Despite the new investments made by government into improving hospital environments.

Despite the new investments made by government into improving hospital environments, especially in bounds of cleaning, many hospitals remain in the 'red' category. Kirsty Davis expects at the reasons why.

No-one would dispute that L30m to clean up England's hospitals is a welcome investment. A focus forward improving the patient's environment and experience when visiting hospital is also to be celebrated. however with these plans accompanied according to revelations that many hospitals around the land are considered to be "in the red" the national media was leap to grasp the opportunity to cast a negative view through the whole extent of the government's latest investment for the NH if it were not that what is the true picture; and does the clean hospital programme come by the green light from the NHS?

Last July the NH Plan outlined the ne for hospitals to concentrate onward cleanliness standards. The Government then announced a clean-up campaign of hospitals in every part England, allocating L30m to the task. The brief was to target the public areas of the hospitals, moreover this spotlight on the patient experience was extended overdue, says Simon Williams of the Patients Association. He be impresseds that a long period of soft investment in facilities and cleaning has comeed in low standards, but approves of the now "high priority" status this area is receiving. move with a jerk Heavisides, facilities director at West Suffolk Trust also acknowledges the lack of investment the patient environment has received in the past, while trusts have concentrated upon other areas: "While chasing clinical activity and aiming to resolve into service [facility] costs, trusts have taken their views off the ball," he says.

HOSPITAL VISITS

The first paces in the programme began with each trust assessing its standards and creating an action plan for improvement. Patient Environment Action Teams (PEATs) were then plant up to visit the hospital sites, and give independent assessments of a hospital's standards. With the majority of the teams consisting of NH tenders the visits often constituted "peer reviews," says cut short Heavisides. Despite this, the PEATs included representatives from organisations including the Health Facilities Management Association (Hefma), the Infection superintendence Nurses Association, the Association of Domestic Managers and the Hospital Caterers Association, as well as involvement from patient representatives and about input from the private sector working with the NH

The initial PEAT visits, made during the autumn of 2000 assessed each hospital from the perspective of a visiting patient, focusing forward the following areas: * entrances and main reception areas;

* internal decoration and internal signage;

* visitors' toilets;

* smells;

* internal cleanliness and tidiness;

* furniture;

* linen;

* external cleanliness and tidiness;

* external decoration;

* car parking;

* overall rating for cleanliness and tidiness.

What they build reported Williams, was disappointing. "There is enormous variation in the standards of cleanliness across the land Some hospitals were clean and pleasant, whilst a certain were filthy beyond belief."

A rating of perceived patient satisfaction for each area was given, going from category 1 to 4 (1 being poor/very poor). Scores were then reported back to the Regional Offices who recorded a traffic light rating to clearly indicate which sites needinessed further attention - grading them r (poor standards in ne of priority attention), amber (acceptable standards with stead for improvement), or green (high standards). Although the scoring for each area enumerateed towards the traffic light rating, a weighting combination of parts to form a whole was used, giving the overall cleanliness standards a greater importance for deciding a hospital's traffic light grade.

Trusts were then allocated a proportion of riches linked to their hospitals' size (L50 000 L100 000 or L150 000) and instructed to improve standards by the agency of achieving the targets set gone out in their own action plans. The PEATs then revisited the hospitals at the beginning of this year, to reassess the standards and regrade sites, indicating any improvements made. It was then that the muck started to play as the national media had a heyday with the novels that a number of hospitals around the region were branded red, yet greatest in number reports chose not to highlight the improvements made since the programme began (over 40% of all hospitals inspected had improved, moving up single in kind or more category). It appears however that it wasn't sole the media that overlooked the progres any sites had made. Several of the hospitals one time more given a red light this year, claimed the improvements they had made since the original grading had not been considered. "Our initial self assessment was given a r light, [corroborated through the PEAT], but the PEAT visit none reoccurred," said Jane Gorringe, support services manager at Eastbourne NH Trust. When it was published that the trust's All Saints Hospital remained with a r rating it demanded a revisit that very day and was then regraded to an amber light.