You may remember that I had contacted NHS England asking for Changing Places to be made compulsory in all hospitals and healthcare settings. They told me that they already make reasonable adjustments in all healthcare settings. I've emailed them back today, this is my response. I'll keep you updated... Thank you for your response that I received on 9th March. You tell me that: “Reasonable adjustments are made for disabled people to access disabled toilet facilities in all healthcare settings”. However, the figures don't back you up on that one. In reality reasonable adjustments are only being made for those with some degree of independent mobility, by providing standard disabled toilets. Only about 30 hospitals in the UK have a registered Changing Places facility, and there are only about 20 Changing Places facilities, in the UK, in other healthcare settings for outpatients and visitors (Changing Places Consortium, 2016). This means that at any other hospital, clinic or GP practise, any individual who has a disability which affects their mobility to the extent that they are fully dependent on others, have no choice other than to be changed in an inappropriate place and without appropriate equipment OR be left in a soiled pad for prolonged periods of time. As pointed out in my previous email this is against all infection control, moving and handling and pressure ulcer management policies that are in place for inpatients. Lack of these facilities for outpatients and visitors is detrimental to the physical and emotional health of both carer and the severely disabled person whom it most directly affects. The argument that I made in my last email and will reiterate here is that those with more severe disabilities NEED a changing bench and hoist to be able to have their toileting needs dealt with in a timely, humane and dignified fashion, it is NOT an option. As healthcare providers you should be leading the way. As an information gathering exercise, following your response, I set up a petition calling on the Government to make Changing Places toilets compulsory in hospitals for outpatients and visitors. I have included the comments made as an attachment, it doesn't make for good reading, and are certainly an indicator that reasonable adjustments are not being made. You also tell me that:”I would like to assure you that every NHS provider trust and commissioner take these issues very seriously and ensure compliance with the Equality Act”. Again, the facts that I have in front of me is that most NHS trusts and commissioners hadn't even taken into consideration what their severely disabled outpatients and visitors do when they need to visit the toilet. This, by the fact that many are having to ask their Estates and/or are calling meetings with Estates and Equality teams. Myself and a fellow campaigner have emailed nearly 300 acute hospital trusts, clinical commissioning groups and some community hospitals. We haven't finished yet, because somebody needs to spread awareness if as an organisation you are unwilling to do so. The point that worries me is that some trusts tell me that they currently don't have space for a full Changing Places facility, are unwilling to change toilet planning specifications for future builds/refurbishments, and have not given me any indication of how severely disabled outpatients and visitors are supposed to access amenities in a dignified and respectful manner in the meantime. This NEEDS to change. Visiting the toilet is not an option for anybody we all have to do it. We are all only a car accident or blood clot away from this being ourselves or a family member. Please reconsider, and provide Changing Places facilities as a matter of course in all our hospitals, and healthcare settings. Kind regards Lorna Fillingham