NHS Estate Guidelines – DOH Sanitary Assemblies/Sanitary Installation Guidelines/ Update to HTM64


This page is written to summarise key points of the current NHS Estates/DOH  guidelines for sanitary assemblies and assist in the selection of suitable hand washing equipment, sinks, wash hand basins (sanitary installations) as recommended by DOH/NHS Estate guidelines.
Part of good practice and compliance with CQC guidelines is ensuring that adequate procedures are in place: Ensure staff are trained in correct hand washing techniques, washing facilities should be accessible by all users and consumables (disinfectant washes, paper hand towels etc) are always available.

It is recommended to confirm suitability of equipment with the relevant authorities where necessary

General Considerations
One is allowed choice in the materials and methods of construction – provided they satisfy the performance requirements outlined by DOH Sanitary assemblies & CQC advice
All surface finishes in healthcare facilities should be chosen with cleaning in mind
Materials and finishes should  be selected to minimise maintenance
Pipework should be planned to avoid restrictions/dead-legs
Exposed surfaces should be smooth and easily cleaned, with no sharp edges
The water temperature at point of delivery (outlet) should be controlled either
By  manual control – using separate hot and cold water taps or TMV blending valves controlled manually by the user. (A  warning notice should be displayed where a tap is supplying water at potential temperatures above 43°C)
By individual thermostatic blending control (TMV mixing of hot and cold water by valve at the fitting).

Consideration should be given to the following when installing sanitary fittings:
HTM04-01: The control of Legionella, hygiene, “safe” hot water, cold water and drinking water systems
HTM07-04: Water management
HTM00-02: Sanitary spaces


Sinks used in clinical areas, such as dirty utilities, should preferentially not have tap holes therefore wall-mounted taps should be used. 
The option to use a sink with tap-holes should only be considered when it is impractical to conceal pipework; in this case, the supply pipework should be surface-mounted below the  sink.
Services should be concealed/ducted. Typical requirements for supply with the sink are: 
Extended lever action taps (TBH1)
Separate manual control of the hot and cold water
Flush-grated (free draining) waste outlet without plug

Non Clinical Sinks
It is permissible for sinks used in general use/domestic/non-clinical services, for example in cleaners’ rooms and kitchens to have tap-holes for use with pillar taps (TP3)

Basins should have a smooth form with easy to clean surfaces.
Overflows should not be provided for infection control reasons.

Wash Hand Basins
Sizes: 500-600mm wide (600mm recommended for wheelchair/seated use)
Basin taps used in clinical areas and food preparation and laboratory areas are required to be operated without the use of hands

Clinical wash-hand basin
Clinical wash-hand basins should be installed in all clinical areas. Washing should be  carried out under running water and therefore a medium or large integral back-outlet (horizontal waste) basin with no plug is recommended. 
Typical requirements are: 
Integral back outlet (horizontal waste outlet);
Washing under running water, therefore basin should incorporate flush grated wastes/no plug 
Wall-mounted single-lever-action (TBH2a) or sensor tap (TBH6) with single self-draining spout 
(Minimum air gap from tap spout outlet: 25mm)
TMV3-approved thermostatic mixing valve fitted in accordance with HTM 04-01
Connection should be to concealed services

Non-clinical wash-hand basin
Non-clinical wash-hand basins with tap-holes should be used for general areas/domestic services combined with a TMV3 approved thermostatic mixing valve and concealed/ducted services.
Washing may be  carried out in a reservoir of water; therefore a bowl with plug is recommended. If plugs are used, they should be attached to an open-link chain  which should be panel-mounted. Typical requirements are:
Washing in reservoir of water, therefore a basin fitted with plug and chain with screw stay
Combined or separate nozzle with non restricting flow straightener
Lever-action taps (TP5 or TP6)

Hand Rinse Basins
Sizes: Up to  400mm wide
Generally for rinsing hands under running water
Basins should have a smooth form and easily cleaned surfaces. Overflows should not be provided for infection control reasons. 
Three sizes of basin should satisfy most of the user requirements in health buildings as follows:
Large basins (500-600mm width) : For use in clinical areas for “scrub-up” purposes, and for use by seated or wheelchair patients, for which wide shallow basins should be selected
Medium basins (400-500mm width) : for use in clinical procedures and in general areas/domestic services
Small basins (below 400mm width): for use inside WC cubicles/stalls, food preparation areas and similar locations. Suitable only for hand-rinsing.
Typical assembly requirements for the above include the following:
Washing takes place under running water, therefore the basin should not have a plug
Taps should offer either combined lever control of flow and water temperature or automatic control of thermostatically mixed water (sensor operation). 
Single flow spout without end restriction
Tap options: Lever-action tap, press (non concussive) tap or sensor tap
TMV3 approved thermostatic mixer.

Basin Fixing Heights:
780-800mm: Ambulant
680-700mm: Wheelchair
Useful Definitions
General pattern:  for use by hospital staff, patients and the public in general, that is, nonclinical use.  Hospital pattern:  for use by clinical staff in connection with clinical procedures.
TBH1: Long Lever Bib Taps
TP3: Long lever High Neck Pillar Taps
TBH6: Wall mounted (bib) Sensor tap
TBH2a: Single lever wall mounted (bib) mixer tap
TP5: Short lever operated basin taps (pairs)
TP6: Washbasin mixer tap, thermostatic, short lever operated

November 2015

References: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/148497/HBN_00-10_Part_C_Final.pdf
NHS Wales:   http://www.wales.nhs.uk/sites3/Documents/254/WHBN%2000-10%20Part%20C.pdf
BREEAM Healthcare : http://www.breeam.com/filelibrary/kn5253_breeam_healthcare_faqs.pdf