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STATUS IN WALES

For queries on the STATUS of this document contact or telephone 029 2031 5512 STATUS Note amended March 2013 HEALTH BUILDING NOTE 20 Facilities for mortuary and post- mortem room services 2001 STATUS IN WALES ARCHIVED This document was superseded by Health Building Note 20 Facilities for mortuary and post- mortem room services 2005 The 2001 edition superseded Health Building Note 20 Mortuary and post- mortem room 1991 Facilities for mortuary and post- mortem room servicesFacilities for mortuary and post- mortem room servicesDESIGN & BRIEFINGF acilities for mortuary and post- mortem room servicesLondon: The Stationery Office Crown copyright 2001. Published with the permission of NHS Estates, an Executive Agency of the Department of Health, on behalf of the Controller of her Majesty s for reproduction should be made in writing to:The Copyright Unit,Her Majesty s Stationery Office,St Clements House,2 16 Colegate,Norwich NR3 0-11-322000-0 First published 2001 Printed in the United Kingdom for The Stationery OfficeAll photographs: Afos Ltd2 Facilities for mortuary and post- mortem room servicesprovides guidance to NHS organisations on planningand designing comprehensive NHS mortuary and post- mortem facilities.

Facilities for mortuary and post-mortem room services provides guidance to NHS organisations on planning and designing comprehensive NHS mortuary and

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1 For queries on the STATUS of this document contact or telephone 029 2031 5512 STATUS Note amended March 2013 HEALTH BUILDING NOTE 20 Facilities for mortuary and post- mortem room services 2001 STATUS IN WALES ARCHIVED This document was superseded by Health Building Note 20 Facilities for mortuary and post- mortem room services 2005 The 2001 edition superseded Health Building Note 20 Mortuary and post- mortem room 1991 Facilities for mortuary and post- mortem room servicesFacilities for mortuary and post- mortem room servicesDESIGN & BRIEFINGF acilities for mortuary and post- mortem room servicesLondon: The Stationery Office Crown copyright 2001. Published with the permission of NHS Estates, an Executive Agency of the Department of Health, on behalf of the Controller of her Majesty s for reproduction should be made in writing to:The Copyright Unit,Her Majesty s Stationery Office,St Clements House,2 16 Colegate,Norwich NR3 0-11-322000-0 First published 2001 Printed in the United Kingdom for The Stationery OfficeAll photographs: Afos Ltd2 Facilities for mortuary and post- mortem room servicesprovides guidance to NHS organisations on planningand designing comprehensive NHS mortuary and post- mortem facilities.

2 It includes accommodation for: the receipt, temporary storage, viewing and removalof bodies; post- mortem examinations; visiting relatives/friends; teaching and guidance may be usd where the full facilities are notnecessary, for example where a body store with viewingonly is required. It may also be used when planning ajoint NHS/public mortuary and post- mortem years have seen an increase in throughput tohospital mortuaries, which has resulted in a shortage ofbody storage spaces and even post- mortem tables insome cases. This document sets out the factors thatneed to be considered when calculating requirementsfor body storage spaces and post- mortem recommends that temporary body storage facilitiesmay be used to cope with both expected increases indeaths (for example due to seasonal variations) andunexpected increases (for example due to majordisasters). Decisions about temporary storage facilitiesshould be planned in advance and agreed with the schedules of accommodation listed at the end ofthis document have adopted a modular approach toplanning to enable project teams to pick and mix those facilities that are document builds on and replaces Health BuildingNote (HBN) 20 Mortuary and post- mortem room.

3 Executive summaryAcknowledgementsNHS Estates gratefully acknowledges all contributions tothis publicationWith particular thanks to:Mr P Hoffman, Public Health Laboratory ServiceMr A Hunt, British Association of Forensic MedicineMr D Middlemiss, Mortuary Services ManagementConsultant, Mortuary CareMs S Morgan, Infection Control Nurses AssociationDr R Spencer, Bristol Public Health LaboratoryHealth and Safety ExecutiveMr S HartleyDr J NeilsonMr I StrudleyMs S WilliamsDorset County Hospital, DorsetMs S Wiseman, Infection Control Nursing Advisor(Public Health Laboratory Service)Guys and St Thomas Hospital, LondonProfessor S Lucas, Professor of Clinical Histopathology,Department of Clinical HistopathologyManchester Royal Infirmary, ManchesterMr T Armstrong, Business Manager,Histopathology/Cytopathology DepartmentMs S Barbaro, Bereavement Services Manager,Bereavement CentreMr P Ward, Mortuary Manager,Histopathology/Cytopathology DepartmentNew Cross Hospital, WolverhamptonDr K Scott, Consultant Pathologist (representing ClinicalPathology Accreditation (UK) Ltd and Royal College ofPathologists)

4 Oldham General Hospital, OldhamMr F Beverley, Senior Mortuary TechnicianRoyal Bolton Hospital, BoltonMs L Shawcross, Senior Mortuary ManagerQueen s Medical Centre, NottinghamMr J Mulligan, Senior Pathology TechnicianMr T Wreathall, Design Engineer, Estates DepartmentRepresentatives from industryMr D Durant, County Hospital and Mortuary EquipmentMr R Storr, LEEC LtdMr P Venners, LEEC LtdMr R Williams, Octaveward LtdMs S Higson, Thistle Publicity (on behalf of Afos Ltd)Department of HealthMr S Denham, Head of Estates, East Regional OfficeMs S Donnelly, Winter and Emergency Services TeamMs C Fry, Nursing Officer Communicable DiseasesMr N Higgins, Estates and Facilities Advisor, North WestRegional OfficeMr J Mallon, Technical Support (Development), Northernand Yorkshire Regional OfficeMs K Norman, Public Health GroupMs L Robertson, Estates Advisor, North West RegionalOfficeMr R Stone, Head of Estates and Facilities, North WestRegional OfficeWith contributions from:Mr J Britton, Assistant Scientific Advisor, NHS EstatesMs R Haigh, Ergonomics ConsultantMr D Morgan, Senior Consultant, CapitecMs M Twin, Activity Database ResearcherMr A Sinclair, Activity Database Researcher, SinclairAlanco 41.

5 Scope of the document page Introduction2. General service considerations page Functions of a mortuary and post- mortem Assessment of scale of Joint NHS/public mortuary and post- mortem facilities3. General functional and design requirementspage Internal environmental Fittings and Floors and Maintenance and Communications4. Risks associated with a mortuary and post- mortem facility page Infection Risks arising from use of Risks associated with disposal of Risks arising from handling radioactive Design considerations for minimising risks5. Location and layout page Staff changing6. Specific functional and design requirementspage Entrances and Body viewing Body store and body handling Post- mortem Possible project option of a PM table in a separate Dirty utility/instrument Post- mortem transit Staff changing Observation Specimen Pathologists Technicians office/rest Disposal Cleaners General purpose and linen Training and teaching General guidance page Upgrading or adaptation of existing Critical Information management and Damage in health Disabled Engineering services page Model specifications and technical Value for money Space requirements for plant and Access to control and isolation Engineering Activity CDM Noise and speech Fire Mechanical Ventilation (substances hazardous to health)

6 Ventilation of post- mortem Ventilation of specimen Ventilation of visitors sanitary Ventilation of dirty Ventilation controls and Hot and cold water Refrigerating plant and body storage Electrical Electrical Socket outlets and power Socket outlets in the post- mortem Emergency electrical Personal alarm Security Dictation Entrance Staff location Call Data and equipment Lightning Internal Cost information page Departmental cost allowance Locational Schedules of Schedules of space Schedules of Departmental Dimensions and Land Engineering Activity Data page Activity data applicable to this guidanceAppendices page 57 Appendix I Categorisation of biological agentsAppendix II Requirements for handling bodies thathave undergone cancer treatments involvingradioactive substances Appendix III Critical dimensionsAppendix IV Health and safety checklist fortemporary body storesReferencesFACILITIES FOR MORTUARY AND POST- mortem ROOM SERVICES231 Scope of the documentINTRODUCTION This document gives guidance on the planning anddesign of comprehensive NHS mortuary and post- mortem (PM) facilities.

7 It covers body receipt andtemporary storage, body viewing, accommodation forvisiting relatives, examination by PM, and thedemonstration of PM findings in cases of clinical interestand for teaching purposes. The guidance may be usedwhere the full facilities are not necessary, for examplewhere a body store with viewing only is required. It mayalso be used when planning a joint NHS/public mortuaryand PM This document replaces Health Building Note (HBN)20 Mortuary and post- mortem room (published in1991). Whilst this guidance provides information that iscurrent at the time of publication, there are obviouslywider considerations associated with the subjectscovered, and other related published guidance must,therefore, be taken into account. Additionally, someaspects of this guidance may be amended or qualifiedin the future. Project teams should consequently ensurethat they check the currency of documents referred towithin the text.

8 In the case of NHS Estates orDepartment of Health documents this may be done viathe NHS Estates website or by contacting the NHSE states Information Centre. Details of these are given inthe reference section of this The Capital Investment Manual contains theDepartment of Health s procedural framework governingthe inception, planning, processing and control ofindividual health building schemes. There are variousmandatory requirements within this overall process, butthe way these tasks are carried out is mainly for NHStrusts and Health Authorities (for directly managedunits), as appropriate, to determine. Approval from theDepartment of Health for business cases will depend onhow NHS organisations intend to carry out themandatory tasks. The Manual gives guidance on thetechnical considerations of the full capital appraisalprocess and also provides a framework for establishingmanagement arrangements to ensure that the benefitsof every investment are identified, realised andevaluated.

9 It emphasises three key points:a. each individual scheme must be supported by asound business case. A business case mustconvincingly demonstrate that the investment iseconomically sound (through an option appraisal) andfinancially viable (affordable to the trust and itspurchasers);b. an exploration of private finance alternatives shouldbe viewed as a standard option whenever a capitalscheme is being considered. Once the OutlineBusiness Case has been approved, the preferredoption should be compared to potential privatefinance alternatives. Approval of the Full BusinessCase will not be given unless there is a cleardemonstration that the private finance alternativeshave been adequately tested;c. the delivery of a major capital project is a difficult andcomplex task. Nevertheless, failure to deliver on timeand to cost diverts resources from direct patient establishment of an appropriate projectorganisation is essential to ensure that projects aredelivered within agreed budgets and FOR MORTUARY AND POST- mortem ROOM SERVICES4 FUNCTIONS OF A MORTUARY AND POST- mortem A mortuary and PM facility fulfils five functions,which, so far as possible, should be kept physicallyseparate.

10 These five functions are: a. the receipt and temporary storage of bodies; b. investigations into the cause of death by performing aPM examination of the body; c. the demonstration of PM findings in cases of clinicalinterest or for teaching purposes; d. the viewing and/or identification of a body;e. accommodating visiting relatives/next of In a complete facility, it must be possible for thesefive functions to be carried out simultaneously in safetyand privacy within the overall accommodation, whichshould be designed to achieve this end. In all facilitiesthe receipt, temporary storage, viewing and collection ofbodies must be achieved safely, and with discretion anddignity. Procedures for body viewing must also respectthe sensitivities of the Post-mortems may be required on:a. deaths occurring in hospital, which are covered bythe local hospital trust;b. people brought to the A&E department who are deadon arrival;c.


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