GP clinic fitouts

A general practice doesn’t fail on finishes. It fails when reception cannot see the door and the waiting room at once, when a nurse walks the length of the tenancy between treatment and the utility room forty times a day, or when a patient in one consulting room can hear the conversation in the next.

General practice is the most standardised of the clinical fitouts, which sounds like it should make it the easiest. It makes it the least forgiving, because rooms are broadly interchangeable and there is nowhere for a bad layout to hide.

The value sits in three places: how patients move from the door to a chair to a room, how staff move between clinical and support spaces, and whether the walls do their job acoustically. Get those right and a practice runs quietly for fifteen years. Get them wrong and every single day costs a few minutes per staff member, forever.

Design for the busiest hour

The most common sizing mistake in general practice is a waiting room sized for the average patient load. Averages do not queue. Monday morning does.

Count the seats you need when every consulting room is running, both GPs are behind, and a practice nurse is doing immunisations. Then add space for prams, walking frames and the gap people leave between strangers, which is why we plan at around 1.4 square metres a seat rather than the 0.8 a chair actually occupies.

Reception is a sightline problem

Reception has to see the entry and the waiting room without turning around, take a phone call without the room hearing it, and hand over a card without a queue forming across the path of travel. It also needs a section usable from a seated position under AS 1428.1, which is a dimension rather than a gesture.

Behind it sits the part nobody plans: records, printers, the scanner, consumables, and somewhere for staff bags. If it’s not drawn, it ends up on the counter.

Consulting rooms, and the wall between them

A workable consulting room holds a desk with the GP and patient at a comfortable angle, an examination couch with access down at least one long side, a basin, and a third person, a parent, carer or interpreter, without anyone shuffling.

Acoustic privacy is where the money goes, and it is cheap at frame stage and expensive afterwards. Partitions run full height to the underside of the slab rather than stopping at the ceiling grid, with insulation in the cavity, seals on the door and attention to any service penetration that goes straight through. A ceiling-height wall in a practice with a shared ceiling void is an acoustic connection between two rooms, not a barrier.

The other half is the door. A hollow-core door with a 15 millimetre gap under it undoes a very good wall.

Access is the other document doing real work here. AS 1428.1 governs the path of travel from the street to the consulting room, and it rules out more tenancies than anything else. Count your closet pans early too: more than one in a bank usually triggers an ambulant cubicle in each block.

Treatment, and clean and dirty

The treatment room takes the procedures that don’t fit a consulting room: sutures, dressings, minor excisions, ECG. It needs room to work around a patient from both sides, appropriate lighting, and surfaces that clean at the junctions rather than just across the middle.

Then the pair that gets forgotten: a clean utility for stock and preparation, and a dirty utility for waste, used instruments and a slop hopper. Combining them is the single most common accreditation problem we see raised on an existing practice.