A Disabled Toilet Isn't Enough: Why Changing Places Toilets Matter

Going to the toilet.

It's something most of us probably don't spend very much time thinking about.

If you're going shopping, travelling somewhere, visiting a tourist attraction, going to a concert or simply spending the day away from home, you probably assume that at some point you'll be able to find a toilet.

You might wonder whether it will be clean. You might have to queue. You might even complain about having to pay to use it.

But imagine having to ask a much more fundamental question:

Will there be a toilet there that I can physically use at all?

For many disabled people and their families, that's not a hypothetical question. It can determine whether they can spend a whole day somewhere, whether they have to return home early — or whether they can go out in the first place.

And that's why we need to talk about Changing Places Toilets.

A disabled toilet is not one-size-fits-all

I think one of the biggest misconceptions around accessible toilets is the assumption that if a building has a standard disabled toilet, the accessibility box has been ticked.

It hasn't.

Disability isn't one-size-fits-all, so why would we expect accessible toilets to be?

In my own case, I'm totally blind. A standard accessible toilet generally works fine for me provided I can orientate myself and work out where everything is.

But my needs are very different from those of somebody who uses a wheelchair and needs assistance with transfers.

Some people may need one carer to help them use the toilet. Others may need two.

Somebody might need to be transferred from their wheelchair using a hoist.

Someone might need an adult-sized changing bench.

They might need significantly more space than an ordinary accessible toilet provides.

That's where a Changing Places Toilet comes in.

🎥 The embedded video explains in detail about Disabled Toilets, why not all Disabled Toilets are accessible, and why Changing Places Toilets are required.

Changing Places Toilets are larger facilities designed for people whose needs cannot be met by standard accessible toilets. In Scotland's current building standards guidance, for example, a Changing Places Toilet includes features such as a ceiling-mounted tracking hoist, height-adjustable adult-sized changing bench, height-adjustable washbasin, peninsular toilet, privacy screen and enough room for assistance from carers. Crucially, the guidance says these facilities should be provided in addition to, rather than instead of, standard accessible toilets. Read the Scottish Government planning circular on Changing Places Toilets.

That last point matters.

We shouldn't be debating which type of disabled person gets an accessible toilet.

We should be designing public spaces which recognise that different disabled people have different needs.

Imagine being changed on a toilet floor?

This is where the subject becomes uncomfortable.

And I think we need to allow it to become uncomfortable.

Because one reason we don't make enough progress on accessible toileting is that, as a society, we aren't particularly good at talking openly about toilets, continence, personal care and what actually happens when somebody cannot access the facilities they need.

Imagine being an adult who needs to be changed while you're away from home?

There is a disabled toilet — but no adult-sized changing bench.

What happens?

In some cases, the only available surface is the floor.

Think about that.

A public toilet floor.

Would you lie down on it?

Would you expect your husband or wife to lie on it?

Would you put your child on it?

Would you consider that dignified?

Yet disabled people and their families have faced precisely these sorts of situations because the equipment they require simply isn't there.

Alternatively, families may decide that they can't change the person at all.

Perhaps they'll restrict how long they stay out.

Perhaps they'll avoid drinking.

Perhaps they'll leave early.

Or perhaps they'll decide that going there isn't worth the difficulty and stay home.

At that point, we're no longer talking simply about toilets.

We're talking about whether someone can participate in society.

"Why Not Just Wear Pads?"

There is an extraordinary article on the Ordinary Hopes blog called "Why Not Just Wear Pads?"

Read "Why Not Just Wear Pads?" on Ordinary Hopes

It was written in 2019 by George, then aged 24, who explained that she had quadriplegic spastic athetoid cerebral palsy, used a powered wheelchair and needed a hoist for transfers.

George was also fully continent.

Yet because toilets with suitable hoists were so difficult to find, she explained that she had routinely had to wear nappies or pads when leaving home.

When a Changing Places Toilet was available, she could simply use the toilet. Without one, her social life could be restricted by worries about leaking pads, having to return home or being left sitting in her own waste. Read George's full account on Ordinary Hopes.

Just think about the absurdity of that situation.

A continent adult being expected to use a pad because society hasn't provided a toilet she can access.

If somebody suggested that an able-bodied adult should simply wear a pad because the nearest ordinary toilet was inconvenient to provide, we'd probably find the suggestion outrageous.

Why should the standard be different for disabled people?

George's account goes considerably further and discusses the enormous impact the situation had on her life and the medical decisions she faced. It's a powerful article, and I really recommend reading it. Read "Why Not Just Wear Pads?" on Ordinary Hopes.

Changing Places aren't only about changing

Another excellent article on Ordinary Hopes is "Who Needs Changing Places?"

Read "Who Needs Changing Places?" on Ordinary Hopes

It makes an important point: the name Changing Places can itself lead to misunderstandings.

People might assume they're essentially larger baby-changing rooms for disabled children and adults.

They're much more than that.

The article explains how different people use the additional equipment and space in different ways. The writer's son needed a hoist to transfer from his wheelchair, while some wheelchair users could transfer themselves if they could position their chair appropriately and use the rails.

In other words, the equipment can actually increase independence, rather than simply allowing somebody else to provide personal care.

And that brings us back to something I talk about regularly on The World According to Reece.

Accessibility isn't always about somebody doing something for a disabled person.

Sometimes accessibility means giving somebody the environment and equipment that allows them to do as much as possible for themselves.

Things have changed since 2017 — but the problem hasn't disappeared

A few years ago, I remember being shocked when I discovered that Building Regulations didn't require Changing Places Toilets to be installed.

That was around 2017.

So I wanted to check what has happened since then before writing this article.

There has actually been significant progress.

Here in Scotland, changes to building standards introduced Changing Places guidance applying to certain larger new buildings from October 2019. Current Scottish guidance says they should be provided in specified larger public buildings, including certain large retail, assembly and entertainment buildings, buildings containing swimming pools, hospitals and secondary schools providing community facilities. There are also provisions covering certain conversions and substantial extensions. Read the Scottish Building Standards Technical Handbook (non-domestic, January 2025). You can also follow the ongoing Scottish Government consultation on Changing Places Toilets.

England subsequently changed its guidance too. Amendments to Approved Document M introduced mandatory provision in appropriately sized publicly accessible buildings, with the change applying from 2021. Read the UK Government Approved Document M on access to and use of buildings.

So compared with the position I remember discovering in 2017, there has been real progress.

And that deserves recognition.

But there's an important catch.

These requirements don't magically retrofit every shopping centre, restaurant, leisure facility, attraction, community building and other public venue that already exists.

Nor do they mean every new public building automatically requires a Changing Places Toilet regardless of its size or type.

So while legislation and building standards have moved forward, disabled people still have to live in the world we've already built.

That means the campaigning isn't finished.

Disability can happen to any of us

There's another reason I think everybody should care about this subject.

Disability isn't some separate community that an able-bodied person can confidently assume they'll never join.

Life can change.

Someone can have a stroke.

Someone can develop a progressive condition.

Someone can be involved in an accident.

Someone's mobility can change as they age.

A person who has never given accessible toilets a second thought could suddenly discover just how much of everyday life depends upon infrastructure they previously never noticed.

That isn't meant to frighten anyone.

It's simply reality.

Accessibility benefits people we know today and people whose needs will change tomorrow.

Toilets determine where people can go

Imagine planning a family day out.

One family checks:

• What time does it open?

• How much are the tickets?

• Where can we get lunch?

Another family has to start with:

Is there a toilet our family member can use?

If the answer is no, everything else may become irrelevant.

That's what makes this issue so important.

A toilet isn't an optional luxury attached to a day out.

If somebody can't use the toilet at a venue, can we really say that venue is accessible to them?

You can have wheelchair ramps.

Automatic doors.

Disabled parking spaces.

Accessible ticket counters.

Staff trained in disability awareness.

But if someone arrives and discovers that they cannot safely use the toilet, their inclusion has an expiry time.

Eventually, they have to leave.

We need to get less embarrassed about talking about toilets

I also think Britain has a cultural problem here.

We're often uncomfortable discussing perfectly natural bodily functions.

We use euphemisms. We change the subject. We find toilet conversations embarrassing.

But embarrassment doesn't make the need disappear.

Disabled adults menstruate.

Disabled adults need personal care.

Disabled adults urinate and defecate.

Disabled adults can be continent or incontinent.

Disabled adults sometimes need help with all of those things.

There is nothing shameful about any of it.

And if we cannot talk openly about what people actually need, how can we possibly design appropriate services?

We need disabled people, carers and families involved in these conversations — particularly people who actually use Changing Places Toilets.

Dignity shouldn't depend on your postcode

I'd like to see a future where finding an appropriate toilet doesn't require military-level planning.

Where a family doesn't have to study a Changing Places map before deciding whether a day out is possible.

Where someone isn't lifted unsafely because the correct hoist isn't available.

Where nobody is placed on a public toilet floor.

Where a continent person isn't expected to use a pad because the building they're visiting hasn't provided an accessible toilet.

And where carers don't have to risk injuring themselves, or the person they're looking after, when trying to transfer somebody in a space that was never designed for them.

We've made progress.

The changes to building standards show that governments increasingly recognise the need.

But accessibility shouldn't merely mean doing the minimum necessary to comply with regulations.

Venues can choose to do better.

Businesses can choose to do better.

Councils can choose to do better.

And all of us can help by understanding why these facilities matter.

Accessibility means everyone

Whenever we talk about disabled access, there's a temptation to imagine a single generic "disabled person".

That person doesn't exist.

My needs as a totally blind person aren't the same as those of someone using a powered wheelchair.

Someone else's needs won't be the same as mine.

That's precisely why a disabled toilet does not mean a one-size-fits-all solution.

A standard accessible toilet works for me.

For somebody else, it may be completely unusable.

Neither person's needs are more legitimate than the other's.

Ultimately, this isn't really a story about toilets.

It's about dignity, independence, family life and participation.

It's about somebody being able to go shopping.

Attend a concert.

Travel.

Meet friends.

Go to college.

Visit a relative in hospital.

Spend a day with their family.

Have something to drink without worrying about what happens later.

Stay out for as long as everybody else.

And simply use the toilet when they need to.

Those are ordinary things.

And perhaps that's exactly the point.

Disabled people shouldn't need extraordinary arrangements simply to live ordinary lives.

Changing Places Toilets help make those ordinary lives possible.

And in a modern society, surely that's something worth changing places for.

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