Martyn’s Law for hospitals, surgeries and clinics.

Hospitals and the provision of physical or mental healthcare are listed uses. A premises must include a building, be wholly or mainly used for a listed use, meet the attendance threshold and have no applicable exclusion.

A small surgery with fewer than 200 people reasonably expected together is outside the premises threshold. A hospital site can be much larger, but its tier still depends on an evidenced simultaneous count rather than its name or service type.

Start with a map showing the buildings and associated land. Where buildings form one group of premises, add their numbers together. Identify separately controlled facilities within the site for further consideration.

Check your tier

Consider patients, visitors and staff present together in the qualifying use area. Include employees, contractors and volunteers. Appointment totals or annual patient numbers do not show the greatest number expected at one time.

Look at overlapping clinics, visiting periods and shift changes when choosing your method. For a hospital, bed numbers are only part of the picture. For a surgery, review waiting rooms, consultation activity and staff rather than counting booked appointments alone.

Use reasonable evidence such as historic attendance, relevant occupancy limits or another justified method. Add staff where the starting data excludes them, and record the assumptions behind your figure. Predictable peaks count; unforeseen one-off spikes do not.

How to count people

For NHS hospitals, the Act fixes responsibility with the operating trust or board. It does not automatically sit with an individual ward manager, receptionist or security lead.

For other healthcare premises, identify whoever controls the premises in connection with its qualifying use. Responsibility is defined by law and cannot be delegated to a consultant, although tasks can be supported by others.

Separate qualifying premises within a larger site may have their own responsible people and co-ordination duties. Where the same responsible person controls nested qualifying premises, they are treated as one. Map shared doors, routes and communication arrangements with other operators.

Understand the responsible person

After commencement, standard premises will need SIA notification and appropriate procedures, so far as reasonably practicable, for evacuation, moving people to a safer place inside, preventing entry or exit, and communication when terrorism is suspected.

Consider patients who cannot move independently, people receiving treatment and visitors unfamiliar with the site. Discuss who gives instructions, how teams communicate between areas and which spaces or entrances your organisation controls.

The duty is proportionate, considering benefit, cost, time and difficulty; no one has to put themselves at risk. Standard tier requires no formal risk assessment or written plan. Documenting procedures is recommended, and staff with roles must know what to do.

The four public protection procedures

Enhanced premises will need assessed and reviewed measures covering monitoring, movement of people, physical safety and security, and information security, so far as reasonably practicable. They also need a required document describing procedures, measures and how these reduce risk.

Where the responsible person is an organisation, it must designate a senior individual in management or control. Review measures when use, occupancy or layout changes, and consider how shared clinical and public areas affect practical arrangements.

Wardcote offers hands-on enhanced tier support from an experienced team it works with for enhanced venues. Buying specialist services or software is not a legal requirement.

Enhanced tier dutiesEnhanced tier support

The core duties are not yet enforceable. Commencement is expected in spring 2027, with no fixed date set. Begin by confirming the responsible organisation, defining the premises and gathering peak occupancy evidence.

For standard-tier premises, Wardcote’s subscription helps write the four procedures, brief staff and volunteers, keep records and prepare the SIA notification. The free tier check is a useful starting point before choosing support.

Check your tierWardcote’s standard-tier software