HTM 61 is gone. It was withdrawn in 2006, yet HTM 61-compliant flooring is still one of the most searched flooring products in healthcare. If you’re responsible for flooring in an NHS building, a private hospital or a CQC-registered care setting, specifying against a standard that no longer exists leaves a real compliance gap. The document that replaced it is Health Building Note 00-10: Part A, known as HBN 00-10 Part A, and it sets out exactly what floor finishes in a healthcare building must achieve. Here’s what changed, what the standard requires, and what it means for your next project.
What HTM 61 Covered
HTM 61 was the Health Technical Memorandum used across NHS estates from the mid-1990s onward. It set out performance requirements for floor finishes in different clinical spaces, covering slip resistance, joint continuity and how a floor should meet a wall in areas like operating theatres. Teams treated it as the default reference for any flooring project, and the term has stuck around in specifications and search habits ever since.
Why the Standard Changed
The Department of Health restructured its guidance library through the 2000s and 2010s, replacing older Health Technical Memoranda with a new suite of Health Building Notes covering the same ground with updated evidence. HBN 00-10 Part A confirms the change. It states that it supersedes Health Technical Memorandum 61. First published in 2013, it remains the current reference for flooring in NHS and healthcare buildings.
HBN 00-10 Part A: The Standard That Replaced It
HBN 00-10 Part A is published by NHS England and sets out the policy and performance requirements for flooring used in healthcare facilities. It applies across primary care premises and acute hospitals, though the exact requirements shift with the type of building and the room’s clinical status. Following the standard gives commissioning organisations and specifiers documented evidence of compliance, and it counts directly toward meeting the Care Quality Commission’s own registration requirements.
How Commissioning Organisations Use the Standard
HBN 00-10 Part A is aimed at commissioning organisations, specifiers, project teams and everyone else involved in building or maintaining a healthcare estate. NHS organisations increasingly use a Premises Assurance Model to give public assurance that services are delivered from buildings meeting national standards, and self-assessments against that model draw directly on evidence like a compliant flooring specification. Complying with HBN 00-10 Part A gives estates teams a documented starting point for that assurance work, rather than a verbal assertion that the floor is fine.
Floor Finish Requirements in Practice
The standard sets out specific expectations for floor finishes and skirtings across clinical areas:
- Continuous coved skirting with a minimum height of 100mm in clinical areas and corridors, to keep cleaning straightforward
- Floor finishes resistant to the detergents and disinfectants a building uses day to day
- Carpets avoided in clinical areas altogether, with any use elsewhere backed by a documented risk assessment
- Impermeable finishes designed to stop water leakage in wet or plumbed areas
- Entrance matting suitable for wheelchairs and trolleys, positioned to reduce dirt being tracked through the building
Slip Resistance and Infection Control Requirements
Two threads run through the whole standard: keeping people upright, and keeping the building clean. Slips and trips cause over a third of all major workplace injuries in Great Britain, according to HSE, and most of these happen because a floor surface is contaminated with water, grease or another liquid. Specifically on slip resistance, HSE recommends the pendulum test as the primary method for assessing how a floor performs, both dry and when contaminated.
The pendulum test gives a Pendulum Test Value, or PTV, which HSE and the UK Slip Resistance Group classify into three bands. A PTV of 0 to 24 means high slip potential, 25 to 35 is moderate, and 36 or above is classed as low slip potential. HBN 00-10 Part A builds on this by requiring healthcare providers to monitor slip resistance at regular intervals throughout a floor’s service life, since cleaning, polishing and general wear can all shift a floor’s PTV over time.
Infection control works alongside this. Flooring needs to be smooth, non-porous and genuinely easy to clean, since contamination with blood or bodily fluid is treated as a real possibility in most clinical settings. Getting this wrong raises the risk of a failed inspection and adds to the daily workload of cleaning and infection prevention teams, who depend on the floor pulling its weight.
Selecting the Right Finish for Each Space
The standard goes well beyond general performance requirements, working through specific space types to set out what each one demands. Hospital streets and corridors need finishes able to withstand heavy wheeled traffic and pedestrian footfall, which is why corridor flooring gets specified differently to a ward bedroom or a consulting room next door. Radiation areas bring their own requirements too, with wall and partition materials needing sign-off from a radiation protection adviser before anything gets fitted.
HBN 00-10 Part A extends the same logic to entrances, requiring slip and trip resistant surfaces in all weather conditions, plus entrance matting suitable for wheelchair and trolley users, positioned to reduce dirt being tracked into the building. Central kitchens are specified in consultation with environmental health officers, and sanitary spaces need finishes designed to stop moisture reaching the building fabric behind them.
A Note on Antimicrobial Flooring Claims
Antimicrobial-impregnated flooring gets marketed heavily in healthcare settings, often with the implication that it’s inherently safer. HBN 00-10 Part A is direct about the evidence here: at present, no definitive data is confirming that antimicrobial coatings or additives reduce healthcare-associated infection more effectively than a standard smooth, non-porous surface that’s cleaned properly. Antimicrobial products can still have a place in a specification, but the basic performance requirements, being easy to clean and resistant to the disinfectants used on site, matter more than the claim printed on the box.
Sustainability and Life-Cycle Costs
The standard also connects flooring decisions to sustainability targets. New healthcare builds are expected to achieve an Excellent BREEAM Healthcare rating, and refurbishments a Very Good one, with flooring choices contributing directly to that assessment. HBN 00-10 Part A also points specifiers toward life-cycle costing rather than upfront price alone, since materials chosen to match their intended lifespan reduce disruption and cost across the life of the building.
What This Means for Your Building
HBN 00-10 Part A is a practical reference for daily specification decisions, backed directly by regulation. CQC Regulation 15 requires all premises and equipment used by a service provider to be clean, secure, suitable and properly maintained, and Health Building Notes are specifically referenced as a route to demonstrating that compliance. A flooring specification that ignores the current standard leaves a building open to enforcement action, and in a worst case, it can affect a provider’s registration status entirely.
This is exactly the kind of detail we work through, whether that’s a corridor in an acute hospital or a treatment room in a smaller healthcare setting. As CFA members and SafeContractor accredited, we bring the same documented standards to every healthcare flooring job, which gives estates teams something concrete to point to when a compliance question comes up. Getting the standard right the first time costs less than fixing a non-compliant floor twice.
Getting Your Next Flooring Specification Right
Three things are worth remembering here. HTM 61 stopped applying back in 2006, and HBN 00-10 Part A is the standard that matters now. Slip resistance and infection control sit at the centre of that standard, treated as core requirements. And working with a contractor who specifies against the current guidance protects your building and the people using it.
If you’ve got healthcare flooring work coming up anywhere across the Thames Valley, get in touch with our team or take a look at our healthcare flooring page for the products and standards we work to every day. The guidance will keep evolving as NHS estates standards are reviewed, and staying ahead of it is a lot easier with a specialist who tracks the changes for you. In the meantime, the practical takeaway is simple: check what your specification references, and if HTM 61 is still sitting in a tender document somewhere, that’s a good sign it’s overdue an update.
