Accessible doorways in hospital



Doors are an essential part of any building. They help control access, provide appropriate access, privacy and help protect against fire by compartmentation. Doors should be considered in the overall design of the building, to support appropriate access for all and only be used where necessary.

In general, new doors should follow the existing building strategy and specification to integrate and be consistent with the building environment. There may be ways to improve a building’s accessibility and consider opportunities to evaluate and enhance accessibility for all users.

In addition to the information in this guide reference in the UK should be to the Building Regulations and in particular: Access to and use of buildings: Approved Document M and British Standard 8300-2: Design of an accessible and inclusive build environment, along side HBN 11-01 Facility for Primary and community care services.

In a healthcare setting, there will be a variety of traffic going in and out of doors such as trolleys, beds, patient hoists, buggies, mobility scooters and wheelchairs. Doorways should be sized to make sure access is inclusive for all users.

Recommended standards:

  • Size door openings to provide a clear width for maximum access to all areas. For an internal door, a door opening of 1000mm will achieve a clear opening width of 825mm.
  • All external doors and internal lobby doors should have a 1000mm clear width opening.
  • To achieve an effective clear width, consider the door’s position and measure from the face of the door in the open position to the door stop on the opposite frame. Consider any obstructions and projecting ironmongery, such as door handles, that stop the door from opening fully.
  • Ensure all hinged doors can open at least 90 degrees. Core Elements HBN 00-03
  • Where possible in children’s’ area, doorways should allow access for a double buggy.
  • Avoid revolving doors as these can be particularly difficult for those with mobility challenges to manage. Ideal alternatives include automatic sliding doors or powered hinged doors.
  • Where revolving doors are installed, there needs to be an alternative doorway either hinged or sliding for people who can’t use the revolving door.

The door location needs to take account of the floor space around the door so people with mobility issues, wheelchairs, scooters, or buggy users have enough space to use the door. Equally ensure the door can be opened by those using any assisted devises.

Recommended standards:

  • There should be a wall nib of at least 450mm between the leading edge of a door and the return wall to ensure sufficient space to operate the door handle by wheelchair users and others using mobility aids.
  • All doorway thresholds should be level, and not be a trip hazard or obstruct the access of those on wheels.
  • Internal doors should open into a room and against an adjoining wall, to avoid obstructions and make manoeuvrability easier.
  • For automatic doors think about the position of sensors so that the door opens and closes with sufficient time and space for access.
  • Avoid trip hazards by positioning door stops on walls instead of the floor.

Doors that are heavy to open can impair independent use of a building. Consider the force required to open a door and the potential use of power operated doors.

Door handles and other door ironmongery should be designed and positioned to maximise accessibility for all users.

Recommended standards:

  • For a door with closers think about the force required to open the door. If a force greater than 20N is needed, then a power-operated system may be required to allow the maximum numbers of users to open the door independently, regardless of any physical disability or injury.
  • Make it as easy as possible for everyone to open doors. Where possible, consider power-assisted doors, ideally operated with automatic push pads for maximum accessibility.
  • Provide low friction hinges to minimise the force needed to open and close a door.

Choose door furniture that allows the door to be used by all users. Door handles should be easy to grip and use without the need for excessive force. Please also refer to the Ironmongery section of this guide for more specific guidance and recommendations.

Recommended standards:

  • If a door does not need to stay closed for day-to-day activities and is only provided for fire compartmentation, consider the use of an electronic hold-open device linked to the fire alarm system.
  • Door handles should be within easy reach and work with a lever action for ease of access.
  • Position lever handles at 800-1050mm above the floor level, preferably at 900mm.
  • Pull handles should be a minimum of 400mm long, positioned vertically, with the bottom of the handle 1000mm above the floor and 50mm clear of the door face.
  • Place pull handles on both sides of double swing doors (doors that swing in both directions) as a user may prefer to pull rather than push the door.
  • Use delay action for closers, this will make sure people have enough time to pass through the doorway before the door closes.
  • Closers should close smoothly and quietly.
  • In children’s clinical areas place door handles out of reach of small children, but accessible for adults with physical disabilities.
  • Ensure finger-guards to the hinge side of the door where every there are children. mandatory in specialised children’s areas to stop fingers being trapped in doors when they close.
  • Accessible toilets should have an emergency release to allow the door to open outwards should a patient collapse behind the door.

Using contrasting colour surfaces and features in a building helps people with visual difficulties navigate their immediate surroundings more clearly.

Recommended standards:

  • Contrast the colour of the door frame and surrounding wall in accordance with Building Regulations and in line with the strategy used throughout the building.
  • Contrast the colour and finish of the ironmongery with the background door leaf finish to improve visibility.
  • If the leading edge of any door is likely to be held open it should visually contrast with the other surfaces of the door
  • Avoid glossy finishes to reduce glare and to stop people thinking that the surface is wet.
  • There are recommendations relating to colour contrast, in particular the relative Light Reflectance Values (LRV) of the adjacent surface colours. A difference in LRV of 30 points is considered to give sufficient contrast.

Vision panels in doors reduce the risk of collisions when people are approaching a door from both sides at the same time. They can help to improve wayfinding by allowing a building user to see into a room from further away. In certain areas, this wayfinding benefit should be balanced with the need for privacy.

Recommended standards:

  • Use vision panels to give directional sight of where a door leads to.
  • Vision panels should generally be visible between 500mm and 1500mm above floor level. Corridor doors should have vision panels at the appropriate height so building users can see people moving towards them.
  • Significant amounts of glazing on doors should have suitable markings or stickers (manifestations) to stop people walking into them.
  • Ensure the edges of any frameless glass doors are easy to see when the door is open or shut.
  • All glass should be of a suitable strength to avoid any breakage or harm.

Doors designed as part of intuitive way finding

Doors can have a significant impact on way finding, so use of door design can that can aid directionally while also helping to avoid disorientation for user in unfamiliar surrounding can be a significant benefit for all users.

Recommended standards:

  • Door signs should be clear and follow standard guidance and dementia best practice. This includes using colour and pictograms wherever possible.
  • Avoid confusion by positioning door signs on the door rather than next to, or above it.
  • Use different colour doors for toilets and clear signage on all doors. Apply a consistent approach throughout the building.
  • Signage should be a combination of lettering and images, include tactile components, such as Braille or raised lettering and symbols wherever possible and within easy reach.
  • Dementia best practice suggests that staff-only doors are “disguised” to avoid use by patients. This may conflict with other accessibility guidance and should be agreed on a project-by-project basis. Consider not unnecessarily highlighting these doors as an option.
  • Further guidance on dementia friendly design can be found in Health building note (HBN) 08-02: Dementia-friendly health and social care environments.

Doors can be used to create an acoustic barrier. Some cognitive conditions and mental health issues can be made worse by intrusive noise. Similarly, those with hearing and sensory impairments may be disturbed by noise reverberation. Overall good use of acoustic material can further help promote calm, comfort and ensure confidentiality.

Recommended standards:

  • Plan the acoustic requirements of a space at an early stage of design and consider how the design and location of the door will impact the room’s acoustics.
  • Situating room doors away from seating areas can improve the acoustics of the clinical rooms and prevent the over-hearing of private conversations.
  • If drop-down seals are used on the bottom of doors to avoid sound transfer, be mindful of the force needed to open the door.
  • Specify door transfer grills to ensure privacy is not compromised.
  • Further guidance on acoustics can be found in Health Technical Memorandum 08-01: Acoustics
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