England now has only one public toilet for every 15,000 people following an alarming surge in closures, a study reveals.

The ‘significant shortfall’ in loos is harming local businesses as some people are so scared of being caught short while out that they are choosing to stay at home, health leaders warn.

Others are reducing the amount they drink while away from home, leaving them at risk of dehydration.

Meanwhile, the lack of toilets increases the number of people who urinate in public, creating unhygienic conditions, the Royal Society for Public Health said.

Its analysis, based on more than 200 Freedom of Information requests to councils in charge of providing public toilets, found the number has decreased by 14 per cent since 2016.

It means there are now 15,481 people for every public toilet in England.

William Roberts, chief executive of the RSPH, said: ‘Access to public toilets is a universal need that we all have, and we shouldn’t shy away from talking about it.

‘One public toilet for per 15,000 people simply isn’t good enough and, without action, that figure will keep rising as we lose more facilities.

‘For some people, access to a public toilet can be the difference as to whether they leave the house, for others it can lead to deliberately restricting fluid intake to avoid the needing to use a toilet.

‘The effects also go far beyond the individual.

‘Having an insufficient number of public toilets has inevitable unsanitary consequences, creating unpleasant environments that degrade our public realm.

‘As a country we can and should be doing better.

‘We need to create public spaces that people want to spend time in, and this means giving local authorities the resources they need to provide the facilities we all rely on.’

To help boost the number of public toilets, the RSPH is calling for new strategic authorities to have a duty to ensure there are sufficient public toilets in the places people go, supported by funding from central Government.

It also said developers must do more, calling for regulations that would require public toilets to be included in any development that includes non-residential units.

At present, local councils get to decide on how many toilets are needed in their area.

In devolved nations the situation is better, with around 8,500 people per public toilet in Scotland and 6,748 in Wales.

A spokesman for the Local Government Association said: ‘The lack of public toilets can disproportionately affect vulnerable groups, including older people, people with disabilities, those with medical conditions, babies and children and people that find themselves sleeping rough.

‘Funding pressures have caused councils to rethink provision, the maintenance of a public toilet could cost a council £25,000 a year, a figure which is greatly impacted by the condition in which they are left by their previous users.

‘Vandalism and anti-social behaviour cost councils millions of pounds a year which means councils having to invest into more regular cleaning and better security, meaning that the taxpayer foots the bill for vandalism in this most basic of public provisions.

‘Many councils have attempted to address and prevent gaps in provision, by working with businesses to develop community toilet schemes.

'However councils are acutely aware that gaps in provision have opened despite these efforts, for instance where businesses have closed on our high streets.’

A spokesman for the Ministry of Housing, Communities and Local Government said: ‘To help councils provide public services like toilets we’ve made over £78 billion available for council finances, with local leaders free to decide for themselves how best to spend the majority of this.’

The RSPH figure of 15,481 people is based on FOI responses from 221 of 309 local authorities in England.

It said 47 million people live in these areas (roughly 82 per cent of the population).

Councils were asked for the number of public toilets in their area in 2016 and 2025.