NHS PAM enables trusts to compare and improve the performance of healthcare estates

The Premises Assurance Model (NHS PAM) aims to provide individual trusts with a way of measuring how well they run their buildings based on a comparison with other similar organisations.

It states: "The NHS estate is an important enabler of high-quality NHS services, as well as a potential source of major risk to safety and service delivery.

The NHS estate is an important enabler of high-quality NHS services, as well as a potential source of major risk to safety and service delivery

"The delivery of a service that takes quality as its organising principle, through a period of financial restraint, is the principal challenge facing the NHS over the next 10 years and, in partial response to this challenge, and to assist the NHS in meeting its goals, the NHS and Department of Health have co-produced NHS PAM. It is a tool that allows trusts to better understand the efficiency, effectiveness and safety with which they manage their estate and how that links to the patient experience.

"NHS PAM gives a guide as to the character and complexity of a trust's estate and facilities, and can be used as a prompt for further enquiry and to stimulate better-informed dialogue as to how the premises can be more efficiently used, more effectively managed, and make a contribution to the overall strategic objectives of healthcare services."

The original version of NHS PAM was launched in April 2010, but applied only to acute trusts. This new, universal, version applies, as far as possible, to all NHS organisations including mental health trusts and primary care providers.

On a local level, it will support clinical leaders, directors of finance and estates managers to make more-informed decisions on the development of their estates.

The tool consists of two parts: A self assessment questionnaire, which provides a list of questions that trusts can consider with regard to their estate and facilities; and the metrics, which use available data - including Hospital Episode Statistics, Patient Environment Action Team analysis and Estates Returns Information Collection data - to produce indicators that show the trust in relation to its peers.

NHS PAM is a tool that allows trusts to better understand the efficiency, effectiveness and safety with which they manage their estate and how that links to the patient experience

It can be used to help organisation meet the requirements of the NHS Constitution, which pledge that services will be provided in a clean and safe environment that is fit for purpose; and supports the QIPP agenda which is aimed at delivering £20billion worth of savings by 2013/14.

The guidance states: "The best way to use the NHS PAM is to complete the supplementary application questionnaires and then compare them to the metrics for your and an appropriate peer. This will highlight differences in the relative context, approach and outputs to be identified."

And it warns that just filling out the questionnaire is not enough, adding: "Local ownership of the completed NHS PAM is important otherwise no action or advantage will be obtained from using it. We would suggest that, once completed, it should be formally presented to the trust's board for approval. This approach is probably required if you intend to use it as evidence for the Care Quality Commission or other external organisation. The board can decide whether they wish the document to remain private or be made available in the public domain."

The NHS estate is currently valued at almost £40billion, making it the single largest property holder in the public sector. The annual running cost of this is estimated at about £7billion.