Press release

Ministers act to increase "Changing Places" toilets for severely disabled people

New shopping centres, stadiums and theme parks are among buildings that could be required to provide Changing Places toilets for severely disabled people.

This was published under the 2016 to 2019 May Conservative government
Image of disabled wheelchair user Anne
  • Local Government Minister Rishi Sunak MP announces proposals to make Changing Places for severely disabled people mandatory in new large public buildings
  • Care Minister Caroline Dinenage confirms 100+ NHS hospitals to build Changing Places facilities backed by £2 million fund

New shopping centres, stadiums and theme parks are among buildings that could be required to provide Changing Places toilets for severely disabled people, under proposals to be put forward by the government.

Ministers will launch a consultation next year on proposals that the essential facilities are included in all new large publicly-accessible buildings and significant redevelopments. Currently, building regulations guidance only recommends Changing Places toilets are provided.

Alongside this, the Department of Health and Social Care has announced £2 million to install over 100 Changing Places toilets in NHS hospitals throughout England. There are currently only around 30 to 40 Changing Places on the NHS England estate, and this investment will enable Trusts to increase accessibility.

People with disabilities and their carers say Changing Places in public can be life changing and allow them to go out in the public without fear or stress. Changing Places toilets are larger than standard disabled toilets and have extra equipment like adult-sized changing benches and hoists.

Local Government Minister Rishi Sunak MP said:

Changing Places toilets make a huge difference to the lives of severely disabled people. I want to see these facilities included as standard in new large buildings like shopping centres and cinemas, so more disabled people can be assured peace of mind and dignity when they are away from home.

The government will consult in the New Year on how best to do this, including changing building regulations if required, if it means more disabled people can get access the essential services they deserve.

Minister for Care Caroline Dinenage, added:

It is utterly shocking how few Changing Places toilets there are currently in NHS hospitals and other public spaces. People with disabilities and their carers rightly expect to find suitable facilities in a hospital of all places.

A quarter of a million disabled people need Changing Places and this investment will mean many more of them can access a toilet safely and comfortably. Whilst this is something most of us take for granted, access to spaces like these make a big difference to the lives of disabled people and their carers.

In the absence of Changing Places facilities, disabled people and/or carers face:

  • limiting what they drink to avoid needing the toilet when they are out – risking dehydration and urinary tract infections;
  • sitting in soiled clothing or dirty nappies until a suitable toilet is found or they return home;
  • having to change a loved one on a dirty toilet floor;
  • manually lifting someone out of their wheelchair – risking safety
  • reducing their time out of the house – restricting their social lives

While the number of the facilities has increased from 140 in 2007 to more than 1,200 today, the government is determined to go even further to improve disabled people’s quality of life.

Today’s announcements follow a recent £2 million investment by the Department for Transport to increase Changing Places facilities in motorway service stations.

The government, with contributions from the devolved administrations, has also provided £70,000 for an online map of the UK that helps carers and disabled people find Changing Places toilets.

Catherine Woodhead, Chief Executive of Muscular Dystrophy UK, which co-chairs the Changing Places Consortium, said:

We are delighted that the Department of Health and Social Care and the Ministry of Housing, Communities and Local Government are committed to making Changing Places toilets more widely available.

Having access to Changing Places toilets increases independence and improves quality of life, and by investing in facilities we can tackle the exclusion many disabled people face on a daily basis.

We, along with our wonderful campaigners, have long pushed for changes to legislation to make Changing Places toilets mandatory in new large public buildings and it’s fantastic that we are now one step closer to that reality.

We are also greatly encouraged by the investment being made in hospitals and motorway services. It is essential that fully accessible toilets are available here; without them, disabled people may struggle to attend important appointments or visit family and friends.

We look forward to working with the government and our campaigners to ensure that Changing Places toilets are available to everyone who needs them.

The government intends to consult during 2019.

Case studies

Lorna Fillingham, Scunthorpe

8 years ago I gave birth to a beautiful little girl, Emily-May. She changed our world forever. We attended baby groups, and it was at these that I first began to notice that she wasn’t meeting her milestones. She wasn’t able to sit (she finally achieved this milestone at the age of 3). She also didn’t babble or explore her environment as the other children did. We were finally told by a paediatrician that Emily-May had developmental delays and that it was likely she might have physical and learning disabilities. What we weren’t told was that my daughters world might start to physically shrink, not because of her physical disabilities but because of the lack of toilet facilities that are available for disabled people like my daughter.

Emily-May is unable to tell me when she needs to use the loo, her learning disabilities mean that she may never become toilet trained, and she is physically unable to transfer herself safely out of a wheelchair. I still, when out and about, have to physically lift her out of her wheelchair and change her on a baby change facility, I am only able to do this because she is small for her age, it feels like we are playing Russian Roulette every time we do this. This will not be an option forever as she grows.

3 years ago, I began campaigning for Changing Places toilets to be made compulsory in larger public buildings, as part of building and planning regulations. Changing Places toilet facilities have an adult changing bench and hoist as well as a toilet, they have enough space for 2 carers, and for bigger wheelchairs.

A lack of Changing Places toilet facilities in the community limits disabled people’s lives. It limits their social, cultural, health and educational options, for who would choose to go to places where the correct toilet facilities are not provided.

As part of my campaign I started to contact hospital trusts, pointing out that the lack of Changing Places toilets was having a detrimental effect on disabled people attending outpatients appointments and visiting family and friends. My former career as a nurse, meant that I knew the techniques that I was using to lift Emily-May put us both at the risk of harm, but also that leaving her sat in one place for a prolonged period of time in a wet or soiled nappy would put her at the risk of pressure sores.

While a handful of Trusts agreed to provide Changing Places toilet facilities, the cost of providing these was cited as an issue from many respondents.

I am therefore very pleased by the governments announcement today that investment will be made on providing Changing Places toilet facilities in hospitals. It means that more disabled people will be able to be toileted in a safe, dignified, timely and humane manner whilst attending outpatients appointments or whilst visiting the wards. I also welcome the Governments consultation into Changing Places provision, and I live in the hope that my daughter’s world will expand again as the toilet facilities she needs will one day be provided in more of the places we go.

Anne Wafula Strike, Harlow

Anne Wafula Strike MBE is a Harlow-based British Paralympic wheelchair racer and campaigner for accessible travel for people with disabilities. Born in Mihuu, Kenya, she contracted polio at the age of two, resulting in lower body paralysis. Arriving in the UK in April 2000, she was introduced to wheelchair racing in 2002 and in 2004 became the first Kenyan wheelchair racer to represent her country, competing in the T53 400m finals at the Paralympics in Athens. Following a successful application for British citizenship in 2006, she became a member of Team GB and now competes as a British athlete.

She was appointed Member of the Order of the British Empire (MBE) in the 2014 Birthday Honours for services to disability sport and charity. In January 2017, while on a CrossCountry train, she was forced to wet herself on a rail journey because the accessible toilet was not working. In the aftermath, she criticised CrossCountry for failing to provide a working disabled accessible toilet on the train.

As a campaigner for disability access and inclusion, I have to come to know that disability is not the problem. When accessibility fails then that’s the problem. I welcome this news as it’s a demonstration of the Government providing reasonable adjustments in health facilities. This will surely empower the severely disabled people, their families and their carers to change and be changed in a safe environment and with dignity. I support all Changing Places campaigners who endure humiliation of changing their loved ones on dirty floors and putting them at risk by lifting them on and off the floor. The Governments’ idea of a consultation on provision of changing places in public buildings is a big step in the right direction to ensuring access and inclusion of disabled people is on the agenda of building planning.

Further information

The cost to install a changing places facility in a hospital is usually between £27,000 and £35,000.

Trusts will be invited to bid for the funding, with bidding opening in 2019. The £2 million funding will be allocated on the principles of matched funding, with Trusts contributing to the cost.

The government has announced its intention to launch a consultation on increasing Changing Places toilets provision, which will seek views on the types and threshold of buildings covered (such as cinemas, shopping centres, sports and music venues and transport hubs). This includes the specifications and cost of the toilets to be installed.

The proposal to change building regulations would apply to England only.

Changing Places are specifically designed to accommodate adults whose needs are not met by standard accessible toilets. These facilities are large accessible spaces with adult-length padded and height adjustable changing tables, hoists, peninsular WCs (further removed from the wall and with space at the sides) and showers.

The government will be engaging with the sector during the consultation. It is a statutory requirement to consult on changes to building regulations.

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Updates to this page

Published 24 December 2018