Specialist services

Health Technical Memorandum

08-03: Bedhead services
Health Technical Memorandum 08-03
Bedhead services
Health Technical Memorandum 08-03 – Bedhead services

© Crown copyright 2013

This document/publication is not covered by the HMSO Click-Use Licences for core or added-value material. If you
wish to re-use this material, please send your application to:
Copyright applications
The Copyright Unit Office of Public Sector Information
Information Policy Team
Kew
Richmond
Surrey TW9 4DU
e-mail: [email protected]

ii
Preface

About Health Technical Memoranda main source of specific healthcare-related guidance for
estates and facilities professionals.
Health Technical Memoranda (HTMs) give
comprehensive advice and guidance on the design, The core suite of nine subject areas provides access to
installation and operation of specialised building and guidance which:
engineering technology used in the delivery of healthcare. • is more streamlined and accessible;
The focus of Health Technical Memorandum guidance • encapsulates the latest standards and best practice in
remains on healthcare-specific elements of standards, healthcare engineering, technology and sustainability;
policies and up-to-date established best practice. They are
applicable to new and existing sites, and are for use at • provides a structured reference for healthcare
various stages during the whole building lifecycle. engineering.

Figure 1 Healthcare building life-cycle

DISPOSAL CONCEPT

RE-USE
DESIGN & IDENTIFY
OPERATIONAL OPERATIONAL
MANAGEMENT REQUIREMENTS

Ongoing SPECIFICATIONS
MAINTENANCE TECHNICAL & OUTPUT
Review

PROCUREMENT
COMMISSIONING

CONSTRUCTION
INSTALLATION

Healthcare providers have a duty of care to ensure that Structure of the Health Technical
appropriate governance arrangements are in place and are Memorandum suite
managed effectively. The Health Technical Memorandum
series provides best practice engineering standards and The series contains a suite of nine core subjects:
policy to enable management of this duty of care. Health Technical Memorandum 00
It is not the intention within this suite of documents to Policies and principles (applicable to all Health
unnecessarily repeat international or European standards, Technical Memoranda in this series)
industry standards or UK Government legislation. Where Health Technical Memorandum 01
appropriate, these will be referenced. Decontamination
Healthcare-specific technical engineering guidance is a Health Technical Memorandum 02
vital tool in the safe and efficient operation of healthcare Medical gases
facilities. Health Technical Memorandum guidance is the

iii
Health Technical Memorandum 08-03 – Bedhead services

Health Technical Memorandum 03 Electrical Services – Electrical safety guidance for low
Heating and ventilation systems voltage systems
Health Technical Memorandum 04 In a similar way Health Technical Memorandum 07-02
Water systems represents:
Health Technical Memorandum 05 Environment and Sustainability – EnCO2de.
Fire safety
All Health Technical Memoranda are supported by the
Health Technical Memorandum 06 initial document Health Technical Memorandum 00
Electrical services which embraces the management and operational policies
from previous documents and explores risk management
Health Technical Memorandum 07
issues.
Environment and sustainability
Some variation in style and structure is reflected by the
Health Technical Memorandum 08
topic and approach of the different review working
Specialist services
groups.
Some subject areas may be further developed into topics
DH Estates and Facilities Division wishes to acknowledge
shown as -01, -02 etc and further referenced into Parts A,
the contribution made by professional bodies,
B etc.
engineering consultants, healthcare specialists and
Example: Health Technical Memorandum 06-02 NHS staff who have contributed to the production of
represents: this guidance.

Figure 2 Engineering guidance

FIC DOC
H SPECI UM
L T EN
A TS
HE
HTM 08
HTM 01
Specialist
Services Decontamination

S T R Y S TA N D A
DU RD
IN S
& EUROPEAN
NAL ST
HTM 07
IO HTM 02
T

AN
NA

Environment & Medical

DA
H E A LT H S P E

INTER

CUMENTS

Sustainability Gases
RDS

HTM 00
RDS
INTER

Policies and
Principles
DA
NA

AN

IO
ST
T

NA
DO

HTM 06 L& N HTM 03

Electrical
IN EUROPEA S Heating &
DU D
C

Services STR AR Ventilation

IF I

IC

Y S TA N D Systems
IF
C

EC
D

HTM 05 HTM 04
O

Fire
SP

U Water
C

M Safety Systems H
EN T
TS AL
HE

iv
Executive summary

Bed spaces and their environment have a significant

impact upon patient experience and delivery of care.
With patients able to choose their provider of healthcare
service and the increased complexity of clinical
techniques and procedures provided at bed spaces, it is
now even more important to ensure that bedhead
facilities are fit-for-purpose in all respects.

v
Health Technical Memorandum 08-03 – Bedhead services

Acknowledgements

Alan Cooper, BEAMA Installation

Allan Jones, AUSTCO Ltd
Charlotte Brown, Patientline Ltd
Chris Turner, Static Systems Group plc
Clive Bray, Medicines and Healthcare products Regulatory Agency (MHRA)
Dennis Bastow, DSSR Consulting Engineers
Gary Bell, Mediplan Ltd
Phil Williams, The Wandsworth Group
Glynis Meredith-Windle, Healthcare planning consultant, Meredith-Windle Associates
Graeme Dell, Cableflow International Limited
John Temple, Architect, Temple Associates
Keith Miller, Health Estates, Northern Ireland
Ken Taylor, DSSR Consulting Engineers
Lorraine Harris, NHS Security Management Service
Mary Green, NHS Institute of Innovation & Improvement
NHS Connecting for Health
Nicholas Bukorovic, Healthcare Lighting Ltd (author of CIBSE’s LG2 2008)
Peter Wiles, Welsh Health Estates

vi
Contents

Preface
Executive summary
Acknowledgements
1 Scope 1
2 Definitions 2
3 Management policy/responsibilities 4
Bedhead services
Statutory requirements and functional guidance
Emergency preparedness
Disability Discrimination Act
Exceptions
Decentralisation of staff bases
4 Operational policy/management 8
Designated staff functions
Validation and verification
Electromagnetic compatibility
Electrical interference
Electrostatic discharge immunity
5 Design considerations 10
System resilience
Control of infection
Fire precautions
Design flexibility
Clinical flexibility
Bedhead services layout/configuration
Controls and markings
Visual and audible alarms
6 Bedhead service installation 14
Trunking systems
Linear horizontal trunking
Vertical trunking units
Plastic enclosures/ducting
7 Bedhead unit 18
Positioning
13A twin switched socket-outlets
Bedlight control
Bedlight control relay
8 Bedhead lighting 21
Bedhead reading luminaires
Bedhead-trunking-mounted general lighting luminaires
9 Alarm systems 23
Cardiac alarm
Operation
Intruder alarm

vii
Health Technical Memorandum 08-03 – Bedhead services

Operation
Attack alarm
Operation
Transmitter
Receiver
Pocket pagers
Priority of calls
10 Nurse-call systems 25
Patient-to-nurse (non-speech)
Basic call system
Visual signals
Audible signals
Staff-to-staff (emergency)
Emergency switch
Visual signals
Audible signals
Patient’s calling devices
Wall- or trunking-mounted push-button
Hand-held nurse-call-only unit
Pull-cord unit
Other call units
Patient’s handset
Reset switch/indicator lamp
Socket for handset
Staff emergency switch
Parking brackets
Dual control (optional)
Other call-system units
Reset unit
Over-door/corridor lamps
Staff communications base
Indicator – mimic or display
Power control units
Speech system
Staff communications base
Operation
Bedhead services unit
Security of communication
Nurse-presence system
Nurse-presence switch
Visual signals
Additional tone sounders
Speech system
11 Entertainment facilities 33
Entertainment services signal distribution
Television services
Radio services
Headsets
12 Integrated communication services 37
13 Voice and data structured wiring and outlets 39
IM & T
Isolation rooms
14 Medical gas pipeline systems 40

viii
 Contents

15 Matrix of bedhead services by clinical service/location 41

16 References 42

ix
Health Technical Memorandum 08-03 – Bedhead services

x
1 Scope

1.1 Bed spaces and their environment have a significant provided at in-patient areas and bed spaces within
impact upon patient experience and delivery of healthcare premises (hereafter described collectively
care. With patients able to choose their provider of as “bedhead services”).
healthcare service and the increased complexity of
1.3 Other systems (such as intruder or personal attack
clinical techniques and procedures provided at bed
alarms), although not strictly part of a bedhead
spaces, it is now even more important to ensure
unit or used at the bed space, are included within
that bedhead facilities are fit-for-purpose in all
the scope of this document by way of their
respects.
interaction with other bedhead-service systems.
1.2 This guidance covers the management policy for,
1.4 This guidance applies to all new capital projects
operational management of, and design
and whenever refurbishment or repair is required to
considerations for bedhead services. It applies to
existing facilities.
the range of engineering services and equipment

1
Health Technical Memorandum 08-03 – Bedhead services

2 Definitions

Bedhead services: Facilities provided for patients and/or Light emitting diode (LED): A robust solid-state
staff to enable the performance of clinical and patient indicator lamp, ideal for low-powered visual display and
non-clinical functions at in-patient locations. They signalling use.
comprise a fixed installation behind, to the side of, or
Management: The owner, occupier, employer, general
above the bed or trolley position. They can consist of
manager, chief executive, or other person who is
low-voltage electrical supplies, extra low-voltage
ultimately accountable for the safe operation of the
communication systems (for example nurse call and IT
healthcare premises.
systems), entertainment, monitoring facilities and
medical gas outlets. MEIGaN: Medical Electrical Installations Guidance
Note published by the Medicines and Healthcare
Bedhead unit: Permanently installed equipment
products Regulatory Agency (MHRA).
intended to supply electric power and/or medical gases
and/or liquids in medical areas such as general wards and Medical gas pipeline system (MGPS): The fixed
special purpose areas (for example induction rooms, medical gases pipework, the associated supply plant or
recovery wards, critical care areas and intermediate care pumping equipment, and the warning and alarm systems.
areas) – see also the definition of Medical supply unit This definition includes medical compressed air, medical
below. vacuum installations and anaesthetic gas scavenging
systems (AGSS).
Computer network technologies: Technologies that
define the way in which computers, printers and other Medical supply unit: Medical supply units can include
devices are connected, physically and logically, in a medical electrical equipment or systems or parts of such
network. equipment or systems, which might be applied to
diagnosis, therapeutics and communications.
Duplex: (Of speech) designating or pertaining to a
method of operation in which information can be • Medical supply units can consist of modular sections
transmitted in both directions simultaneously between for electrical supply, lighting for therapy or
two points; that is, at both the staff communications base illumination, communication, and the supply of
and the bedhead. medical gases, liquids and anaesthetic gas scavenging
systems.
Electromagnetic compatibility (EMC): Capability of
electrical and electronic equipment or systems to be • Typical examples of medical supply units are known
operated within a defined margin of safety, in the as bedhead services modules, ceiling pendants, beams,
intended operational environment, at designed levels of booms, columns and pillars (refer to BS EN ISO
efficiency, without degradation due to interference and so 11197 Medical Supply Units).
as not to cause interference to other such systems. • Bedhead units (see definition) are an integral part of
Essential: Any part of the electrical distribution and/or medical supply units.
final circuits that can be automatically supplied by mains, Monitored call circuit: A registered alarm call that is
generator or other electrical supplies (see Health activated if the nurse-call handset unit plug has been
Technical Memorandum 06-01 – ‘Electrical services disconnected from its socket or an open circuit cable fault
supply and distribution’ for further guidance). occurs.
GUI: Graphical user interface – a display of text and Simplex: (Of speech) designating or pertaining to a
graphics for ease of use on patient entertainment consoles method of operation in which information can be
etc. transmitted in either direction – but not simultaneously
– between two points.

2
 2 Definitions

SIP: Session Initiation Protocol – for the delivery of Touchdown base: A workstation located close to patients
telephony services over an Internet-protocol based but not within single rooms or multi-bed rooms. It
network. provides a place for accessing and updating electronic
patient records (EPRs) and other computer work. For
Staff communications base: The administrative and
detailed guidance on touchdown bases, see Health
communication centre of a clinical unit.
Building Note 00-03 – ‘Clinical and clinical support
System (communication): A system designed to provide spaces’ and also Health Building Note 04-01 – ‘Adult in-
transfer of information between two or more locations, patient facilities’.
either by direct wiring or by other means. The system will
VoIP: Voice over Internet Protocol network for the
embrace the necessary control units and power supplies.
delivery of telephony services.
System (electrical): A system in which all the electrical
equipment is, or may be, electrically connected to a
common source of electrical energy, including such
source and such equipment.

3
Health Technical Memorandum 08-03 – Bedhead services

3 Management policy/responsibilities

Bedhead services d. Staff-to-staff emergency call systems: to call

assistance from other staff.
3.1 It is the responsibility of management to ensure
that patients and staff are provided with an e. Medical gas outlets: typically oxygen, vacuum
appropriate quantity and quality of bedhead and medical compressed air for patient clinical
services at each in-patient bed space and at other use.
nursing locations to fulfil the patient and clinical f. Facilities for the use of a telephone.
needs at that location for as long as is required.
g. Patient entertainment systems: these include the
3.2 Areas in which bedhead services may be required use of television, radio, audio systems and
include, but are not limited to: Internet broadband facilities.
• adult in-patient wards; h. Patient-monitoring facilities for remote
• critical care areas; indication of alarms.
• emergency admission wards; j. Medical equipment rails: for the mounting and
support of equipment and accessories.
• post-anaesthesia areas;
k. Data points: to enable the electronic provision
• resuscitation rooms; of general trust information, hotel services
• dialysis stations; information and connection to the Internet.
• children’s wards/neonatal units; m. Data points: for the display of picture archiving
and communications systems (PACS)
• mental health accommodation. information and to enable viewing and
3.3 The extent and range of facilities provided by reporting of patient clinical information.
bedhead services will be dependent on the clinical n. Attack alarm security systems: to raise
activity and patient group specific to an in-patient awareness of intruders and summons assistance.
location (see Chapter 15, ‘Matrix of bedhead
services by clinical service/location’). Some p. Cardiac alarm systems: to alert emergency care
examples include (this is not an exhaustive list): teams.
a. Electrical power outlets: to supply equipment q. Nurse presence systems.
and services for clinical and patient use (the 3.4 The bedhead services installed should be reassessed
latter to be at the discretion of the healthcare periodically by management to ensure that they
organisation), including intermittent use of remain adequate for the purpose intended and
medical equipment at the bed/trolley such as perform satisfactorily. The frequency of inspection
mobile X-ray, resuscitation equipment, hoists and assessment will depend on the care provided,
etc. complexity of system, required resilience, and risk
b. Luminaires: for general room lighting, patient to patient and clinical care.
reading, observation, minor examination, night 3.5 Management should ensure that bedhead service
lighting (including their associated controls). systems are designed and installed in a manner
c. Patient-to-nurse call systems: based upon simple which allows the simple and economic adaptation,
“follow-the-light” concepts up to comprehensive amendment, maintenance or addition of services by
systems incorporating speech communication, competent people to reflect changing clinical needs
nurse-presence and pager systems. or variations in clinical use.

4
 3 Management policy/responsibilities

Statutory requirements and functional provided, particularly in relation to nurse-call

systems. Suitable provisions should be incorporated
guidance
into the design and layout of bedhead service
3.6 It is the responsibility of management to ensure input/output devices to enable this.
that their premises and bedhead services are safe, fit
3.14 Part M of the Building Regulations should be
for purpose, and comply with all statutes, relevant
complied with in relation to the provision of
codes of practice and standards.
emergency assistance (nurse) call and reset units for
3.7 Management has an overriding general duty of care wheelchair users, ambulant disabled people, people
under the Health and Safety at Work etc Act 1974. of either gender with babies and small children, or
3.8 Materials, components and completed installations people encumbered by luggage.
should conform as applicable with the current
Exceptions
Standards, including all amendments. Construction
products should comply with European Standards 3.15 The following are exceptions to Part M of the
and Technical Specifications (ESTS). Wherever Building Regulations in respect of emergency
reference is made to a British Standard, a assistance (nurse) call reset units within sanitary
corresponding ESTS (generally ISO series) should spaces.
be equally acceptable.
3.16 Pull cord units: these units should be as described
in paragraph 10.44.
Emergency preparedness
3.17 Patient accommodation areas: call reset units in
3.9 Emergency preparedness and contingency planning sanitary spaces within patient accommodation
for loss of services (for example ventilators) is where clinical staff have responsibility of care
critical to patient care, especially in respect of should be located near to the room entrance door
critical care areas. for clinical staff to operate upon entry to the room.
3.10 It is the responsibility of management to ensure This is to ensure that clinical staff attend the call
that appropriate risk assessments are carried out irrespective of whether the call has been activated
and suitable contingency plans recorded and tested by accident or not (see also Health Building Note
consistent with emergency plans throughout the 00-02 – ‘Sanitary spaces’).
healthcare facility. Reference should be made to 3.18 Non-clinical public areas: call reset units in WCs
Health Technical Memorandum 00 – ‘Policies and within non-clinical public areas should be located
principles of healthcare engineering’. adjacent to the WC as recommended in Part M of
3.11 The healthcare facility may also be designated as a the Building Regulations. This will allow users to
key facility in case of external major incidents, reach and reset the call in the event of accidental
thereby increasing the necessity to sustain bedspace activation; however, each call should still be
services in particular areas. A minimum of two registered and recorded by the system, as is the case
electrical power circuits (normally from the for clinical areas.
essential supply system) should therefore feed a bed 3.19 Call reset units in bathrooms and showers within
space in accordance with IEC 60364-7-710 non-clinical public areas should not be located
(International Electrotechnical Commission) and where they could be damaged by water ingress (see
the guidance given in Health Technical also Health Building Note 00-02 – ‘Sanitary
Memorandum 06-01 – ‘Electrical services supply spaces’).
and distribution’.
Decentralisation of staff bases
Disability Discrimination Act
3.20 In adult in-patient areas, a design option is for staff
3.12 Management should ensure compliance with the bases to be decentralised so that staff can work
Disability Discrimination Act is achieved and locally throughout the ward unit (as advocated in
patients are assessed for their disability during their Health Building Note 04-01 – ‘Adult in-patient
period of care within the healthcare premises. facilities’).
3.13 Appropriate measures should subsequently be 3.21 Please note: For adult in-patient areas, this is
instigated to ensure these patients have access to, only one design solution; planning teams may
and are able to operate, the bedhead services

5
Health Technical Memorandum 08-03 – Bedhead services

still decide to include a central staff base within • Each touchdown base should be capable of
the facility. Notwithstanding the above, the transferring all calls to another touchdown base
central staff base is still considered essential in within the same managed clinical area or to a
critical care areas and in accident and emergency designated touchdown base within an adjoining
facilities. managed clinical area. The same will apply with
regard to acting as a base for receiving
3.22 Irrespective of whether the design concept
transferred calls.
incorporates decentralised bases or retains the
central staff base configuration, it is important that • Each touchdown base should be sufficiently
whenever a call is activated, all relevant staff are resilient and contain adequate standby
alerted and are guided to attend the call as quickly emergency electrical power facilities to continue
as possible by the most appropriate and shortest to operate reliably and normally during loss of
route. mains incoming electrical supplies.
3.23 Where “touchdown bases” are to be provided in • Consideration for repeater units to alert staff
place of a centralised staff base, the following temporarily away from the touchdown base
specific requirements should apply: should be given to any associated shared
facilities such as sluice rooms, staff rest rooms,
• Each touchdown base should incorporate all the
interview rooms etc.
necessary control and indication facilities:
• In circumstances where a relatively large
(i ) for staff to identify and respond to alarms
number of nurse touchdown bases are employed
and calls that emanate from the clinical area
(for example one per bed room or per pair of
served by the touchdown base; and
bed rooms) and where it is uneconomical to
(ii) which are required for communication with provide bedhead service facilities at each base,
other touchdown bases throughout the wider consideration might be given to allocating a lead
clinical area being managed. touchdown base within a chosen cluster group
• For each clinical area served by a touchdown to incorporate the required bedhead service
base, the “follow the light” principles to guide facilities. The chosen touchdown bases operate
staff to the origin of the call should begin at the as described above and should be capable of
relevant touchdown base. alerting all staff within the cluster area
concerned whilst retaining the advantages of
• Patient–nurse calls relating to a specific reduced staff journey times etc.
touchdown base should activate that touchdown
3.24 To reduce travelling time for nurses, avoid wasted
base only – all other touchdown bases associated
with the managed clinical area should remain journeys, and reassure patients who may feel
inactive, or with visual indication only, for a isolated, there may be a need for two-way speech
preset delay period that is adjustable for up to between the patient and nurse, and from nurse to
15 seconds. Should the call remain unanswered nurse in single rooms.
by the activated touchdown base after the preset 3.25 Consideration should also be given to the use of
period, the patient–nurse call should mobile communication devices linked to the nurse-
automatically fully activate other touchdown call system (for example paging, paging with
bases in the same managed clinical area with speech, and digital enhanced cordless
local audible and visual indication. Each remote telecommunications (DECT)).
touchdown base activated should provide
3.26 The pattern of a healthcare facility floor layout may
appropriate visual and audible signals to assist
be such as to make practical a flexible nursing
clinical staff to quickly identify and locate the
arrangement embracing two or more ward areas.
origin of the call.
Where the degree of patient dependency or bed
• Emergency, cardiac and attack alarm calls occupancy varies greatly or regularly, it may be
should automatically and simultaneously advantageous to have the ability to increase or
activate all touchdown bases within the decrease the number of beds covered by the nursing
managed clinical area, with appropriate audible staff.
and visual indication provided to alert and
3.27 Call systems therefore require flexibility to move
guide relevant staff to the origin of the call.
calls from one staff area to another. Where two-way

6
 3 Management policy/responsibilities

speech is used, the transfer facility should include

the transfer of the speech facility.
3.28 See Health Building Note 04-01 – ‘Adult in-patient
facilities’ and Health Building Note 04-02 –
‘Critical care units’ for further guidance on in-
patient care facilities.

7
Health Technical Memorandum 08-03 – Bedhead services

4 Operational policy/management

4.1 To ensure that bedhead services installations remain operation of emergency services and to service/
adequate, safe and reliable, medical nursing and maintain the elements of bedhead services.
administrative action is essential to introduce and
enforce operational policies designed to minimise Validation and verification
the dangers that may arise from misuse. Those 4.4 On completion of the installation of bedhead
policies should ensure that no work, however services or modification of an existing system, each
minor, can be undertaken without the knowledge system should undergo a process involving witness
and permission of the appropriate competent testing to ensure that the systems function
person. correctly, as specified, before handover. All test
4.2 Management should ensure that an operational results should be recorded and held by the
plan is in place for each site under their control. healthcare organisation for future reference. Copies
This should comprise: of manufacturers’ and installers’ as-fitted drawings,
product service manuals, schematics and validation
a. a list and description of the main emergency
and verification certificates should be provided
plant and electrical equipment associated with
along with software programming details, system
the electricity supply;
user manuals and recommended maintenance
b. a list showing the location of essential medical schedules/requirements.
gas supply equipment such as plant and local
4.5 All members of staff who are to operate the various
area control valves;
bedhead systems should be adequately trained in
c. identification of qualified personnel who have their use and operation, including protocols to
received adequate training; ensure the rapid rectification of faults should they
arise.
d. a schedule of maintenance dates for each type of
equipment and where maintenance is 4.6 Subsequent to commissioning, all bedhead services
contracted out, and details of how to call the should be regularly tested and maintained in
contractors to site (including outside normal accordance with the manufacturers’
working hours); recommendations and experience gained over time.
All bedhead service equipment should be easily
e. a control system to monitor performance
accessible for maintenance in order to minimise
against the maintenance plan;
downtime and disruption. Where additional capital
f. an inventory of essential spare parts; to improve the quality of the initial installation has
g. a schedule of possible emergency incidents with the potential to achieve reduced maintenance effort
remedial operational procedures; or time, this should be given due consideration.

h. a routine of staff training in the operation of the Electromagnetic compatibility

various bedhead services;
j. consideration of providing off-site monitoring Electrical interference
of systems for rapid response and minimal 4.7 With the possibility of increased sensitivity to
downtime. electromagnetic interference within the patient
environment due to the many and varied items of
Designated staff functions general or medical electrical equipment utilised
4.3 Only trained, authorised and competent persons around the bed, the requirement for appropriately
should be appointed by management to control the electrically screened containment is paramount.

8
 4 Operational policy/management

4.8 BS EN 60601-1 and Health Technical must meet the EMC requirements of BS EN
Memorandum 06-01 – ‘Electrical services supply ISO 11197.
and distribution’ give guidance on these issues.
Electromagnetic compatibility (EMC) aspects and Electrostatic discharge immunity
compliance criteria for medical supply units are 4.11 Static electricity is potentially a risk to both patients
defined within BS EN ISO 11197. and sensitive electronic components in the patient
4.9 Best-practice methods should be implemented to environment, and measures to minimise the
minimise the risk of malfunction of equipment due potential impact should be included.
to interference. This should take account of the 4.12 To achieve this, the use of floor coverings and bed
quality of internal electrical distribution systems, tyres made with dissipative material should be
the use of mobile phones/portable media players, considered, along with other possible methods
wiring segregation etc emanating from within and agreed with the healthcare organisation.
outside of the bed space.
4.13 Account should be taken of relative humidity
4.10 Particular regard should be given to:
profiles at the bed space and the fact that:
a. identifying and ensuring adequate protection • e lectrostatic discharges can develop between
for sensitive electronic components that require dissimilar materials when rubbed together; and
high levels of immunity against electrostatic and
electromagnetic interference (for example • a rtificial fibres in clothing and bedding
medical devices); materials can produce very high levels of static
build-up.
b. ensuring that the EMC of electronic equipment
or systems is sustainable within the 4.14 Medical supply units, including handsets, should
manufacturer’s defined margins of safety and have an electrostatic discharge immunity sufficient
designed levels of efficiency, without to withstand, without damage, the effects of
degradation due to interference, whilst active in electrostatic discharge that can occur within the
the intended operational environment; environment in which the equipment is expected to
operate. They should, at least, meet the ± 4 kV
c. ensuring that electrical equipment meets the contact discharge and ± 8 kV air discharge
requirements of the Electromagnetic electrostatic discharge tests specified in BS EN
Compatibility Regulations 2006 for both 61000-4-2:1995, IEC 61000-4-2:1995.
emissions and immunity. Medical supply units

9
Health Technical Memorandum 08-03 – Bedhead services

5 Design considerations

5.1 The design and installation of bedhead services Control of infection

should be fully coordinated to provide efficient and
effective services throughout the bed space/nursing 5.6 Planning teams should note the contents of
area for use by patients and staff. Particular account ‘The Health Act 2006: Code of practice for the
should be taken of the varying clinical practices prevention and control of healthcare associated
required to be carried out at the bed space, the infections’ (Department of Health, January 2008).
nursing methods employed, and the patients’ This code of practice sets out criteria by which
expectations and abilities to use the various systems. managers of NHS organisations are to ensure that
patients are cared for in a clean environment and
where the risk of healthcare-associated infections is
System resilience kept as low as possible. The document contains a
5.2 It is essential that bedhead services continue to comprehensive list of the Department’s guidance
operate reliably and safely in service, particularly on the prevention of healthcare-associated
nurse-call systems and other important alarms. infection.
5.3 Specific attention should therefore be made to 5.7 Bedhead services are located in the patient
ensure that the risk of failure of critical systems environment, which can present a risk of
such as cardiac arrest calls, attack alarm systems, healthcare-associated infection.
emergency calls, electrical sockets serving medical
5.8 Informed by an assessment of the clinical risk
devices, and medical gas pipeline supplies is
associated with the patient and clinical activity, the
minimal.
design and installation of bedhead services should
5.4 With regard to the provisions recommended for the take account of control of infection issues and
protection against: incorporate adequate measures to minimise that
• loss of electrical supplies, refer to Health risk so far as is practicable. Where gaps appear
Technical Memorandum 06-01 – ‘Electrical between bedhead trunking systems and the wall,
services supply and distribution’; these should be sealed with a suitable substance to
control the propagation of bacteria.
• loss of medical gas pipeline systems, refer to
Health Technical Memorandum 2022 – 5.9 All exposed surface finishes should be generally
‘Medical gas pipeline systems’; smooth, accessible and easy to wipe clean.
5.10 Sloped horizontal surfaces are less likely than flat
• loss of services to medical devices, see the
Medicines and Healthcare products Regulatory horizontal surfaces to harbour large amounts of
Agency’s (MHRA) ‘Medical Electrical dust deposits. Where possible, bedhead services
Installations Guidance Note’ (MEIGaN). equipment that is regularly handled by the patient,
such as radios and TV headsets, should be capable
5.5 It is important that bedhead services are suitable for of being disinfected or sterilized between patient
the purpose intended and the environment in use or be of the disposable type, whichever is the
which they are to operate. Specific attention should most economical method to adopt (for further
also be made to ensure that the resilience of guidance, see Health Facilities Note 30 – ‘Infection
bedhead services which use a common control in the built environment’).
infrastructure, such as an integrated
communication data highway, is sufficiently robust Fire precautions
in terms of software reliability and in the event of
loss of normal electrical supply to prevent false 5.11 The design and installation of bedhead service
operation or loss of the bedhead services. equipment should be in compliance with the

10
 5 Design considerations

requirements of Firecode such that the risk of a fire emergency situations. With regard to the clinical
and/or damage and disruption caused due to faulty functions likely to be undertaken at the bed space,
equipment and its installation is minimised. the decision to locate clinical elements of bedhead
services should take into account clinical risk, ease
5.12 Where practical, low-smoke-and-fume (LSF)
of access, safety and ergonomic efficiency.
halogen-free electrical cables should be used in
conjunction with non-flammable materials. 5.17 The “clinical zone” should be the area where most
of the clinical functions/activity are controlled from
Design flexibility and should encompass the patient chair. Variances
in clinical practice between projects and between
5.13 Owing to the improving and evolving nature of
departments should be considered, and any
healthcare facilities, it is important to have in-built movement of furniture should not result in
flexibility of service provision at the bedhead. bedhead services being obscured. Reference to the
Where a room undergoes a change of use, the Department of Health’s research and development
system should be capable of seamlessly changing document entitled ‘Lighting and colour for hospital
the nurse-call facility within that room both from a design’ on the contribution of natural light to the
software and from a hardware point of view. For healing process should also be considered when
example, if an emergency unit needs to change to a determining where the patient will sit and their
cardiac unit, the software and interchangeability of ease of access to the bedhead services.
the components should be such that there is
minimal disruption to the installation in terms of
wiring and plate and enclosure sizes (some systems
Bedhead services layout/configuration
have common apertures for their clip-in 5.18 The layout/configuration of bedhead services
components to facilitate this). To allow such equipment should be designed and installed to:
interchangeability, all legends and instruction
• be ergonomically efficient, providing good
wording (such as “emergency”) should be applied
accessibility to both patients and clinical staff;
to the nurse-call component and not the plate.
• reflect as compact an arrangement as possible in
Clinical flexibility order to maximise the space available for clinical
and patient activity around the bed space/
5.14 Flexibility of clinical function at the bedhead is key nursing area;
to modern healthcare protocols. The provision of
all services on one side of the bed in order to • allow the speedy and economic adaptation,
propagate single-sided nursing should therefore be amendment, reconfiguration or addition of
avoided wherever possible. (Conversely, services services by competent people to take account of
should not be duplicated either side of the bed.) changing clinical functionalities or variations in
clinical or patient needs;
Note • be integrated as much as possible to provide a
In critical care areas (see Health Building Note 04-02 neat and tidy arrangement that ensures that the
– ‘Critical care units’), provision for treatment from risk of harm arising from accidental trips over
both sides of the bed may be necessary. loose cables and/or contact with articulated
overhead equipment support arms is minimal.
5.15 However, where circumstances dictate that it is The use of purpose-designed and manufactured
practical to provide services on one side of the bed trunking systems and suitable articulated arms
only (due, for example, to constructional to provide coordinated support access to
arrangements), consideration should be given by bedhead services may be considered to aid this
clinical staff as to which side the bedhead services process;
should be located at. • be readily accessible for maintenance so as to
5.16 The chosen locations of bedhead services should, minimise downtime and disruption.
wherever practical, be made consistent throughout 5.19 Provision should be made to prevent the bed or bed
the ward or clinical functional unit in order to help attachments damaging the bedhead services
staff to memorise alarm activation point positions equipment while the bed is being moved, raised or
and to minimise the potential for confusion during

11
Health Technical Memorandum 08-03 – Bedhead services

lowered (for example to provide some means of loudness to ensure high priority attention is
buffering fixed to wall, bed or floor). achieved from staff at the signal-receiving positions
(see also paragraphs 10.10 and 10.23).
5.20 This protection could be mounted as a separate
system so as to prevent interference to bedhead 5.24 All signal indicators and backplate assemblies,
service delivery systems such as trunking or vertical together with sign notations, should provide
containment systems. adequate colour contrast and tactile markings to
ensure that the visually impaired and hard of
Controls and markings hearing can locate and distinguish the relevant call
device.
5.21 All controls and alarm activation points associated
with bedhead services equipment should be 5.25 As stipulated in Part M of the Building
adequately marked with symbols and/or text in a Regulations, the difference in light reflectance value
manner that enables patients and staff to readily between (i) control switches and reassurance
understand its function and operate the device with indicator lights and (ii) surrounding surfaces should
minimal training. Labels should be sufficiently be not less than 30 points. Detailed guidance
robust to withstand the normal use to which the provided by BS 8300 should also be taken into
equipment is likely to be exposed during its account with regard to the appropriate choice of:
serviceable life without degradation to the point • surface finishes;
where it becomes illegible. User manuals sufficient
to explain the operation of the system(s) to patients • visual, audible and tactile signs; and
and staff should be made available as necessary. • the characteristics and use of hearing
Where possible, the markings should be on the enhancement systems.
controls and not on the plates associated with them
in order to ensure interchangeability and flexibility. 5.26 The colours for alarm panels and reassurance lights
associated with a call are shown in Table 1.
5.22 The use of standardised colours to help users
distinguish different functional devices is 5.27 Audible and visual alarm signal rates that should be
encouraged. Conventionally, call activation buttons used are shown in Table 2.
associated with: 5.28 The tone frequency of emergency calls, cardiac calls
• patient–nurse calls are orange; and controlled drugs cupboard alarms should be
different, with cardiac calls having the highest
• emergency staff–staff calls are red; and frequency, followed by emergency calls, then
• cardiac calls are blue. controlled drugs cupboard calls having the lowest
frequency.
Visual and audible alarms 5.29 Audible signals associated with attack alarm systems
5.23 Visual and audible signals associated with bedhead should take account of the healthcare facility’s
service alarm systems should be distinguishable security alarm policy to ensure the signal is
from all other call systems within the clinical area appropriately coordinated with this policy and
concerned and be of sufficient luminance and other security alarm signals present on the site.

12
 5 Design considerations

Table 1 Recommended colours for alarm switches and reassurance lights associated with a call

Colours
Patient call switch and indicator Amber
Patient call reset switch and indicator Light grey
Staff presence switch and indicator Green
Over-door indicator Amber a
Emergency nurse-call switch Red
Cardiac alarm switch Blue
Intruder/attack alarm switch Black
Controlled drugs cupboard indicator Red (including remote indicators)
Door entry call switch and indicator Yellow
Equipment fault indicator b Brown
Notes:
The pull-cords associated with patient calls should be red as stipulated in Part M of the Building Regulations.
a This is a single light that covers all calls.
b Where possible, nurse-call systems should be capable of automatically identifying that a fault(s) is present on the system which
will impair its normal operation, irrespective of whether an alarm is present or not. The presence of a fault should be indicated
on the relevant staff communications base panel by means of a brown light, labelled “equipment fault”, which should remain
illuminated until the fault(s) is cleared. Where fault identification is installed, the system should, if required, be able to
automatically communicate the fault condition, together with as much detail as possible, to other systems in order to quickly
alert maintenance staff. A suitable means should also be provided on the staff communication panel to adequately mute
audible alarms arising from the fault(s) which cannot be reset and silenced locally at the source of fault.

Table 2 Audible alarms and indicator lamp activation periods

Time audible alarm Time audible alarm Period Indicator Lamp

Alarm in order of priority ON OFF ON/OFF
(seconds) (seconds) (seconds)
Cardiac alarm 0.25 (dual tone) 0.25 (dual tone) 0.25 on; 0.25 off
Intruder/attack alarm Variable tone Variable tone 0.25 on; 0.25 off
Staff emergency call 0.5 (dual tone) 0.5 (dual tone) 0.5 on; 0.5 off
Bathroom, shower and WC call 1 3 Steady
Patient call 1 9 Steady
Controlled drugs cupboard 1 20 1 on; 20 off
Staff presence n/a n/a Steady
Notes:
The visual and audible indication associated with alarms that have a higher priority should override any calls on the system that
have a lower priority. When a higher priority call has been cleared, any lower priority calls should automatically be re-established
on the system until all calls have been cleared. See also paragraph 9.25.
Tones should operate within the frequency range of 500–1000 Hz.

13
Health Technical Memorandum 08-03 – Bedhead services

6 Bedhead service installation

6.1 The degree of engineering necessary to provide Trunking systems

bedhead services will be influenced by the method
of building construction adopted together with the 6.8 The design of a bedhead services trunking system
number of services and whether the installation should be in accordance with BS EN ISO 11197.
involves new or refurbishment work. Key features should include the following:

6.2 Supporting bedhead services and ancillary medical • The construction of the trunking should
equipment on or in lightweight walling minimise the effects of electrical interference.
construction consisting of composite studwork • The design of the trunking should have
partitions will require a totally different approach minimal horizontal surfaces and promote high
to solid brick/blockwork walling. standards of infection control with surfaces that
6.3 Many items of wall-mounted medical equipment are easy to wipe clean.
have maximum loading requirements, and the • The front surfaces of the panels should generally
method of wall construction adopted must be show no fixing device used to attach
coordinated to accommodate these requirements. components to the panels, nor should there be
6.4 Where practical, fixed bedhead equipment, any obvious blemishes resulting from such
accessories and services should be flush-mounted or fixings.
hidden to minimise exposed parts that could • The controls on bedhead services panels should
increase the risk of healthcare-associated infection. be easy to use. They should be marked by
Where this is uneconomical or impractical, suitably adequately sized engraving, silk-screening or any
sealed bedhead services should be contained within other indelible labelling method; the colour of
linear surface-mounted metal trunking systems. the marking should be in bold contrast to the
6.5 For new and major refurbishment and where the panel colour.
bedhead services requirements are minimal, the • The trunking systems should be
installation may employ flush boxes and conduits corrosionresistant and be available in a variety of
set into the wall structure and connected into the colours and finish options.
ceiling void at each bed position.
6.9 When choosing an appropriate system,
6.6 Where the extent and volume of bedhead services is consideration should be given to those systems that
significant, the method of installation described provide services which are accessible from either
above may become complex and uneconomical and side of the bed.
could constitute an unacceptable weakening of the
building fabric. In such cases, surface trunking Linear horizontal trunking
systems should be considered as a suitable
6.10 A linear horizontal bedhead services trunking
alternative.
system is a recognised method of accommodating
6.7 Where purpose-built ducting systems are installed, bedhead services for the following reasons:
they should comply with the requirements for
• It allows easy access from both sides of the bed.
medical supply units defined within BS EN ISO
11197. • Management of equipment cabling and tubing
is easier in a linear form.
• Modifications or changes in required positions
of bedhead service equipment along the
trunking length should be easily carried out.

14
 6 Bedhead service installation

This is particularly useful where the type of • Riser sections (where used) can be set away from
nursing may change with time. the corner of the wall to enable adequate access
for maintenance and cleaning.
• Electrical and gas connections can be fed in at
one point, usually at one end of the run of • Accessibility for maintenance and service is
trunking. This can be fed from the rear of the convenient in accordance with product
trunking system or via a specific standards and recognised codes of practice.
multicompartment vertical riser or dropper that
• Horizontal trunking systems can be supplied
is a designed component of the overall trunking
completely pre-piped and pre-wired and
system.
factory-tested where the nature of the
installation is suitable.
Figure 1 Typical elevation on bedhead showing horizontal trunking

2
6b

6a 5
6a
6b

1 1.8 m
minimum for

6a
luminaire
Mounting height 1000 1.8 m
for medical minimum
equipment rail. for
700 3 3 trunking
mounted
given for options, luminaire
but siting on one 400
side of the bed 4
will be by local
preference

Note:

Key:

1. Horizontal bedhead services trunking with a range of accessories to suit.

2. Surface trunking rising to ceiling void.

3. Medical equipment rail.

4. Low level socket for electrical bed supply.

5. Patient entertainment system – maybe separate as indicated or integral within bedhead services
trunking.

6a. Options for patient reading light:

6b. Options for room lighting:

15
Health Technical Memorandum 08-03 – Bedhead services

Vertical trunking units 6.12 Where a vertical solution is installed, its flexibility,
adaptability, ease of maintenance and accessibility
6.11 Vertical units may be used for bedhead services
should be no less than that of a horizontal system
provision where the constructional arrangements of
and should be in accordance with BS EN ISO
the particular facility do not encourage the use of
11197.
linear horizontal containment. However, due to the
limitation of single-sided nursing offered by vertical 6.13 The ability of vertical units to significantly vary the
solutions, they should generally only be used in heights of services outlets will have to be considered
cases where it is preferred by nursing management carefully in context of the patient, user safety and
or where the constraints of the building’s design clinical service requirements.
dictate otherwise.

Figure 2 Typical elevation on bedhead showing vertical trunking

2
6b

6a 5

1 6a

1.8 m
Mounting height 1000 minimum
for medical
equipment rail.
700 3 3
Three levels are
given for options,
but siting on one 400
side of the bed 4
will be by local
preference

Note:
In specialist locations where the quantity of sockets required can be high (for example critical care
areas) and there is a requirement to serve equipment near the foot of the bed space, consideration
should be given to installing ceiling-mounted pendants close to the equipment.

Key:

1. Vertical bedhead services trunking with a range of accessories to suit.

2. Surface trunking rising to ceiling void – component part of 1 above.

3. Medical equipment rail.

4. Low level socket for electrical bed supply.

5. Patient entertainment system – maybe separate as indicated or integral within bedhead services
trunking.

6a. Options for patient reading light:

• Trunking-mounted articulated arm;
• Wall-mounted (independent).

6b. Options for room lighting:

• Wall-mounted (independent).

16
 6 Bedhead service installation

Plastic enclosures/ducting
6.14 The use of plastic enclosures/ducting and surface
cabling for bedhead services installations is not
recommended. The stringent requirements of EMC
legislation need to be met, and the use of metal
installation components enclosing wiring and
equipment will contribute significantly to this end.
EMC requirements of medical supply units are
defined within BS EN ISO 11197 and Health
Technical Memorandum 06-01.

17
Health Technical Memorandum 08-03 – Bedhead services

7 Bedhead unit

7.1 Bedhead units and medical supply units provide 13A twin switched socket-outlets
the main base component from which a number of
bedhead services are delivered to the bed space or 7.7 An adequate number of 13A twin switched socket-
nursing area, particularly with regard to electrical outlets (with fused plugs) complying with BS 1363
socket-outlets, nurse call and bedhead lighting should be installed as part of the bedhead services
controls. Patients’ handsets are normally connected to supply electrical power to the various items of
to a socket on the bedhead unit. non-clinical equipment and obviate the need to use
extension leads. These should be positioned and
7.2 Bedhead services provided from bedhead units may coordinated with other bedhead services equipment
be provided by a variety of concepts such as: to provide a safe and efficient layout with minimal
• individual accessories mounted within the wall; exposed cable.

• a dedicated bedhead panel containing the 7.8 A sufficient number of these outlets should also be
accessories; provided to power fixed and mobile medical
electrical equipment, including sockets mounted at
• dedicated units mounted within a medical low level to serve electrically operated beds.
supply unit.
7.9 The design specification should ensure that in
7.3 Whichever concept is adopted, it should be clinical areas all power supply circuits are served
possible to electrically isolate any number of from two essential supplies in accordance with the
bedhead panels in any combination for removal guidance in Health Technical Memorandum 06-01
and maintenance purposes whilst retaining full – ‘Electrical services supply and distribution’.
operation of other bedhead units and bedhead
services that form part of the same system. 7.10 Socket-outlets installed on an essential supply
should be readily identifiable if they are installed
7.4 The bedhead services system should be along with outlets from a non-essential supply.
ergonomically designed and robust, with all Outlets from an uninterruptible power supply
exposed surfaces having an appropriate ingress (UPS) and isolated power supply (IPS) should be
protection (IP) rating (see BS EN 60529) suitable further identifiable and distinguishable.
to enhance the control of infection and prevent
danger or malfunction due to fluid spillage. 7.11 In locations where a power circuit is supplying
equipment that is considered essential to life,
Positioning consideration should be given to these outlets being
unswitched. In areas containing equipment that is
7.5 A bedhead unit or accessories mounted on the wall considered essential to life, such circuits should be
or mounted within medical supply units and to the backed up by a monitored UPS in accordance with
side of the bed is a convenient means of providing the guidance in Health Technical Memorandum
the electrical services that will be required by both 06-01 – ‘Electrical services supply and distribution’.
patients and staff. Units located central to the bed
7.12 All circuits in the same room should be from the
space generally do not provide the same degree of
access and ergonomic efficiency. same phase.
7.13 Socket-outlets and switches should not be installed
7.6 Raising, lowering or tilting a bed or trolley should
not obscure or damage any bedhead services within a 200 mm radius from the centre of a
provision or any components inserted or attached medical gas terminal unit.
to such services outlets. This may be aided by the
installation of a bedhead buffer.

18
 7 Bedhead unit

7.14 Where socket-outlets are panel-mounted, they 7.22 Where other luminaires are intended to be switched
should allow for full plug insertion as required by from the bedhead, additional lighting controls
BS 1363-2. should be provided as part of the bedhead services
provision.
7.15 To ensure protection of patients from electrical
hazards, additional protective measures are 7.23 Dimmable fluorescent lamps will require
recommended in the relevant parts of IEC 60364- interfacing with a momentary switch. Such lamps
7-710. Areas of patients’ activity are grouped into: should be capable of being dimmed anywhere
between 1 and 100% of their total lumen output.
• Group Zero – medical location where no
Where used, tungsten filament lamps can be
applied parts are intended to be used;
dimmed by the use of a capacitor within the
• Group 1 – medical location where applied parts lighting circuit.
are intended to be used both externally and
7.24 Compact fluorescent lamps (anglepoise type)
partly internally;
generally require a 20A double-pole switch as part
• Group 2 – medical location where applied parts of the bedhead services and are further controlled
are intended to be used in applications such as by a switch located on the luminaire head. Energy-
intracardiac procedures, operating theatres and efficient lamp sources should be encouraged (see
vital treatments. CIBSE’s ‘LG2: Hospital and health care building
7.16 In critical care areas, bedhead services may require lighting guide’ 2008 – hereafter referred to as
IPS and UPS systems to be installed. CIBSE’s Lighting Guide (LG) 2 2008).
7.25 A bedlight fused connection unit complying with
7.17 All sockets should have clear circuit labelling for
nursing staff use as well as technical staff. BS 1363-4 should be fitted if:

7.18 Certain sockets may require specific protection

• power for the reading lamp is derived from the
against the ingress of liquids (for example in wet 13A socket wiring via a flush-mounted fuse
areas or in children’s play areas). Such ingress can carrier; and
be assessed by reference to the IP code of the • the fuse carrier:
product assembly, which is defined in BS EN
(i) is suitable for use on a 32A ring main; and
60529.
(ii) incorporates a 3A fuse to BS 1362 which is
Bedlight control replaceable from the front of the panel. The
panel should be marked with the word
7.19 Depending upon the type of local bedhead light “Bedlight”.
specified, this will dictate the type of control to be
provided. Low-energy lighting is preferred,
provided that the colour-rendering properties of
Bedlight control relay
the lamp are acceptable for the clinical use to which 7.26 Where two-way switching of the bedlight is
the light may require to be used in service. required between the bedhead services control
switch and the nurse-call handset, this is normally
7.20 A bedlight control switch complying with BS EN
facilitated by a bespoke nurse-call system relay.
60669-1, BS 3676-1 should be fitted as part of the
bedhead services provision. This switch should be a 7.27 The relay provides the means to switch the low
flush two-way three-position rocker type and voltage (LV) bedlight on and off from the patient’s
should be clearly labelled to indicate its function handset via a PELV (protective extra low voltage)
and operation (for example “Dim–Off–Bright” or control section of the bedhead panel while the
“Bedlight” – the latter where 1–100% dimming is bedlight control switch is in the “Bright” position.
available).
7.28 There are varying methods of luminaire control,
7.21 The switch, when connected to the selected which will be influenced by the lamp source
luminaire, must be able to control the power adopted/specified.
supply to the luminaire and the dimming function.
7.29 Where fluorescent lamps are used within the
If lighting is to be used to aid clinical activities, the
bedlight luminaire, they should be capable of being
provision of an essential power supply should be
dimmed from the nurse-call handset by means of
considered.
momentary switches or other suitable means to

19
Health Technical Memorandum 08-03 – Bedhead services

enable the patient to vary the light output (see 7.31 For all other types of lamp, the relay should operate
paragraph 7.19, ‘Bedlight control’). in the same manner, thus allowing two-way
switching and dimming from the bedhead switch
7.30 In circumstances where a tungsten lamp is used
or the patient–nurse call handset via the relay.
within the bedlight luminaire, the nurse-call
handset should be capable of operating the
luminaire only when the bedhead-mounted switch
is in the “Bright” position.

20
8 Bedhead lighting

8.1 Bedhead lighting has a significant effect on the • ceiling- or wall-mounted luminaires with
patient experience and the environment in which combined direct/indirect distribution;
staff work. Recommendations for bedhead and
• linear luminaire integral to a linear medical
ward lighting, including required colour-rendering
supply unit.
properties for clinical quality, can be found in
CIBSE’s LG2 2008. In addition, further guidance
can be found in BS EN 12464-1. Reference should
Notes
also be made to the Department of Health’s Adjustable-arm luminaires may have bacterial and
‘Lighting and colour for hospital design’ on the infection-control issues associated with them. In
contribution of natural light to the healing process. addition, the aesthetics of such luminaires will not
always be beneficial to certain environments; their use
8.2 There are varying illumination requirements at, or
also increases the chance of clashing with some patient
by, the bed which may not necessarily be provided
entertainment equipment.
by the same luminaire and which will vary among
clinical departments. At staff communications bases Different lighting options may be best suited to
or touchdown bases, appropriate task lighting may different clinical departments. Integrated luminaires or
be required to enable staff to monitor and operate ceiling-mounted luminaires may be the best solution
the various bedhead services alarm and control in paediatric in-patient accommodation.
systems located at that position.
Ceiling-mounted luminaires should not be installed
8.3 Bedhead lighting is required to provide the directly above a patient’s head, and viewed luminance
following functions/tasks: levels (glare), as stated in CIBSE’s LG2 2008, should
be met.
• observation lighting;
• minor procedures lighting; 8.5 Where bedhead lights are specified and mounted
• patient reading; integral or onto linear medical supply units, these
luminaires should provide the required illuminance
• general bedroom lighting; whilst allowing for any shielding of the patient’s
• watch lighting; head and shoulders.

• night-time lighting; 8.6 Where such luminaires are installed in trunking

along with medical gas pipelines and associated
• clinical procedures – examination lighting. terminal units and/or where integrated general
8.4 In order to achieve the above, a minimal number of room luminaires are also installed in a similar
luminaires should be provided, each designed to manner, the requirements of both CIBSE’s LG2
fulfil one or more of the various functions/tasks. 2008 and the guidance given in Health Technical
The luminaire types and configuration should Memorandum 2022 – ‘Medical gas pipeline
include the following methods: systems’ should be complied with, including the
control of glare for patient comfort and safety.
• articulated adjustable-arm-type luminaire
mounted to the medical supply unit or directly
to the wall;
Bedhead reading luminaires
8.7 Bedhead luminaires designed for use by patients to
• fixed/limited movement luminaire mounted
read and by clinicians to carry out night
above the bedhead;
observations etc should be manufactured to BS EN
• ceiling-mounted luminaires, surface or recessed; 60598-2-25:1995, IEC 60598-2-25:1994. They

21
Health Technical Memorandum 08-03 – Bedhead services

should be designed to reduce the incidence of of control. In addition, having a controlled variable
bacteria build-up and should support ease of output will help patients and staff retain visual
cleaning with minimal horizontal surfaces. acuity at various times of the day.
8.8 Luminaires should only be used for the purposes
for which they are designed. Lamps within such Bedhead-trunking-mounted general
luminaires should be suitably protected to prevent lighting luminaires
damage or an explosion occurring if accidentally 8.13 Bedhead luminaires designed to support general
splashed with liquids. Any damage or explosion room illumination should comply with CIBSE’s
resulting from such an incident should not put the LG2 2008 and comprise suitably mounted and
safety of individuals at risk. arranged luminaires to ensure that the specified
8.9 Energy-efficient fluorescent (or other) lamps should illumination levels and colour-rendering
be used in preference to incandescent GLS (general requirements are appropriate for the clinical
lighting service) lighting, with appropriate environment being illuminated.
colourrendering properties for clinical use and 8.14 For display screen equipment, refer to CIBSE’s
dimming facilities, when required. LG3 – ‘The visual environment for display screen
8.10 Examination luminaires should be manufactured to use’.
BS EN 60598 Part 2.25. 8.15 Account should be taken of the need to comply
8.11 Where patient observation is required at night, it is with BS 5266-1 and the requirement to ensure
necessary to provide a small amount of light at the patient safety during periods of electricity-supply
bedhead (see CIBSE’s LG2 2008). This may be failure.
achieved by dimming the reading luminaire. 8.16 Some horizontal linear bedhead services trunking
Dimming of fluorescent lamps within reading systems are designed to incorporate uplight
luminaires is normally the most economical systems, which can act as a supplementary source
method, and can contribute towards improving of general illumination for the in-patient area.
energy efficiency and the patient experience and
towards aiding clinical functionality at the bedhead. 8.17 For cleaning and infection-control purposes, the
The use of incandescent GLS lamps should be luminaire should be easy to clean and ideally have
avoided where possible. no ledges or ridges where dust can gather.
8.12 A dimming range of between 1 and 100% of a light 8.18 Emergency lighting provision should be designed
source’s total output will generally satisfy the and installed to meet the requirements of
requirements for energy management and flexibility BS 5266-1.

22
9 Alarm systems

Cardiac alarm should be provided to discriminate the alarm. In

the latter case, both emergency calls and intruder
9.1 Where a cardiac alarm system is required to alert an alert calls should be able to operate simultaneously.
emergency care team, it should be initiated by a
special switch installed at the bed position as part 9.7 Where specified, additional visual and audible
of the nurse-call system (see Chapter 10). alarm signals should be provided to alert staff at
other locations (for example adjacent wards,
9.2 The cardiac call should register at a permanently hospital switchboard, porter’s room, security
staffed centre from where the emergency care team room).
can be alerted and directed by telephone, pocket
pager or other means.
Attack alarm
Operation 9.8 In certain clinical areas such as Accident and
Emergency departments and mental health wards,
9.3 Operation of the cardiac alarm switch should
staff can become subject to attack; therefore, it may
indicate the local call system with the
be appropriate to install a personal-attack alarm
accompanying lamps and sounders. The lamps and
system.
sounder operation should not be the same as those
for an emergency call (see paragraph 5.21, 9.9 A personal-attack alarm system should be designed
“Controls and markings” and paragraph 10.23, to alert security and other personnel to render
“Staff-to-staff (emergency)”). A separate sounder immediate assistance to staff located within an area
operation should be used to discriminate the type who have become subjected to an attack.
of call. The cardiac call will override all other calls
on the system, which will be stored and reinstated Note
when the cardiac call is cancelled.
Consideration should be given to connecting the
9.4 Cancellation of a cardiac alarm will be achieved by attack alarm to the closed-circuit television (CCTV)
returning the alarm switch to normal. Typical system.
switches would be a pull-on/push-off blue switch
that is similar in construction to the emergency 9.10 The personal-attack alarm system should be
switch (see paragraph 10.23). It should be indelibly designed to be as reliable and resilient as possible
marked “Cardiac Pull”. and, where necessary, should contain an integral
power supply to sustain operation during periods of
Intruder alarm loss of normal electricity services. Where radio
signals are used, these should be strictly managed
9.5 The purpose of this alarm, when required, is to
and controlled to ensure that the limiting
alert security and other staff to the presence of an
parameters such as frequency, signal strength and
unauthorised person in the ward or nursing area.
range as laid down by the manufacturer and
Consideration should be given to the location of a
statutory authorising bodies are not exceeded.
concealed switch that operates the alarm.
Where infrared-only signals are used, account
should be taken of the “line of sight” and blocking
Operation
of signals through obstacles, clothing, body etc.
9.6 Operation of the intruder alarm switch should
activate the local nurse-call system. The lamps and Operation
sounder operation should either be as described for
9.11 Attack alarm systems generally consist of a portable
the emergency call (see paragraph 10.23), or
transmitting device worn by staff plus a receiver at
alternatively a separate sounder/lamp operation

23
Health Technical Memorandum 08-03 – Bedhead services

which the transmitter signal is received and 9.19 Transmitting devices should be reliable and capable
transferred to a central indicator unit situated at a of being worn by staff such that they can be
permanently staffed position. When attacked, the activated quickly whilst under attack. The
member of staff will activate the transmitting transmitting device should be of robust
device which – via the receiver – will register the construction and produce a suitable visual/audible
location of the attack at the permanently staffed warning signal to staff whenever its power source is
position. Staff at this position will immediately reaching a point at which it cannot be relied upon
alert security staff/the staff response team to go to to operate satisfactorily. Once activated, the
the location of the attack. warning signal should allow the device to
satisfactorily operate for at least 12 hours before the
9.12 Once an attack call has been initiated, a visual and
power source is replenished.
audible sounder should operate in the immediate
area or remotely (subject to local policy) in order to Receiver
alert other staff to give assistance to the member of
staff being attacked, and to help deter the attacker. 9.20 The system should be able to identify, as accurately
The level of sound/visual alarm should be sufficient as possible, the location at which the attack alarm
to be heard but not so loud as to prevent verbal was triggered, and not be confused with calls
conversation/instructions between staff. The system emanating from other areas. This should be
should be reset remotely and not via the achieved by suitably-placed receiver units, or other
transmitting device. communication devices, alarmed back to the
central indicator unit that is situated at a
9.13 The period between activation of the transmitting
permanently staffed position.
device and alerting of security staff/the staff
response team should be as short as possible.
Pocket pagers
9.14 Activation of the signal-transmitting device by staff
9.21 Where required, pocket pagers should be provided
being attacked should cause the immediate
to sound and display alarm calls in circumstances
provision of visual, audible and staff location details
where staff need to respond to a call but are beyond
to be displayed at the permanently staffed position.
earshot of the various alarm call tones generated
The system should be capable of recording the staff
within a specific clinical area.
reference, time and location of the attack and
should handle up to three multiple calls 9.22 The staff base unit within the clinical area should
simultaneously. be linked to a transmitter to initiate the relevant
call signal to be received by the pocket pager(s).
9.15 Visual and audible signals associated with an attack
The time between activation of a call and display
alarm should be distinguishable from all other call
on the pocket pagers should be minimal.
systems and be of sufficient luminance and
loudness to ensure high priority attention from 9.23 The information displayed by the pocket pager
staff at the signal-receiving positions (see paragraph should be sufficient for the recipient to clearly
5.21, “Controls and markings”). identify the type and origin of the call and quickly
progress directly to the call location.
9.16 A multiple mode system should be used to report
the attack location and to raise a general alarm. A 9.24 Where more than one clinical area operates a
failure of one of these signals should not prevent a pocket pager system, the pocket pager system
response to the alarm. should be designed to ensure that it operates
reliably, with calls emanating from a clinical area
Transmitter being retained exclusive to that area and not
9.17 This should comprise a suitable transmitting device wrongly received by another clinical area.
worn by staff, or located at specified strategic
Priority of calls
points, that will activate the attack alarm system
when triggered. 9.25 Pager signals should differentiate between other
types of call. The types of call in order of high to
9.18 Body-worn alarm-raising transmitter units should
lower priority are: cardiac alarm, attack alarm, staff
be supplemented by wall-mounted push-buttons
emergency call, bathroom/WC call, and patient
where additional protection is required.
call.

24
10 Nurse-call systems

10.1 The ability for patients to summon nursing equipment, including the use of symbols to avoid
assistance at the bed space or nursing location, and confusion.
for clinical staff to communicate remotely with the
10.9 Where staff are responsible for the adjacent ward or
patient and with each other, is an essential lifesafety
wards (for example during the night), it is advisable
component of bedhead services.
to incorporate a transfer system whereby any calls
10.2 A variety of systems are now available, collectively from the adjacent ward or wards are enunciated at
known as “nurse-call systems”, and include: the staff communications base. Examples of typical
call-system arrangements are given in the rest of
• patient-to-nurse (non-speech) calls;
this section.
• staff-to-staff (emergency calls).
10.3 Nurse-call systems should be designed to be Patient-to-nurse (non-speech)
resilient, fault-tolerant and easy to maintain. It
should be possible for the system to log all of the Basic call system
calls/events and provide detailed history reports 10.10 Patients require this facility to call for nursing
when required. support.
10.4 Systems vary from a simple pear-push employing a 10.11 A basic call system relies on the “follow-the-light”
“follow-the-light” concept to extensive speech concept and consists of the following elements:
communication systems, nurse-presence
monitoring and auto-paging systems. The level of • a means for the patient to make a call;
sophistication will vary depending on the clinical • a device for latching or maintaining the call
specialty and particular project brief. until it is cancelled;
10.5 The majority of accessories for calling assistance • a means of resetting the call;
(for example in bathrooms and WCs) are very
• a lamp to reassure the patient that the call has
similar irrespective of complexity of the system, and
been made;
it is mainly the bedhead handset or local equipment
that will vary. • an indicator at the staff communications base
to indicate that a call has been made;
10.6 It is important that there is no risk of confusion
between audio/visual signals from the various types • a lamp or lamps along the route between the
of nurse-call system and other systems or in-built staff communications base and calling point to
medical device alarms. Similarly, the audio and guide staff to the source of the call as quickly
visual signals should not interfere, or cause and efficiently as possible;
operational difficulties, with other systems such as
• an audible tone until the call is cancelled;
fire alarm systems, IT or telecommunication
networks. • a power supply and control unit.
10.7 The sound level of audio call signals should be Visual signals
within statutory safety limits and at least 5 dB
above background noise levels sufficient to enable 10.12 A patient call will be initiated by operating a push-
hospital staff to hear the call whenever activated button on the handset, a wall-mounted push
(see also Health Building Note 08-01 – ‘Acoustics’). button in areas such as dayrooms, treatment rooms
etc, or by pull-cord switches in toilets, bathrooms,
10.8 Symbols and language issues should be considered
showers etc. Combined within, or in close
to help patients to understand how to operate the

25
Health Technical Memorandum 08-03 – Bedhead services

proximity to, these calling devices, a reassurance 10.22 The tone sound should be reproduced, when
lamp should illuminate steadily within sight of the required, in areas such as the sister’s office, ward
patient. kitchen and utility rooms; in these cases it may be
preferable to have no reduction of volume at night.
10.13 Combined within the local reset push, a lamp
The sister’s office unit may need to incorporate an
should illuminate steadily.
on/off switch.
10.14 A lamp outside and above the door of the ward/
cubicle should illuminate steadily. Where no door Staff-to-staff (emergency)
exists, a lamp should be positioned in an
alternative position such as in the corridor ceiling. Emergency switch
10.15 Where the calling location is not adjacent to the 10.23 It is necessary to give nursing staff the ability to
main corridor and is, for example, served by a side call for assistance should the need arise while
corridor or passageway, the lamp should be attending a patient. A switch for this purpose
duplicated as often as necessary so that a follow the should be incorporated on the bedhead services
light procedure can apply. and in any other area where assistance may be
10.16 A lamp or liquid crystal display (LCD) should required. Areas that have no other form of
illuminate steadily at the staff communications communication may require this facility (for
base. example treatment rooms).

10.17 A lamp should illuminate steadily, when required, Visual signals

in areas such as the sister’s office, ward kitchen and
10.24 Operation of the staff emergency switch at any bed
utility rooms, where staff are frequently located.
or other location, where fitted, should cause the
10.18 All of the above lamps should remain in the steady sequence of lamps as described in paragraph 10.10
state until the related call is cancelled at the to illuminate in a flashing mode (whether a normal
associated reset unit. It should not be possible to call is in force or not) until the emergency switch
cancel the call at any other position. is returned to normal (see paragraph 5.21 for
10.19 Where groups of calling points occur, as in audible alarm and indicator lamp activation
multibed wards, WCs and bathrooms, it is usual to periods).
provide a single over-door lamp to indicate any of 10.25 Where a group lamp is positioned to indicate calls
the calls collectively. This arrangement would from more than one source, the raising of an
continue with any duplicated corridor repeater emergency call from one section should not be
lamps and also at the staff communications base. masked by a steady illumination from another
10.20 The existence of a call should not prevent any section that has a normal call in operation.
other call from being made. The resetting of a call 10.26 Operation of the emergency switch should cause
should not cancel or affect any other call that is in the system to operate in one of the following ways:
force. An exception is where a WC/bathroom suite
is controlled by a common reset unit. • it should override any patient calls and
bathroom/WC calls on the system when the
Audible signals emergency call is made, storing these until the
emergency call is cancelled, when they are
10.21 Audible signals should be provided at the staff reinstated automatically;
communications base in the form of a tone with a
fixed or variable frequency sufficient to alert the • it should not affect any patient or emergency
staff to the type of call being made (typically in the calls from any other point that are in force or
range 500 to 800 Hz) (see paragraph 5.21, need to be made during the emergency.
“Controls and markings” for guidance on audible
alarm and indicator lamp activation periods). A Audible signals
switch on the communications base panel should 10.27 Use of an emergency switch should cause all the
be provided to reduce the volume at night. There tone sounders of the system to operate in phase
should be no means of switching off the tone with the flashing lamps (see paragraph 5.21).
altogether.

26
 10 Nurse-call systems

10.28 If the quiet (or mute) setting of the control switch on or alongside the device. Examples of typical
at the staff communications base has been selected, nurse symbols are shown in the diagram below.
this will be overridden.
10.31 The device should be easy to operate by the patient
10.29 For operation of cardiac, intruder and attack irrespective of whether he/she is ambulant,
alarms, see Chapter 9. disabled or confined to bed.
10.32 Patient-to-nurse calling devices are normally of the
Patient’s calling devices push-button type; however, different designs and
10.30 Patient-to-nurse calling devices should have a configurations should be available to suit
tactile feel. The push-button or pull-ring should be individual patient condition requirements. These
easily recognised by its colour (normally amber) should be capable of utilising a common base
and by a nurse symbol indelibly engraved/printed socket connector unit to allow flexibility in use at
each call point.
Figure 3 Typical layout of patient handset with example of symbols

Nurse call
button with
reassurance

Channel
display

Channel
selection

Volume
control

Bedlight
control

27
Health Technical Memorandum 08-03 – Bedhead services

10.33 For ease of location at night, the hand unit should circuitry of the call-only unit should be compatible
be permanently back-lit, but not so brightly that it with that of the handset so that the socket can be
could be confused with the reassurance lamp. used for either.
10.34 A reassurance lamp in the form of a light-emitting 10.40 The control of infection should also be considered
diode (LED) should be positioned adjacent to, or in the design and manufacture of the patient
should be integrated within, the call device. handset unit. It should be designed with an
appropriate IP rating (see BS EN 60529) so that
10.35 The voltage potential difference between any two
the unit can withstand submersion in various
points, including earth, likely to be experienced by
liquids.
patients or persons associated with the call unit or
its cable should not exceed that which applies to 10.41 It should also be designed to allow patients with a
medical equipment described in the MEIGaN range of disabilities not only to operate the unit
regulations either under normal or fault but also to understand the functions of the unit.
conditions. The nurse-call circuit should be
10.42 Some means of attaching the call-only unit
automatically monitored so that a break in the
securely to the bedclothes or the patient’s clothes
cable or withdrawal of the plug will initiate a call.
should be available, but it should be so designed
that any undue force will allow the clip to
Wall- or trunking-mounted push-button
disengage without tearing the materials.
10.36 The push-button should be large enough and
10.43 A parking clip or bracket should be provided to
easily recognisable and suitable for all areas of a
allow the unit to be stored on the wall or locker
healthcare facility frequented by ambulant patients
when not in use.
or where it may be intended to be used. Associated
with the push-button – either integrally or
Pull-cord unit
alongside – a reassurance lamp should be fitted.
10.44 In showers, bathrooms and toilets, the
Hand-held nurse-call-only unit patientcalling device is normally a ceiling-mounted
pullcord unit with pull rings as described in Part
10.37 A hand-held unit used solely for patient–nurse call
M of the Building Regulations – namely, coloured
purposes should consist of a push-button attached
red, located as close to the wall as possible, and
to a fixed unit by means of a suitable cable plug/
having two red 50 mm diameter bangles (or
socket connector. The push-button should be large
similar) set at different heights. It is important that
and easily recognisable, with a reassurance lamp in
the pull-cord is easily recognised as the calling
the form of an LED fitted either integrally or
device and cannot be confused with a light switch.
alongside.
The pull-cord unit should provide reassurance that
10.38 The push-button should be permanently the system has operated. The switch should have a
illuminated to a level sufficient to allow easy momentary action to activate a call. Use of pull-
location in the dark, but should not be so bright as cords within mental illness units needs careful
to be confused with the nurse-call reassurance consideration to avoid potential ligature points,
lamp. and in any case, the cord should have a low
10.39 The unit should be ergonomically designed, with a breaking strain.
flexible lightweight cable of sufficient length to
Other call units
enable patients to activate a call from the bed or
whilst sitting in a bedside chair or nursing area etc. 10.45 Pneumatically-operated call units can be used for
The means of attachment at both ends of the cable patients who are unable to use their hands. The
should be in the form of an effective strain-relief unit comprises an air bulb and connecting tube,
device in order to minimise risk of cable failure. terminating in an air-velocity-operated switch that
The plug attachment to the base unit should be of is integral with the wall unit.
a pattern that will disengage from the wall socket
10.46 Other forms of call unit that facilitate operation by
when strain is applied to the cable from any angle
disabled patients should be considered if these
without damage to plug, socket or cable. Where
provide enhanced and more efficient use. The
the same plug and socket is used for a patient
design and manufacture of such units should be
handset as an alternative to a call-only unit, the
sufficiently robust to provide a safe and reliable

28
 10 Nurse-call systems

service, and their method of operation should be 10.54 The handset should be designed to fit a parking
compatible with the remainder of the patient call bracket attached in an accessible position to either
system. the bedside locker and/or the bedhead unit.
10.55 The control of infection should also be considered
Patient’s handset in the design and manufacture of the patient
10.47 Patients will require a handset to operate the handset unit. It should be designed with an
nurse-call system at the bedhead together with appropriate ingress rating (see BS EN 60529) so
entertainment and other facilities, where provided. that the unit can withstand submersion in various
The patient should be able to operate the handset liquids.
from the bed, nursing position or patient chair 10.56 It should also be designed to allow patients with a
position adjacent to any bed location. range of disabilities not only to operate the unit
10.48 Normally, the patient handset will include the but also to understand the functions of the unit.
following services: 10.57 The rear of the unit should incorporate an anti-slip
• patient-to-nurse call; surface to prevent the handset from being dragged
onto the floor by the weight of the cable when
• TV and radio volume and channel control; placed on a standard over-bed table or locker.
• bedhead reading light “on/off/dim” control;
Reset switch/indicator lamp
• optional service call button for non-clinical
staff. 10.58 To allow staff to reset an initiated patient–nurse
call, there should be a local switch marked “Reset”.
10.49 The patient-call’s push-button should be suitably
coloured and marked with the nurse symbol. It Socket for handset
should be the largest button on the unit and the
switch should have a tactile feel. 10.59 The socket should be suitable for receiving the
plugs fitted to both the patient’s handset and the
10.50 All controls should be clearly marked to indicate call-only unit.
their function and be simple to operate (see
paragraph 10.30). These should be consistent and 10.60 Where it may be necessary to deprive a patient of a
should mirror controls located on the medical handset or call-only unit due to misuse, a dummy
supply unit or bedhead panel. plug should be available, insertion of which will
enable the call (which is automatically raised with
10.51 A clip should be provided on the handset or the no plug present) to be cancelled.
cable to allow attachment to the patient’s clothes
or bedclothes. It should be so designed that any 10.61 Handset faults should be capable of being
undue force will allow the clip to disengage cancelled at the source of the call. A permanent
without tearing the materials. message should be displayed at the staff
communications base until:
10.52 The handset cable should be lightweight and
flexible, anchored positively with strain-release • the fault is fully rectified; or
attachments, and of a pattern that will disengage • a dummy plug is inserted to replace the faulty
from the wall socket when strain is applied to the handset; or
cable from any angle without damage to plug,
socket or cable. Where the same plug and socket is • the faulty handset is replaced with a fully
used for a call-only unit as an alterative to a patient operational unit.
handset, the circuitry of the call unit should be
compatible with that of the handset so that the Staff emergency switch
socket can be used for either. 10.62 Typical switches should have a pull-on/push-off
10.53 The nurse-call circuit should be automatically red switch with reassurance light. It should be
monitored so that a break in the cable or indelibly marked “Emergency Pull”.
withdrawal of the plug will initiate a call.
Parking brackets
10.63 Suitable means of parking the handset and headset
should be provided to facilitate safe storage of

29
Health Technical Memorandum 08-03 – Bedhead services

these units when not required to be held by the Over-door/corridor lamps

patient or when the bed space is not in use.
10.68 Situated at the entrance to calling locations, the
10.64 Requirements are as follows: over-door lamp will indicate the source of that call
to staff responding to a call. For areas such as
• The handset and headset parking bracket
bedded bays, the lamp should be mounted in the
should be marked with an appropriate symbol
corridor ceiling at the entrance to the bay. Where
and be located as near as practical within reach
the calling points are situated alongside passages,
of the patient.
the over-door lamp will need to be repeated at the
• A further handset-parking unit should be main corridor and at other intermediate places
located on the bedhead trunking, or where along the route, if necessary.
appropriate, to facilitate storage of the handset
and headset when the bed space is not in use. Staff communications base
• When parked in proximity to the patient, the 10.69 The staff communications base is the
handset should be capable of being operated by administrative and communication centre of a
the patient. clinical unit. All patient calls will need to be
indicated here by audible and visible means (for
• The brackets/parking units should hold their
example LCD or computer visual display units
handset and/or headset positively so that they
(VDUs)).
do not become accidentally dislodged by such
knocks and pulls as may be expected in normal 10.70 A switch should be provided to attenuate the
service. The units should, however, be designed volume of sound at night. There should be no
to suitably disengage from the parking unit and “Off ” position.
point of connection to prevent harm to
patients, staff or visitors who may accidentally Indicator – mimic or display
trip or snag the cables. 10.71 For a large and complex ward layout, it may be
appropriate to provide a mimic indicator engraved
Dual control (optional)
with a plan of the ward at the staff
10.65 Duplication on the panel of the channel selection communications base. Patient-call lamps and
and volume controls featured on the multifunction nurse-presence lamps can be positioned on the
handset will make entertainment facilities available plan to give a clear picture of call and nurse
(with operation by staff if necessary) to patients locations. Normally, indication would be to room
who are without a handset or unable to use one. level.
10.72 Alternatively, a flat-screen graphic package or LCD
Other call-system units display/touch screen can be used. It must be noted,
however, that the orientation of a mimic or
Reset unit graphical layout is critical in determining exactly
10.66 For areas not requiring a bedhead unit, patient- where a call is coming from. This type of system
made calls need to be retained by means of an does not lend itself to changes in room use or ward
electronic latch-on device. The function of the layout and can therefore be less flexible than
reset unit is to unlatch the electronic module and indicator/GUI systems.
effect cancellation of the call. A reassurance lamp
with a light-grey lens should be incorporated Power control units
within the switch used for resetting. The switch 10.73 Power will be derived a from single-phase LV
should be clearly labelled “Reset”. Where supply unit or multiple units fed via the essential
appropriate, the reset unit can also incorporate a supply system, and should provide suitable battery
call-push and/or an emergency switch. backup to support the system while normal
10.67 A reset unit may be used to reset calls from a single supplies switch to and from the hospital standby
calling location or multiple calling locations such generator systems. All power supply units should
as a suite of bathrooms/WCs or a multi-bed ward. be suitably sited to allow easy access for
maintenance.

30
 10 Nurse-call systems

• a wall-mounted loudspeaker/microphone. This

Note arrangement is satisfactory in single or twin-
The backup should be able to sustain adequate power bedded rooms;
to the system during loss of normal electrical supplies. • a loudspeaker/microphone incorporated within
the patient’s handset. This arrangement is more
user-friendly, being similar to ordinary
Speech system
telephone use. The loudspeaker and
10.74 The addition of a speech facility to a nurse-call microphone should be mounted separately
system can save nursing time. It has the advantage within the handset in positions similar to a
that nursing staff at the base can ascertain the telephone handset;
needs of the patient prior to attending the bed. It
• a trunking-mounted speaker/microphone.
eliminates some visits altogether, yet still gives
reassurance to the patient. 10.82 Where audible monitoring of patients is a
requirement, the wall-mounted loudspeaker/
Staff communications base microphone arrangement will be the most
10.75 The staff communications base panel should be effective. Monitoring will only be practical in
fitted with a suitable telephone handset or single rooms, and will normally form part of a
loudspeaker/microphone arrangement, or be separate system.
hands-free. Identification of the source of the call 10.83 It should be possible to insert a speech handset
may be by indicator lamps, LCDs or VDUs. into a non-speech bedhead panel or a non-speech
Selection of the speech channel will be by handset into a speech bedhead panel and maintain
keyboard, selector switch or touchscreen. use of the basic call system. This will allow
10.76 For privacy reasons, it is recommended that maximum flexibility in establishments where both
communications base panels with speech be speech and non-speech systems with handsets are
provided with a telephone-type handset as an in use.
alternative to the loudspeaker/microphone.
Security of communication
Operation 10.84 Where a patient–nurse speech system is a
10.77 Selection of the speech channel should enable the requirement or where the staff communications
nurse to speak to the patient. The patient should base will be unattended for various periods, it is
not be able to speak to the staff base until a necessary to ensure that communication following
patient–staff call has been established. a call will be established without delay. This can be
achieved by:
10.78 Where a speech system is used to audibly monitor
the patient, the patient should be aware that the • the nurse responding to the door/corridor
monitoring is taking place. indicators and tones and reporting directly to
the bed as in a non-speech system;
10.79 Duplex speech operation is the preferred option;
however, if a simplex system is used, the staff • the nurse, on leaving the communications base,
communications base will be fitted with a “push to picking up a paging receiver; this will direct
speak” switch. them to the source of any call made;

10.80 It should be possible with a speech system to • the nurse responding to the tones or paging
cancel patient calls from the staff base, but only receiver and making use of “slave” centres
after communication has been established. placed in strategic positions.
Cancelling of emergency calls should not be
possible unless at the bed space. Nurse-presence system
10.85 With the greater proportion of single rooms in
Bedhead services unit hospitals, the installation of a nurse-presence
10.81 The provision of a speech facility as part of the system will allow easier location of staff.
bedhead services for a patient may take one of the
following forms:

31
Health Technical Memorandum 08-03 – Bedhead services

Nurse-presence switch required, indication may also be provided in the

sister’s office to show the location of staff.
10.86 Each room and bedded bay can be provided with a
switch for the nurse to operate as they enter and
Additional tone sounders
leave the location. In single rooms, the switch can
be part of the bedhead services installation, but 10.89 It may be appropriate to install a tone sounder in
more easily it is placed at the entrance of each area each area that has a presence switch. The switch,
so fitted. when operated, will connect the tone sounder so
that any patient or emergency call will be heard by
10.87 It may be possible to install a presence system that
the nurse in that location.
will respond automatically to the entry and exit of
a nurse. A device can be attached to the nurse’s 10.90 The success of a nurse-presence system will depend
person, which will activate a wall-mounted unit; on the discipline exercised in operating the
this will initiate the necessary indications at the switches for each and every visit.
staff communications base etc.
Speech system
Visual signals 10.91 A nurse-presence system lends itself to the addition
10.88 Operation of the switch will illuminate a lamp of a staff-to-staff speech system (intercom). By
adjacent to or integral with the switch; knowing where nurses are located, the staff
additionally, either lamps, LCDs or VDUs will communications base can initiate a speech call to
give indication of the whereabouts of the nurse. If whichever nurse needs to be contacted.

32
11 Entertainment facilities

11.1 To enhance the patient’s well-being and experience transferred to the bed space or other area, where the
during their in-patient care, entertainment facilities signal is required to be decoded.
should be made available as a bedhead service and
11.6 Entertainment controls for the patient should be
delivered to the patient via visual screens,
clearly labelled to indicate their function and
headphones and controls incorporated into a
should have the capability of simple operation
patient’s handset and/or bedhead unit as
taking into account the range of disabilities that
appropriate.
patients may have.
11.2 The various entertainment provisions required
11.7 Consideration should be given to interfacing the
should be sufficient to meet the needs of patients
entertainment services with other central
within the clinical service area(s) concerned. These
infrastructure services such as TV aerial, radio
will include one or more of the following facilities:
(including a local hospital radio station or chapel
• television systems; service circuit) or telephone systems.
• Internet services; 11.8 Where services are required to interface with the
healthcare facility’s information management
• radio;
systems (for example to provide patient-interactive
• landline telephone; facilities for food ordering, patient surveys, patient
• DVD player; administration systems etc), the healthcare facility’s
IT manager should be involved at the earliest
• cable services; opportunity before design work commences.
• healthcare information management systems. Agreement should be reached before going to
tender, particularly with regard to software security
11.3 The method of procurement, design and protection and any specific interface requirements.
installation of each of the above services will vary
dependent upon the size and complexity of the 11.9 Where required, entertainment services should be
system required. Whichever entertainment services installed in other areas of the healthcare premises
and associated equipment are chosen, they should (for example dayrooms, waiting rooms) either as an
be designed and installed to provide high-quality, integral provision of entertainment systems that
fully coordinated, ergonomic and integrated serve bed spaces or as independent systems. The
facilities for patient use within the bed space. Each quality of installation, equipment and output
entertainment service should be capable of being associated with these services should be at least
manually or automatically switched off when not in equivalent to that of those serving bed-space areas.
use at the bed space or specific area being served. 11.10 Easily understandable user guides (in hard-copy or
11.4 The design and installation of entertainment electronic formats) should be supplied with the
services should take into account the impact of various entertainment services, one for each bed
equipment noise (for example sound from headsets) space or entertainment service user outlet, in order
on adjoining bed spaces and of the possible need to assist patients to gain access and operate the
for noise attenuation, particularly in circumstances facilities.
where very ill patients may be nearby.
Entertainment services signal
11.5 Advantage should be taken of the use of digital
techniques to provide high-quality services distribution
generated from compact central units and 11.11 Where there is an opportunity for entertainment
services to utilise a common distribution structure,

33
Health Technical Memorandum 08-03 – Bedhead services

in order to ensure better sound quality and bedhead services, since – through the use of
reliability than equivalent traditional analogue modern techniques – these systems are capable of
systems, multiplexed digital forms of multi-functional use encompassing a variety of
entertainment signal distribution should be other viewing services. These include:
installed to carry radio, TV and other
• TV channels and services;
entertainment services to the patient. Multi-core
direct-wired systems, however, should still be • Internet services;
considered where appropriate, for example for • healthcare information services;
small establishments and/or extensions to existing
installations. • video/DVD system.
11.12 A basic scheme should employ a central receiver/ 11.19 To achieve the above, it will be necessary for TV
encoder with suitable FM/TV aerials delivering the systems to be designed to interface with the
required channels. The central receiver/encoder healthcare facility’s IT network in addition to
should receive signals from all programme sources terrestrial TV aerial and satellite distribution
and encode the audio onto a screened data cable. systems. Where connection to the healthcare
facility’s IT infrastructure is required, this should
11.13 Unless otherwise specified, ultra-high frequency
include all necessary interface equipment and
(UHF)/satellite signals provided to the comply with all relevant safety and signal protocols
entertainment facilities should be derived from a that are stipulated by the healthcare facility’s IT
common aerial/receiver installation. Signalboosting manager to ensure a satisfactory and fully
amplifiers and attenuators should be employed as operational system.
necessary to ensure adequate signal strength and
balance is achieved at each entertainment outlet 11.20 The TV system should provide at least five
for the equipment being served. channels with the additional provision to
incorporate the healthcare organisation’s own
11.14 Where data cables branch off into wards and other
video/DVD player or video system, when
areas, a suitable isolator should be installed to available. This should enable local broadcasts,
ensure that a fault developing in a particular area including hospital chapel services (where
does not reflect back into the main central system. economically possible), to be received and
11.15 Within the ward and other areas, the data cable distributed to patients.
should be routed to the various entertainment 11.21 Aerial and satellite communication services specific
service outlets. The signal decoded by the bedhead for UHF radio and TV viewing will usually be
or service-point electronics should then be derived from a common aerial installation and
amplified, as necessary, to provide adequate signal should include all relevant equipment,
strength to drive the entertainment output devices signalboosting amplifiers, attenuators and
(for example headsets, speakers, TV, radio) and distribution facilities designed and installed to
allow relevant communication control. provide adequate signal strength and balance at
11.16 In areas such as dayrooms and workshops, each aerial outlet to ensure stable and acceptable
loudspeakers may be required to provide the picture quality.
entertainment. The data cable will connect into a 11.22 In order to carry the TV signals, where possible, a
decoder/amplifier unit complete with controls in multiplexed distribution system carrying other
order to drive the loudspeakers. In dayrooms, entertainment services should be used in
audio induction loops will normally be fitted. preference to traditional dedicated aerial
11.17 Accommodation should be made available to distribution systems (see paragraph 11.11).
house central consoles, including the provision of 11.23 Digital flat-screen TV display units (for example
operator workstations, particularly for LCD or plasma) should be used wherever
administrative and technical control purposes practical. They should be mounted on an
when the local hospital radio is active. articulated arm or on the bedside locker to
facilitate viewing by the patient and staff. The
Television services display units should be of sufficient quality and
11.18 The provision of television services at the bed output resolution capability to meet the
space is an increasingly important element of requirements of the chosen services being viewed,

34
 11 Entertainment facilities

particularly when required to view clinical • careful consideration should be given to

information. The unit should be of a sufficient size allowing the use of loudspeakers directly in
not to interfere with clinical practice and should multi-bed wards. Such an arrangement is open
be capable of being easily cleaned. to misuse and potential annoyance.
11.24 During the migration from terrestrial analogue to
digital transmission throughout the UK, TV Radio services
equipment and systems should be capable of 11.29 Radio services should be relayed to the various
receiving both existing analogue and digital signals. bedhead positions from a UHF aerial distribution
11.25 TV installations should at least offer free-to-air system that includes all necessary boosting
digital channels via a digital aerial and digital tuner amplifiers (normally centrally located), attenuators,
or set-top box, with preference being given to low-loss cable and distributing equipment to
systems that provide pure digital TV signals over a provide adequate signal strength and balance at
network in order to produce high picture quality each radio outlet to ensure noise-free clear
and to allow future-proofing. reception of each channel. Where possible, a
multiplexed distribution system carrying other
11.26 User controls should be contained within the entertainment services should be used in
patient handset or be easily accessible to all preference to the traditional dedicated aerial
patients and allow interactive use by the patient, as distribution systems in order to carry the UHF
appropriate. Relevant controls should also be fitted signals (see paragraph 11.11).
integral to the TV for use by staff to alter basic
settings. Programme selection and volume control 11.30 The radio system should be capable of delivering
should be via the patient handset. high-quality digital sound for at least five FM
radio stations, with channel and volume control
11.27 The method of delivering high-quality sound from being incorporated into the patient’s handset.
the TV sound systems should take account of any Provision should also be made with regard to
potential noise abuse that may be experienced by incorporating the healthcare organisation’s own
neighbouring patients. These methods will include radio system, where available, in order to receive
the use of the TV loudspeaker and/or headphones and distribute local broadcasts to the patients.
at the bed space.
11.31 The method of delivering radio sound will depend
11.28 Relaying of TV/sound to the patient will depend on the type and configuration of the clinical
upon the type and configuration of the clinical facility involved and should take account of any
facility involved. The following possible methods potential noise abuse that may be experienced by
should be considered: neighbouring patients.
• in a single room, it may be acceptable to
dispense with the headset and use the TV Headsets
loudspeaker direct; 11.32 Where patient headsets are to be used, they should
• a multi-bed ward with a basic system may have be lightweight and ergonomically designed so as to
the sound output of the TV wired around the minimise any possible restrictions to the
bed positions for headphone listening, the entertainment services that the patient is likely to
loudspeaker being disconnected. Where the encounter within the clinical environment due to
sound output is taken remotely from the TV, a their disabilities.
suitable isolation/matching transformer will 11.33 The design of the headset should also take into
need to be interposed between the TV and the account control of infection issues, particularly
ward circuits; with regard to minimising the risk of bacterial
• control of the television picture will be by the growth. Consideration should be given to:
remote control unit provided with the TV or • its capability of being disinfected;
by the controls on the TV by patients or staff;
• replacement disposable earpieces between
• where TV sound channels are generated patient use; or
centrally, all beds in all wards should be served
by this means via headsets; • where possible, its capability of being sterilized
between patient use.

35
Health Technical Memorandum 08-03 – Bedhead services

11.34 As with nurse-call handsets, a range of different 11.36 Connection of a headset to the bedhead or wall-
headset designs may be necessary to facilitate panel unit should be by means of a robust
patient access to entertainment-service sound. connector and plug/socket arrangement capable of
frequent and reliable use. The plug should be of a
11.35 Headsets should be capable of delivering high-
pattern that will disengage from the wall socket
quality sound to the patient and, where practical,
when strain is applied to the headset assembly
be utilised as a common device to deliver sound
without damage to plug, socket or headset.
from other entertainment services at the bed space/
nursing area.

36
12 Integrated communication services

12.1 The use of data cable and infrastructures within the bottom of this page. When required, the device
healthcare premises to carry information to and should also be capable of being interfaced with the
from the bedhead opens up the possibility of using hospital information systems and IT network for
the data cable for other facilities (see also paragraph use by hospital staff and to reduce installation and
11.11). maintenance costs.
12.2 Where data cables (for example Cat 5e, fibre-optic) 12.7 Prior to installation, all facilities that utilise
are used to carry communication and control common data infrastructure systems should be
information to and from the bedhead, or other adequately assessed with regard to their potential
nursing position, in support of IP (Internet effect on other hospital systems, particularly in
protocol)-based nurse call, patient/nurse speech, respect of any capacity, security and safety
telephony, Internet and entertainment services etc, implications. Suitable provisions should be
these should be capable of fully supporting the incorporated to ensure that such systems operate
required computer network technologies as directed safely and reliably, with no unwanted interference
by the healthcare facility’s IT manager. Examples of being incurred sufficient to cause operational
computer network technologies include 10Base-T, difficulties between systems.
100Base-T, 1000Base-T (Gigabit) Ethernet, and
12.8 Appropriate input and output interfaces should be
Token Ring.
provided as necessary to ensure a fully operational
12.3 Utilising a common data highway may, however, system in compliance with manufacturers’
impact upon business and clinical risk. Therefore, requirements and with functionality as specified
careful consideration should be given to the extent elsewhere in the project specification.
to which provisions are incorporated into the
12.9 Once installed, the capacity of a data cable is
system to ensure adequate reliability and resilience
potentially considerable, so expansion of facilities
of the various services so as to minimise such risks.
in the ward or nursing area becomes possible with
12.4 Data cables used for bedhead services will normally the appropriate input and output interfaces.
be independent of the main healthcare facility’s
12.10 Some features that may be developed are:
primary IT network (unless otherwise directed by
the healthcare facility’s IT manager), but they will • Bed status: to indicate whether the bed is
interface with the network at appropriate strategic occupied, vacant, in the course of preparation
points. or out of commission.
12.5 Relevant protocols and test procedures to achieve • Patient monitoring: to allow the output
the required functional transparency and resilience signals from medical apparatus to be
should be agreed between the bedhead services’ multiplexed onto the data line. This may take
equipment supplier(s) and healthcare facility’s IT the form of a simple on/off medical alarm or a
manager before the interface(s) is/are installed. constant reporting of varying analogue signals
to indicate a changing medical condition.
12.6 Entertainment (radio and TV) and communication
(telephony and Internet access) services may be • Menu selection: to enable the patient to view
provided through a low-energy digital device at and select their choice of meal.
each bedhead. Such devices should not be used as • Patient details: to enable the entry of a
the primary control for any patient and staff calls, patient’s name, address and all relevant personal
but should be capable of being used for patient information at the bedside.
health education and for menu-ordering in
addition to other services as described in the list at

37
Health Technical Memorandum 08-03 – Bedhead services

• Medication requirements: to display all • Door access and security: to allow the nurse-
medical details to the nurse or doctor at the call system to be integrated with CCTV and
bedhead. door-access systems.
• Patient entertainment: Internet etc. • Clinical report displays: to enable laboratory
results, X-rays and computed tomography
• Communication: Voice over Internet Protocol
(CT) scans to be displayed to clinical staff at
(VoIP) telephony.
the bedside.
• Patient administration systems: to provide
• Administration of drugs: to facilitate the
full clinical access to the healthcare facility’s
accurate discharging and recording of drugs
clinical data IT network at the bedside.
administered at the bedside.

38
13 Voice and data structured wiring and outlets

13.1 In the interests of EMC and possible adverse 13.3 Where a bedside telephone is required, the
interaction with ward communications, the use of socketoutlet should be incorporated within the
personal electronic equipment by patients, staff and medical supply unit provision on the voice and data
visitors in sensitive hospital departments (for structured wiring system, or it should be integrated
example critical care areas, operating theatres) with the nurse-call system via a VoIP (voice-over
should not be permitted unless by agreement with Internet protocol) or SIP (session initiation
the healthcare organisation. See also the protocol) application utilising the same cabling
Department of Health’s (2009) ‘Using mobile infrastructure. Alternatively, healthcare
phones in NHS hospitals’. organisations should make commercial
arrangements for the provision of such patient
IM & T services.
13.2 Where appropriate, clinical bed spaces should allow
for the use of electronic patient record (EPR) and
Isolation rooms
PACS. Whether the EPR will be wireless or 13.4 Suitable provision should be made for
hardwired will vary from project to project. EPR communications between patients and staff in
access should be via: isolation rooms (see Health Building Note 04-01
Supplement A – ‘Isolation facilities in acute
• hand-held devices;
settings’).
• flat-screen monitor/computer/keyboards
mounted on trolleys; or
• wall-mounted bedside computers that can also
double up as patient entertainment consoles.

39
Health Technical Memorandum 08-03 – Bedhead services

14 Medical gas pipeline systems

14.1 Where medical gas pipeline systems are used, the the need for rigid fixings, ease of access for
terminal unit provided should be as recommended maintenance, and minimisation of risk in the event
in Health Technical Memorandum 2022 – of gas leakage. See also “Firecode” for guidance on
‘Medical gas pipeline systems’). Terminal units for the positioning of MGPS isolation valves in in-
medical gases, medical and surgical air, and medical patient areas.
vacuum should be in accordance with BS EN 737-
14.3 Where terminal units are integrated with other
1, whereas terminal units for AGSS should be in
bedhead services, care must be taken to ensure
accordance with BS EN 737-2.
adequate space for ease of use of medical
14.2 Methods of installation should be to the guidance equipment such as flowmeters, vacuum control
given in Health Technical Memorandum 2022 – units etc.
‘Medical gas pipeline systems’, taking into account

40
15 M
 atrix of bedhead services by clinical
service/location

15.1 The extent and range of facilities provided by

bedhead services will be dependent on the clinical
activity and patient group specific to an in-patient
location. The attached matrix has been included as
a basic checklist. It is provided for guidance
purposes only and is not exhaustive. The provisions
identified should be amended, as appropriate, to
meet the specific clinical and non-clinical functions
associated with each particular project.

41
 Call Number of medical gas terminal units Power/data Entertainment

Appendix A – M
Twin socket-
Cardiac call

monitoring
Staff emer-

Telephone
Nurse call

Television
gency call

Intruder/

Resilient

terminal
alarm *
LOCATION / CARE GROUP

Patient
outlets

supply
N2O/ He/

attack

Radio
Data
O2 N2O MA4 SA7 VAC AGSS
O2 O2

BED SPACES
• Acute care (appropriate for adult acute, children and older people)
Single room   P 1 – – 1 – 1 – – 4  4 P  
Multi-bed room (per bed space)   P 1 – – 1 – 1 – – 4  4 P  
• Emergency admissions
Multi-bed room (per bed space)    1 – – 1 – 1 – – 14  8   

 atrix of bedhead services by location/care group

• Maternity/neonatal
Single room – Maternity   1 – – P – 1 – – 4  4  
Multi-room – Maternity (per bed space)   1 – – P – 1 – – 4  4  
Nursery (per cot space)
Provision for 2 cots only irrespective of number of cot spaces   1 – – – – 1 – – 2 2

Birthing room (normal/abnormal) – Mother   1 – 1 – – 2 – – 4  6  P P

Birthing room – Baby (per cot space) (allow for 2 cots only)   1 – – 1 – 1 – – 2  2  P P
Neonatal unit (per cot space)
Note: One set either side of the bed space, if installed in fixed location eg trunking; or both sets in an   2 – – 2 – 2 – – 6  2
articulated supply pendant that can be positioned either side of the bed space
• Day patient
Single room   1 1 4 4 P P
Multi-bed room (per bed space)   1 1 4 4 P P
Per dialysis station   1 – – 1 – 1 – – 14 4  
Chemotherapy treatment bay   1 – – 1 – 1 – – 4 4 P P
• Mental health
Single room  2 2
• Critical care area
Per bed space
Note: One set either side of the bed space, if installed in fixed location eg trunking; or both sets in an    4 2P 2P 4 – 4 2P 2P 14   8 
articulated supply pendant that can be positioned either side of the bed space
Coronary care unit (CCU) (per bed space)    4 – – 4 – 4 – – 14   8 
High dependency unit (HDU) (per bed space)    4 4 4 10   8 
Burns unit   2 2P 2P 2 – 2 2P – 10   8 
Neonatal intensive care
Note: One set either side of the trolley space, if installed in fixed location eg trunking; or both sets in an    2 – – 2 – 2 – – 10   8 
articulated supply pendant that can be positioned either side of the bed space
RESUSCITATION/A&E
Resuscitation room (per trolley space)
Note: O
 ne set either side of the trolley space, if installed in fixed location eg trunking; or both sets in an   2 2 – 2 – 2 2 – 14  8 
articulated supply pendant that can be positioned either side of the bed space
• Post-anaesthetic recovery
Post-anaesthetic recovery (per bed/trolley space)
Note: One set either side of the bed space, if installed in fixed location eg trunking; or both sets in an  P 2 – – 2 – 2 – – 6  4 
articulated supply pendant that can be positioned either side of the bed space
Post-anaesthetic recovery – Day Case (per bed space)  P 1 1P 1 6 4
Post-anaesthetic recovery – Maternity (per bed space)  P 1 – – 1 – 1 – – 6 4

TREATMENT
Treatment room/cubicles – General out-patients P  1 1P 1P 1 1P 8 4
Treatment room – Ward (appropriate for adult acute, children and older people) P  1 – – 1 – 1 – – 8 4
Treatment room – Day ward P  1 – – 1P – 1 – – 8 4
Treatment room/cubicle – A&E    1 – – – – 1 1P – 8 4
Electroconvulsive therapy (ECT) room  1 1 – 1 – 1 1 – 6 4
Major treatment/plaster room (per trolley space)  1 1 1P 1 1P 1 1 – 6 6
Notes:
P = Project options
For recommended number of medical gas outlets in each location/care group, see Health Technical Memorandum 02-01 – ‘Medical gas pipeline systems. Part A: Design, installation and verification’.
The above table is provided for guidance purposes only and is not exhaustive. The provisions identified should be amended, as appropriate, to meet the specific clinical and non-clinical functional requirements associated with each particular project.
* It is a matter for local discretion as to which type of device is more appropriate.
Health Technical Memorandum 08-03 – Bedhead services

16 References

Health Technical Memorandum 06-01 – ‘Electrical Health Building Note 57 – ‘Facilities for critical care’.
services supply and distribution’.
‘Lighting and colour for hospital design’. DH, 2004.
Health Building Note 00-03 – ‘Clinical and clinical
BS 8300:2009 Design of buildings and their approaches
support spaces’.
to meet the needs of disabled people. Code of practice.
Health Building Note 04-01 – ‘Adult in-patient facilities’.
British Standards bookshop.
Medicines and Healthcare products Regulatory Agency.
BS EN 60529:1992 Specification for degrees of
BS EN ISO 11197:2009 Medical Supply Units. protection provided by enclosures (IP code).
British Standards homepage. BS 1363-2:1995 13 A plugs, socket-outlets, adaptors and
connection units. Specification for 13 A switched and
Health and Safety at Work etc Act 1974.
unswitched socket-outlets.
Health Technical Memorandum 00 – ‘Policies and
IEC 60364-7-710 Electrical installations of buildings -
principles of healthcare engineering’.
Part 7-710: Requirements for special installations or
International Electrotechnical Commission. locations – Medical locations.
Disability Discrimination Act. BS EN 60669-2-1:2000 Switches for household and
The Building Regulations – Access to and Use of similar fixed-electrical installations. Particular
Buildings Approved Document M. requirements. Electronic switches.

Health Building Note 00-02 – ‘Sanitary spaces’. CIBSE SLL LIGHTING GUIDE 2: Hospitals and
Health Care Buildings.
Health Building Note 57 – ‘Facilities for critical care’.
BS 1363-2:1995 13 A plugs, socket-outlets, adaptors and
Electromagnetic Compatibility Regulations. connection units. Specification for 13 A switched and
BS EN 61000-4-2:1995, IEC 61000-4-2:1995 unswitched socket-outlets.
Electromagnetic compatibility (EMC). Testing and BS 1362:1973 Specification for general purpose fuse
measurement techniques. Electrostatic discharge links for domestic and similar purposes (primarily for use
immunity test. Basic EMC publication. in plugs).
Health Technical Memorandum 2022 – ‘Medical gas BS EN 60598-2-25:1995, IEC 60598-2-25:1994.
pipeline systems’.
CIBSE LG3 – ‘The visual environment for display screen
Medicines and Healthcare products Regulatory Agency use’.
(MHRA). ‘Medical Electrical Installations Guidance
Note’ (MEIGaN). Health Building Note 08-01 – ‘Acoustics’.

Health Act 2006: Code of practice for the prevention and Using mobile phones in NHS hospitals. DH, 2009.
control of healthcare associated infections. Health Building Note 04-01 Supplement A – ‘Isolation
Health Facilities Note 30 – ‘Infection control in the built facilities in acute settings’.
environment’.
Firecode (the Health Technical Memorandum 05 series).

42