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NHS health centre design in England starts with Health Building Note 11-01 (HBN 11-01), then adds the other Health Building Notes (HBNs) and Health Technical Memoranda (HTMs) relevant to the project’s rooms, services and engineering systems. HBNs guide facility planning and design; HTMs address specialist building and engineering technology. NHS England treats them as best-practice technical guidance, not as a blanket substitute for legislation. For a live project, check the current NHS estates publication list and record any departure through the applicable derogation process.
Which NHS health centre design standard should a project start with?
For a GP surgery, health centre or primary care centre in England, start with HBN 11-01, Facilities for primary and community care services. NHS England identifies it as guidance for a range of primary and community care settings, including GP surgeries and health centres, primary care centres, resource centres, urgent care centres and community hospitals. It helps project teams consider facilities and how they are selected and zoned for the care to be provided.
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HBN 11-01 is a starting point, not a single document that answers every design or construction question. The applicable guidance depends on the services in the brief, the rooms and activities they require, and the building systems within the project. A new centre, a refurbishment, an extension and a change of use can all have different design scopes; identify the actual scope before deciding which notes and memoranda apply.
The NHS England publication page for HBN 11-01 says it was first published on 20 March 2013 and was updated on 31 January 2024. Those dates identify the page and publication history, but do not establish that no later revision or archive action has occurred. Check the NHS England HBN index and complete NHS estates publication list before relying on a particular edition for a live project.
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What is the difference between an HBN and an HTM?
HBNs primarily support healthcare building planning and design; HTMs provide healthcare-specific advice on specialist building and engineering technology. They are complementary series, so the practical question is not which one to choose, but which HBNs and HTMs fit the project.
| Question | HBN | HTM |
|---|---|---|
| Main focus | Facility briefing, planning, design, adaptation and extension | Specialised building and engineering technology, including design, installation and operation |
| Typical project question | What facilities, spaces and zoning suit the care activity? | How should a relevant engineering system be designed, installed, operated and managed? |
| Health centre example | HBN 11-01 for primary and community care; HBN 00-03 for clinical and clinical support spaces | The relevant memorandum for systems such as medical gas pipelines, ventilation, water or fire safety |
| How to apply it | Select facility-specific and topic-specific design guidance for the brief | Identify applicable system guidance across the building lifecycle |
NHS England describes HBNs as best-practice guidance for designing and planning new healthcare buildings and adapting or extending existing facilities. Its HTM series addresses specialist technical systems at different stages of a building’s life, and NHS guidance says to read relevant parts of the HTM series alongside HBNs. The actual combination must be established from the service brief, activities, rooms, systems and project stage—not inferred from the building label alone.
Which other HBNs may apply to a health centre?
Use additional HBNs where their subject matter matches the spaces and activities in the brief. Two useful reference points are HBN 00-01 for general design principles and HBN 00-03 for clinical and clinical support spaces.
HBN 00-01 provides general design guidance and context for planning healthcare buildings, including future-proofing considerations. It expressly is not comprehensive: it does not replace facility-specific guidance, topic notes or the project’s engineering design work. The publication page records a first publication date of 20 March 2013 and an update to the page on 31 January 2024; the general guidance was last updated on 3 June 2014. Check its current status rather than treating those historical dates as proof of a current edition.
HBN 00-03 addresses clinical and clinical support spaces. It can help when the project includes such rooms, but the project team still needs to identify the relevant requirements for each activity and coordinate the rooms with the applicable facility and technical guidance. Do not assume that citing a general HBN settles a particular room’s detailed design.
HBN 11-01 also has Supplement A on resilience and emergency planning. This is relevant to consider when establishing the facility brief and its approach to resilience; the existence of a supplement does not, by itself, determine the project-specific measures required.
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Which HTMs should a health centre design team check?
There is no one HTM that applies to every health centre. Map the building systems in the project scope to the relevant current HTM entries, then coordinate their requirements with the applicable HBNs and the design disciplines responsible for those systems.
Potential subjects identified in NHS technical guidance include medical gas pipeline systems, ventilation, water and fire safety. These are examples, not a universal checklist: a system’s relevance depends on the planned services and building scope. For instance, do not assume that every primary care building has the same medical gas requirements as another type of healthcare facility. Confirm the system needs from the clinical brief and project design.
The HTM index illustrates why edition checks matter: it lists HTM 02-01, Medical gas pipeline systems, dated 19 August 2026, and HTM 05-01, Managing healthcare fire safety, dated 11 February 2026. These are examples of dated entries, not a complete list of requirements for a particular centre. Verify the relevant HTM and its current parts or status on the NHS England HTM page and estates publication list before design decisions are fixed.
Are HBNs and HTMs mandatory?
Do not describe every sentence in an HBN or HTM as law. NHS England characterises the series as best-practice technical guidance and says projects should comply; where a project departs from the guidance, the departure should be recorded through the estates derogation process. Statutory and regulatory obligations remain a separate, essential part of project compliance.
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The 2026 NHS England neighbourhood health centre design and performance specification reinforces that distinction. It says the specification does not introduce new compliance mechanisms and uses “must” for existing legal or regulatory requirements. Otherwise, it sets common principles and aspirations for local adaptation. It is a companion document directing teams to relevant HBNs and HTMs, the NHS Net Zero Building Standard and other applicable requirements—not a replacement for the technical series.
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For neighbourhood health centre proposals, read the NHS England design and performance specification alongside the regional or ICB guidance, relevant HBNs and HTMs, the NHS Net Zero Building Standard and other applicable requirements. It also calls for centres to be co-designed with communities. The local service model and community input therefore belong in briefing, rather than being treated as a design detail to add after the core plan is settled.
How should a project team apply the guidance?
Use a traceable sequence from the service brief to the building systems. This reduces the risk of selecting guidance by habit, overlooking a relevant topic, or leaving a departure unexplained.
- Define the project and service brief. Record the building type, care activities, services, new-build or alteration scope, and intended users. For an existing facility, identify what is being adapted or extended and which systems are affected.
- Use HBN 11-01 to frame the facility plan. Apply its primary and community care focus to facility selection and zoning. Use the service activities—not merely the name “health centre”—to determine what the building needs to support.
- Identify room and activity guidance. Check whether other HBNs, including HBN 00-03 for clinical and clinical support spaces, match the proposed rooms. Consider HBN 00-01 for general design and future-proofing context, while recognising that it is not comprehensive.
- Map technical systems to HTMs. Ask the relevant design disciplines to identify the applicable current technical guidance for systems actually in scope, such as ventilation, water, medical gases or fire safety. Include operation and lifecycle considerations, not just installation.
- Check current publication status. Confirm editions, parts, updates and archive status through the NHS estates publication list and relevant HBN or HTM index. Avoid carrying forward an old project reference without checking it.
- Coordinate and record the design basis. Keep a project schedule linking each relevant note or memorandum to the affected spaces, system, design decision and responsible discipline. Record where guidance has been considered and how the design responds.
- Escalate departures through the proper route. Where the project departs from applicable NHS estates guidance, follow the current derogation process, obtain the required review and approval, and retain supporting evidence.
The last two steps are important for construction as well as briefing. A drawing set should make the design intent and interfaces intelligible to the people coordinating, installing, commissioning and handing over the building. A guidance reference without a clear connection to an actual design decision is difficult to use as assurance.
What should a derogation record include?
If the project departs from NHS estates technical guidance, use the current NHS England process for managing and reporting derogations rather than treating the departure as an informal design note. The process is the route for recording and supporting the case; it does not mean that a departure is automatically acceptable.
The NHS guidance identifies supporting material such as drawings, infection-control and fire-safety information, certificates, commissioning records and handover documentation. Which evidence is relevant will depend on the departure and project. Build the record around the specific guidance provision, the reason for the proposed alternative, the affected areas or systems, the evidence used to assess it, and the approvals required under the current process.
Keep the record coordinated with the design and construction information. If the proposed solution changes, the supporting drawings or evidence may need to change as well. The project team should verify the process requirements and approval route against the current NHS England derogations guidance; this article cannot determine whether a particular deviation should be accepted.
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What planning tools can support briefing and design?
NHS guidance describes the Activity DataBase (ADB) as data and software intended to assist healthcare project teams with briefing and design. Its described functions include activity-based room data sheets; personnel and planning relationships; environmental considerations; space requirements; graphical layouts; equipment and component schedules; project-level schedules; drawings; and adaptable reference data.
ADB may help structure information for a project, but the existence of a planning tool does not make its outputs a substitute for checking the applicable HBNs, HTMs, regulations or project-specific design. The NHS Improvement FOI response dated 25 March 2019 describes ADB as a Department of Health-produced computerised package and reports that technical provision and helpdesk service had been delivered externally at that time. That is historical information only; it does not establish who supplies or supports ADB now.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.How do you avoid using an outdated or mismatched document?
Check the official NHS estates publication list before quoting an edition or applying guidance to a live project. NHS England’s HBN and HTM index pages state that documents hosted on its website are current, while also explaining that a “withdrawn” label on GOV.UK can result from a document redirect rather than withdrawal of the NHS-hosted guidance. The complete estates publication list is the appropriate place to check whether a document has been updated or archived.
For each reference, note the title, number, part or supplement, publication or revision information shown by the official source, and the date your project checked it. Keep a record of the source and the design decision it informed. This makes it easier to revisit an assumption if guidance changes during a long design or construction programme.
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Also check that the document is relevant to the actual service and scope. A health centre might include different clinical activities, support spaces and engineering systems from another facility that shares the same label. Selecting a standard based on a building name alone can leave teams with guidance that is too general, incomplete or aimed at a different system.
What is the practical takeaway for a construction project?
Use HBN 11-01 to establish the primary and community care facility approach, then select other HBNs for the spaces and activities and HTMs for the technical systems actually required. Confirm current document status, coordinate the design basis across disciplines, and treat any departure as a formal assurance issue that needs to be recorded and supported—not as an undocumented exception.
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For live work, use the official NHS publications and project-specific professional advice. The guidance helps teams plan and assure healthcare buildings, but it does not replace the applicable law, a project-specific design review, site assessment, or the approvals and responsibilities established for that project.
Frequently Asked Questions
Does HBN 11-01 apply to a GP surgery refurbishment as well as a new build?
Yes. NHS England describes HBNs as guidance for new healthcare buildings and for adapting or extending existing facilities, and HBN 11-01 covers primary and community care settings. The relevant parts still depend on the refurbishment scope and the activities and systems affected.
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Can I buy a printed copy of HBN 11-01?
The Stationery Office catalogue lists a printed reference, ISBN 9780113229796. For project decisions, use the official NHS England publication page and confirm the current status; print availability does not prove that a copy contains the latest applicable information.
What is NHS England’s Activity DataBase used for?
ADB is described as a briefing and design resource with room data, space and environmental information, layouts, schedules and drawings. An NHS Improvement FOI response from 25 March 2019 gives historical supplier context, but does not establish who currently provides its support.
Does the neighbourhood health centre specification replace the HBNs and HTMs?
No. NHS England presents the 2026 specification as a companion and directs project teams to relevant HBNs, HTMs and other requirements. It also frames local co-design as a principle for neighbourhood centres.
