Calls for standardisation of mental health buildings

Architects, construction companies and product suppliers are calling for standardisation in the design of mental health buildings in an effort to boost business and bring down the cost of developing facilities in the UK.

Currently suppliers lack visibility of the pipeline, which leads to every product having to be specially made, causing long delays and costing more than off-the-shelf solutions.

In addition, a lack of guidance and standards means every trust is demanding its own series of tests from each supplier to ensure the safety of mental health patients and staff.

If people are really driven to reduce cost then we can do it, but we will have to adopt some sort of standardisation

The problems were outlined at the first annual Design in Mental Health Conference and Exhibition held this week in Birmingham.

Gary Barnes, senior director at construction company, Kier Health, said: “Even when we use the same form of architecture for a project, the resulting designs vary quite significantly, so suppliers have no visibility of the pipeline of work.

“Often manufacturers will not have stock ready and it can take eight weeks to make. They tell us that if everything was designed to a template, then they would be able to keep it in stock and then just change the finishes or ironmongery.

“If people are really driven to reduce cost then we can do it, but we will have to adopt some sort of standardisation.”

And Mark Nash, operations director at Vistamatic, manufacturer of secure vision panels, added: “Every trust is asking for something different. Even in the same sort of environments, different products are being specified.”

But any move towards standardising either building or product design would mean the need to draw up clear standards to ensure that products are safe and fit for purpose.

Nash warned: “We are a manufacturer at the end of the day and I would not feel comfortable saying ‘this is ideal for a high-secure mental health environment’. We as a company have invested a lot in tests, but we are not standard setters. We have looked at and tried to formulate some sort of standard, but if someone gets hurt and it is because of a panel we have specified as being ideal for a particular environment, then I would not want to be the person responsible, but I do want to be the person who is helping to put that standard in place.

“What we need are a set of clear standards for testing products for low, medium and high-secure mental health environments.”

A spokesman for safety window manufacturer, Britplas, added: “The fact there are no standards for mental health developments is an issue. We need clear guidance on standards for anti-ligature products, for robustness, for fit for purpose, and for aesthetics. These need to be decided by end users, safety officers and clinical staff and they need to lay out how products should be tested. We need organisations such as BRE or the Design in Mental Health Network to provide independent testing and approval. This is missing at the moment.”

We need clear guidance on standards for anti-ligature products, for robustness, for fit for purpose, and for aesthetics. These need to be decided by end users, safety officers and clinical staff and they need to lay out how products should be tested

The idea is being cautiously welcomed by NHS trusts. Alan Kenny, director of estates, assets and commercial services at Birmingham and Solihull Mental Health NHS Foundation Trust, told the conference: “The first thing my trust is interested in is safety of the environment. We would standardise as long as we get that as the end result. If we standardise it has got to be standardisation that supports functionality.

“It is true that suppliers are not stocking items and if you need a fitting for a bathroom and it takes weeks to manufacture, then you have to take that facility out of operation and this causes issues. Standardisation may be able to solve problems like this.”

In terms of standardising architectural elements of the building, St Andrews Healthcare, the UK’s largest mental health charity, has produced a building design guide for its facilities, providing an optimum generic ward design. This includes a new approach to traditional nursing stations, which have been scrapped in favour of multi-disciplinary team bases that encourage more interaction with patients.

“Having developed many facilities, we have come up with the optimum generic ward design. This includes lots of therapy spaces and secure garden spaces, which are very important, particularly for those patients who have restrictions put on their access to the outside world.”

The charity has specialist units for mental health patients who are deaf or hard of hearing, for women, for people with learning disabilities and brain injuries, and for younger people. Its standards cover the optimum environment for all of these specialist groups. Features include clear vision panels in doors to aid signing, induction loops built into the facilities, and sensitive lighting for deaf patients. For women, there is an emphasis on soft furnishings, increased extra care facilities, and more anti-ligature products, due to women having a higher tendency to self-harm or attempt suicide.”

Barnes said the six principal supply chain partners working on the P21+ procurement framework were currently holding discussions about possible future standardisation.

He added: “We are looking at standardising partitions, doors and ironmongery, ceilings, flooring, mechanical and electrical services, and FF+E, as well as possible standards for bedrooms and bathrooms and whole departments. We need to try to find elements of standardisation without restricting personalisation. You may buy a suit off the peg, or made-to-measure, or from Saville Row, and sometimes it is not that easy to tell the difference. Standardisation does not always have to mean less impressive.”