Patient-Led Assessments of the Care Environment (PLACE), 2025

Owing to the nature of the collection, retrospective validation is not possible. Accuracy of scoring is achieved through the provision of guidance and training to teams undertaking the assessments, but there is an inherent element of judgement involved. Scores must however be agreed between the staff and patient assessors before data is entered onto the EFM system. Although it is not a requirement of the process, Independent Review (also known as External Validation) is recommended good practice and in 2025, 178 of the 1068 sites completing valid assessments (16.7%) included this in their assessment. This compares with 224 sites (20.5%) in 2024.

All data are provided by participating organisations through an online reporting system (the Estates and Facilities Management (EFM) system), or via one of the mobile reporting solutions. All possible responses to each question are provided by a ‘drop down’ facility and therefore out-of-range responses are not possible. The collection system additionally has internal validation systems which prevent contradictory responses.

Once an organisation has entered and validated all data their provisional result is produced. At this stage further amendments can be made to data, but not once committed.

Final submission of data cannot be completed until all required responses have been entered. Where any data are missing the collection system will highlight this to the person entering data. Data providers are asked to have senior signoff before committing their data, and once committed no changes to data can be made without prior consultation with NHS England.

Any alterations after commitment of data can only be made with the approval of NHS England, and this will only be carried out in exceptional circumstances. Requests to change assessment data are investigated by NHS England and are generally required to be accompanied by a written statement from the patient assessors to confirm the change is due to a genuine error.

1. 3 sites were excluded as they did not fully complete, validate, and commit their assessments.

2. A further 9 sites were excluded as they did not fully meet the required patient‑to‑staff ratio for the assessments. This included 6 sites where the minimum requirement of 2 patient assessors was not met, and three assessment days where the minimum requirement of 50% patient to staff assessors was not achieved.

These exclusions were necessary because, while staff make every effort to record an independent view, failure to meet the required ratios may impact the reliability of capturing the patient‑led “voice” within the assessments.

Where data had been entered, organisations are still able to view these assessments and the associated indicative results for their sites via the PLACE‑Lite module within the collection system (login required; available to PLACE users only).

3. 13 sites were marked with an asterix (*) in the data reports after not meeting the minimum required number of assessments without a valid reason (for example, ward closure or a clinical incident). These sites are still included in the dataset because they completed assessments of their care environment.