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One in six hospital sites score 100 per cent on cleanliness in patient-led assessments

• 11 per cent increase in public involvement on 2013

*HSCIC must be quoted as the source of these figure

*Regional data available from this report

218 hospital sites (16.1 per cent) scored 100 per cent for cleanliness3 in the latest Patient-Led Assessments of the Care Environment (PLACE)4 report. The report released today by the Health and Social Care Information Centre (HSCIC) saw 1,356 hospital sites assessed.

PLACE results for 2014 show that the national average score for cleanliness has increased by 1.5 per cent on 2013. This improvement was across all site types5 except treatment centres; the largest increase was in the Community sector at 1.9 per cent.

PLACE is now in its second year and aims to give the public a chance to assess a range of non-clinical services within the NHS and the independent and private healthcare sector in England.

The assessment criteria used within PLACE represents aspects of the care environment which patients and the public have identified as important6.

PLACE covers four specific areas: cleanliness; food and hydration; privacy, dignity and wellbeing; and condition, appearance and maintenance7.

6,523 patient assessors8 were involved in the PLACE programme in 2014 - an 11.0 per cent increase on 2013 (5,877). Patient assessors have to make up at least 50 per cent of each assessment team; the size of the team varies depending on the size of the hospital but should consist of at least three people, two of whom are patient assessors.

During March - June 2014 a total of 1,356 assessments were undertaken in sites (e.g. Hospitals, Treatment Centres, Hospices) across 287 organisations.

The total number of organisations taking part has increased this year by 12, but a greater proportion of these were non-NHS organisations, of these9:

  • 232 were NHS, a decrease of two on 2013.
  • 55 were from the voluntary/independent/private sectors, an increase of 14 on 2013.

Key findings within the report include:

Cleanliness (including assessment of bathrooms, furniture, fixtures and fittings):

  • The national average score was 97.3 per cent, compared to 95.8 per cent in 2013
  • 95.0 per cent of hospital sites (1,290 sites) scored 90 per cent or above of which 218 sites scored 100 per cent.

Condition, appearance and maintenance (including assessment of decoration, signage, linen and car-parking access):

  • The national average score was 92.0 per cent, compared to 88.8 per cent in 2013.
  • 69.3 per cent of hospital sites (940 sites) scored 90 per cent or above, of which 61 sites scored 100 per cent.

In 2014 the methodology relating to the following areas was changed so is not comparable with 2013 data:

Food and hydration10 (including assessment of choice, taste, temperature and availability over 24 hours):

  • The national average score was 88.8 per cent.
  • 59.3 per cent of hospital sites (766 from a total of 1,292 sites) scored 90 per cent or above, of which one site scored 100 per cent.

Privacy, dignity and wellbeing11 (including assessment of changing and waiting facilities, appropriate separation of single sex facilities, telephone access and appropriate patient clothing):

  • The national average score was 87.7 per cent.
  • 36.1 per cent of hospital sites (490 sites) scored 90 per cent or above, of which 17 sites scored 100 per cent.

HSCIC Chair Kingsley Manning said: "Cleanliness is something that has consistently been highlighted as a key area which patients expect, and they have a right to expect healthcare providers to get right.

"The increase in the level of public involvement also shows that there's a growing interest in this programme. Organisations can use these assessments as a benchmark to see where they can improve in the areas the programme covers."

The report can be accessed at:


Notes to editors

  1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 220 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.
  2. Counts are exact. Percentages have been rounded to one decimal place.
  3. The assessment of cleanliness is defined within PLACE as being free from all visible removable dirt including dirt, dust, stains, adhesive residue, litter, blood or other body substances, hair, cobwebs, insects, food debris, grease, scum, smears and spillages of liquids or powders. The list covers the majority of issues, but others should be recorded as and when they are seen by the patient assessor.
  4. The aim of PLACE assessments is to provide a snapshot of how an organisation is performing against a range of non-clinical activities which impact on the patient experience of care - cleanliness; the condition, appearance and maintenance of healthcare premises; the extent to which the environment supports the delivery of care with privacy and dignity; and the quality and availability of food and drink. The criteria included in PLACE assessments are not standards, but they do represent both those aspects of care which patients and the public have identified as important, and good practice as identified by professional organisations whose members are responsible for the delivery of these services, including but not limited to the Healthcare Estates Facilities Managers Association, the Association of Healthcare Cleaning Professionals and the Hospital Caterers Association
  5. Hospital (site) types covered: Acute/specialist; mixed acute and mental health/learning disabilities; community; learning disabilities; mental health; mental health and learning disabilities; treatment centre and Hospice.
  6. The scope and content of PLACE assessments was initially determined by the NHS Quality Board and a sub-group of the Board, and through consultations and discussions with patient/public representative bodies and professional organisations. Following the completion of the 2013 programme a review was undertaken seeking views from both staff and patient assessors.
  7. All guidance and assessment forms issued in relation to the programme can be found on the NHS England website:
  8. It is a matter for each organisation to recruit their patient assessors, although they have been urged to always approach their local Healthwatch to offer them the opportunity to provide patient assessors. Whether local Healthwatch choose to do so is entirely a matter for them to determine. Anyone can act as a patient assessor except: existing members of staff from the hospital/organisation being assessed; ex-staff from the hospital/organisation who have left within the last two years (this allowing for a common sense approach so that someone who is within a few weeks of having left for two years may be deemed eligible). The remaining members of the assessment team are staff members.
  9. Participation in PLACE is voluntary but, considered good practice. All known eligible NHS organisations (with ten or more in-patient beds) participated in the programme. The precise number private/independent sector organisation that may be eligible to participate is not known.
  10. In 2014 the methodology relating to the organisational questions element of the food and hydration score was changed to introduce a weighting mechanism. Had this change not been made, the 2014 National average for food any hydration would have been 0.13% higher, the scores for 2013 and 2014 are not therefore directly comparable. Please note only 1,292 sites were eligible to be assessed in this section.
  11. Due to a change in the assessment criteria, particularly around access to television and radio, the scores for privacy, dignity and wellbeing for 2013 and 2014 are not directly comparable.
  12. For media enquiries please contact the press office on 0300 303 3888 or
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