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Patient Environment Action Teams (PEAT)

PEAT data 2011

In 2011 the management of PEAT transferred to the NHS Information Centre.


The 2011 PEAT data and all future information related to PEAT are available from the NHS Information Centre.


About PEAT

PEAT is an annual assessment of inpatient healthcare sites in England that have more than 10 beds. 

It is a benchmarking tool to ensure improvements are made in the non-clinical aspects of patient care including environment, food, privacy and dignity. 


The assessment results help to highlight areas for improvement and share best practice across healthcare organisations in England.

Additional data 2010

On 14 October 2010, the NPSA published additional PEAT data, showing the questionnaire used and the answers from individual sites. More about additional PEAT data.




About PEAT


PEAT is self assessed and provides a framework for inspecting standards to demonstrate how well individual healthcare organisations believe they are performing in key areas including:

  • food
  • cleanliness
  • infection control
  • patient environment (including bathroom areas, lighting, floors and patient areas)



PEAT is an annual assessment, established in 2000, of inpatient healthcare sites in England with

more than ten beds.


The scores demonstrate how well individual healthcare providers believe they are performing in key areas including food, cleanliness, infection control and patient environment (including bathroom areas, décor, lighting, floors and patient areas.


NHS sites and NHS trusts are each given scores from 1 (unacceptable) to 5 (excellent) for standards of environment, food and dignity and privacy within buildings).


Assessments are carried out by NHS staff (nurses, matrons, doctors, catering and domestic service managers, executive and non-executive directors, dieticians and estates directors).


Patients, patient representatives and members of the public are also part of this assessment process. 


In 2011 the management of PEAT transferred to the NHS Information Centre.


The 2011 PEAT data and all future information related to PEAT are available from the NHS Information Centre.


Archived PEAT results


In 2011 the management of PEAT transferred to the NHS Information Centre.


The 2011 PEAT data and all future information related to PEAT are available from the NHS Information Centre.


In 2010 trusts were asked to conduct the assessment between January and March 2010.

In 2010 trusts were asked to conduct the assessment between January and March 2010.

1,242 sites from 323 trusts and 146 hospitals from the independent sector took part in the PEAT assessment. 


Not all sites show a full set of annual PEAT results since 2000. This may be because the organisation no longer exists, has merged or changed its name. Some sites are registered as self catering (56 sites in 2010) and were therefore not assessed for food.


How to participate

NHS or private healthcare organisations in England with 10 or more inpatient beds are eligible to participate. Healthcare organisations meeting these criteria can contact us for more information.


PEAT validators

Each year, the NRLS validate a proportion of the PEAT assessments. A validator who is not an employee of the inspected organisation participates as an independent team member to support the PEAT process.

These validators include patient representatives, including members of LINKS, WRVS or the Better Hospital Food Group, estates and facilities, nursing staff, infection control representatives, domestic services staff, dietitians and catering representatives.

Validators undertake this role as volunteers and are not paid. They are often involved with PEAT within their own site and find validation a great way to transfer experiences and best practice tips.

All trusts welcome external and patient representation and some may face particular challenges in recruiting retaining participants. If you are a member of the public and would like to be involved then please contact your local trust’s patient representative group in the first instance.


What is the time commitment?

There is no minimum amount of visits for any validators and we understand that some may be able to spend more time than others. Training is provided for validators before the start of every PEAT round.

You will receive regular email updates throughout the PEAT process which will detail how it is all progressing, where we need validators and when.

For more information please contact us.

Frequently asked questions 



What does PEAT assess?

A PEAT assessment examines standards, from a patient's perspective, in three main areas at each site:

  • Environment: cleanliness, decoration, linen, furniture and state of repair

  • Food: quality of food and its nutritional value

  • Privacy and dignity: the quality of sleeping accommodation as well as toilet/bathroom facilities

How often is PEAT conducted?

PEAT is conducted annually. In 2010 trusts were asked to conduct the assessment between 
January and March 2010.


Where did PEAT originate?

PEAT was established and developed by NHS Estates in 2000 as a benchmarking tool to ensure improvement in non-clinical aspects of patient healthcare experience. The NPSA took over management of PEAT in 2006 after the closure of NHS Estates. PEAT was established following the publication of the NHS Plan in 2000.

What do the scores say about individual hospitals?

The scores tell us how well individual healthcare providers believe sites are performing in the key areas including cleanliness, food and nutrition, infection control, hand hygiene and design of buildings.


Why is PEAT necessary?

Hospital food and cleanliness are at the heart of patient confidence in healthcare. PEAT assesses these standards every year and highlights areas for improvement and facilitates the sharing of best practice across the NHS.

How are the scores achieved?

NHS organisations are each given scores from 1 (unacceptable) to 5 (excellent) for standards of environment, food and dignity and privacy within their buildings.  The NPSA publishes these results every year.


Is PEAT self assessed?

Yes. Assessments are conducted by trusts and they are free to choose which staff conduct the assessment. NPSA recommend involving patients as well as staff from estates and facilities, domestic, catering, nursing and dietetic departments. Some trusts also involve patient forum representatives. Results are fed back to the NPSA and shared among the NHS, Care Quality Commission, Monitor and Department of Health.


How reliable are the scores if they are self assessed?

This process of self assessment follows methods used for regulation by the Care Quality Commission and Monitor.  The NPSA provide independent validation for a number of trusts each year, ensuring the assessment is conducted fairly.


Should I worry if my local hospital has received a low score?

There are a variety of factors that can affect the score awarded to an individual hospital site. The NPSA recommends that sites with a low score produce an individual action plan for improvement.  Any member of the public who has concerns about the scores awarded to their local hospital should contact the hospital directly for advice or help.


Why do trusts with high levels of hospital acquired infections score relatively well in PEAT?

PEAT does not directly measure a site's performance in preventing and controlling infection. The environment score includes, among other things, a measurement of cleanliness and hand hygiene. However, it is well established that infection rates are affected by other variables that PEAT does not measure.
The PEAT scores also reflect the findings on the day the assessment was performed.


What happens to sites that do not score very well in PEAT?

The performance management of individual sites is a matter for primary care trusts, strategic health authorities, Monitor and the Care Quality Commission.  These organisations regulate and manage the performance of local NHS healthcare providers and these organisations should determine what, if any, action should be taken.


Are patients involved in the assessment process?

The NPSA recommends PEAT assessment teams include a patient or patient representative. In addition teams are encouraged to seek the opinions of patients during their assessment. Some trusts across England actively involve their patient forum or LINKS representatives, something the NPSA recommends.


Have there been changes in how PEAT is assessed over recent years?

The questions are adapted annually to reflect current key priority areas of the NHS and requirements of patients and their carers/relatives. The three areas of environment, food and privacy and dignity have remained the same.


What type of trust does PEAT assess?

PEAT assesses all trusts with 10 or more inpatient beds. These include acute, mental health and primary care trusts. It does not assess ambulance trusts or strategic health authorities. This year 1,242 hospitals were assessed from 323 trusts. In addition 146 hospitals from the independent sector took part. 

Case studies


Gateshead Health NHS Foundation Trust and Torbay Care Trust have each scored excellent in each area of PEAT.  Below are quotes from each organisation which describes how they achieved high scores within this assessment.


Gateshead Health NHS Foundation Trust

“The Trust takes a very proactive approach to the provision of an appropriate patient environment. In particular, good practice and development in domestic services includes the provision of a dedicated domestic team with responsibility for delivery of the Trust's deep clean programme. This team also provides a domestic response service which is available to all wards and departments 24 hours a day, seven days a week.
“Our catering service is provided on the hospital site using the highest quality fresh ingredients from local suppliers. A great deal of research has gone into ensuring religious and cultural needs are met, with our most recent menu being developed using our many links with the local community.
“Privacy and Dignity is a key priority for the Trust and we have raised the profile of this issue through education and mandatory training, as well as through our annual Privacy and Dignity Conference. A co-ordinated programme of audit and assessment also provides regular evaluation of patient feedback and we are currently evaluating a piece of work in our Outpatient Department.”


Allan Smith, Director of Operations at Gateshead Health NHS Foundation Trust.


Torbay Care Trust

“For patients, visiting hospital can be a worrying time and we are committed to making the experience as comfortable as possible.  We know that cleanliness and environment are two factors that go right to the heart of patients’ confidence in their healthcare.

“To maintain exceptionally high standards monthly Cleanliness and Environmental Audits of our community hospitals are conducted by the Hospital Matrons and Hotel Service Manager.  A database has been specifically created to record and monitor results and actions required.

“The Trust has appointed a specialist cleaning team which undertakes a deep clean of clinical areas every six months or following any outbreak of infection, which is in addition to the existing daily, routine cleaning schedule.


“Patient experiences and satisfaction are very important and we actively seek opinions through comment cards.  This gives patients the opportunity to feedback on the standards of hygiene, food and privacy and dignity.

“The Trust’s aim is to work with staff to promote a culture of pride and ownership and to develop an understanding of how the care environment directly affects health and wellbeing.”


Becky Ranson, Matron at Torbay Care Trust.