Patient-Led Assessments of the Care Environment (PLACE), 2024 - England

PLACE aims to promote the principles established by the NHS Constitution that focus on areas that matter to patients, families and carers:

• Putting patients first;
• Active feedback from the public, patients and staff;
• Adhering to basics of quality care;
• Ensuring services are provided in a clean and safe environment that is fit for purpose.

PLACE encourages the involvement of patients, the public, and both national and local organisations that have an interest in healthcare in assessing providers.

PLACE assesses a number of non-clinical aspects of the healthcare premises identified as important by patients and the public, known as domains:

• • Cleanliness
  • Food and hydration
  • Privacy, dignity and wellbeing
  • Condition, appearance and maintenance
  • Dementia: how well the needs of patients with dementia are met
  • Disability: how well the needs of patients with a disability are met

The criteria for each represent good practice as identified by professional organisations whose members are responsible for the delivery of these services e.g. the Healthcare Estates Facilities Managers Association, the Association of Healthcare Cleaning Professionals and the Hospital Caterers Association. Dementia domain criteria draw heavily on the work of The King’s Fund and Stirling University.

All healthcare settings in England are eligible. Whilst the programme is voluntary, all sites are encouraged to participate provided they meet certain criteria as the assessments give patients and the public a voice in discussions about local service provision.

A fundamental part of PLACE is the inclusion of lay assessors known generically as ‘patient assessors’. All assessment teams must include a minimum of 2 patient assessors, making up at least 50% of the team.

In 2024:

• In addition to assessing communal and external areas, teams visited and assessed 4,144 wards (2,914 acute/community and 1,230 mental health/learning disability), 1,922 outpatient departments and 336 emergency departments/minor injuries units.
• 1,860 food assessments were undertaken in total at sites where meals are provided (1,007 sites). This excludes hospitals and units which are fully self-catering, clinical exceptions sites⁶, and those without inpatient beds. It also excludes sites where patients have very specific dietary requirements, so the standard scorecard is not applicable (clinical exceptions).

During the programme:

• A total of 6,971 patient assessors took part in the programme. Of these, 52.2% were patients, 22.1% were patient advocates, 6.7% were people from other organisations in the NHS and 19.0% were other types, e.g., members of the public.
• A total of 4,315 staff assessors took part in the programme.
• Assessments took place over a total of 1,623 “assessment days”.

Note that the bullet points directly above relate to the number of patient assessor “involvements” rather than individual people – some patient assessors may have undertaken more than one assessment or been involved in more than one day of a single assessment.

On the day(s) of assessment, the teams visit the various areas of the hospital and unit (e.g. wards, communal areas) filling out the relevant scorecards (paper or digital) based on observed conditions. The full suite of assessment forms and associated guidance are available here: The PLACE collection

Results are sent to NHS England by hospital staff using the Estates and Facilities Management (EFM) online portal (login required).

Marks awarded for each question count towards one or more domains. Domain totals are then calculated on EFM and expressed as a percentage of the maximum marks available for each domain for each organisation and site.

National, site types, commissioning region, and organisation (mean) averages are calculated using the formula:

Average score = Sum of [site achieved points x beds at site]

                                         Total beds in all assessed sites