Within a hospital, washroom design is not a single discipline.
For instance, the requirements for a theatre scrub room bear no resemblance to those of a staff office toilet. Getting the specification wrong in a clinical setting carries real consequences for infection control and patient safety.
NHS estates guidance, including HTM 64 (Sanitary assemblies) and HTM 63 (Plumbing), outlines five distinct washroom environment types.
Each carries its own specification requirements for fixtures, fittings, infection control surfaces and accessibility provisions. Understanding the categories is the starting point for any hospital washroom refurbishment or new-build project.
Here is a practical overview of all five, written for facilities managers, estates teams and developers working within NHS or private healthcare settings.
Clinical Dry
Clinical dry environments include single-bed and multi-bed wards, consulting rooms, treatment rooms and clean utility spaces. Hand hygiene is frequent in these settings, including between patients, after examinations and following any contact with clinical equipment. In response, washbasins must meet clinical-grade standards.
Key specification requirements for clinical dry areas include:
Washbasins: HTM 64 specifies clinical-grade basins with the waste outlet positioned at the rear of the bowl. This reduces the risk of contamination from standing water and makes the basin easier to clean thoroughly.
Tap operation: All taps in clinical dry areas must be operable without the use of hands. Elbow-operated lever taps are the standard solution, preventing cross-contamination between hand-washed hands and tap surfaces. Thermostatic blending valves are typically required to control scalding risk and maintain Legionella-safe water temperatures.
IPS ducting: Integrated panel systems (IPS) for waste and service pipes eliminate exposed pipework from ward walls, reducing the number of harbourage points for bacteria and making surfaces easier to wipe down.
Basin design: Basins with an antibacterial glaze inhibit the growth of bacteria on the ceramic surface itself. Designs that minimise splashback, typically those with deeper bowls or a more vertical front face, are preferred in clinical dry settings to reduce floor contamination risk.
Clinical Wet
Clinical wet areas encompass patient shower rooms, assisted bathrooms and dirty utility rooms. Dirty utility spaces are used for the cleaning and holding of clinical equipment, disposal of clinical waste and the handling of patient specimens.
The infection control demands are higher than in clinical dry environments, and the specification reflects this.
Clinical waste sinks: Dirty utility rooms require a clinical waste sink fitted with a rear outlet, consistent with clinical dry standards. These sinks are designed for the disposal of clinical waste and fluids without risk of splatter.
Sluice sinks: A sluice sink which is fabricated from stainless steel is required wherever bedpans, urinals and reusable clinical equipment need to be processed. Stainless steel is specified for its resistance to the high-temperature cleaning and chemical disinfection cycles these sinks undergo.
Accessible design: HTM 64 sets out minimum room dimensions and fixture spacings in clinical wet areas to ensure wheelchair access and assisted transfers are achievable. Clear turning circles, transfer spaces alongside WCs and height-adjustable or fixed-height equipment must all be considered at the design stage.
Surface specification: Grouted joints, exposed fixings and surface irregularities all create cleaning challenges in wet clinical areas. The design brief should minimise these wherever possible, with seamless or large-format wall panels preferred over tiled finishes in the highest-risk zones.
Clinical Specialist
Clinical specialist areas are theatre suites and scrub rooms: the environments with the most demanding infection control requirements anywhere in a hospital. Everything in the specification is oriented towards surgical hand disinfection (SHD) and the elimination of contamination risk before a patient enters the operating field.
Scrub sinks and troughs: Clinicians undertake a structured hand and forearm disinfection process prior to surgery, washing from the fingertips to above the elbows. Stainless steel scrub troughs are specified for this purpose. They are typically two or three stations wide to allow multiple members of the surgical team to scrub simultaneously. The geometry of the trough and the position of outlets is designed to prevent cross-contamination between users.
Tap control: Physical contact with taps must be avoided entirely in clinical specialist areas. Elbow-operated taps remain in use in some settings, but sensor-operated taps are increasingly the standard. Specification should include adjustable flow duration and pressure settings to allow the scrub protocol to be followed correctly without needing to adjust fittings mid-wash. Fail-safe thermal controls are also required.
Plaster sinks: In theatres where orthopaedic procedures or fracture clinics are managed, a dedicated plaster sink is required. These are fitted with a sieving mechanism to prevent plaster of Paris entering and blocking drain runs, which presents a maintenance and infection risk if not addressed at the design stage.
Surface and joint specification: As in clinical wet areas, surfaces in theatre suites should minimise joints, recesses and ledges. Monolithic wall systems and coved skirtings are typically specified.
Non-Clinical Wet
Non-clinical wet areas are patient-facing spaces that are used without clinical assistance: en-suite bathrooms, general patient toilets, shower rooms and outpatient facilities. These areas do not carry the same infection risk as clinical environments, but they are used by people who may be post-operative, elderly, visually impaired or of limited mobility, so accessibility is the primary design driver.
Grab rails: Fixed grab rails are required adjacent to WCs and within shower areas. Rail positioning and load rating must comply with BS 8300 (accessibility of buildings) and the specific guidance within HTM 64. Fold-down rails allow the same space to serve ambulant and wheelchair users.
Floor finishes: Non-slip flooring with an appropriate Pendulum Test Value (PTV) for a wet barefoot environment is required throughout. Smooth finishes that appear clinical are often unsuitable. The slip resistance properties of any specified floor finish should be confirmed for wet conditions.
Sensor technology: Motion-activated taps, flush valves and hand dryers reduce surface contact and the spread of bacteria, and are increasingly standard in non-clinical wet patient areas. They also benefit patients with limited dexterity who may struggle with lever or push-button controls.
Contrasting colours and visual clarity: For patients with visual impairments, adequate tonal contrast between fixtures, walls and floors aids orientation within the space. BS 8300 and HTM design guidance both reference the importance of colour contrast in healthcare washroom design.
Non-Clinical Dry
Non-clinical dry covers the supporting estate of a hospital: staff offices, storerooms, administration areas and facilities that are not involved in direct patient care. Standard washroom provision applies in these areas, but the hospital setting means infection control remains a relevant design consideration.
Standard fixtures with clinical awareness: WCs, washbasins and hand-drying facilities follow standard commercial specifications in non-clinical dry areas. However, elbow-operated or sensor-operated taps, motion-activated flush valves and touchless hand dryers are all advisable staff working in non-clinical dry areas still move between these spaces and clinical zones.
Non-slip flooring: As with all hospital environments, non-slip floor finishes with appropriate PTV ratings for the use case are required.
Ventilation: Adequate mechanical ventilation should be provided in line with HTM 03-01 (Heating and ventilation systems). This is a compliance matter in all hospital washrooms, not only clinical areas.
Hospital Washroom Installation UK
Every hospital washroom has a requirement to install the correct fixtures and fittings to protect patients, staff and visitors. However, the exact products or specifications required will differ depending on the environment type.
The best way for us to help select the most appropriate materials for your building environment and the project budget is to get in touch. From there, we can give you tailored advice so that you can maximise the outcome of your hospital washroom project.
Why not download our brochure to get some ideas of what we can do for you? Browse our full range of colours and materials to help bring your washroom project to life!
If you’re ready to book in with us, or if you need any further advice on anything we’ve mentioned above, please give us a call on 0115 811 4242 or drop us an email and our friendly team will be in touch.