient care

2.6 Ultrasound examinations are an important element 2.11 A pregnant woman may need to be admitted as an
of most antenatal screening and monitoring. Some in-patient in a CLU for more detailed assessment
women may require more than the routine two and monitoring. The stage of gestation must be
ultrasound examinations to assist in the diagnosis taken into account – some units now routinely take
and management of complications of pregnancy, women from an early gestation for conditions such
whereas others may require procedures under as hyperemesis. A woman may need to stay on the
ultrasound guidance – for example amniocentesis. antenatal ward for a few hours only, or until
Ultrasound examinations are also important in the delivery. A mixture of single rooms and multi-bed
management of neonates, a factor that should be accommodation can be provided. See paragraph
considered when planning ultrasound facilities. 8.46, ‘In-patient spaces’.
2.7 A large CLU will have dedicated ultrasound
facilities, a proportion of which will be equipped Birth
for invasive procedures. Some small units may not 2.12 Unless she has been previously admitted as an
have their own ultrasound facilties but will access antenatal patient, a woman in labour will go
the ultrasound facilities in the main imaging directly to the MLU or CLU. On arrival she will be
department. See Chapter 5, ‘Ultrasound suite’. assessed, ideally in a triage suite. This facility is
increasingly being used to assess women before
Early pregnancy care transfer to birthing rooms, to reduce unnecessary
2.8 This guidance reflects the increasing provision for admissions. All women in confirmed labour should
early pregnancy management for women with be admitted to a single birthing room with an en-
complications in the first few months of the suite facility, which most will usually occupy for the
pregnancy, including spaces for screening and entire period of their stay.
counselling. Some women with complications may 2.13 Women who are in hospital for induction of labour
be managed in the community. Others will be seen may go to an induction suite/ antenatal ward and
in the early pregnancy assessment unit (EPAU). then be transferred to a birthing room when the
This may be located in the maternity unit or within delivery process commences. Those who go into
the gynaecology department. spontaneous labour while an in-patient will be
2.9 Facilities are required for confirmation of transferred to a birthing room at the onset of
pregnancy by pregnancy test and ultrasound to labour, so that they have the same privacy as
check the viability of the pregnancy, gestational age women in early labour at home.
and that the pregnancy is intra-uterine. This is a 2.14 The birthing rooms in an MLU will be set up and
very anxious time for women, and the facilities designated for straightforward births and will often
must above all be easily accessible and designed include birthing pools.
with these sensitivities in mind. See Chapter 6,
‘Early pregnancy assessment unit’. 2.15 In the case of any unexpected complications
arising, the mother will be moved to a CLU with
Pregnancy (fetal and maternal) assessment the appropriate facilities and equipment. There
should be good telecommunication links with
2.10 Women may attend a pregnancy assessment unit in other units within the managed clinical network
a CLU for more detailed scanning or fetal and facilities for transfer and transport
assessment in late pregnancy. This is to assess arrangements as and when required. Any MLU on
potential complications in later pregnancy without a community hospital or isolated site will need
the need for admission to the antenatal in-patient clear and unfailing transfer arrangements. There
facilities. The unit provides a full range of fetal should be a clear referral pathway for each unit.
monitoring services, which includes
cardiotocography and ultrasound. Access is
3
2.16 The birthing rooms in a CLU will be designed and move but to stay in the same room until they are
equipped for birth that will encompass different transferred home. However, project teams should
levels of intervention, assistance and support. They ensure that there are sufficient postnatal beds
provide for a higher clinical function than is available in order to maximise the efficient use of
required in an MLU. The appropriate concealment/ space at peak times. Women who have had a
storage of interventional equipment is important. caesarean section will need to be accommodated in
a bed in the postnatal bed area.
2.17 Whatever the setting and the type of care that the
woman is receiving, the environment should be as 2.22 Multi-bed accommodation may be provided.
non-clinical as possible with a comfortable, non-
2.23 Where there have been complications, the mother
institutional ambience and should enable self-
and/or the baby may need extra care or
management in privacy whenever possible. In all
intervention. The main philosophy of care is that
units, rooms should be designed to give women
mothers and babies should stay together. The
choice and control over their labour and birth, to
project team may decide to provide a well-baby
normalise the process and welcome family
nursery to allow mothers to obtain rest; security
participation. The social needs of higher-risk
will be an important consideration. See paragraph
groups should not be overlooked.
8.46, ‘In-patient spaces’.
2.18 Partners and other supporters should be made to
feel welcome, and their presence should be a key Newborn care
consideration in designing facilities for birth. There 2.24 Every type of birthing unit, whether or not care of
should be overnight accommodation for partners sick babies is undertaken, must have clearly
within the rooms or within or close to the unit. See established arrangements for the prompt, safe and
paragraph 8.9, ‘Birthing spaces’. effective resuscitation and thermal care of babies,
and for the care of babies who require continuing
Surgical procedures support, either in the birthing unit or by safe
2.19 A woman will be moved to a dedicated obstetric transfer elsewhere.
theatre if unanticipated problems arise or more 2.25 All birthing rooms should include:
serious interventions are required than can be
offered in the birthing rooms. Arrangements must • a n area designated and equipped for
be in place for MLUs to transfer women to a resuscitation of a newborn baby;
hospital with the appropriate facilities. Access • s pace at the bedside so that a healthy newborn
routes to the theatres for emergency caesarean baby can be cared for alongside its mother;
sections, both from within the unit and from
outside, must be designed to ensure speed of access • t he ability to care for a baby for short periods in
and high levels of privacy for the mother. a warm environment, for example during
neonatal examination, or for observation after
2.20 Elective caesarean sections may also take place in birth. This will normally be achieved in a cot
these theatres or in the main theatres. Women alongside the mother. Phototherapy may be
usually go straight to theatre then to a single room carried out here.
following the procedure. See Chapter 9, ‘Obstetric
2.26 Healthy newborn babies, healthy pre-term babies,
operating theatre suite’.
those born by assisted and operative procedures and
babies transferred from the neonatal unit will be
Postnatal/neonatal care cared for in cots alongside the mother, where
general maternal care and certain medical and
Postnatal care
nursing procedures will be carried out.
2.21 This guidance recognises the general need for an
2.27 A neonatal unit is a facility for those newborn
increase in single room provision in the postnatal
babies requiring care that cannot be provided
period in order to enhance the experience and
beside the mother (see the BAPM ‘Standards for
improve privacy and dignity. Women will either
hospitals providing neonatal intensive and high
remain in the birthing room for their recovery
dependency care and Categories of babies requiring
period and go straight home from it, or be
neonatal care’ (2001) for definitions of the levels of
transferred to the postnatal area, ideally to a single
neonatal care). A neonatal unit may be provided
room. Women’s preferences are generally not to
4
2 Service context
depending on the clinical network and local 2.30 Every CLU, secondary and tertiary, must have
requirements, equipped according to the level of ready access to high dependency and critical care
care that the unit is designated to provide. facilities on site. The provision required will relate
Accessibility of neonatal units and parent facilities to the number of births per year and needs to be
is very important. See paragraph 8.9, ‘Birthing assessed locally for each project. In tertiary centres,
spaces’. the number of cases requiring high dependency
care can be more than 5% of the number of
Transitional care deliveries per year.
2.28 Transitional care facilities are increasingly being 2.31 At an MLU remote from a hospital, temporary
provided, where mothers can look after their baby/ high dependency care can be provided in the
babies with supervision from midwives and birthing room. A paramedic ambulance would treat
neonatal professionals (for up to two weeks) prior and stabilise the mother before transfer. There
to transfer home. These usually take the form of should be recognised routes of access to critical care
generic multi-bed bays associated with the facilities, together with equipment and staff for safe
postnatal beds. transfer. See paragraph 8.46, ‘In-patient spaces’.
Adult high dependency/critical care Bereavement support

2.29 Women who develop serious problems, for example 2.32 Access to appropriate facilities is very important for
fulminating pre-eclampsia or eclampsia, major women and families who suffer bereavement at any
organ failure, clotting disorders or severe stage of pregnancy.
haemorrhage, require prompt access to high
• W
omen attending the out-patient clinic, EPAU
dependency, intensive care and/or resuscitation
and pregnancy assessment facilities should have
facilities. These women will need intensive
access to quiet spaces for counselling in the
observation, treatment and nursing care and may
event of bad news.
require invasive cardiovascular monitoring.
Provision will depend on the workload, casemix • T
he birthing suite and in-patient facilities
and local circumstances. High dependency care should include single bedroom(s), away from
may be provided within the CLU, but critically ill the birthing area and with a separate exit from
women requiring artificial ventilation will need to the ward, for use in the event of a bereavement.
be transferred to critical care facilities.
5
3 Whole maternity unit considerations
Location of birthing facilities 3.7 If an MLU is provided within a hospital, it should

have direct access for women and families separate
3.1 The consultant-led unit (CLU) should be located from the access to the CLU. Ideally, it should have
to enable 24-hour easy access for ambulances and a dedicated entrance. There should be internal
cars. Women may arrive by ambulance, taxi or car communication for ease of transfer if necessary, and
and need to be dropped off at the entrance to the a time-efficient access route between the two.
unit. Particular consideration is needed to ensure
that partners can park their cars easily and then
accompany women into the building.
3.2 The CLU should be adjacent or close to the
midwifery-led unit (MLU), if there is one, and
have good access to the neonatal unit. Adult high
dependency and critical care facilities should be
close enough for direct transfers to take place, and
close enough for the mother to visit the baby or
vice versa. Easy access to surgical and medical
consultants is desirable to facilitate consultation.
3.3 Access to external spaces is important in all units.
The location should protect other patients and
visitors in the hospital from the noise of women in
labour whether the windows are open or shut.
Positioning of courtyards is important, since these
areas are used for relaxation or play.
3.4 Units should ideally not be sited near A&E or
mental health units as these patients may wander,
and security of the CLU/MLU is an important
consideration.
3.5 A maternity unit should have its own separate
entrance, because of the need for 24-hour access
and security control. The entrance to all units
should be designed and located to provide easy
access and to provide a welcoming, non-clinical
environment. WC facilities should be provided in
this area. Entrance areas to larger units may
Reception area, Barts and the London NHS Trust
incorporate a café facility. Photographer: Lisa Payne
3.6 It is essential that 24-hour immediate access for
women in advanced labour is provided. On arrival, 3.8 Figures 2 and 3 illustrate the key relationships of
the means of communicating with staff and the separate and combined units.
routes to the unit need to be immediately clear
inside the entrance. Entrance via a deserted lobby
should be avoided.
6
3 Planning and design considerations
Entrance
Entrance
Ante-
natal
Birthing rooms
MLU
US
Obs
Main theatres Critical
theatres
care
Birthing
PA rooms
CLU
Discrete
exit Admin
EPAU NNU
Pre-/post- Gynae beds
natal beds
KEY
Possible access
PA = Pregnancy assessment
US = Ultrasound Gynae
OPD
NNU = Neonatal unit
Link
OPD
Flex in
room
use
Figure 2 Combined CLU and MLU – key functional relationships
Sup
Birthing
MLU
rooms
Entrance
The MLU and CLU may be located on

Entrance the same site or a different site. Transfer
arrangements are key
Ante-
natal
US
Obs
Main theatres Critical
theatres
care
Birthing
PA rooms
CLU
KEY Discrete
exit Admin
EPAU NNU Gynae beds
PA = Pregnancy assessment Pre-/post-
natal beds
US = Ultrasound
NNU = Neonatal unit

Possible access
Sup = Support facilities
Gynae
OPD
Link
Flex in
room
use OPD
Figure 3 Separate CLU and MLU – key functional relationships
7
Design considerations identifying and apprehending an abductor.

Previous infant abductions have shown that
Inclusivity abductors generally plan their abductions
thoroughly, which includes visiting different
3.9 In calculating numbers of birthing pools, project maternity units to establish security strengths and
teams will need to take into account that certain weaknesses. CCTV should ideally be monitored
ethnic groups will not use pools. and recorded at the security control room. Digital
3.10 General guidance on inclusivity is set out in Health recording is now normal practice as it allows for
Building Note 00-01 – ‘General design principles’ instant retrieval of images while the system is still
(under ‘Functional design issues’). recording and being used during an incident.
3.15 A system of electronic tagging of babies may be
Security
considered. See ‘Safe and Sound: Security in NHS
3.11 General security guidance is set out in Health maternity units’ (National Association of Health
Building Note 00-01 – ‘General design principles’ Authorities and Trusts, 1995) for further
(under ‘Functional design issues’) and in Health information. In some centres, controlled entry
Technical Memorandum 00 – ‘General engineering using FM cards has been used in preference to baby
principles’ (under ‘Security’). tagging, which has been difficult to control. Project
teams should consult their local security adviser
3.12 Security is an issue of importance for staff, mothers
when considering any electronic tagging system.
and babies.
3.16 A separate, differently-coloured identification
a. Babies born in hospital should be cared for in a
badge is commonly used to denote staff permitted
secure environment to which access is restricted.
access to young children and infants.
b. An effective system of staff identification is
3.17 An integrated security system should link the
essential.
building/fire door alarm system to the baby
c. A robust and reliable baby security system tagging, and CCTV systems to an appropriate
should be enforced, such as baby tagging, monitoring station.
closed-circuit television, alarmed mattresses.
3.18 Signage should be displayed alerting users of the
d. Strict criteria for the labelling and security of security systems in place, for example CCTV
the newborn infant are essential. cameras and baby tagging systems.
3.13 The number of entry and exit points to the unit 3.19 Security systems in place should not impede
should be reduced to a minimum. Public access movement of staff or safe transfer of mother or
and egress should be limited to one door, which baby in the event of an emergency.
should be in the vicinity of and with good natural
3.20 The need to provide system security to deter
surveillance from the reception desk/staff
potential criminal behaviour and to reassure parents
communication base; although security should not
should be balanced with the need to create a
solely rely on the presence of staff/observation. The
welcoming atmosphere on the unit.
use of centrally managed access control using one
of the following systems should be considered 3.21 In birthing rooms, the woman should be able to
essential: swipe card, proximity or biometric control access of visitors from the bedhead. Staff
recognition. Swipe cards are considered the least should be able to override this from the staff base.
secure, with biometric recognition being the most
secure. Digital code locks should be avoided. Infection control
Where this is not possible, access/egress controls to 3.22 Birthing pools and other equipment should be
wards should be operated at ward level. disposed of or thoroughly cleaned and dried after
3.14 Overt and well-publicised CCTV cameras should every use, in accordance with local infection
be installed at all entrances to the unit. Where the control policies. Local information and guidelines
unit is only one department within a larger health regarding prevention of legionella build up in water
facility building, consideration should be given to supply from seldomly used pools should be
installing CCTV at all exits from the building in obtained from the local estates team and should be
order to maximise the opportunity for detecting,
8
3 Planning and design considerations
adhered to. See also Health Facilities Note 30 – records, and the space within units should be
‘Infection control in the built environment’. reduced accordingly. Project teams will also need to
take into account initiatives such as the clinical
Records messaging initiative and the Integrated Care
3.23 There is a statutory requirement in maternity care Record, which will replace the Hospital
to provide contemporaneous records of all events, Information System, the EPR and the Integrated
and records need to be kept for 25 years to support Children’s System.
any litigation claims. There should be storage 3.26 Easy access for staff and confidentiality are key
facilities to keep records traceable and secure considerations.
against loss, damage or use by unauthorised
persons. Archived records do not need to be kept Storage
on the unit itself, but should be accessible within
3.27 Over and above general storage requirements,
24 hours.
which are dependent upon local supply and storage
3.24 Women carry their own notes in the antenatal and policies, maternity facilities require storage space
postnatal period. In antenatal facilities some space for a large volume of items such as birthing packs.
is required for the storage of paper overview See also Health Building Note 00-01 – ‘General
records, while postnatal facilities require a retrieval design principles’ (under ‘Supplies, storage and
system for re-filing full records. distribution’).
3.25 Requirements for records storage need to take into
consideration the development of electronic
9
4 Antenatal clinic
4.1 Within a hospital setting, the antenatal clinic complications, and this should be considered when
should be designed so that it has an identity of its determining the clinic size. An influential factor in
own and can function independently from the determining the number of sessions will be the level
general out-patients department. It should be of services provided in other facilities. Rooms
located on the ground floor, well signposted and should be designed for maximum flexibility of use.
with a separate entrance that is easily accessible
4.6 The schedules of accommodation are based upon
from outside the hospital. This can be via the main
estimated attendances/clinic sessions for the given
entrance to the maternity unit.
numbers of births.
4.2 Antenatal clinics may also be used as gynaecology
4.7 It is assumed that a Midwifery-led unit (MLU) co-
clinics. There are likely to be local variations in
located with a Consultant-led unit (CLU) would
where the early pregnancy assessment unit (EPAU)
utilise the clinic facilities in the CLU.
is located. The EPAU is usually separate from the
antenatal clinic, but nearby to allow patients with 4.8 Where stand-alone MLUs remote from the CLU
unexpected problems on scanning to be referred are providing antenatal clinics and maternal
easily. assessment, they should include at least two C/E
rooms and the ability to undertake ultrasound
4.3 Attendance at an antenatal clinic is often a woman’s
scanning.
first introduction to a healthcare facility. The suite
should appear attractive and user-friendly, with a Functional relationships
quiet, relaxed atmosphere that will maintain the
woman’s confidence and dignity. The partner, 4.9 C/E rooms should have easy access to ultrasound.
friends or other family members, including The link to pathology services may be by way of a
children, may accompany her. Waiting areas should pneumatic tube transport system. Near-patient
be planned with this in mind, with access to play testing facilities may be provided within the unit,
areas, drinking water and WCs. Wall décor should depending on local policy. There should be easy
be non-clinical in nature and not adorned with access to the birthing area and maternity in-patient
medical diagrams. beds. See Figure 4 and Chapter 3, ‘Whole
maternity unit considerations’.
4.4 Specific clinical areas include: Spaces
• a suite of standard/multidisciplinary consulting Reception and waiting
and examination (C/E) rooms;
4.10 The waiting area should have a welcoming and
• interview rooms; informal atmosphere. Many pregnant women will
• u
ltrasound rooms, which may be shared with be accompanied by a friend or relative and may
the EPAU. have small children with them. The area should be
planned so that it can be subdivided into separate
4.5 The size of the antenatal clinic suite will depend on waiting spaces.
the number of expected attendances per session, the
4.11 Within or adjacent to the waiting area, an
number of proposed sessions, the number of
doctors and midwives, and the number of information/resource space should be provided.
education classes. Clinic sessions may be dedicated This is likely to include a combination of printed
to women with specific care needs, for example and electronic media.
diabetes, other medical conditions or pregnancy
10
4 Antenatal clinic
R = Reception/Waiting/
Counselling
Child play Admin
C = Consultation
G = Group room/
Antenatal clinic
Parentcraft
Staff link
Stores
C R Entrance
Patient flow/link
G
Ultrasound
Ultrasound
Figure 4 Antenatal clinic functional relationships
4.12 If not conveniently located elsewhere, the following and layout of the room should ensure that the
facilities should be provided: privacy and dignity of the woman is protected.
Acoustic privacy is also important.
• WCs
4.15 Blood-taking may be carried out in the C/E rooms
• Refreshment facilities
(in line with the Children’s NSF preference), or
• Children’s play area separate phlebotomy rooms may be provided,
• Baby changing depending on local decision. The schedules of
accommodation are based upon blood-taking being
• Infant feeding carried out in the C/E room.
• Wheelchair parking bay 4.16 Some C/E rooms may be larger to facilitate multi-
4.13 See also ‘WCs’ in Health Building Note 00-02 – disciplinary consultations. This will be a project
‘Sanitary spaces’ and ‘Entrance, reception and decision.
waiting’ in Health Building Note 00-03 – ‘Clinical 4.17 See ‘Consulting/examination room: single-sided
and clinical support spaces’. couch access’ in Health Building Note 00-03 –
‘Clinical and clinical support spaces’.
4.14 A general-purpose single-sided C/E room should be Pregnancy assessment room (MLUs only)
used, to increase flexibility of use. The C/E room 4.18 In a stand-alone MLU remote from a CLU, one
will be large enough to accommodate electronic C/E room may be used to carry out pregnancy
monitoring and diagnostic equipment. The assessments. Ultrasound examinations will not
examination couch should be screened by a curtain usually be carried out in an MLU unless an
to allow privacy. The couch needs to be accessible antenatal clinic or pregnancy assessment clinic is
on the right-hand side and at the foot. The design associated with it. Portable equipment may be used.
11
C/E room, Consultant-led unit (CLU) antenatal clinic Courtesy Queen C/E room, Midwifery-led unit (MLU) antenatal clinic Courtesy Queen
Elizabeth Hospital NHS Trust Photographer: Lisa Payne Elizabeth Hospital NHS Trust Photographer: Lisa Payne
4.19 See ‘Consulting/examination room: single-sided Preparation for parenthood room/relaxation

couch access’ in Health Building Note 00-03 – classes
‘Clinical and clinical support spaces’.
4.23 Local community facilities are often used for this
activity. If provided in the hospital it should be
Interview rooms
used flexibly. The location should facilitate easy
4.20 Depending on the size of the unit, rooms may be access for people in the evening and at weekends.
used flexibly for counselling, parental education, It should not create any security issues and should
staff training and meetings. However, ideally, ideally be located within a 24-hour functioning
dedicated facilities should be provided so that there unit. The room should provide enough space to
is always a space available when required. accommodate at least ten couples (plus facilitators),
4.21 The locations of rooms used for counselling should with room to move freely and use birth balls, mats
be discreet, and exit routes from them should not and other equipment. This room will also be used
pass through public or waiting areas. These rooms for relaxation classes.
should provide a non-clinical environment for 4.24 Equipment used in classes will include: mats;
discussion with people who may be distressed. cushions; birthing aids such as balls; comfortable
Privacy is essential. chairs; display boards for posters; a flipchart stand
4.22 See ‘Interview room: 4 places’ and ‘Interview room: and sheets; audiovisual equipment (OHP/video/
7 places’ in Health Building Note 00-03 – ‘Clinical DVD); and a whiteboard. Ceiling hooks and ropes
and clinical support spaces’. may be provided for use with slings. Computer(s)
with Internet access should also be available.
4.25 It is important to be able to control the lighting,
and have access to fresh air and cool drinking water.
Ideally there should be access to tea and coffee-
12
4 Antenatal clinic
making facilities. There should be access to WC Support spaces

facilities close by.
4.30 The following support spaces are required, but may
4.26 See ‘Group rooms’ in Health Building Note 00-03 be shared with other out-patient or maternity
– ‘Clinical and clinical support spaces’. facilities:
• Clean utility
Preparation for parenthood store (optional)
• Dirty utility
4.27 The preparation for parenthood store may be
located within or adjacent to the preparation for • Disposal hold
parenthood room. The door should be lockable for
• Cleaners’ room
the safekeeping of valuable teaching aids. Storage is
required for mats, bean bags, pillows, balls etc. • Staff changing
• Staff rest/beverage bay
• Offices
4.28 A treatment room may be required for diagnostic
and clinical procedures, which may include • Stores
specimen collecting and cardiotocography (CTG). • Specimen collection/pneumatic tube (optional)
A couch and two chairs should be provided, along
with an adjustable examination lamp. A clinical 4.31 See Health Building Note 00-02 – ‘Sanitary spaces’
wash-hand basin is required. Adequate space is and ‘Utility’, ‘Refreshments and rest’, ‘Offices’ and
required for mobile surgical trolleys, and ‘Facilities management’ in Health Building Note
monitoring and diagnostic equipment. 00-03 – ‘Clinical and clinical support spaces’.
4.29 See ‘Treatment rooms’ in Health Building Note
00-03 – ‘Clinical and clinical support spaces’.
13
5 Ultrasound suite
5.1 Imaging procedures may be required for the Spaces

diagnosis of complications in the postnatal period
or for the management of newborn babies. Reception/waiting
Although suitable portable imaging equipment
should be available within a Consultant-led unit 5.6 Women will be directed to the ultrasound suite
(CLU) and within easy access of the neonatal unit, from the reception desk in the antenatal clinic.
it is assumed that most women requiring Waiting space is required close to the ultrasound
ultrasound imaging procedures will have these rooms (this may be shared with the antenatal
performed in the main imaging department. clinic). The number of seats required will depend
upon the estimated throughput of women. Cold
water drinking facilities will be required.
5.2 The accommodation requirements will depend on Ultrasound rooms
local factors including the number of deliveries in a 5.7 A standard treatment room with black-out and a
particular unit, the casemix, the ultrasound dimmable lighting system is appropriate for the
scanning policy for the population served by that procedures carried out in this clinic. An
unit, and whether portable ultrasound equipment examination light should be provided. Privacy for
is used. An ultrasound scanning room can cope women dressing and undressing is essential. Seating
with approximately 5000 mixed routine is required for the sonographer and the woman’s
examinations per year. This guidance is based on escorts. In accordance with current policy,
the provision of a minimum of two scanning rooms instruments will be sent to central sterilizing
in a CLU to allow invasive procedures, for example facilities.
amniocentesis, to be performed while routine
scanning continues in the other room. 5.8 See ‘Treatment rooms’ in Health Building Note
5.3 The wider introduction of nuchal translucency
across the NHS will have an impact on the number Interview rooms
of ultrasound rooms required in a unit. These
examinations take longer to perform and slow 5.9 Interview rooms for counselling should be located
down the throughput in clinics. adjacent to the ultrasound rooms to avoid families
having to walk through busy circulation areas. Two
Functional relationships exit/entry doors may be considered.
5.10 See ‘Interview room: 4 places’ and ‘Interview room:
5.4 Where a dedicated ultrasound suite is provided
within a larger unit, it should be located within, or 7 places’ in Health Building Note 00-03 – ‘Clinical
close to, the antenatal clinic. It should be close to and clinical support spaces’.
the C/E rooms and reception, with easy access to
WCs
records. WCs should be provided immediately
adjacent to ultrasound rooms. There should be easy 5.11 WC facilities should be provided immediately
access from the pregnancy assessment facilities. adjacent to ultrasound rooms. One WC is required
Consideration should be given to access from in- per scanning room; one should be an accessible
patient areas, depending on local policy. WC. Additional WCs should be available in the
waiting area.
5.5 See Chapter 4, ‘Antenatal clinic’ and Chapter 3,
‘Whole maternity unit considerations’. 5.12 See ‘WCs’ in Health Building Note 00-02 –
‘Sanitary spaces’.
14
5 Ultrasound suite
Support spaces • Staff rest room/beverage bay

5.13 Support facilities are required as for the antenatal • Offices
clinic, with which they may be shared:
• Stores
• Clean utility
• Specimen collection/pneumatic tube (optional)
• Dirty utility
5.14 See Health Building Note 00-02 – ‘Sanitary spaces’
• Disposal hold and ‘Utility’, ‘Offices’ and ‘Facilities management’
in Health Building Note 00-03 – ‘Clinical and
clinical support spaces’.
• Staff changing
15
6 Early pregnancy assessment unit
6.1 Within a Consultant-led unit (CLU), a dedicated Spaces

early pregnancy assessment unit may be required
with its own reception and waiting area. This may Reception and waiting
be co-located with the gynaecology clinic/ward,
with which it may share certain facilities. For 6.7 The waiting area should have a welcoming and
reasons of privacy and dignity, patient spaces in a informal atmosphere. Many pregnant women will
dedicated EPAU should be physically separate from be accompanied by a friend or relative and may
the antenatal clinic and the pregnancy assessment have small children with them. The area should be
unit. planned so that it can be subdivided into separate
waiting spaces.
Scope and size of provision 6.8 Within or adjacent to the waiting area, an
information/resource space should be provided.
6.2 Specific clinical areas include:
This is likely to include a combination of printed
• C/E room(s) (pre-scanning); and electronic media.
• u
ltrasound room(s), although ultrasound 6.9 The waiting area may be shared with the
facilities close by may be used; gynaecology clinic.
• interview room(s) (post-scanning). 6.10 If not conveniently located elsewhere, the following
facilities should be provided:
6.3 The number of C/E and scanning rooms will
depend upon the number of women attending per • W
Cs: located conveniently for the waiting area,
session. There will also be a percentage of C/E rooms and the ultrasound rooms. These
emergency assessments to consider. The schedule of include a wheelchair-accessible WC. They
accommodation is based upon estimated should not be directly overlooked by the waiting
attendances/ clinic sessions for the given numbers area.
of births.
• Refreshment facilities
Functional relationships • Children’s play area
6.4 A key consideration in its location is ease of • Baby changing

accessibility for staff. It should also be within easy • Infant feeding
reach of the in-patient beds and the operating
theatre suite. Women who need to be admitted • Wheelchair parking bay
overnight will be transferred to an in-patient area. 6.11 See ‘WCs’ in Health Building Note 00-02 –
6.5 There should be good links to pathology facilities ‘Sanitary spaces’ and ‘Entrance, reception and
and the blood transfusion service. WCs should be waiting’ in Health Building Note 00-03 – ‘Clinical
immediately adjacent. Easy access is required to rest and clinical support spaces’.
facilities and counselling facilities.
6.6 See Figure 5 and Chapter 3, ‘Whole maternity unit
6.12 Blood-taking may be carried out in the C/E rooms
considerations’.
(in line with the Children’s NSF preference), or
separate phlebotomy rooms may be provided; this
is for local decision. See ‘Consulting/examination
room: single-sided couch access’ in Health Building
Note 00-03 – ‘Clinical and clinical support spaces’.
16
6 Early pregnancy assessment unit
KEY
Staff link
Patient flow/link
R = Reception/waiting
Ultrasound
scanning
Consult/ Blood-
exam transfusion
service
FEMA
To Day
surgery
Sitting
R Entrance
Discrete
exit
To Path lab To A&E
Admin/staff amenities
Counselling
Gynae
Gynaecology/OPD ward
EPAU
Figure 5 Early pregnancy assessment unit functional relationships
Touchdown base Building Note 00-03 – ‘Clinical and clinical

support spaces’.
6.13 A midwifery/nurse touchdown base is required for
regular observation of women, and co-ordination
Interview rooms
of movements to theatre and in-patient areas. See
‘Touchdown base’ in in Health Building Note 6.16 One or two interview rooms should be provided for
00-03 – ‘Clinical and clinical support spaces’. discussion post-scanning. See ‘Interview room:
4 places’ and ‘Interview room: 7 places’ in Health
Ultrasound rooms Building Note 00-03 – ‘Clinical and clinical
support spaces’.
6.14 A standard treatment room with black-out and a
dimmable lighting system is appropriate for the
Sitting area
procedures carried out in this clinic. An
examination light should be provided. Privacy for 6.17 A small waiting/sitting area is required; privacy and
women dressing and undressing is essential. quiet are essential.
6.15 Seating is required for the sonographer and the Support spaces
woman’s escorts. In accordance with current policy,
instruments will be sent to central sterilizing 6.18 The following may be provided separately or shared
facilities. See ‘Treatment rooms’ in in Health with other units that may be co-located, depending
on the overall design:
17
• Patient beverage and snack preparation facilities • O

ffices: A medical/midwifery office is required
within the pregnancy assessment unit to allow
• Clean utility
for administration duties and private discussion
• D
irty utility: There should be easy access for of problems by medical and midwifery staff.
women who often bring their own urine This should include telecommunications
specimens for checking. It should be adjacent to facilities.
the WC facilities so that women can also
• Stores
provide specimens for investigation within easy
reach of the test room. • Specimen collection/pneumatic tube (optional)
• Disposal hold 6.19 See Health Building Note 00-02 – ‘Sanitary spaces’
and ‘Refreshments and rest’, ‘Utility’, ‘Offices’ and
‘Facilities management’ in Health Building Note
• Staff changing 00-03 – ‘Clinical and clinical support spaces’.
• Staff rest/beverage bay
18
7 Pregnancy (fetal and maternal) assessment
unit
7.1 Local policy will determine the functional 7.8 Within or adjacent to the waiting area, an
requirements, and the opportunity for sharing information/resource space should be provided.
facilities will depend on the size of the unit and the This is likely to include a combination of printed
timing and organisation of clinics. leaflets, videos and selected websites.
7.9 The waiting area may also be used as a sitting area,
Scope and size of provision where women can sit comfortably and relax during
7.2 Facilities are required for C/E, ultrasound, the assessment. This combined facility should be
phlebotomy, amniocentesis (invasive testing) and private and separate from the circulation areas. It
continuous CTG. These may take the form of should include comfortable seating, entertainment
individual rooms and/or multi-bay spaces. services and access to refreshments.
Reclining chairs and possibly beds should be 7.10 If not conveniently located elsewhere, the following
provided, with access to ultrasound facilities within facilities should be provided:
or adjacent to the unit.
• WCs
7.3 The level of provision of pregnancy assessment
facilities will depend on the number of patients and • Refreshment facilities
appointment times and the number of healthcare • Children’s play area
professionals available to work in the unit.
• Baby changing
7.4 The schedule of accommodation for an assessment
unit is based upon estimated attendances and clinic • Infant feeding
sessions for the given numbers of births. • Wheelchair parking bay
7.11 See ‘WCs’ in Health Building Note 00-02 –
Functional relationships ‘Sanitary spaces’ and ‘Entrance, reception and
7.5 The pregnancy assessment unit should ideally be waiting’ in Health Building Note 00-03 – ‘Clinical
located close to the birthing facilities. It would then and clinical support spaces’.
have access to emergency laboratory facilities. If the
same workforce is shared between the antenatal Consulting/examination rooms
clinic and the pregnancy assessment unit, the 7.12 See ‘Consulting/examination room: single-sided
proximity of the two units is desirable. couch access’ in Health Building Note 00-03 –
7.6 See Figure 6 and Chapter 3, ‘Whole maternity unit ‘Clinical and clinical support spaces’.
considerations’.
Pregnancy assessment room/bays
Spaces 7.13 These are multi-use rooms with reclining chairs for
performing CTGs. Sufficient space should be
Reception/sitting provided by the recliners for using the CTG
7.7 The waiting area should have a welcoming and monitor and mobile ultrasound machine. Curtains
informal atmosphere. Many pregnant women will should be provided round each area.
be accompanied by a friend or relative and may
have small children with them. The area should be Ultrasound rooms
planned so that it can be subdivided into separate 7.14 These may be dedicated facilities or shared with the
waiting spaces. antenatal clinic if co-located. See ‘Treatment rooms’
19
R = Reception/sitting/
beverage bay
Ultrasound
Ultrasound
Birthing area
Pregnancy
assessment
Entrance
R
FEMA
Triage
Consult/
exam
Admin/staff amenities
Counselling
FEMA Birthing
Figure 6 Pregnancy (fetal and maternity) assessment unit functional relationships
Pregnancy assessment bay Two-bay layout
20
7 Pregnancy (fetal and maternal) assessment unit
Separate C/E room – in a Consultant-led unit

(CLU)
All images above Courtesy Queen Elizabeth

Hospital NHS Trust
Photographer: Lisa Payne
in Health Building Note 00-03 – ‘Clinical and • P

atient beverage and snack preparation facilities:
clinical support spaces’. may be adjacent to the reception/sitting area
• Clean utility
Interview rooms
• D
irty utility: There should be easy access for
7.15 These may be dedicated facilities or shared with the
women who often bring their own urine
antenatal clinic if co-located. See ‘Interview room:
specimens for checking. It should be adjacent to
4 places’ and ‘Interview room: 7 places in Health
the WC facilities so that women can also
Building Note 00-03 – ‘Clinical and clinical
provide specimens for investigation within easy
support spaces’.
reach of the test room
Staff communications base • Disposal hold
7.16 This is the central communications hub of a unit, a • Cleaners’ room
base at which midwives may receive, read or give
• Staff changing
instructions and record information in the records
held there. It should be centrally located and easily • Staff rest/beverage bay
identified by staff and visitors. It may be located
• O
ffices: A medical/midwifery office is required
near the clean utility room. The staff base should be
within the pregnancy assessment unit to allow
wired as the centre for the help call system within
for administration duties and private discussion
the area and central monitoring equipment for
of problems by medical and midwifery staff.
telemetry if used.
This should include telecommunications
7.17 There should be good communication links, facilities
including telephones and IT. A computer terminal
• Stores
and associated equipment with a link to laboratories
and EPR and PACS will be required. The security • Specimen collection/pneumatic tube (optional).
of records and noise associated with equipment 7.20 See Health Building Note 00-02 – ‘Sanitary spaces’
should be considered. and ‘Refreshments and rest’, ‘Utility’, ‘Offices’ and
7.18 Work stations for the computers will be needed, the ‘Facilities management’ in Health Building Note
quantity dependent on local policy. 00-03 – ‘Clinical and clinical support spaces’.
Support spaces
7.19 The following may be provided separately or shared
with other units that may be co-located, depending
on the overall design:
21
8 Birthing facilities (and associated in-patient

facilities)
8.1 This Health Building Note describes facilities • w

hether or not the maternity services are likely
required in all types of maternity unit for: to be reorganised/ relocated in the foreseeable
future;
a. direct admission of women;
• w
hether or not the unit has undertaken any
b. observation and assessment of pregnant women;
workforce study (for example Birth Rate Plus)
c. uncomplicated labour and births; that is likely to change the way care is delivered.
d. complicated labour and births (Consultant-led 8.3 Length of stay is variable in all stages of the
units (CLUs) only); maternity care pathway. When planning a unit,
e. operative obstetric procedures (CLUs only); length of stay should be considered in the context
of the model of care.
f. resuscitation of the baby;
g. observation and recovery of infants; CLU functional relationships
h. observation and recovery of mothers; 8.4 In-patient accommodation should be easily
accessible from, and within a short distance of, the
j. partners, relatives and friends; hospital entrance. Antenatal and postnatal areas
k. medical, midwifery, nursing and other staff; should be co-located for flexibility and they should
not be located adjacent to gynaecological facilities.
m. clinical training of midwifery, nursing and
See Figure 7.
medical staff.
MLU functional relationships
8.5 See Figure 8 and Chapter 3, ‘Whole maternity unit
8.2 The number of antenatal beds, birthing rooms and
considerations’.
postnatal beds will be a local decision based on a
number of factors. The aim is to provide
appropriate care for women and babies close to Front of house spaces
home. Project teams should consider the model of
care, current practices and any perceived changes
planned over the short, medium and long term. 8.6 The reception desk should be located to enable all
The following are key considerations: visitors entering or leaving the unit to be
monitored. See ‘Entrance, reception and waiting’ in
• t he size of the population served, including any
Health Building Note 00-03 – ‘Clinical and clinical
tertiary referrals;
support spaces’.
• t he demographic trends that will influence the
number of deliveries in the area; Triage room
• t he existing and predicted work trends in 8.7 A two-sided C/E room may be required for the
relation to any clinical developments; initial medical examination and midwifery
assessment of newly-arrived women, depending on
• w
hether or not the unit will attract women
local policy. There should be easy access to WCs,
arriving by ambulance;
ideally en-suite, otherwise close by. See
• w
hether or not the unit will attract transfer in of ‘Consulting/examination room: double-sided
mothers and babies from other units (that is, couch access’ in Health Building Note 00-03 –
tertiary referrals); ‘Clinical and clinical support spaces’.
22
8 Birthing facilities (and associated in-patient facilities)
CLU Hospital
Planned and emergency (from outside unit) C-sections
Anaes
office
Critical
Birthing rooms Obs care
theatres
As
Admin/staff
amenities
R
24-hour
access
Neonatal
Post- As = Assessment
unit
Ante- natal beds
natal bed R = Reception
Support
facilities
Figure 7 CLU functional relationships
MLU
OR
MLU Possibly primary care
Transfer to secondary/
tertiary care
Discreet route
Note: may be
Stores located in CLU
Assessment
Antenatal
clinic
Staff com.
base
Access to
outside 24-hour access
space/
garden Reception
Birthing
rooms
Admin/
staff
amenities
Figure 8 MLU functional relationships
23
Induction suite permanently take up space in the room or, if

folded back into the wall, may reduce the
8.8 A four-bed bay with en-suite toilet and shower
flexibility in the use of the room;
should be provided for women who are admitted
for induction of pregnancy. The number of beds f. a wall-mounted baby resuscitaire with oxygen,
will be based on demand. They will be equipped as air and vacuum outlets, and, if a multi-birth
a standard four-bed bay. They should be located room, space for additional mobile resuscitaires
close to the birthing rooms. See ‘Multi-bed room’ to be brought into the room (which will require
in Health Building Note 00-03 – ‘Clinical and additional medical gas outlets and socket-outlets
clinical support spaces’. if not running off battery and bottled supplies).
The location of the wall-mounted resuscitaire is
Birthing spaces likely to be influenced by and/or to influence
the location of access to the en-suite and/or the
Birthing rooms birthing pool area, and should be away from
draughts;
8.9 The key principles for the design of birthing rooms
are: g. medical gas outlets (including oxygen, nitrous
oxide/oxygen and vacuum) at the bedhead for
a. ensuring the safety of mothers and babies;
the mother. The nitrous oxide/oxygen outlet
b. offering people privacy, dignity, comfort and should be accessible to women using a variety of
freedom of movement; birthing aids and a variety of positions within
the room. To assist with achieving a non-clinical
c. enabling staff, equipment and services to be
environment these services can be concealed
available to women in one place, that is,
until required.
without them being moved;
h. twin socket-outlets. Some outlets should also be
d. being functionally suitable for all activities that
provided in the store to be available for charging
will take place in them;
equipment;
e. providing flexibility in their use both on a short-
j. if Electronic Patient Records are in use, a trolley
term basis and as needs and policies develop;
in the room, as required. A small writing surface
f. reducing the risk of cross-infection. may be required depending on local policy;
g. providing access to water during labour to k. a clinical wash-hand basin.
relieve pain.
8.11 A series of ergonomic studies was carried out into
Key recommendations birthing room design during the preparation of this
guidance. The range of activities from the most
8.10 All birthing rooms should include the following: straightforward to the most complex births was
a. en-suite sanitary facilities; investigated, and the space required for each
activity measured.
b. convenient storage for the mother’s holdall and
belongings; 8.12 Based on these studies, two room sizes have been
used within the schedule of accommodation and
c. access to facilities to make hot drinks and to are illustrated in the room layouts: a room intended
cold water; for single birth and a room suitable for twin/
d. local storage within or adjacent to the room for complex births. The schedule of accommodation
storage of equipment, sterile packs etc out of assumes that 20% of the birthing rooms in a
sight until required. Storage facilities will be Consultant-led unit (CLU) will be the larger size
fitted out to meet project-specific storage but that all the birthing rooms in a Midwifery-led
requirements; unit (MLU) will be sized for single birth. See
paragraph 8.22, ‘Birthing room layouts and
e. provision for partners to stay at night. The ergonomic evidence’.
layouts and space definitions in this guidance
assume that this is achieved using a fold-up bed,
which can be stored within the local store for
the room. The other available options either
24
Birthing room set up for high-risk birth Birthing room set up for low-risk birth
Both: Courtesy Queen Elizabeth Hospital NHS Trust
Bedhead services Mobile resuscitaire set up for high-risk birth Wall-mounted resuscitaire set up for high-risk
birth
All: Courtesy Queen Elizabeth Hospital NHS Trust Photographer: Lisa Payne
Birthing room in adjacent MLU

Courtesy Dartford and Gravesham NHS Trust
25
Birthing room in stand-alone birth centre (view from the doorway) Birthing room in stand-alone birth centre (view from the wall)
Courtesy Barts and the London NHS Trust
En-suite 8.14 Studies have shown that women’s preference for

bidets varies considerably (National Childbirth
8.13 This guidance assumes that all en-suite facilities
Trust ‘Creating a Better Birth Environment’
include a bath. Where a shower is required, this
toolkit, 2003). Where these are to be provided, the
should be included separately within the room and
specification of the fitting should meet the
not located over the bath. The bath need not be
requirements for bidets in Health Building Note
free-standing, but this will be a project decision.
00-10 Part C ‘Sanitary assemblies’. The schedule of
The areas defined in the schedule of
accommodation assumes that bidets are not
accommodation assume that it is not free-standing.
En-suite facilities
Courtesy Barts and the London NHS Trust
En-suite facilities
Queen Elizabeth Hospital NHS Trust
26
provided. See also ‘Bathrooms’ in Health Building main birthing room area is suitably close by and
Note 00-02 – ‘Sanitary spaces’. there is no obstruction to access from the pool area.
8.20 A nitrous oxide/oxygen point may be provided, or
Birthing pool areas (optional)
portable cylinders may be used.
8.15 Birthing pool areas, where provided, should be an
integral part of some birthing rooms. The number
of these will be a project decision. When not in use,
they can be curtained off from the main room. The
area needs non-slip flooring suitable for wet areas,
and this flooring usually extends a little way into
the main room.
8.16 There are a number of birthing pools on the
market. They vary in shape, size, and means of
getting in and out, and offer different sitting
positions. In selecting a model, it is important to
assess it in respect of the ergonomic implications of
the midwife’s activities as well as the woman’s – in
particular, the positions they will be adopting while
assisting the mother and in accessing the drainage
controls.
8.17 Several different models of fixed pool are available
in this country and from Europe. Manufacturers’
instructions regarding installation, routine
maintenance and disinfection must always be
followed, and local operational policies should be
in place. In particular, regular flushing is required
to avoid stagnation of water if the pools are not
used regularly. Filtration systems should be checked
with the manufacturer. Cleaning regimes should be
agreed locally with the infection control
representative.
8.18 There are certain safety considerations:
• T
he midwife should have access from both Birthing pool, CLU birthing room
sides, with provision of a plinth. “Slip-proof ” Courtesy Queen Elizabeth Hospital NHS Trust
steps into and out of the pool should be
provided, and the floor to the bath should be
slip-proof. Assisted bathroom(s)
• G
rab rails and other aids should be provided to 8.21 All CLU units should have one assisted bathroom.
help the woman out of the bath. See ‘Bathroom: assisted’ in Health Building Note
• T
here should be access to hot and cold water. 00-02 – ‘Sanitary spaces’.
The midwife should be able to control the
temperature of the pool water. Birthing room layouts and ergonomic evidence
• T
here should be access to an emergency call 8.22 Room layout options are provided for birthing
button. rooms suitable for (a) single births and (b) twin/
complex births. For further details of the space
• O
ccasionally, women need to be lifted out of studies that informed these layouts, see the separate
the pool onto the bed or a trolley. The provision ergonomic report (forthcoming).
of a hoist is a matter for local decision.
8.19 It is not necessary to provide a clinical wash-hand
basin within the pool area if the basin within the
27
Activities f. use of one wall-mounted resuscitaire and one

mobile resuscitaire (Note: space will allow for
Birthing room suitable for single births
two mobile resuscitaires);
8.23 The following activities may take place in this
g. transfer of a baby out of room, from wall-
room:
mounted resuscitaire, using additional mobile
a. non-birthing activities, for example relaxing, resuscitaire;
preparing refreshments, watching TV, baby
h. clinical hand-washing;
feeding etc;
j. recovery.
b. pre-birth activities, for example use of birthing
ball, stool and mat; Optional
c. monitoring and recording activities; k. accessing and updating EPRs; where not
provided within the room, these need to be
d. normal single birth;
available nearby from a touchdown base or
e. assisted single birth, including the scenario of similar. It is generally assumed that paper
both mother and baby needing resuscitation records will be used.
and subsequent transfer of both out of the
room; Space studies
f. transfer of the baby from the room, from a wall- (4900) Length
mounted resuscitaire, using a mobile

resuscitaire;
(2100)
g. clinical hand-washing; Minimum clear space for
evacuation of mobile
h. recovery. resuscitaire
Optional
j. accessing and updating EPRs; where not 100
0
600 for in
provided within the room, these need to be tubatio
n
available nearby from a touchdown base or
similar. It is generally assumed that paper
records will be used.
Birthing room suitable for twin and complex births

sc ile
ire
su b
ita
re Mo
8.24 The following activities may take place in this

room:
a. non-birthing activities, for example relaxing,
preparing refreshments, watching TV, baby
feeding etc;
b. pre-birth activities, for example use of birthing
ball, stool and mat;
c. monitoring and recording activities;
Figure 9 Activity space length
d. normal birth of twins;
e. assisted birth of twins, including the scenario of
8.25 The functional space required for birthing activities
both twins requiring resuscitation and transfer
– that is, 4900 mm × 4200 (single birth) or
out of the room, together with the mother
4650 mm (twin birth) – has been verified by a
experiencing cardiac collapse and also requring
series of space studies. The actual room area is the
resuscitation and subsequent transfer out of the
result of combining various functional activity
room;
spaces (for example, birthing, clinical hand-
washing, storage and pool) into a room design.
28
Generally, access space is excluded from DH core

space recommendations; however, the optional
(2300) between fixed units

indicative designs illustrated show that a minimum
allowance of 2 m2 to access the room will be
required to provide functioning spaces.
(4650)
8.26 Where a birthing pool is required, an additional
9 m2 has been recommended, based on the space Zone for active
birth, mat etc
studies.
1900
Ceiling
8.27 The recommendations set out here primarily relate hook
to the key critical dimensions rather than the area.

The following sections aim to illustrate the key Vertical support rail
dimensions and explain why they have been 2100
defined. Where local teams make different Figure 13 Twin birth option 1
assumptions, these critical dimensions may need to
Mid
be changed.
Activity space widths
Obs
lle ing
tro ress
y
D
Cot
(2300) between fixed units
CTG Mid
Bed moved for active

(4200)
birth
Zone for active

birth, mat etc
1900
approx 850
Ceiling Figure 14 Twin birth option 2 (450)
hook
450 assume
no access
Vertical support rail Mid
2100
Figure 10 Single birth option 1
Obs
Mid
lle ing
tro ress
y
D
CTG Cot
Mid
Obs
Cot
lle ing
tro ress
y
CTG
D
Mid
900
Space to access
approx 850
storage
(450)
Figure 11 Single birth option 2 450 assume
Figure 15 Twin birth option 3
no access
Mid The room length of 4900 mm

8.28 The length of the room is greatly affected by the
Obs
requirement to pull the mother’s bed away from the
wall for her resuscitation and still allow sufficient
space for moving a resuscitaire from the birthing
Cot
room. A clear space of 2100 mm is required at the
lle ing
tro ress
y
foot of the bed for transferring and evacuating an

D
CTG
Mid
infant from a wall-mounted to mobile resuscitaire,

when the bed has been withdrawn 600 mm for
resuscitation of the mother (note the 600 mm
29
assumes that intubation of the mother will not be within a room depending upon the bed location
necessary). and the use of a privacy screen.
The room width of 4200 mm

8.29 This was considered:
• acceptable for active birth at the side of the bed
where the bed is moved from its normal
position, which was considered normal practice;
• a cceptable for all general birth activity,
including the evacuation of an infant in a
mobile resuscitaire when the mother is being
resuscitated;

• a cceptable whether the resuscitaire was located
at 45 deg in the corner or at 90 deg to the wall
as shown;
• r estrictive for twin births, requiring two
resuscitaires, as the midwife dealing with the
mother would be trapped by equipment.
The room width of 4650 mm
8.30 This was considered:
• a cceptable for active birth by the side of the
bed, with the bed in its normal position.
• a cceptable for twin births, where two

resuscitaires are required – a fixed wall-mounted
resuscitaire in one corner and a mobile
resuscitaire in the second (note: it is assumed
that the mobile resuscitaire is operated on Figure 16 Bed location/privacy
battery power and bottled gas);
• acceptable whether the resuscitaires were located Local storage
at 45 deg in the corner or at 90 deg to the wall
as shown. 8.34 Storage space is required en-suite or nearby to the
room for:
Storage at the head of the bed
a. birthing mat;
8.31 The storage zone shown at the head of the bed was
only suitable for consumables and small trolleys/ b. birthing stool;
CTG equipment. Note: storage space or c. bean bag;
consumables only amounts to three small storage
boxes-worth (approximately 150H × 150W × 300L d. wedge;
each) and space for a spare set of linen. e. fold-up bed (for partner/relative use only);
8.32 The size of the opening in the storage must allow f. light and stand (may be ceiling-mounted but
easy access in an emergency. this can be difficult to make non-clinical);
Bed location and privacy g. small and large trolley (may not require both);
8.33 It is recommended that the bed is located around

h. drip-stand;
the corner from the door/entrance location of the j. height-adjustable cot;
room to assist in protecting the woman’s privacy.
k. mobile resuscitaire (for twin birth, or one per
The illustration shows notional privacy zones
four rooms generally when wall-mounted
resuscitaire is included).
30
8.35 Also, but separately, assumed to be in a cupboard 8.36 Area of local store = 3.75 m2, or 5.4 m2 with
next to the bed: resuscitaire.
a. monitors (fetal heart monitor/CTG, blood 8.37 Average across four rooms = (3 × 3.75 plus
pressure etc); 1 × 5.4)/4 = 4.16 or 4 m2.
b. personal storage.
Evacuation of the mother in the bed/door width
Space for trolleys, cot, drip stands, Space for mobile
exam light and equipment on shelves resuscitaire 8.38 Evacuation of the mother was tested with two drip-
approx 2500 approx 1100 stands (a) one either side of the bed and (b) both
behind the bed, simulating bed-mounted drip
stands; both scenarios with four members of staff.
• W
ith drip-stands at the side of the bed and with
two midwives partly behind the bed, egress was
achieved reasonably comfortably with a 1700
Bean Shelf with
bag bean bag etc mm clear opening doorway (effective clear
width; ecw).
• W
ith two midwives and two drip-stands behind
approx 1200–1400
the bed, egress was achieved reasonably

comfortably with a 1450 mm clear opening
doorway (ecw).
8.39 See Health Building Note 00-03 – ‘Circulation and
Figure 17 Local storage 1 communication spaces’ for the associated
requirements for clear corridor widths outside of
the room depending on the ecw of the door
opening.
Folding bed
Trolley
Resuscitaire
1500
Cot
Drip stands
Figure 18 Local storage 2
4900 4900
1000 1000
4200
4200
4650
4650
3000 (2400 tested) 1700

3250 (2600 tested) 1450
Figure 19 Door size 1 Figure 20 Door size 2
31
Room layout options

Single/twin birth – room layout options
Store/
4200
8.40 The overall room area will be dependent on the
4650
support
relationship of associated spaces (clinical wash-hand

basin, storage and en-suite) and whether additional
space will be required in order to access the room.
En-suite Store/ En-suite
support
En-suite En-suite
4200
4650
Figure 23 Single/Twin birth option 3

Store/
support
Zone Single birth m² Twin birth m²

Figure 21 Single/Twin birth option 1 Birthing area 4.2 × 4.9 = 20.6 4.65 × 4.9 = 22.8
Zone Single birth m² Twin birth m² Clinical wash-
1.2 1.2
hand basin
Birthing area 4.2 × 4.9 = 20.6 4.65 × 4.9 = 22.8
Access space 4.0 4.0
Clinical wash-
1.2 1.2 Total 25.8 (26.0) 28.0
hand basin
Total 21.8 (22.0) 24.0 Storage Average 4.0 Average 4.0
Storage Average 4.0 Average 4.0 Single birth with pool – room layout options
Note: this layout includes some compromise of functional 8.41 The overall room area will be dependent on the
space because of the privacy curtain. relationship of associated spaces (clinical wash-hand
basin, pool and en-suite) and whether additional
En-suite En-suite
space will be required in order to access the room.
3000
4200
4650
Store/
support
Store/ Store/
support support
Birthing
3100
pool
Figure 22 Single/Twin birth option 2
4200
Zone Single birth m² Twin birth m²

Birthing area 4.2 × 4.9 = 20.6 4.65 × 4.9 = 22.8
Clinical wash- En-suite
1.2 1.2
hand basin
Store/support
Access space 2.0 2.0
Total 23.8 (24.0) 26.0
Storage Average 4.0 Average 4.0
Note: The total areas of 24 m² and 26 m², for single and
twin birth respectively, have been included within the
Zone Single birth m²
associated schedule of accommodation, since the space
compromise above was not considered acceptable for a Birthing area 4.2 × 4.9 = 20.6
baseline allowance. Clinical wash-hand basin 1.2
Access space 3.3
Pool 3.0 × 3.0 = 9.3
Total 34.4 (34.5)
Storage Average 4.0
Note: 34.5 m² has been included in the associated schedule
of accommodation. It is necessary to include access
within the indicative room layout.
32
• r elease or activate the bed brakes if they are

Birthing located at the head of the bed.
pool
8.45 The clinical wash-hand basin should be near the

4200
entrance to the room (used on entry and exit) and

be visible, by mother/partner etc, when used.
En-suite
Store
En-suite
In-patient spaces
Antenatal and postnatal bed spaces
Figure 25 Single birth option 2 8.46 Single rooms are preferred for privacy and dignity
reasons and to reduce noise (postnatally). Bed
Zone Single birth m² spaces for antenatal and postnatal care should
Birthing area 4.2 × 4.9 = 20.6 ideally be co-located and the rooms should be
Clinical wash-hand basin 1.2 suitable for both antenatal and postnatal care for
Access space 4.0 maximum flexibility.
Pool 3.0 × 3.0 = 9.0 8.47 Standard single rooms are suitable for antenatal
Total 34.8 (35.0) care and for postnatal care accommodating twins.
Storage Average 4.0
Project teams may wish to consider providing larger
single rooms for multiple births.
Specific spatial/functional issues
8.48 A variable-height baby’s cot(s) will be provided in
8.42 This guidance assumes the use of a wall-mounted rooms used postnatally. In the event of an
resuscitaire as a default situation. However, there emergency, a mobile resuscitaire for the baby will
will always be a requirement for access to a mobile be brought into the room.
resuscitaire for transport, for when the wall-
8.49 All single bedrooms should have en-suite WC,
mounted unit requires maintenance or for twin
wash basin and shower facilities. It should be
births. It is recommended that when a wall-
possible to push sani-chairs easily into WCs.
mounted resuscitaire is available in each room, a
minimum of an additional two mobile resuscitaires
should be available for every six birthing rooms (ie
one per three rooms).
8.43 The active birth area should:
• b e discreetly positioned so that the area is not
on view from the room entrance;
• h
ave the possibility of being located by a wall
and include patient staff call, entonox outlet,
grabrails/hooks in the ceiling to provide support
for women in labour.
8.44 The bedhead services for the mother must include
oxygen, vacuum and entonox supply and a Single room, CLU. Courtesy Queen Elizabeth Hospital NHS Trust.
minimum of six electrical supply points, staff Photographer: Lisa Payne
emergency call and patient staff call. Note: the
tubes for oxygen and vacuum must be easily able to
reach the mother when the bed is moved away Multi-bed spaces
from the wall for resuscitation etc (suggest approx 8.50 Project teams may decide to include some multi-
1500 mm distance between the outlets and the bed rooms for antenatal, postnatal and transitional
mother). Consideration must also be given to staff care. Some antenatal women may prefer the
access to: company of other women but may not be well
• switch on/and unplug equipment etc; enough to visit the day rooms. Some postnatal
women may prefer to be in the company of other
• use of emergency call;
33
High dependency area

8.55 The birthing rooms and single bedrooms will
generally be suitable for postnatal high dependency
care. However, after giving birth, some mothers
with suspected complications will need more
intensive monitoring than might be provided in the
birthing/postnatal area, usually for short periods.
This guidance assumes that a four-bed space should
be sufficient, but project teams will need to
confirm that this is appropriate for their local
needs. Consideration may be given to equipping
and servicing the spaces as for a theatre recovery
Four-bed room, CLU. Courtesy Queen Elizabeth Hospital NHS Trust. area. Mobile monitoring equipment can allow
Photographer: Lisa Payne privacy without compromising safety (such as for a
woman who is in labour).
new mothers. Multi-bed spaces may be especially
suitable for teenage mothers. Generally, these 8.56 Depending on the location of the theatres and the
spaces should not exceed four beds in one room. maternity unit, the high dependency area and the
theatre recovery areas can be co-located. See
8.51 Standard multi-bed spaces are considered sufficient
‘Recovery spaces’ in Health Building Note
for a cot, for mothers to sit and feed their baby, and 00-03 – ‘Clinical and clinical support spaces’.
to accommodate visitors. All multi-bed rooms
require en-suite sanitary facilities. The provision of
baths and/or showers will be a project decision. En-
Support spaces
suites should be directly accessible from inside the
Bereavement suite
bedroom.
8.57 A woman who has lost her baby should not be
8.52 A degree of visual privacy can be provided by bed
accommodated on a ward/bed room where there
curtains. Disturbing noise from babies crying and
are new mothers. A self-contained family suite(s)
visitors is inevitable in these rooms. The provision
with en-suite facilities should be provided, away
of acoustically absorbent materials for ceilings,
from the birthing and in-patient areas, where
walls and floors can reduce the noise. Hard surfaces
families can grieve the loss of their baby. It consists
should be avoided. Rooms should have closeable
of an hotel-type family room with a bed,
doors so that mothers are not exposed to noises and
comfortable seating, a low table, some personal
light from outside their room, particularly at night.
storage, a beverage point and an en-suite facility.
Small comfortable rooms should be available
Access to a secluded garden space is very desirable.
nearby where private conversations can take place.
8.53 See ‘Multi-bed room’ in Health Building Note
Isolation facilities
8.54 Single rooms provide an effective facility for
isolating patients with a variety of HCAIs.
However, in some circumstances it will be necessary
to provide a higher level of isolation, particularly
for those patients with airborne diseases or for
immuno-suppressed patients who may be at risk of
infection from others. In these cases, an isolation
suite – which includes an entrance lobby, bedroom
and en-suite bathroom – will be necessary. See Bereavement suite. Courtesy Queen Elizabeth Hospital NHS Trust.
Health Building Note 04-01 Supplement A – Photographer: Lisa Payne
‘Isolation facilities for infectious patients in acute
settings’.
34

8.58 Staff communication and touchdown bases should
be located to suit the layout in relation to all in-
patient rooms. The staff communication base
should overlook the entrance to the suite of
birthing rooms.
8.59 Staff communication bases are the centre for the
patient-to-staff and a staff call system within the
area and central monitoring equipment for radio
telemetry (CLUs only). The base should
incorporate a facility for transferring a nurse-to-
nurse emergency call to another manned point. A
suitable entry control system, with audio and video
functions, as appropriate, will be provided.
Day space. Courtesy Dartford and Gravesham NHS Trust.
Touchdown bases are normally shared between four Photographer: Lisa Payne
to six rooms. See ‘Staff communication base’ and
‘Touchdown base’ in Health Building Note 00-03
– ‘Clinical and clinical support spaces’. Private rooms for expressing milk
Treatment room (optional) 8.62 In MLUs, mothers can express milk at their
bedside. In secondary and tertiary level units, where
8.60 If multi-bed areas are included, a treatment room babies may be transferred to a neonatal unit and
should be provided. Ultrasound examinations perhaps stay in hospital after their mother has been
could also be performed in this room using mobile transferred home, there is a need for small,
equipment. attractive, private rooms with lockable doors for
mothers to use for expressing breast milk, using an
Day room(s)/transfer lounge electric pump provided by the unit. These rooms
8.61 The provision of a day spaces(s) is desirable should be located within either the postnatal area
antenatally and postnatally to offer women a or the neonatal unit, or be easily accessible to those
change of environment and opportunities for areas, so that the mother does not have to be
socialising. They can be flexibly used for dining, separated from her baby while expressing. They
sitting or waiting. Postnatal day spaces should be require a chair and facilities for hand-washing.
large enough to accommodate cots. Wherever Access is needed to a fridge, located in a secure
possible, women and their families should have area, for the exclusive use of expressed breast milk.
access to gardens or courtyards during their stay. Sterilizing facilities are needed close by.
A day space may be used as a transfer lounge for
mothers who are being transferred home under the Milk kitchen/store/training room
care of a community midwife. 8.63 Many healthcare providers no longer supply
formula feeds. Mothers are expected to supply
them and make them up, so a preparation area is
required where staff will demonstrate the
preparation of baby feeds on a domestic scale and
mothers can prepare feeds. This room will include a
small refrigerator, a sink with a drainer, storage
facilities, and a clinical wash-hand basin.
Interview rooms
8.64 Within each unit, there should be a comfortably
furnished room(s) for counselling and interviewing.
Rooms may be provided close to the postnatal
facilities to accommodate “satellite services” such as
Day space. Courtesy Queen Elizabeth Hospital NHS Trust. registration of births and interviews with other
Photographer: Lisa Payne specialists and agencies such as health visitors and
35
social services. See ‘Interview room: 4 places’ and Staff facilities

‘Interview room: 7 places’ in Health Building Note
8.67 The following staff facilities are required:
• Staff changing
Other support spaces
• Staff rest room with beverage bay
8.65 The following support spaces are required:
• Seminar room
• C
lean utility/preparation or clean supply
room: According to hospital policy on supply Office accommodation
and disposal and taking into account the 8.68 The provision of dedicated office space is only
integral storage in the birthing rooms. justified when they are in constant use, and
• D
rug store: For central storage of consideration should be given to the flexible use of
pharmaceuticals and intra-venous fluids. space.
• D
irty utility: The room also serves as the 8.69 A medical/midwifery office is required to allow for
temporary storage point and testing area for administration duties and private discussion of
specimens. Products of conception will be problems by medical and midwifery staff. This
collected and examined here. A set of scales may should include telecommunications facilities.
be needed to weigh the placenta. 8.70 The change in medical workforce means that
• N
ear-patient testing lab: A blood gas/pH doctors will be working shifts rather than be on-call
analyser should be available in any unit in hospital. A multidisciplinary office should be
undertaking continuous fetal heart rate available in the unit or very close to it for
monitoring. Space is also required for the obstetricians and anesthetists working a shift.
equipment required for biochemical tests carried 8.71 Provision of other office accommodation is project-
out during and after birth. This is normally specific. This may include offices for anaesthetists
located within the CLU birthing area, but may who do not have an office elsewhere, clinical
be shared with the neonatal unit. mangers, consultant midwives etc. An
• K
itchen/pantry: According to the policy for administrative zone will be required for the Head
the meal provision for mothers and staff. of Midwifery and other midwife consultants, with
secretarial support. An indication of requirements
• B
loodbank: The blood refrigerator/storeroom
for single and multi-workstations is included in the
should be easily accessible from the birthing
schedules of accommodation.
rooms.
8.72 Teaching accommodation is a project option and
• R
esuscitation trolley: Emergency equipment
dependent on the size of the unit.
should be parked where it is easily accessible to
birthing and bedrooms but does not obstruct 8.73 See Health Building Note 00-02 – ‘Sanitary spaces’
circulation areas. and ‘Utility’ and ‘Refreshments and rest’ and
‘Offices’ in Health Building Note 00-03 – ‘Clinical
• Stores, including linen
and clinical support spaces’.
• Switchgear cupboard
8.66 See ‘Utility’ and ‘Refreshments and rest’ in Health
Building Note 00-03 – ‘Clinical and clinical
support spaces’.
36
9 Obstetric operating theatre suite
9.1 A dedicated obstetric operating theatre suite is between two theatres, but need not be directly
required. The functional and environmental design accessible by both.
requirements and accommodation requirements of
9.7 If an area is planned where a patient will wait for a
the suite, including support accommodation, are
theatre to be vacated, it must have piped oxygen
the same as for a general operating theatre suite.
and suction. This guidance assumes that a recovery
9.2 The majority of consultant-led units (CLUs) will space or anaesthetic room will be used for this
have two theatres. If the number of births exceeds purpose.
6000 per year, three theatres may be required. Very
small CLUs may only require one theatre. Obstetric theatres
9.3 See Health Building Note 26 Volume 1 – ‘Facilities 9.8 A general theatre space is appropriate for
for surgical procedures’. undertaking obstetric procedures.
9.9 In addition:
a. A resuscitation area for the baby is also required,
9.4 The location of obstetric operating theatres is which requires a warmer local environment.
critical: The high air flow/air changes within a theatre
• D
irect access, 24 hours a day, is required from make it more difficult to keep a baby warm,
all birthing facilities within and from outside because convection currents cool the baby even
the CLU. That is, there should be easy access when the theatre temperature is high. The area
from the main entrance and birthing rooms. may be provided immediately outside the
theatre or within the theatre; if provided within
• T
heatre(s) should also be close to the neonatal the theatre, project teams should seek advice on
unit, for ease of transfer of the baby, with good appropriate engineering solutions.
access to adult critical care facilities.
b. Space is required for “parking” the transport
• P
roximity to other specialist theatres, for incubator and neonatal ventilation equipment
example cardiac theatres, may need to be in or close to the theatre.
considered in tertiary centres.
c. The orientation of the table is important (with
Spaces the mother’s head towards the door).
d. Theatre lights should not reflect so that the
Anaesthetic room woman (or her partner) can see the operation as
9.5 In an obstetric operating theatre suite, the if in a mirror.
anaesthetic is often administered in the theatre, e. Many women having a caesarean section will
obviating the need for an anaesthetic room. have the induction of anaesthesia carried out in
9.6 Inclusion of an anaesthetic room might, however, this room. However, women often remain
provide flexibility for a wider range of uses. For conscious during a caesarean section and may be
example, an anaesthetic room may be used for the accompanied by a partner. The colour scheme
administration of spinal/epidurals for elective and lighting should therefore promote a relaxing
caesarean section, and catheterisation, and this atmosphere, but the lighting should not
would offer a higher degree of privacy for the compromise clinical functionality. It is essential
mother than the theatre. It is therefore included in that daylight simulating lighting is specified in
the schedule of accommodation. It may be shared recovery areas and in theatres.
37
Recovery spaces mother. An area is required close to where the

mother is being kept for recovery and where the
9.10 Recovery rooms are essential wherever there is an
midwives can observe the baby. It should be warm
operating theatre until a woman can be transferred
and out of any draughts, with access to oxygen, air,
back to her room.
suction and a power supply. See ‘Recovery spaces’
9.11 The baby may also need a period of observation in Health Building Note 00-03 – ‘Clinical and
prior to deciding whether they should go to the clinical support spaces’.
neonatal unit or to the postnatal ward with the
38
10 Whole maternity unit staff accommodation
10.1 Staff accommodation should be designed to allow 10.4 While it is important that members of specialist
consultant medical staff and their secretarial consultant teams have ready access to their specific
support to communicate effectively both within ward and operative areas, it is equally important
and across clinical specialties, enabling them to that their offices should have close proximity to
deliver their clinical commitments effectively. each other, to offer better cover, to streamline
referrals between specialties, and to allow close
10.2 The facilities are as follows:
proximity to research facilities. These offices may
• office space for consultants and secretaries; be shared.
• seminar facilities, with audio-visual services etc; 10.5 Electronic access to laboratory results should be
• other facilities to accommodate teaching and available, along with access to external email and
research activities, to be discussed with the internet. A photocopier, shredder and private area
client. for facsimile should be easily available or within
clinic. Staff areas should be secure, and
10.3 Clinical administrative spaces should be provided consideration should be given to the use of key
in a flexible environment with a mixture of pad/proximity sensor locks (or similar) to control
continuous use and hot desk spaces with associated access to staff areas. See ‘Offices’ and ‘Group
quiet and breakout spaces. rooms’ in Health Building Note 00-03 – ‘Clinical
and clinical support spaces’.
39
11 Specific engineering considerations
General engineering and low sound in other areas, the ventilation

distribution ductwork should be designed to
11.1 The scope of the services included relate to the minimise the transmission of sound from one area
local services required for the functioning of this to another by suitable routing or separate
unit. Midwifery-led units (MLUs) remote from an distributions. Any ductwork “cross-talk”
acute or community hospital will additionally attenuators required should be designed and
require suitable resilient engineering services installed to avoid the harbouring of bacteria and for
infrastructure including incoming electricity, water, ease of cleaning.
gas and telecommunications/IT network, together
with main plant including boilers, switchgear etc. 11.4 Each maternity theatre suite should ideally be
served by its own air handling plant, provided with
Sustainability and energy efficiency standby set-back control.
11.2 Since passive solar design should be employed to 11.5 In birthing rooms and recovery areas where
ensure that, as far as possible, areas such as wards, analgesic and anaesthetic gases are exhaled, the
recovery units and offices are located where they ventilation rate should be of sufficient capacity to
can benefit from natural daylight, certain spaces control substances within the appropriate
within the unit, for reasons of privacy and dignity, occupational exposure limits (COSHH). In order
will require the use of blinds at times. See Heath to optimise the ventilation efficiency to minimise
Technical Memorandum 07-07 – ‘Sustainable the amount of ventilation required, consideration
health and social care buildings: Planning, design, should be given to low-level extract at the bedhead
construction and refurbishment’. in recovery areas and to proprietary scavenging
systems in birthing rooms.
Ventilation 11.6 See also Health Technical Memorandum 03-01 –
‘Specialised ventilation for healthcare premises’,
11.3 In order to contain noise within birthing rooms
Parts A and B.
and to provide adequate levels of confidentiality
Table 1 Birthing room ventilation design criteria

Ventilation Air-change Pressure Supply Noise Temperature Comments
rates per (Pascals) filter (NR) (°C)
hour
Birthing Supply and 15 Negative G4 40 18–25 In birthing rooms, the use of
room extract anaesthetic gas is controlled on
demand by the patient. This may
result in significant leakage that – in
order to reduce staff exposure – will
need to be controlled by establishing
a clean air-flow path. A supply at high
level at the foot-end of the bed with
extract at low level at the head-end
will provide such a path
40
Hot and cold water systems 11.10 See also Health Technical Memorandum 04-01
– ‘The control of Legionella, hygiene, “safe” hot
11.7 Designers should consider the option of bidets or water, cold water and drinking water systems’.
showers with flexible hoses (that can be used at low
level) to be used in en-suites.
Medical gases
11.8 Prevention of backflow contamination of the water
11.11 Nitrous oxide/oxygen is predominantly used in
supply to fluid category 5 should be provided
maternity facilities and not widely used in other
where there is a risk of submerged inlets by flexible
facilities. Therefore, it should be assumed that no
shower hoses in baths, wash-basins, WCs and
such facility exists within the main hospital and
bidets. Alternatively a system of hose restraint rings
that a local bottle store and manifold room is to be
could be employed.
provided. This should be contained within a
11.9 A supply of cooled drinking water should be suitable external enclosure located adjacent to road
provided for in-patients. access.
Table 2 Number of medical gas terminal units, AVSUs and alarms

Oxygen Nitrous Nitrous Medical Surgical Vacuum Gas Helium/ Area Alarms
oxide oxide/ air air scavenging oxygen valve
oxygen mixture service
mixture units
(AVSUs)
Birthing room: 1 set
per 6–8
rooms
Mother 1 0 1 0 0 2 0 0
Baby (per cot 1 0 0 1 0 1 0 0
space)
Operating suite: 1 set 1 set
hp/lp
Anaesthetist 1 1 0 1 0 1 1 0
Obstetrician 0 0 0 0 0 2 0 0
Paediatrician 1 0 0 1 0 1 0 0
Post-anaesthesia 1 0 0 1 0 1 0 0 1 set 1 set
recovery (per bed
space)
In-patient 1 set for 1 set
accommodation: ward
unit
Single bed 1 0 0 0 0 1 0 0
Multi-room, per 1 0 0 0 0 1 0 0
bed space
41
Table 3 Design flow for medical gas terminal units (litres per minute)
Oxygen Nitrous oxide Nitrous oxide/ Medical air Surgical air Vacuum
oxygen mixture
Birthing room:
Mother 10 0 275 0 40
Baby (per cot 10 0 0 40 40
space)
Operating suite:
Anaesthetist 100 15 0 40 40 Max 130
Min 80
Obstetrician 0 0 0 40
Paediatrician 10 0 0 40
Post-anaesthesia 10 0 0 40 40
recovery (per bed
space)
In-patient accommodation:
Single bed 10 0 0 40
Multi-room, per 10 0 0 40
bed space

11.12 See also Health Technical Memorandum 02-01 present a visually pleasing and non-clinical
– ‘Medical gas pipeline systems’. appearance.
11.16 Birthing rooms (single birth) should provide the
Electrical services following bedhead services:
11.13 Uninterruptible power supplies combined with • s ufficient twin switched socket-outlets for the
isolated power supplies (medical IT (isolated from mother and baby;
earth)) should be provided to serve obstetric
operating theatres, recovery areas and other spaces • n
itrous oxide/oxygen (optional) and scavenging
such as birthing rooms where high levels of if provided;
intervention may be involved. This will • oxygen, medical vacuum and medical air
incorporate local or plant-mounted cubicalised outlets;
equipment with dual circuitry to outlets in
pendants and bedhead trunking. See Health • bedhead luminaire switch;
Technical Memorandum 06-01 – ‘Electrical • nurse call;
services supply and distribution’.
• staff emergency call;
Bedhead services • socket for patient handset;
11.14 Allowance should be made for the introduction of • IT connection(s);
television and radio systems in waiting areas, to • radio/TV headset connection;
create a relaxing atmosphere, staff rest areas, and in
locations where it would be beneficial in masking • telephone connection;
sound transfer. • entertainment system (optional).
11.15 In locations requiring multiple electrical, IT and 11.17 Appropriate provision should be made for multiple
medical gases, suitable trunking systems should be births with additional power, IT connections and
considered for containment of the services and medical gas outlets for the introduction of a
outlets and to readily facilitate the addition or mobile resuscitaire.
repositioning of outlets as may be required. This
consideration should be balanced against the need 11.18 A handset control should also be provided
in some areas (for example birthing rooms) to incorporating:
42
• nurse call button; 11.19 See also Health Technical Memorandum 08-03
– ‘Bedhead services’.
• reassurance lamp;
• luminaire switch/dimmer control; Acoustics
• radio/TV selector switch; 11.20 See Health Technical Memorandum 08-01 –
• radio/TV volume control. ‘Acoustics’ for details on birthing rooms.
Table 4 Bedhead services design criteria

Call Power/data Entertainment
systems
Nurse call Staff Twin- Telephone Data Patient Television Radio
emergency socket monitoring
call outlets terminal
Birthing room:
Project Project
Mother Yes Yes 4 Yes 6 Yes
option option
Baby (per Project Project
Yes Yes 2 Yes 2 Yes
cot space) option option
Post-
anaesthesia
recovery 6 4
(per bed
space)
In-patient accommodation:
Single bed Yes Yes 4 Yes 4 Yes Yes
Multi-
room, per Yes Yes 4 Yes 4 Yes Yes
bed space
43
12 Schedule and cost information
Maternity schedules of accommodation c. 9500 births per annum: comprising 8000 births
in a CLU and 1500 births in an MLU.
12.1 Schedules of accommodation are given for the
following service examples: 12.2 The examples provide information for an MLU
co-located with a CLU and for a stand-alone MLU.
a. 3500 births per annum: comprising 3000 births For MLUs co-located with community facilities,
in a consultant-led unit (CLU) and 500 births the schedule indicates the required adjustment in
in a midwife-led unit (MLU); the engineering allowance.
b. 6000 births per annum: comprising 5000 births
in a CLU and 1000 births in an MLU;
44
Example schedule of accommodation for Health Building Note 09-02 - 'Maternity care facilities' (2nd edition). Example 1: 3000 births in a consultant-led birthing unit (CLU) and 500
births in a midwife-led birthing unit (MLU). Includes MLU co-located with CLU and a stand-alone MLU.
ADB data for rooms without codes will be available at the end of March 2011
Consultant-led birthing unit (3000 births/annum)

ADB code Room name/function Unit area Quantity Total area Paragraph reference Comments
allowance
Public spaces for clinics and assessment units
Entrance and reception
J0232 Reception (size based on number of places) 5.5 2 11.0 Para 4.2
Waiting area (size based on number of places) 1.5 10 15.0 Para 4.2, 4.4d
Children's play area (size based on number of places) 1.5 3 4.5 Minimum of 3 places per individual play area. Number of places
equivalent to approximately 10% of waiting places.
Shops and café No space allowed. Local determination of external source of
funding.
P0808 Vending machine 3.0 1 3.0 Para 4.4b
V1131 Nappy changing room 5.0 1 5.0 Para 4.4f
S0012 Infant feeding room 6.0 1 6.0 Para 4.4g
G0180 Parking bay for wheelchair 2.0 1 2.0 Para 4.4h
V1121 WC: semi-ambulant 2.5 2 5.0 Para 4.4 1 WC for every 25 waiting places plus 1 less provision for
independent wheelchair WCs. Minimum 2 scheduled to allow for
male and female provision.
V0922 WC: independent wheelchair 4.5 1 4.5 Para 4.4 1 per 500 sqm (net internal area) of clinical space within clinics and
assessment units.
Clinical spaces for clinics and assessment units

Antenatal and ultrasound clinics
J0232 Reception (size based on number of places) 5.5 2 11.0 Para 4.2 1 per 6 clinical rooms (excluding interview rooms).
Waiting area (size based on number of places) 1.5 25 37.5 Para 4.2, 4.4d 3 places per core clinical room (excluding interview rooms).
P0811 Drinking water dispenser 0.5 1 0.5 Para 4.4 1 per 50 waiting places.
V1121 WC: semi-ambulant 2.5 2 5.0 Para 4.4 1 per 25 waiting places.
V0922 WC: independent wheelchair 4.5 0 0.0 Para 4.4 Allowance included in entrance area.
Information/resource centre: 3 persons 12.0 1 12.0 Para 4.3
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 2 24.0 Para 4.8 4.20 1 per 6 consulting/examination rooms.
C0235 Consulting/examination room: single-sided couch access 12.0 5 60.0 Para 4.5, 4.7 Derived from clinical planning.
C0237 Consulting/examination room: double-sided couch access 16.0 1 16.0 Para 4.6 Derived from clinical planning.
X0145 Ultrasound room 16.0 3 48.0 Para 4.19 Derived from clinical planning.
V0922 WC: independent wheelchair 4.5 1 4.5 Para 4.21 1 WC per ultrasound room including independent wheelchair WCs.
Adjacent to ultrasound room.
V1121 WC: semi-ambulant 2.5 2 5.0 Para 4.21 1 WC per ultrasound room including independent wheelchair WCs.
Pregnancy assessment unit

Waiting area (size based on number of places) 1.5 10 15.0 Para 4.4d, 6.2 3 places per core clinical room (excluding interview rooms).
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 1 12.0 Para 6.6 May be co-located with interview rooms for antenatal and
ultrasound clinics.
C0235 Consulting/examination room: single-sided couch access 12.0 1 12.0 Para 6.3 1 per 2 maternity assessment rooms.
B2532 Maternity assessment room: 2 places 24.0 2 48.0 Para 6.4 Derived from clinical planning.
P0625 Pantry/refreshment area 8.0 0 0.0 Para 6.7 In shared support.
T0211 Staff communication base (size based on number of places) 5.5 1 5.5 Para 6.9
X0145 Ultrasound room 16.0 1 16.0 Para 6.5 May be co-located with antenatal ultrasound rooms.
V0923 WC: independent wheelchair/semi-ambulant 5.5 1 5.5 Para 6.8
ADB Codes, Activity Database Data is © Crown copyright 2009.

Published by the Department of Health.
45
Page 1 of 8
46
Early pregnancy assessment unit (EPAU) Location likely to be near gynaecology clinic or ward.
Waiting area (size based on number of places) 1.5 10 15.0 Para 5.2 3 places per clinical room.
C0235 Consulting/examination room: single-sided couch access 12.0 1 12.0 Para 5.3 Derived from clinical planning.
V0923 WC: independent wheelchair/semi-ambulant 5.5 1 5.5
M0724 Interview room: 4 places (including 1 wheelchair place) 8.0 1 8.0 Para 5.7 1 per consulting/examination room. Room requires discreet exit.
Sitting and beverage bay: 6 places 12.0 1 12.0 Para 5.8, 5.9
Shared support for clinics and assessment units Location dependent on design.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0 Para 4.10, 5.11, 6.12
T0538 Clean utility room without controlled drugs cupboard 8.0 2 16.0 Para 4.10, 5.11, 6.12 1 per 12 clinical rooms.
Y0431 Dirty utility room 8.0 2 16.0 Para 4.10, 5.11, 6.12 1 per 12 clinical rooms.
Y0642 Disposal hold: 1700 litres 8.0 1 8.0 Para 4.10, 5.11, 6.12 1 per 500 sqm (net internal area) of clinical spaces for clinics and
assessment units.
Y1510 Cleaners' room 8.0 1 8.0 Para 4.10, 5.11, 6.12 1 per 500 sqm (net internal area) of clinical spaces for clinics and
assessment units.
W1585 General store 1.0 16 16.0 Para 4.10, 5.11, 6.12 1 sqm per core clinical room.
Pneumatic tube station 1.0 1 1.0 Para 4.10, 5.11, 6.12 Optional.
V1010 WC: ambulant 2.0 2 4.0 Staff WC.
V0653 Locker bay: 12 small lockers 1.5 2 3.0 For immediate access to staff possessions.
P0625 Pantry/refreshment area 8.0 1 8.0 Para 5.9, 6.8
allowance
Public spaces for wards, birthing suite and theatres
J0232 Reception (size based on number of places) 5.5 2 11.0 Para 7.02 Location dependent on design.
Waiting area (size based on number of places) 1.5 20 30.0 Para 7.02 2 places per birthing room with a minimum of 20.
V1121 WC: semi-ambulant 2.5 0 0.0 Para 7.02 1 WC for every 25 people plus 1 less provision for independent
wheelchair WCs.
V0923 WC: independent wheelchair/semi-ambulant 5.5 3 16.5 Para 7.02 Allowance 1 per 500 sqm (net internal area) of wards, birthing suite
and theatres.
P0808 Vending machine 3.0 1 3.0 Para 7.02
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 3 36.0 Para 7.34 1 per 4 birthing rooms to cover ward and birthing suite
requirements. Minimum 3.
Clinical spaces for wards, birthing suite and theatres

Antenatal and postnatal ward
B0305 Single-bed room 19.0 16 304.0 Para 7.18 Derived from clinical planning.
V1645 Shower room: en-suite: chamfered 4.5 16 72.0 Para 7.21 1 per singe-bed room.
B0308 Isolation room 19.0 1 19.0 Para 7.24 1 per 30 beds.
G0510 Lobby to isolation room 5.0 1 5.0 Para 7.24 Associated with isolation room.
V1645 Shower room: en-suite: chamfered 4.5 1 4.5 Para 7.24 Associated with isolation room.
B0405 Multi-bed room: 4 beds 64.0 1 64.0 Para 7.22 One 4-bed room per 30 beds or as clinical planning indicates.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 7.22 En-suite to multi-bed room.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 7.22 En-suite to multi-bed room.

Published by the Department of Health. Page 2 of 8
X0145 Treatment room: double-sided couch access 16.0 1 16.0 Para 7.3 Only provided if multi-bed rooms used.
V1736 Bathroom: assisted 15.0 1 15.0 Para 7.17 1 per 30 beds.
T0535 Clean utility room 16.0 1 16.0 Para 7.35a 1 per 30 beds.
Y0331 Dirty utility room for bedpan processing 12.0 2 24.0 Para 7.35c 1 per 15 beds.
P0627 Ward pantry 12.0 1 12.0 Para 7.35g 1 per 30 beds.
Y1510 Cleaners' room 8.0 1 8.0 Para 7.35 1 per 30 beds.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0 Para 7.35 1 per 30 beds.
T0211 Staff communication base (size based on number of places) 5.5 2 11.0 Para 7.28 1 place per 15 beds. Location dependent on design.
T0151 Touchdown base 2.0 4 8.0 Para 7.28 1 per 6 beds.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0 Para 7.38, 7.39 1 per 30 beds.
G0180 Parking bay for resuscitation equipment 2.0 1 2.0 Para 7.35j 1 per 30 beds.
G0180 Parking bay for mobile hoist 2.0 1 2.0 1 per 30 beds.
M0727 Sitting room: 7 places (including 1 wheelchair place) 12.0 1 12.0 Para 7.31 1 per 30 beds.
Kitchen: milk feeds preparation 12.0 1 12.0 Para 7.33 1 per unit.
S0012 Room for expressing milk 6.0 1 6.0 Para 7.32 1 per unit. Consider locating near neonatal unit.
Ward storage 1.0 33 33.0 Para 7.35k For consumables, equipment and linen. 5% of net internal area of
ward.
W1585 General store 0.0
W1584 Clinical equipment store 0.0
W1594 Linen store 0.0
V0653 Locker bay: 12 small lockers 1.5 1 1.5 1 per 30 beds. Project to determine best location.
allowance
Birthing suite (consultant-led)
C0237 Triage/assessment room 16.0 2 32.0 Para 7.3 1 per 4 birthing rooms.
V0923 WC: independent wheelchair/semi-ambulant 5.5 1 5.5 Para 7.3 Associated with triage/assessment room.
B0405 Multi-bed room: 4 beds 64.0 1 64.0 Para 7.4 For induction.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 7.4 Associated with induction area.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 7.4 Associated with induction area.
P0711 Mini kitchen 5.0 1 5.0 Para 7.8d 1 per 12 birthing rooms.
Birthing room 24.0 6 144.0 Para 7.8
Birthing room with pool 34.5 1 34.5 Para 7.8 Minimum 1. Additional requirements to be determined by local
policy and need
Birthing room: twin birth 26.0 2 52.0 20% of birthing rooms.
V1726 Bathroom: semi-ambulant 6.0 7 42.0 Para 7.8 1 bathroom per birthing room with 20% independent wheelchair.
V1731 Bathroom: independent wheelchair 9.0 2 18.0 Para 7.9 1 bathroom per birthing room with 20% independent wheelchair.
Store: birthing room 4.0 7 28.0 Para 7.35k One 4-sqm store per birthing room. To be close to birthing rooms.
Store: birthing room (twin birth) 6.0 2 12.0 Para 7.35k
G0180 Parking bay for resuscitation equipment 2.0 1 2.0 Para 7.35j 1 per 12 birthing rooms.
G0180 Parking bay for mobile hoist 2.0 1 2.0 1 per 12 birthing rooms.
Y0331 Dirty utility room for bedpan processing 12.0 2 24.0 Para 7.35 1 per 8 birthing rooms.
T0535 Clean utility room 16.0 1 16.0 Para 7.35 1 per 12 birthing rooms.
L1308 Near patient testing room 8.0 1 8.0 Para 7.35f Accessible to birthing rooms, theatres and neonatal unit.
Blood fridge bay 2.0 1 2.0 Para 7.35h Accessible to birthing rooms and theatres.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0 Para 7.35
Y1510 Cleaners' room 8.0 1 8.0 Para 7.35
W1585 General store 1.0 9 9.0 Para 7.35k 1 sqm per birthing room.
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 15 27.0 Para 7.36b Allows 40% of birthing and theatre staff on duty to use rest room at
same time.
H1304 Seminar room 32.0 1 32.0 Para 7.36c
Store: seminar room ADB Codes, Activity8.0
Database Data is 8.0
1 © Crown copyright 2009.
47
Page 3 of 8
48
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 2 32.0 Para 7.38, 7.39
Maternity theatres
Operating theatre: general 48.0 2 96.0 Para 8.02 Derived from clinical planning. Proposed area for general theatre
reduced from 55 sqm to 48 sqm based on initial post project
evaluation. Further research is currently underway.
Anaesthetic room 19.0 1 19.0 Para 8.01 1 per 2 theatres. Recommended area may be increased to 22 sqm
to allow transfer from a bed within the room.
Scrub-up and gowning bay: 3 places 7.0 2 14.0 Para 8.01 1 per theatre.
Preparation room 12.0 2 24.0 Para 8.01 1 per theatre.
Dirty utility: serving 1 theatre 12.0 2 24.0 Para 8.01 1 per theatre.
Exit/parking bay: theatre: 1 bed/trolley 12.0 2 24.0 Para 8.01 1 per theatre.
W1584 Clinical equipment store 1.0 2 2.0 Para 8.01 Allowance of 1 sqm per theatre. May be located near theatre.

Transport incubator bay 4.0 1 4.0 Para 8.04 1 per maternity theatre suite.
Resuscitation room: 2 infants 20.0 1 20.0 Para 8.03 1 per maternity theatre suite.
B0405 High dependency bay: 4 beds 64.0 1 64.0 Para 7.25 Co-located with theatre recovery.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 7.22 For HDU bay.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 7.22 For HDU bay.
Recovery bay: post anaesthetic 14.0 2 28.0 Para 8.08 1 place per theatre. Assumes solid side walls and clinical wash-
hand basin in each space. Subject to further review.
Communal changing area theatres (size based on number of lockers) 1.4 15 21.0 Para 8.01 Staff change associated with theatres. Allowance based on 7
persons per theatre plus 10% contingency. Space allowance is a
rough estimate only and covers a range of spaces (see below). For
full details see HBN 00-03. Design solution to be determined locally.
V0554 Communal changing room

V0725 Semi-ambulant changing room
V1321 Shower room: ambulant
Blues/greens supply
V0725 Changing room: semi-ambulant 2.0 1 2.0 Para 8.01 Additional changing facilities associated with theatres to allow for
male and female segregation.
V1321 Shower room: ambulant 2.5 1 2.5 Para 8.01 Additional showering facilities associated with theatres to allow for
V1010 WC: ambulant 2.0 2 4.0 Para 8.01 Staff change associated with theatres.
allowance
Bereavement suite
Overnight stay: single 13.0 1 13.0 Para 7.27 1 per 9 birthing rooms.
V1323 Shower room: semi-ambulant: standing use 5.0 1 5.0 Para 7.27 1 per 9 birthing rooms.
P0711 Mini kitchen 5.0 1 5.0 Para 7.27 1 per 9 birthing rooms.
Staff spaces
Shared staff support

Communal changing area (size based on number of lockers) 1.4 70 98.0 Para 4.1, 7.36a For all staff changing except theatre change. Assumes 44 staff on
duty. Allowance includes for shift crossover except for clinics: 1
person per core clinical room in clinics; 1 person per 4 beds in ward;
2 people per birthing room; 1 person per HDU bed. Space
allowance is a rough estimate only and covers a range of spaces
(see below). For full details see HBN 00-03. Design solution to be
determined locally.
V0554 Communal changing room 0.0

V0725 Semi-ambulant changing room 0.0
V1321 Shower room: ambulant 0.0
V0667 Uniform exchange 0.0
V1010 WC: ambulant 2.0 2 4.0 1 WC per 40 lockers.
V0922 WC: independent wheelchair 4.5 1 4.5 1 per changing area.
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 7 12.6 Para 4.1, 7.36b For clinic and ward staff. Allows 30% staff on duty to use rest room
at same time. Provision dependent on whole hospital policy for staff
rest facilities. Space allowance is a rough estimate only. For full
details see HBN 00-03.
0.0
Office accommodation 0.0
M0251 Office: 1-person 8.0 3 24.0 Para 4.10; 7.37; 9.1-9.6
Open plan office including support spaces (size based on number of 6.6 18 118.8 Para 4.10;7.37; Offices for 21 managers, consultants, admin support and other
workstations) 9.1-9.6 clinical staff. Overall estimate based on 1 workstation per 200 births
plus one single-person office per 8 workstations. Space allowance
is a rough estimate only and covers a range of spaces (see below).
For full details see HBN 00-03. Design solution to be determined
locally.
M0268 Administration area: continuous use 0.0
M0278 Administration area: shared use 0.0
M0281 Quiet workspace 0.0
M0724 Interview room: 4 places (including 1 wheelchair place) 0.0
M0410 Photocopying/printing room 0.0
M0731 Breakout space 0.0
H1304 Seminar room 32.0 1 32.0 Para 9.3
Store: seminar room 8.0 1 8.0
V1010 WC: ambulant 2.0 1 2.0 Approximately 1 per 15 staff including independent wheelchair
WCs.
V0922 WC: independent wheelchair 4.5 1 4.5 Minimum 1 allowed.
Net internal area (NIA) 2719.4

Circulation allowance 30.0% 815.8
Communication allowance 10.0% 271.9
Engineering space allowance 28.5% 775.0
Gross internal area (GIA) 4582.2
Optional accommodation
X0145 Treatment room: double-sided couch access 16.0 1 16.0 Para 4.15 Optional for antenatal clinic and EPAU.
C0522 Phlebotomy room 12.0 1 12.0 Para 4.16; 5.05 Optional for antenatal clinic and EPAU.
Nursery well baby: 4 cots 12.0 1 12.0 Para 2.18 Optional on postnatal ward.
B0405 Transitional care multi-bed room: 4 beds 64.0 1 64.0 Para 2.23 Optional on postnatal ward.
49
Page 5 of 8
50
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 2.23 Associated with transitional care multi-bed room
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 2.23 Associated with transitional care multi-bed room
W0812 Records store 12.0 1 12.0 Para 2.39 For antenatal clinic. Dependent on records storage policy.
H1322 Preparation for parenthood room (size based on number of places) 4.0 10 40.0 Para 4.11 Room can accommodate 10 people using standard mats.
W1585 General store 1.0 1 12.0 Para 4.14 Associated with preparation for parenthood room.
Midwife-led birthing unit (500 births/annum co-located with consultant-led unit)

ADB code Room name Unit area Quantity Total area Paragraph reference Comments
allowance
Public spaces
Entrance and reception Shared with CLU.
Clinical spaces
Birthing suite (midwife-led)
C0237 Triage/assessment room 16.0 1 16.0 Para 3.17; 4.7
C0235 Consulting/examination room: single-sided couch access 12.0 0 0.0 Para 3.17 Use other hospital facilities/community for clinics.
Birthing room 24.0 1 24.0 Para 7.8 Derived from clinical planning.
Birthing room with pool 34.5 2 69.0 Para 7.8 Derived from clinical planning.
V1726 Bathroom: semi-ambulant 6.0 2 12.0 Para 7.8 1 bathroom per birthing room with 1 being independent wheelchair.
V1731 Bathroom: independent wheelchair 9.0 1 9.0 Para 7.8 1 bathroom per birthing room with 1 being independent wheelchair.
Store: birthing room 4.0 3 12.0 Para 7.35k 4 sqm per birthing room. To be en-suite or close to birthing rooms.
P0627 Ward pantry 12.0 1 12.0 Para 7.35 1 per MLU.
Y1510 Cleaners' room 8.0 1 8.0 Para 7.35 1 per MLU.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0 Para 7.35 1 per MLU.
T0211 Staff communication base (size based on number of places) 5.5 2 11.0 Para 7.28 2 places per MLU.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0 Para 7.38 1 per MLU.
Staff spaces
Staff support
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 3 5.4 Para 7.36b Provision for 50% of staff on duty (estimated as 1 person per
birthing room plus 2). Co-located with staff rest in CLU.
Communal changing area (size based on number of lockers) 1.4 10 14.0 Para 7.36a Provision for twice the number of staff on duty to allow for staff
changeover. Co-located with staff changing in CLU.

V1010 WC: ambulant 2.0 1 2.0 Para 7.36a 1 per MLU.
Net internal area (NIA)

ADB Codes, Activity Database Data is © Crown253.4
copyright 2009.
Engineering space allowance 27.5% 69.7 Percentage assumes combined with 3000 birth CLU.
Midwife-led birthing unit (500 births/annum, standalone)

allowance
Public spaces
Sitting and beverage bay: 6 places 12.0 1 12.0 Para 7.2
Clinical spaces
C0237 Triage/assessment room 16.0 1 16.0 Para 3.17; 4.7
C0235 Consulting/examination room: single-sided couch access 12.0 2 24.0 Para 3.17 Derived from clinical planning. Only provided if clinics are to be
held.
Birthing room with pool 34.5 2 69.0 Para 7.8 Derived from clinical planning. Minimum 50% with pool. Local
determination of higher ratio according to local need.
V1726 Bathroom: semi-ambulant 6.0 3 18.0 Para 7.8 1 bathroom per birthing room with 1 being independent wheelchair.
Y0331 Dirty utility room for bedpan processing 12.0 1 12.0 Para 7.35
P0627 Ward pantry 12.0 1 12.0 Para 7.35 1 per 12 birthing rooms.
Staff spaces
Staff support
Sitting and beverage bay: 6 places 12.0 1 12.0 Para 7.36b 1 per MLU.
Communal changing area (size based on number of lockers) 1.4 10 14.0 Para 7.36a Lockers based on maximum staff at shift crossover. Space
determined locally.
V0667 Uniform exchange
V1010 WC: ambulant 2.0 2 4.0 Para 7.36a

51
Page 7 of 8
52
Optional accommodation for MLU

B0305 Single-bed room 19.0 1 19.0 Para 7.18
V1645 Shower room: en-suite: chamfered 4.5 1 4.5 Para 7.21
H1322 Preparation for parenthood room (size based on number of places) 4.0 10 40.0 Para 4.11 Can accommodate 10 people using standard mats.
Note 1 Relationship of schedule to ADB room names

The ADB room codes listed may not carry a title, in ADB, identical to the room name/function in the schedules. Use of the appropriate ADB room code will, however, result in the correct room being accessed.
Note 2 Relationship of schedule to ADB for scalable rooms (i.e. those for which a recommended room size does not exist)
ADB room code relates to one example size of this space and does not reflect space requirements of these schedules. Projects will scale up/down according to schedule.
Note 3 Rounding of scalable rooms
The number of waiting spaces and lockers (in the communal changing areas) have been rounded to the nearest multiple of 5. The number of seats in the staff rest rooms have been rounded to the nearest multiple of 10. The
number of workstations in the open plan offices have been rounded to the nearest even number.
Note 4 Essential complementary accommodation
Accommodation to which the department needs access but may be shared with nearby departments.
Note 5 Optional accommodation
Accommodation which is not expected in all departments but, dependent on local policy, may be needed in addition to or instead of rooms listed in the schedule.
Note 6 Circulation allowance
The circulation allowance is based upon the previously published allowance for Health Building Note 21.
Note 7 Engineering space allowance
For the purposes of calculating the engineering space allowances it has been assumed that each CLU is located on an acute (multi-purpose) hospital site with a GIA of approximately 25,000 sqm. For larger or smaller
facilities, or where there needs to be largely dedicated engineering services plant space, the engineering space allowances will vary, generally downwards as GIA increases.
Note 8 Status of defined metrics

All of the defined metrics (calculations for quantifying spaces) in the notes column have been included as a reasonable basis for initial briefing. They are not intended as and should not be considered requirements.

Example schedule of accommodation for Health Building Note 09-02 - 'Maternity care facilities' (2nd edition). Example 2: 5000 births in a consultant-led birthing unit (CLU) and
1000 births in a midwife-led birthing unit (MLU). Includes MLU co-located with CLU and a stand-alone MLU.

allowance
Waiting area (size based on number of places) 1.5 10 15.0 Para 4.2, 4.4d
funding.
P0808 Vending machine 3.0 1 3.0 Para 4.4b
V1121 WC: semi-ambulant 2.5 2 5.0 Para 4.4 1 WC for every 25 waiting places plus 1 less provision for
V0922 WC: independent wheelchair 4.5 2 9.0 Para 4.4 Allowance 1 per 500 sqm (net internal area) of clinical space within
clinics and assessment units.

J0232 Reception (size based on number of places) 5.5 3 16.5 Para 4.2 1 per 6 clinical rooms (excluding interview rooms).
Waiting area (size based on number of places) 1.5 40 60.0 Para 4.2, 4.4d 3 places per core clinical room (excluding interview rooms).
P0811 Drinking water dispenser 0.5 1 0.5 Para 4.4 1 per 50 waiting places.
V1121 WC: semi-ambulant 2.5 2 5.0 Para 4.4 1 per 25 waiting places.
V0922 WC: independent wheelchair 4.5 0 0.0 Para 4.4 Allowance included in entrance area.
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 2 24.0 Para 4.8, 4.20 1 per 6 consulting/examination rooms.
C0235 Consulting/examination room: single-sided couch access 12.0 8 96.0 Para 4.5, 4.7 Derived from clinical planning.
C0237 Consulting/examination room: double-sided couch access 16.0 2 32.0 Para 4.6 Derived from clinical planning.
V0922 WC: independent wheelchair 4.5 1 4.5 Para 4.21 1 WC per ultrasound room including independent wheelchair WCs.
V1121 WC: semi-ambulant 2.5 3 7.5 Para 4.21 1 WC per ultrasound room including independent wheelchair WCs.

Waiting area (size based on number of places) 1.5 20 30.0 Para 4.4d, 6.2 3 places per core clinical room (excluding interview rooms).
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 2 24.0 Para 6.6 May be co-located with interview rooms for antenatal and
ultrasound clinics.
C0235 Consulting/examination room: single-sided couch access 12.0 2 24.0 Para 6.3 1 per 2 maternity assessment rooms.
B2532 Maternity assessment room: 2 places 24.0 3 72.0 Para 6.4 Derived from clinical planning.
P0625 Pantry/refreshment area 8.0 0 0.0 Para 6.7 In shared support.
T0211 Staff communication base allowance (size based on number of 5.5 1 5.5 Para 6.9
places)
X0145 Ultrasound room 16.0 1 16.0 Para 6.5 May be co-located with antenatal ultrasound rooms.
53
Page 1 of 8
54
Waiting area (size based on number of places) 1.5 10 15.0 Para 5.2 3 waiting places per clinical room.
C0235 Consulting/examination room: single-sided couch access 12.0 1 12.0 Para 5.3 Derived from clinical planning.
M0724 Interview room: 4 places (including 1 wheelchair place) 8.0 1 8.0 Para 5.7 1 per consulting/examination room. Room requires discreet exit.
Sitting and beverage bay: 6 places 12.0 1 12.0 Para 5.8, 5.9
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0 Para 4.10, 5.11, 6.12
T0538 Clean utility room without controlled drugs cupboard 8.0 2 16.0 Para 4.10, 5.11, 6.12 1 per 12 clinical rooms.
Y0431 Dirty utility room 8.0 2 16.0 Para 4.10, 5.11, 6.12 1 per 12 clinical rooms.
Y0642 Disposal hold: 1700 litres 8.0 2 16.0 Para 4.10, 5.11, 6.12 1 per 500 sqm (net internal area) of clinical spaces for clinics and
assessment units.
Y1510 Cleaners' room 8.0 2 16.0 Para 4.10, 5.11, 6.12 1 per 500 sqm (net internal area) of clinical spaces for clinics and
assessment units.
W1585 General store 1.0 23 23.0 Para 4.10, 5.11, 6.12 1 sqm per core clinical room.
Pneumatic tube station 1.0 1 1.0 Para 4.10, 5.11, 6.12 Optional.
P0625 Pantry/refreshment area 8.0 1 8.0 Para 5.9, 6.8
allowance
J0232 Reception (size based on number of places) 5.5 2 11.0 Para 7.02 Location dependent on design.
Waiting area (size based on number of places) 1.5 30 45.0 Para 7.02 2 places per birthing room with a minimum of 20.
V1121 WC: semi-ambulant 2.5 0 0.0 Para 7.02 1 WC for every 25 people plus 1 less provision for independent
wheelchair WCs.
V0923 WC: independent wheelchair/semi-ambulant 5.5 4 22.0 Para 7.02 Allowance 1 per 500 sqm (net internal area) of wards, birthing suite
and theatres.
P0808 Vending machine 3.0 1 3.0 Para 7.02
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 4 48.0 Para 7.34 1 per 4 birthing rooms to cover ward and birthing suite

B0305 Single-bed room 19.0 29 551.0 Para 7.18 Derived from clinical planning.
V1645 Shower room: en-suite: chamfered 4.5 29 130.5 Para 7.21 1 per single-bed room.
B0308 Isolation room 19.0 2 38.0 Para 7.24 1 per 30 beds.
G0510 Lobby to isolation room 5.0 2 10.0 Para 7.24 Associated with isolation room.
V1645 Shower room: en-suite: chamfered 4.5 2 9.0 Para 7.24 Associated with isolation room.
B0405 Multi-bed room: 4 beds 64.0 2 128.0 Para 7.22 One 4-bed room per 30 beds or as clinical planning indicates.
V1635 Shower room: assisted: in-patient 6.5 2 13.0 Para 7.22 En-suite to multi-bed room.
V1121 WC: semi-ambulant: in-patient 2.0 2 4.0 Para 7.22 En-suite to multi-bed room.
X0145 Treatment room: double-sided couch access 16.0 1 16.0 Para 7.3 Only provided if multi-bed rooms used.
V1736 Bathroom: assisted 15.0 Para 7.17 1 per 30 beds.
ADB Codes, Activity Database Data 2is © Crown 30.0
copyright 2009.
T0535 Clean utility room 16.0 2 32.0 Para 7.35a 1 per 30 beds.
Y0331 Dirty utility room for bedpan processing 12.0 3 36.0 Para 7.35c 1 per 15 beds.
P0627 Ward pantry 12.0 2 24.0 Para 7.35g 1 per 30 beds.
Y1510 Cleaners' room 8.0 2 16.0 Para 7.35 1 per 30 beds.
Y0646 Disposal hold: 3000 litres 12.0 2 24.0 Para 7.35 1 per 30 beds.
T0211 Staff communication base (size based on number of places) 5.5 3 16.5 Para 7.28 1 place per 15 beds. Location dependent on design.
T0151 Touchdown base 2.0 7 14.0 Para 7.28 1 per 6 beds.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 2 32.0 Para 7.38, 7.39 1 per 30 beds.
G0180 Parking bay for resuscitation equipment 2.0 2 4.0 Para 7.35j 1 per 30 beds.
M0727 Sitting room: 7 places (including 1 wheelchair place) 12.0 2 24.0 Para 7.31 1 per 30 beds.
Kitchen: milk feeds preparation 12.0 1 12.0 Para 7.33 1 per unit.
S0012 Room for expressing milk 6.0 1 6.0 Para 7.32 1 per unit. Consider locating near neonatal unit.
Ward storage 1.0 59 59.0 Para 7.35k For consumables, equipment and linen. 5% of net internal area of
ward.
allowance
C0237 Triage/assessment room 16.0 4 64.0 Para 7.3 1 per 4 birthing rooms.
V0923 WC: independent wheelchair/semi-ambulant 5.5 2 11.0 Para 7.3 Associated with triage/assessment room.
B0405 Multi-bed room: 4 beds 64.0 1 64.0 Para 7.4 For induction.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 7.4 Associated with induction area.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 7.4 Associated with induction area.
P0711 Mini kitchen 5.0 2 10.0 Para 7.8d 1 per 12 delivery rooms.
Birthing room 24.0 10 240.0 Para 7.8
Birthing room with pool 34.5 1 34.5 Para 7.8 Minimum 1. Additional requirements to be determined by local
policy and need
V1726 Bathroom: semi-ambulant 6.0 11 66.0 Para 7.8 1 bathroom per birthing room with 20% independent wheelchair.
V1731 Bathroom: independent wheelchair 9.0 3 27.0 Para 7.9 1 bathroom per birthing room with 20% independent wheelchair.
Store: birthing room (twin birth) 6.0 3 18.0 Para 7.35k
G0180 Parking bay for resuscitation equipment 2.0 2 4.0 Para 7.35j 1 per 12 birthing rooms.
L1308 Near patient testing room 8.0 1 8.0 Para 7.35f Accessible to birthing rooms, theatres and neonatal unit.
Blood fridge bay 2.0 1 2.0 Para 7.35h Accessible to birthing rooms and theatres.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0 Para 7.35
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 19 34.2 Para 7.36b Allows 40% of birthing and theatre staff on duty to use rest room at
same time.
H1304 Seminar room 32.0 1 32.0 Para 7.36c
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 2 32.0 Para 7.38, 7.39
55
Page 3 of 8
56
Maternity theatres
Operating theatre: general 48.0 2 96.0 Para 8.02 Derived from clinical planning. Proposed area for general theatre
Anaesthetic room 19.0 1 19.0 Para 8.01 1 per 2 theatres. Recommended area may be increased to 22 sqm
Scrub-up and gowning bay: 3 places 7.0 2 14.0 Para 8.01 1 per theatre.
Preparation room 12.0 2 24.0 Para 8.01 1 per theatre.
Dirty utility: serving 1 theatre 12.0 2 24.0 Para 8.01 1 per theatre.
Exit/parking bay: theatre: 1 bed/trolley 12.0 2 24.0 Para 8.01 1 per theatre.
W1584 Clinical equipment store 1.0 2 2.0 Para 8.01 Allowance of 1 sqm per theatre, may be located local to theatre..

Transport incubator bay 4.0 1 4.0 Para 8.04 1 per maternity theatre suite.
Resuscitation room: 2 infants 20.0 1 20.0 Para 8.03 1 per maternity theatre suite.
B0405 High dependency bay: 4 beds 64.0 1 64.0 Para 7.25 Co-located with theatre recovery.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 7.22 For HDU bay.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 7.22 For HDU bay.
Recovery bay: post anaesthetic 14.0 2 28.0 Para 8.08 1 place per theatre. Assumes solid side walls and clinical wash-
Communal changing area theatres (size based on number of 1.4 15 21.0 Para 8.01 Staff change associated with theatres. Allowance based on 7
lockers) persons per theatre plus 10% contingency. Space allowance is a

Blues/greens supply
V0725 Changing room: semi-ambulant 2.0 1 2.0 Para 8.01 Additional changing facilities associated with theatres to allow for
V1321 Shower room: ambulant 2.5 1 2.5 Para 8.01 Additional showering facilities associated with theatres to allow for
V1010 WC: ambulant 2.0 2 4.0 Para 8.01 Staff change associated with theatres.
allowance
Bereavement suite
Overnight stay: single 13.0 2 26.0 Para 7.27 1 per 9 birthing rooms.
V1323 Shower room: semi-ambulant: standing use 5.0 2 10.0 Para 7.27 1 per 9 birthing rooms.
P0711 Mini kitchen 5.0 2 10.0 Para 7.27 1 per 9 birthing rooms.
Staff spaces

Communal changing area (size based on number of lockers) 1.4 106 148.4 Para 4.1, 7.36a For all staff changing except theatre change. Assumes 66 staff on
determined locally.

V0667 Uniform exchange: 70 lockers 0.0
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 11 19.8 Para 4.1; 7.36b For clinic and ward staff. Allows 30% staff on duty to use rest room
0.0
M0251 Office: 1-person 8.0 4 32.0 Para 4.10; 7.37; 9.1-9.6
Open plan office including support spaces (size based on number of 6.6 30 198.0 Para 4.10;7.37; Offices for 34 managers, consultants, admin support and other
workstations) 9.1-9.6 clinical staff. Overall estimate based on 1 workstation per 200 births
locally.
H1304 Seminar room 32.0 2 64.0 Para 9.3
WCs.

X0145 Treatment room: double-sided couch access 16.0 1 16.0 Para 4.15 Optional for antenatal clinic and EPAU.
C0522 Phlebotomy room 12.0 1 12.0 Para 4.16; 5.05 Optional for antenatal clinic and EPAU.
Nursery well baby: 4 cots 12.0 1 12.0 Para 2.18 Optional on postnatal ward.
57
Page 5 of 8
58
B0405 Transitional care multi-bed room: 4 beds 64.0 1 64.0 Para 2.23 Optional on postnatal ward.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Para 2.23 Associated with transitional care multi-bed room
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Para 2.23 Associated with transitional care multi-bed room
W0812 Records store 12.0 1 12.0 Para 2.39 For antenatal clinic. Dependent on records storage policy.
H1322 Preparation for parenthood room (size based on number of places) 4.0 10 40.0 Para 4.11 Room can accommodate 10 people using standard mats.

allowance
Public spaces
Clinical spaces
Birthing suite (midwife led)
C0237 Triage/assessment room 16.0 1 16.0 Para 3.17, 4.7

C0235 Consulting/examination room: single-sided couch access 12.0 0 0.0 Para 3.17 Use other hospital facilities/community for clinics.
Birthing room with pool 34.5 3 103.5 Para 7.8 Derived from clinical planning.
V1726 Bathroom: semi-ambulant 6.0 4 24.0 Para 7.8 1 bathroom per birthing room with 1 being independent wheelchair
accessible.
Staff spaces
Staff support
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 4 7.2 Para 7.36b Provision for 50% of staff on duty (estimated as 1 person per
Communal changing area (size based on number of lockers) 1.4 14 19.6 Para 7.36a Provision for twice the number of staff on duty to allow for staff

V1010 WC: ambulant 2.0 1 2.0 Para 7.36a 1 per MLU.


allowance
Public spaces
Sitting and beverage bay: 6 places 12.0 1 12.0 Para 7.2
Clinical spaces
C0237 Triage/assessment room 16.0 2 32.0 Para 3.17, 4.7
C0235 Consulting/examination room: single-sided couch access 12.0 2 24.0 Para 3.17 Derived from clinical planning. Only provided if clinics planned to be
held.
Birthing room with pool 34.5 3 103.5 Para 7.8 Derived from clinical planning. Minimum 50% with pool. Local
V1726 Bathroom: semi-ambulant 6.0 5 30.0 Para 7.8 1 bathroom per birthing room with 1 being independent wheelchair
accessible.
V1731 Bathroom: independent wheelchair 9.0 1 9.0 Para 7.8 1 bathroom per birthing room with 1 being independent wheelchair
accessible.
Staff spaces
Staff support
Sitting and beverage bay: 6 places 12.0 1 12.0 Para 7.36b 1 per MLU.
Communal changing area (size based on number of lockers) 1.4 15 21.0 Para 7.36a Lockers based on maximum staff at shift crossover. Space
determined locally.
59
Page 7 of 8
60
V1010 WC: ambulant 2.0 2 4.0 Para 7.36a


B0305 Single-bed room 19.0 1 19.0 Para 7.18
V1645 Shower room: en-suite: chamfered 4.5 1 4.5 Para 7.21
H1322 Preparation for parenthood room (size based on number of places) 4.0 10 40.0 Para 4.11 Can accommodate 10 people using standard mats.

The ADB room codes listed may not carry a title, in ADB, identical to the room name/function in the schedules. Use of the appropriate ADB room code will, however, result in the correct room being accessed.
The number of waiting spaces and lockers (in the communal changing areas) have been rounded to the nearest multiple of 5. The number of seats in the staff rest rooms have been rounded to the nearest multiple of 10.
The number of workstations in the open plan offices have been rounded to the nearest even number.
Accommodation to which the department needs access but may be shared with nearby departments.
Accommodation which is not expected in all departments but, dependent on local policy, may be needed in addition to or instead of rooms listed in the schedule.
The circulation allowance is based upon the previously published allowance for HBN 21.
For the purposes of calculating the engineering space allowances it has been assumed that each CLU is located on an acute (multi-purpose) hospital site with a GIA of 25,000 sqm. For larger or smaller facilities, or where
there needs to be largely dedicated engineering services plant space, the engineering space allowances will vary, generally downwards as GIA increases.

All of the defined metrics (calculations for quantifying spaces) in the notes column have been included as a reasonable basis for initial briefing. They are not intended as and should not be considered requirements.

Example schedule of accommodation for Health Building Note 09-02 - 'Maternity care facilities' (2nd edition). Example 3: 8000 births in a consultant-led birthing
unit (CLU) and 1500 births in a midwife-led birthing unit (MLU). Includes MLU co-located with CLU and a stand-alone MLU.

ADB code Room name/function Unit area Quantity Total area Comments
allowance
J0232 Reception (size based on number of places) 5.5 2 11.0
Waiting area (size based on number of places) 1.5 10 15.0
funding.
P0808 Vending machine 3.0 1 3.0
V1131 Nappy changing room 5.0 1 5.0
S0012 Infant feeding room 6.0 1 6.0
G0180 Parking bay for wheelchair 2.0 1 2.0
V1121 WC: semi-ambulant 2.5 2 5.0 1 WC for every 25 waiting places plus 1 less provision for
V0922 WC: independent wheelchair 4.5 2 9.0 Allowance 1 per 500 sqm (net internal area) of clinical space within
clinics and assessment units.

J0232 Reception (size based on number of places) 5.5 4 22.0 1 per 6 clinical rooms (excluding interview rooms).
Waiting area (size based on number of places) 1.5 65 97.5 3 places per core clinical room (excluding interview rooms).
P0811 Drinking water dispenser 0.5 2 1.0 1 per 50 waiting places.
V1121 WC: semi-ambulant 2.5 3 7.5 1 per 25 waiting places.
V0922 WC: independent wheelchair 4.5 0 0.0 Allowance included in entrance area.
Information/resource centre: 3 persons 12.0 1 12.0
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 4 48.0 1 per 6 consulting/examination rooms.
C0235 Consulting/examination room: single-sided couch access 12.0 13 156.0 Derived from clinical planning.
C0237 Consulting/examination room: double-sided couch access 16.0 2 32.0 Derived from clinical planning.
X0145 Ultrasound room 16.0 6 96.0 Derived from clinical planning.
V0922 WC: independent wheelchair 4.5 1 4.5 1 per ultrasound room including independent wheelchair WCs.
V1121 WC: semi-ambulant 2.5 5 12.5 1 per ultrasound room including independent wheelchair WCs.

Waiting area (size based on number of places) 1.5 20 30.0 3 places per core clinical room (excluding interview rooms).
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 2 24.0 May be co-located with interview rooms for antenatal and
ultrasound clinics.
C0235 Consulting/examination room: single-sided couch access 12.0 2 24.0 1 per 2 maternity assessment rooms.
B2532 Maternity assessment room: 2 places ADB Codes, Activity Database24.0Data is © Crown
4 copyright 96.0 Derived from clinical planning.
2009.
61
Page 1 of 9
62
P0625 Pantry/refreshment area 8.0 0 0.0 In shared support.
T0211 Staff communication base allowance (size based on number of 5.5 1 5.5
places)
X0145 Ultrasound room 16.0 1 16.0 May be co-located with antenatal ultrasound rooms.
Waiting area (size based on number of places) 1.5 15 22.5 3 waiting places per clinical room.
T0211 Staff communication base (size based on number of places) 5.5 1 5.5
C0235 Consulting/examination room: single-sided couch access 12.0 2 24.0 Derived from clinical planning.
X0145 Ultrasound room 16.0 1 16.0 Derived from clinical planning.
M0724 Interview room: 4 places (including 1 wheelchair place) 8.0 2 16.0 1 per consulting/examination room. Room requires discreet exit.
Sitting and beverage bay: 6 places 12.0 1 12.0
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0

T0538 Clean utility room without controlled drugs cupboard 8.0 3 24.0 1 per 12 clinical rooms.
Y0431 Dirty utility room 8.0 3 24.0 1 per 12 clinical rooms.
Y0642 Disposal hold: 1700 litres 8.0 2 16.0 1 per 500 sqm (net internal area) of clinical spaces for clinics and
assessment units.
Y1510 Cleaners' room 8.0 2 16.0 1 per 500 sqm (net internal area) of clinical spaces for clinics and
assessment units.
W1585 General store 1.0 33 33.0 1 sqm per core clinical room.
Pneumatic tube station 1.0 1 1.0 Optional.
P0625 Pantry/refreshment area 8.0 1 8.0
allowance
J0232 Reception (size based on number of places) 5.5 2 11.0 Location dependent on design.
Waiting area (size based on number of places) 1.5 45 67.5 2 places per birthing room with a minimum of 20.
V1121 WC: semi-ambulant 2.5 0 0.0 1 WC for every 25 people plus 1 less provision for independent
wheelchair WCs.
V0923 WC: independent wheelchair/semi-ambulant 5.5 6 33.0 Allowance 1 per 500 sqm (net internal area) of wards, birthing suite
and theatres.
P0808 Vending machine 3.0 1 3.0
M0727 Interview room: 7 places (including 1 wheelchair place) 12.0 6 72.0 1 per 4 birthing rooms to cover ward and birthing suite

B0305 Single-bed room 19.0 53 1007.0 Derived from clinical planning.
V1645 Shower room: en-suite: chamfered 4.5 53 238.5 1 per single-bed room.
B0308 Isolation room 19.0 3 57.0 1 per 30 beds.
G0510 Lobby to isolation room 5.0 3 15.0 Associated with isolation room.
V1645 Shower room: en-suite: chamfered 4.5 3 13.5 Associated with isolation room.
B0405 Multi-bed room: 4 beds 64.0 3 192.0 One 4-bed room per 30 beds or as clinical planning indicates.
V1635 Shower room: assisted: in-patient 6.5 3 19.5 En-suite to multi-bed room.
V1121 WC: semi-ambulant: in-patient 2.0 3 6.0 En-suite to multI-bed room.
X0145 Treatment room: double-sided couch access 16.0 1 16.0 Only provided if multi-bed rooms used.
V1736 Bathroom: assisted 15.0 3 45.0 1 per 30 beds.
T0535 Clean utility room 16.0 3 48.0 1 per 30 beds.
Y0331 Dirty utility room for bedpan processing 12.0 5 60.0 1 per 15 beds.
P0627 Ward pantry 12.0 3 36.0 1 per 30 beds.
Y1510 Cleaners' room 8.0 3 24.0 1 per 30 beds.
Y0646 Disposal hold: 3000 litres 12.0 3 36.0 1 per 30 beds.
T0211 Staff communication base (size based on number of places) 5.5 5 27.5 1 place per 15 beds. Location dependent on design.
T0151 Touchdown base 2.0 12 24.0 1 per 6 beds.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 3 48.0 1 per 30 beds.
G0180 Parking bay for resuscitation equipment 2.0 3 6.0 1 per 30 beds.
M0727 Sitting room: 7 places (including 1 wheelchair place) 12.0 3 36.0 1 per 30 beds.
Kitchen: milk feeds preparation 12.0 1 12.0 1 per unit.
S0012 Room for expressing milk 6.0 1 6.0 1 per unit. Consider locating near neonatal unit.
Ward storage 1.0 99 99.0 For consumables, equipment and linen. 5% of net internal area of
ward.
allowance
T0211 Staff communication base (size based on number of places) 5.5 2 11.0
C0237 Triage/assessment room 16.0 6 96.0 1 per 4 birthing rooms.
V0923 WC: independent wheelchair/semi-ambulant 5.5 2 11.0 Associated with triage/assessment room.
B0405 Multi-bed room: 4 beds 64.0 1 64.0 For induction.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Associated with induction area.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Associated with induction area.
P0711 Mini kitchen 5.0 2 10.0 1 per 12 birthing rooms.
Birthing room 24.0 16 384.0
Birthing room with pool 34.5 1 34.5 Minimum 1. Additional requirements to be determined by local
policy and need
V1726 Bathroom: semi-ambulant 6.0 17 102.0 1 bathroom per birthing room with 20% independent wheelchair.
63
Page 3 of 9
64
V1731 Bathroom: independent wheelchair 9.0 5 45.0 1 bathroom per birthing room with 20% independent wheelchair.
Store: birthing room 4.0 17 68.0 4 sqm per birthing room. To be en-suite or close to birthing rooms.
Store: birthing room (twin birth) 6.0 5 30.0
G0180 Parking bay for resuscitation equipment 2.0 2 4.0 1 per 12 birthing rooms.
Y0331 Dirty utility room for bedpan processing 12.0 3 36.0 1 per 8 birthing rooms.
T0535 Clean utility room 16.0 2 32.0 1 per 12 birthing rooms.
L1308 Near patient testing room 8.0 1 8.0 Accessible to birthing rooms, theatres and neonatal unit.
Blood fridge bay 2.0 1 2.0 Accessible to birthing rooms and theatres.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0
Y1510 Cleaners' room 8.0 2 16.0
W1585 General store 1.0 22 22.0 1 sqm per birthing room.
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 29 52.2 Allows 40% of birthing and theatre staff on duty to use rest room at
same time.
H1304 Seminar room 32.0 1 32.0
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 2 32.0
Maternity theatres
Operating theatre: general 48.0 3 144.0 Derived from clinical planning. Proposed area for general theatre
Anaesthetic room 19.0 2 38.0 1 per 2 theatres. Recommended area may be increased to 22 sqm
Scrub-up and gowning bay: 3 places 7.0 3 21.0 1 per theatre.
Preparation room 12.0 3 36.0 1 per theatre.
Dirty utility: serving 1 theatre 12.0 3 36.0 1 per theatre.
Exit/parking bay: theatre: 1 bed/trolley 12.0 3 36.0 1 per theatre.
W1584 Clinical equipment store 1.0 3 3.0 Allowance of 1 sqm per theatre. May be located near theatre.
Y1510 Cleaners' room 8.0 1 8.0

Transport incubator bay 4.0 1 4.0 1 per maternity theatre suite.
Resuscitation room: 2 infants 20.0 1 20.0 1 per maternity theatre suite.
B0405 High dependency bay: 4 beds 64.0 1 64.0 Co-located with theatre recovery.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 For HDU bay.
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 For HDU bay.
Recovery bay: post anaesthetic 14.0 3 42.0 1 place per theatre. Assumes solid side walls and clinical wash-
Communal changing area theatres (size based on number of 1.4 25 35.0 Staff change associated with theatres. Allowance based on 7
lockers) persons per theatre plus 10% contingency. Space allowance is a

Blues/greens supply
V0725 Changing room: semi-ambulant 2.0 1 2.0 Additional changing facilities associated with theatres to allow for
V1321 Shower room: ambulant 2.5 1 2.5 Additional showering facilities associated with theatres to allow for
V1010 WC: ambulant 2.0 2 4.0 Staff change associated with theatres.
allowance
Bereavement suite
Overnight stay: single 13.0 3 39.0 1 per 9 birthing rooms.
V1323 Shower room: semi-ambulant: standing use 5.0 3 15.0 1 per 9 birthing rooms.
P0711 Mini kitchen 5.0 3 15.0 1 per 9 birthing rooms.
Staff spaces
Communal changing area (size based on number of lockers) 1.4 160 224.0 For all staff changing except theatre change. Assumes 98 staff on
determined locally.

D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 15 27.0 For clinic and ward staff. Allows 30% staff on duty to use rest room
0.0
M0251 Office: 1-person 8.0 6 48.0
Open plan office including support spaces (size based on number of 6.6 48 316.8 Offices for 54 managers, consultants, admin support and other
workstations) clinical staff. Overall estimate based on 1 workstation per 200 births
locally.
65
Page 5 of 9
66
H1304 Seminar room 32.0 2 64.0
WCs.

X0145 Treatment room: double-sided couch access 16.0 1 16.0 Optional for antenatal clinic and EPAU.
C0522 Phlebotomy room 12.0 1 12.0 Optional for antenatal clinic and EPAU.
Nursery well baby: 4 cots 12.0 1 12.0 Optional on postnatal ward.
B0405 Transitional care multi-bed room: 4 beds 64.0 1 64.0 Optional on postnatal ward.
V1635 Shower room: assisted: in-patient 6.5 1 6.5 Associated with transitional care multi-bed room
V1121 WC: semi-ambulant: in-patient 2.0 1 2.0 Associated with transitional care multi-bed room
W0812 Records store 12.0 1 12.0 For antenatal clinic. Dependent on records storage policy.
H1322 Preparation for parenthood room (size based on number of places) 4.0 10 40.0 Room can accommodate 10 people using standard mats.
W1585 General store 1.0 1 12.0 Associated with preparation for parenthood room.

ADB code Room name Unit area Quantity Total area Comments
allowance
Public spaces
Clinical spaces
C0237 Triage/assessment room 16.0 2 32.0
C0235 Consulting/examination room: single-sided couch access 12.0 0 0.0 Use other hospital facilities/community for clinics.
Birthing room 24.0 3 72.0 Derived from clinical planning.
Birthing room with pool 34.5 4 138.0 Derived from clinical planning.
V1726 Bathroom: semi-ambulant 6.0 6 36.0 1 bathroom per birthing room with 1 being independent wheelchair.
V1731 Bathroom: independent wheelchair 9.0 1 9.0 1 bathroom per birthing room with 1 being independent wheelchair.
P0627 Ward pantry 12.0 1 12.0 1 per MLU.
Y1510 Cleaners' room 8.0 1 8.0 1 per MLU.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0 1 per MLU.
T0211 Staff communication base (size based on number of places) 5.5 2 11.0 2 places per MLU.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0 1 per MLU.
Staff spaces
Staff support
D0434 Staff rest and mini kitchen (size based on number of seats) 1.8 5 9.0 Provision for 50% of staff on duty (estimated as 1 person per
Communal changing area (size based on number of lockers) 1.4 20 28.0 Provision for twice the number of staff on duty to allow for staff

V1010 WC: ambulant 2.0 1 2.0 1 per MLU.


ADB code Room name Unit area Quantity Total area Comments
allowance
Public spaces
V1131 Nappy changing room 5.0 1 5.0
S0012 Infant feeding room 6.0 1 6.0
G0180 Parking bay for wheelchair 2.0 1 2.0
Sitting and beverage bay: 6 places 12.0 1 12.0
67
Page 7 of 9
68
Clinical spaces
Birthing suite (midwife led)
C0237 Triage/assessment room 16.0 2 32.0
C0235 Consulting/examination room: single-sided couch access 12.0 2 24.0 Derived from clinical planning. Only provided if clinics planned to be
held.
Birthing room 24.0 4 96.0 Derived from clinical planning.
Birthing room with pool 34.5 4 138.0 Derived from clinical planning. Minimum 50% with pool. Local
V1726 Bathroom: semi-ambulant 6.0 7 42.0 1 bathroom per birthing room with 1 being independent wheelchair.
V1731 Bathroom: independent wheelchair 9.0 1 9.0 1 bathroom per birthing room with 1 being independent wheelchair.
P0627 Ward pantry 12.0 1 12.0 1 per MLU.
Y1510 Cleaners' room 8.0 1 8.0 1 per MLU.
Y0646 Disposal hold: 3000 litres 12.0 1 12.0 1 per MLU.

T0211 Staff communication base (size based on number of places) 5.5 2 11.0 2 places per MLU.
M0330 Office/meeting room: 10 places (including 2 workstations) 16.0 1 16.0 1 per MLU.
Staff spaces
Staff support
Sitting and beverage bay: 6 places 12.0 1 12.0 1 per MLU.
Communal changing area (size based on number of lockers) 1.4 20 28.0 Lockers based on maximum staff at shift crossover. Space
determined locally.
V1010 WC: ambulant 2.0 2 4.0


Information/resource centre: 3 persons 12.0 1 12.0
B0305 Single-bed room 19.0 1 19.0
V1645 Shower room: en-suite: chamfered 4.5 1 4.5
H1322 Preparation for parenthood room (size based on number of places) 4.0 10 40.0 Can accommodate 10 people using standard mats.
W1585 General store ADB Codes, Activity Database
1.0Data
is ©Crown1 copyright 12.0 Associated with preparation for parenthood room.
2009.

The ADB room codes listed may not carry a title, in ADB, identical to the room name/function in the schedules. Use of the appropriate ADB room code will, however, result in the correct room being
accessed.

The number of waiting spaces and lockers (in the communal changing areas) have been rounded to the nearest multiple of 5. The number of seats in the staff rest rooms have been rounded to the
nearest multiple of 10. The number of workstations in the open plan offices have been rounded to the nearest even number.
Accommodation to which the department needs access, but may be shared with nearby departments.
Accommodation which is not expected in all departments, but, dependent on local policy, may be needed in addition to or instead of rooms listed in the schedule.

The circulation allowance is based upon the previously published allowance for HBN 21.
For the purposes of calculating the engineering space allowances it has been assumed that each CLU is located on an acute (multi-purpose) hospital site with a GIA of 25,000 sqm. For larger or
smaller facilities, or where there needs to be largely dedicated engineering services plant space, the engineering space allowances will vary, generally downwards as GIA increases.

All of the defined metrics (calculations for quantifying spaces) in the notes column have been included as a reasonable basis for initial briefing. They are not intended as and should not be
considered requirements.

69
Page 9 of 9
Health Premises Cost Guides (HPCGs) briefing schedules show example notional
accommodation and are not to be taken as ideal
12.3 Departmental Cost Allowance Guides (DCAGs) provision for any particular project.
have been replaced by Healthcare premises cost
guides (HPCGs). HPCGs have been produced for 12.6 For full details of how the HPCGs were calculated
the example briefing schedules attached, which see the ‘Healthcare premises cost guides’.
involve configurations of consultant-led units
(CLUs) and midwife-led units (MLUs) for different Engineering space allowance
population sizes. Cost information has therefore 12.7 The example briefing schedules include an
been produced for the following: engineering space allowance. For (a) and (b) above,
a. CLU; it is assumed in the HPCGs that the primary
engineering services are shared with the rest of the
b. CLU with adjacent MLU;
acute hospital premises. The cost information for
c. totally stand-alone MLU. (c) above is based on buildings with fully dedicated
engineering equipment.
12.4 A cost per square metre is provided for building
and engineering services costs. For cost information 12.8 For cost information for engineering services for an
for an MLU co-located with a community MLU co-located with a community healthcare
healthcare facility, project teams should refer to the facility, project teams should refer to the
community healthcare facility cost information in community healthcare cost information in the
the ‘Healthcare premises cost guides’. HPCGs.
12.9 For further details of how the engineering space
Costing the example briefing schedules allowances have been calculated see the HPCGs.
12.5 The HPCGs have been calculated by costing each
example briefing schedule in detail. (Note: The
70
13 References
Department of Health ‘Safe and Sound: Security in NHS maternity units’.

National Association of Health Authorities and Trusts,
Health Building Note 00-01 – General design principles. 1995.
Health Technical Memorandum 00 – General Heath Technical Memorandum 07-07 – ‘Sustainable
engineering principles. health and social care buildings: Planning, design,
Health Facilities Note 30 – Infection control in the built construction and refurbishment’.
environment. ‘Safe and Sound: Security in NHS maternity units’.
Health Building Note 00-02 – Sanitary spaces. National Association of Health Authorities and Trusts,
1995.
Health Building Note 00-03 – Clinical and clinical
support spaces. National Screening Committee Report.
Health Building Note 00-10 Part C – Sanitary Standards for Maternity Care: Report of a Working Party.
assemblies. Towards Better Births: A Review of Maternity Services in
Health Building Note 04-01 Supplement A – Isolation England.
facilities for infectious patients in acute settings. Intrapartum care: management and delivery of care to
Health Building Note 26 Volume 1 – Facilities for women in labour.
surgical procedures. National Service Framework for Children, Young People
Health Technical Memorandum 03-01 – Specialised and Maternity Services.
ventilation for healthcare premises, Parts A and B. British Association of Perinatal Medicine guidance:
Health Technical Memorandum 04-01 – The control of Obstetric standards for the provision of perinatal care
Legionella, hygiene, ‘safe’ hot water, cold water and Standards for hospitals providing neonatal intensive and
drinking water systems. high dependency care and Categories of babies requiring
Health Technical Memorandum 02-01 – Medical gas neonatal care
pipeline systems. Creating a Better Birth Environment: An audit toolkit
Health Technical Memorandum 06-01 – Electrical Are women getting the birth environment they need?
services supply and distribution.
BAPM Standards for hospitals providing neonatal
Health Technical Memorandum 08-03 – Bedhead intensive and high dependency care and Categories of
services. babies requiring neonatal care.
Health Technical Memorandum 08-01 – Acoustics.
Healthcare premises cost guides.
71

Children, Young People and Maternity Services: Health Building Note 09-02: Maternity Care Facilities

Uploaded by

Copyright:

Available Formats

Children, Young People and Maternity Services: Health Building Note 09-02: Maternity Care Facilities

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Children, Young People and Maternity Services: Health Building Note 09-02: Maternity Care Facilities

Uploaded by

Copyright:

Available Formats

Children, young people and

© Crown copyright 2013

Other resources in the DH Estates and Activity DataBase (ADB)

ANTENATAL CARE BIRTH POST-NATAL/NEONATAL CARE

PARENTHOOD & HEALTH ED

EARLY FETAL AND EMERGENCY

ANTENATAL IN-PATIENT CARE

Ultrasound services Antenatal in-patient care

Adult high dependency/critical care Bereavement support

3 Whole maternity unit considerations

Location of birthing facilities 3.7 If an MLU is provided within a hospital, it should

Figure 2 Combined CLU and MLU – key functional relationships

The MLU and CLU may be located on

NNU = Neonatal unit

Figure 3 Separate CLU and MLU – key functional relationships

Design considerations identifying and apprehending an abductor.

Figure 4 Antenatal clinic functional relationships

4.19 See ‘Consulting/examination room: single-sided Preparation for parenthood room/relaxation

making facilities. There should be access to WC Support spaces

5.1 Imaging procedures may be required for the Spaces

Support spaces • Staff rest room/beverage bay

6 Early pregnancy assessment unit

6.1 Within a Consultant-led unit (CLU), a dedicated Spaces

Functional relationships • Children’s play area

6.4 A key consideration in its location is ease of • Baby changing

Figure 5 Early pregnancy assessment unit functional relationships

Touchdown base Building Note 00-03 – ‘Clinical and clinical

• Patient beverage and snack preparation facilities • O

Figure 6 Pregnancy (fetal and maternity) assessment unit functional relationships

Pregnancy assessment bay Two-bay layout

Separate C/E room – in a Consultant-led unit

All images above Courtesy Queen Elizabeth

in Health Building Note 00-03 – ‘Clinical and • P

8 Birthing facilities (and associated in-patient

8.1 This Health Building Note describes facilities • w

Planned and emergency (from outside unit) C-sections

Figure 7 CLU functional relationships

MLU Possibly primary care

Figure 8 MLU functional relationships

Induction suite permanently take up space in the room or, if

Birthing room in adjacent MLU

En-suite 8.14 Studies have shown that women’s preference for

Activities f. use of one wall-mounted resuscitaire and one

mounted resuscitaire, using a mobile

Birthing room suitable for twin and complex births

8.24 The following activities may take place in this

Generally, access space is excluded from DH core

(2300) between fixed units

to the key critical dimensions rather than the area.

Bed moved for active

Zone for active

Vertical support rail Mid

Mid The room length of 4900 mm

foot of the bed for transferring and evacuating an

infant from a wall-mounted to mobile resuscitaire,

8.33 It is recommended that the bed is located around

the bed, egress was achieved reasonably

Figure 18 Local storage 2

3000 (2400 tested) 1700

8 Birthing facilities (and associated in-patient