2012-13 Built Environment Key Performance Indicators (KPIs)
Built Environment Key Performance Indicators (KPIs)
Purpose
These KPIs are published to enable Directors and Managers of the NHS Estate &
Facilities and their NHS Finance colleagues to make an informed judgement
about how efficient and effective their estate and facilities are in supporting patient
care. An overview and user guide is set out below – including guidance on how to
access specific trust data – together with advice on how to interpret the indicators.
The data collection and KPI production methodology is at Annex A.
Note: The KPIs no longer include data relating to Primary Care Trusts owing
to them cease to exist on the 31 March 2013.
Overview
1. The direct revenue expenditure on the infrastructure of land, buildings and
equipment in the NHS was £7.2 billion in 2012-13. This did not include
depreciation, cost of capital and other related costs.
2. The NHS estate is therefore one of the largest and one of the most complex
property portfolios in Europe. It contains a range of buildings, from the most
modern hospitals and primary care facilities, located and designed specifically to
meet the demands of modern and future health care, to hospitals that can trace
their roots back hundreds of years and which require considerable investment or
radical reshaping or relocation to make them appropriate for the modern day.
3. To successfully manage the NHS estate, information is needed to identify areas
of good practice and where improvements are needed. To assist NHS managers
in this work, we currently publish the Built Environment Key Performance
Indicators (KPIs) to allow NHS organisations to consider the efficiency and
effectiveness of their estate and facilities against their peers. The 2012-13 KPIs
are now available.
4. These KPIs can be used in a variety of ways:
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To support internal NHS organisation budgeting, planning and decision
making, especially in terms of the financial challenges the NHS
currently faces;
As part of NHS Board level reporting and strategic planning, and;
To support the on-going Quality, Innovation, Productivity
and Prevention (QIPP) initiative.
The KPIs only relate to the financial aspects of estates & facilities management
and not the safety or qualitative aspects such as patient experience. For an
integrated overview of estates & facilities we recommend using the NHS Premises
Assurance Model (NHS PAM) Metrics currently available at:
https://www.gov.uk/government/publications/nhs-premises-assurance-modellaunch
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2012-13 Built Environment Key Performance Indicators (KPIs)
5. These KPIs allow informed judgement on the efficiency and condition of the
estate. All are based on indicators that are expressed as ratios of a trust’s
building and land areas. A simple traffic light exercise classifies Performance
Indicators into three categories:
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Green:
Amber:
Red:
In the top third of Trusts
In middle third of Trusts
In the lowest third of organisations
It is important to note that a Trusts position will depend on their situation. For
instance, Trusts with a new estate will generally have lower Backlog Maintenance
than an older estate. This needs to be carefully considered when reviewing the
Performance Indicators.
6. The use of radar capacity charts using Performance Indicators demonstrates
the potential for a trust to improve its asset management against similar
organisations and the national average for its cluster. They also assist Trusts,
Commissioners, and other interested stakeholders to compare high level
performance and will provide a basis for identifying potential areas for
improvement as well as role models.
7. It is important to note that while these KPIs provide information on the efficiency
and effectiveness of a Trusts estate, they do not give information on areas such
as the safety of the estate or the quality of the patient environment. To fully
understand and assess the estate in a holistic manner, we suggest the use of the
NHS Premises Assurance Model (PAM) available from
PAMhelpdesk@dh.gsi.gov.uk
8. The generic trust used in the following example has been grouped with others
using the Department of Health’s, basic level clustering, ie: Acute, Teaching,
Multi-Service, Community, Ambulance etc., so that comparisons are with peer
organisations.
9. As the structure of the NHS changes, organisations will be created, merge and
cease to exist. The KPIs can only be effectively produced where data is
consistently available for the whole year for an individual organisation. This
therefore means, that for some organisations, in 2012-13, it has not been possible
to produce KPIs for them.
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2012-13 Built Environment Key Performance Indicators (KPIs)
User Guide
For ease of use the Excel spreadsheet 2012-13 KPIs Final .xlsm is best copied to
your computer hard drive using the mouse to drag and drop the file, via Windows
Explorer, to the required area of a hard drive. (Instructions on how to do this can
be found in the online Help featured in Explorer.)
STARTING THE WORKSHEET
Open the 2012-13 KPIs Final.xlsm file.
Press Ctrl and hold it down, then press the letter i; this will display a toolbar
containing four buttons:-
Existing
Existing data from ERIC
New
This is where new data about your Trust can be added.
Graphs
This produces radar charts compiled from the grouping
information you request.
Trust
This allows access to your data when you type in your Trust
Activation ID number found in column A of the Base Data
worksheet .
Initially, the first three buttons will be dimmed and unavailable for use.
ACCESSING YOUR TRUST DATA
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Click on Trust on the toolbar; this will display the Activation ID Key box
Type in your Trust ID number; which can be found in column A of the Base
Data worksheet or in the worksheet called “ID & Cluster Group” [NB: these
worksheets also provide information on the cluster designation for each
organisation].
Click OK; you will be presented with the four-button toolbar again, all the
buttons will now be available for selection.
Click on the Graphs button, this will bring up the PI Filter Wizard.
You can now request the database to compile data as you wish using the PI Filter
Wizard.
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2012-13 Built Environment Key Performance Indicators (KPIs)
PI FILTER WIZARD
Grouping Filters
This screen allows you to choose the trusts with which to compare your trust data.
There are four different methods of filtering:All Trusts
No filter parameters chosen; this will use data from all
available trusts.
By Trust Type
The data used will be from all trusts falling into the Trust type
groups defined by the DoH’s Top, Standard and Basic Level
cluster groups. These can be found for your Trust by viewing
the number in columns E,F,G in the Base Data worksheet
and then cross referencing to the corresponding definition in
the Static Data worksheet. Selection of the choice of these
cluster groups is determined by the user.
SHA
The data used will be only from trusts within the Strategic
Health Authority (SHA) selected by the user.
Trust Type & SHA The data used will be from trusts falling into the cluster
group(s) and SHA(s) selected by the user.
Year
You can choose whether to use your existing data from
ERIC returns or new data for a future year. Data for a future
year (eg. to inform potential outcomes of your Trust Estates
Strategy) must be entered manually.
Choosing Grouping Filter Criteria:
All Trusts
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Select ‘All Trusts’ by clicking on the checkbox.
Click on ‘Next’.
Select either 2012/2013 or “future year” (NB: future year data can only be used
if you have manually entered the data yourself by clinking onto the ‘New’
button on the four button toolbar then entering data into the table. Please note
that new data will remain unchanged unless altered by the user, irrespective of
groupings or Trust selected.)
Click on ‘Next’.
Click on ‘Finish’.
You will be presented with a ‘Data processing will take a few seconds’
message box’; click OK.
The screen flickers quickly whilst the data is compiled. This is normal but may
take a few minutes, please wait until the compilation is complete.
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2012-13 Built Environment Key Performance Indicators (KPIs)
By Trust Type
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.
Select ‘By Trust Type’ by clicking on the checkbox.
Click on ‘Next’ button on the bottom of the box.
Select either 2012/2013 or “future year” (DN: future year data can only be
used if you have manually entered the data yourself by clinking onto the ‘New’
button on the four button toolbar then entering data into the table. Please note
that new data will remain unchanged unless altered by the user, irrespective of
groupings or Trust selected.)
Click on ‘Next’.
Select the grouping/cluster type (Top, Standard, Basic) by clicking the
appropriate checkbox and by using the drop down list
Click on ‘Next’.
Click on ‘Finish’.
By Strategic Health Authority (SHA)
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Select ‘by SHA’ by clicking on the checkbox.
Click on ‘Next’ button on the bottom of the box.
Select either 2012/2013 or “future year” (DN: future year data can only be
used if you have manually entered the data yourself by clinking onto the ‘New’
button on the four button toolbar then entering data into the table. Please note
that new data will remain unchanged unless altered by the user, irrespective of
groupings or Trust selected.)
Click on ‘Next’.
Choose one or more SHA(s) by clicking the appropriate checkboxes in the list
of SHA(s).
Click on ‘Next’.
Click on ‘Finish’.
You will be presented with a ‘Data processing will take a few seconds’
message box’; click OK.
The screen flickers quickly whilst the data is compiled. This is normal but may
take a few minutes, please wait until the compilation is complete.
By Trust Type and SHA
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Select ‘by Trust Type and SHA’ by clicking on the checkbox.
Click on ‘Next’ button on the bottom of the box.
Select either 2012/2013 or “future year” (DN: future year data can only be
used if you have manually entered the data yourself by clinking onto the ‘New’
button on the four button toolbar then entering data into the table. Please note
that new data will remain unchanged unless altered by the user, irrespective of
groupings or Trust selected.)
Click on ‘Next’.
Select the Trust grouping/cluster type (Top, Standard, Basic) by clicking the
appropriate checkbox and by using the drop down list
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2012-13 Built Environment Key Performance Indicators (KPIs)
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Click on ‘Next’.
Choose one or more SHA(s) by clicking the appropriate checkboxes in the list
of SHA(s).
Click on ‘Next’.
Click on ‘Finish’.
You will be presented with a ‘Data processing will take a few seconds’
message box’; click OK.
The screen flickers quickly whilst the data is compiled. This is normal but may
take a few minutes, please wait until the compilation is complete.
Once the data has been compiled the screen displays tables of data and 5 Radar
Charts; these may be viewed by moving round the screen using the scroll bars or
printed out using the instruction below.
To change the parameters for the filter, add new data or type in a new Trust
Activation ID number, press the CTRL+I key to redisplay the 4-button toolbar.
ADJUSTING THE RADAR CHARTS AXES
If a value on a radar chart is very large in comparison to the others, it may be
necessary to adjust the axes in order to properly view all the results.
Adjusting Axes
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Point with the mouse at one of the axes on the chart.
Double click on the axis and the ‘Format Axis’ dialogue box will appear.
Select the ‘Scale’ tab at the top of the box.
Click in the Maximum checkbox to remove the tick and type in the required
maximum for the chart.
Click OK.
Adjust the axis scale as necessary to obtain a balanced chart.
PRINTING THE TABLES AND CHARTS
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Select ‘File’ and ‘Print’ from the Menus at the top of the screen.
In the Print dialogue box click on the ‘Preview’ button at the bottom of the box.
Check that the tables and charts fit correctly on the pages, if not change the
page set-up by clicking on the ‘Setup’ button at the top of the screen and
adjusting the necessary parameters.
Click OK when the page layout has been adjusted satisfactorily.
Click on the ‘Print’ button at the top of the screen to print out the reports.
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2012-13 Built Environment Key Performance Indicators (KPIs)
Interpretation
Please note: These KPIs are intended for users who are familiar with the NHS
Estates & Facilities, specifically NHS Directors of Estates and Estates Managers
as well as NHS finance staff who work with them. Therefore the KPIs and
interpretation guidance below assume a level of knowledge regarding both the
NHS and Estates & Facilities which other potential users may not have. This
needs to be considered when interpreting the KPIs.
Specific points to note:
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The KPIs are provided for Trusts in existence and as constituted at the
31st March 2013;
Activity data used relates to Total Inpatient Episodes, therefore activity
relating to other clinical areas e.g. Outpatient will not be counted;
Premises costs data is not available for all NHS organisations, though
all other types of data are considered complete;
The data used is as provided by the NHS organisations themselves and
has not been altered centrally;
Every effort has been made to ensure these KPIs are accurate,
however if you have any questions relating to them please contact
Michael Bellas (mike.bellas@dh.gsi.gov.uk) or Simon Wright
(simon.wright@dh.gsi.giv.uk).
The complicated nature of the NHS estate, the interrelationship between the
different PIs and the differing situations for Trusts means that providing
interpretation of all possible results is not possible. However, the example below
is designed to walk users through an interpretation and provide guidance on how
to interpret specific PIs.
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2012-13 Built Environment Key Performance Indicators (KPIs)
The summary for the example Trust being considered is:
Grouping PI (Percentile Bands)
PI SUMMARY
Trust PI
33%
34%
33%
275
4
161
294
253
63
129
270
254 and 306
64 and 97
130 and 161
271 and 326
307
98
162
327
161
112
63
985
129
97
60
1036
130 and 161
98 and 134
61 and 164
1037 and 1437
162
135
165
1438
433
113
46
112
149
91
113
97
150 and 276
92 and 117
114 and 180
98 and 134
277
118
181
135
161
60
22
63
129
67
13
16
130 and 161
68 and 92
14 and 47
17 and 57
162
93
48
58
985
367
469
112
1036
244
255
97
1037 and 1437
245 and 302
256 and 336
98 and 134
1438
303
337
135
Space Efficiency
Income £10/m²
Activity/100m²
Asset Value £10/m²
Occupancy Cost £/m²
Asset Productivity
Asset Value £10/m²
Capital Charges £/m²
Total Backlog £/m²
Premsies Costs £/10m²
Asset Deployment
Land £/m²
Building £10/m²
Equipment £/m²
Capital Charges £/m²
Estate Quality
Asset Value £10/m²
Depreciation £/m²
Critical Backlog £/m²
Risk Adjusted Backlog £/m²
Cost of Occupancy
Premises Costs £/10m²
Energy/Utility £/10m²
Maintenance Costs £/10m²
Capital Charges £/m²
Annex A gives the source of the data for each PI shown.
The Trust is generally using floor space efficiently (Income £10/m2,
Activity/100m2, Asset Value £10/m2 are all green) because its income, activity
levels and asset values are all good.
However, the PIs suggest an estate which may be near the end of its designed life
and possibly in need of rationalisation to achieve a more modern and functionally
suitable estate (Depreciation £/m2 is low). There are also strong indications that
the quality of this estate is generally below acceptable standards (Total Backlog
£/m2 is high).
It is not possible to deduce strong messages from some of these PIs, and
therefore it will be necessary to use local knowledge and interpretation to fully
understand the data.
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2012-13 Built Environment Key Performance Indicators (KPIs)
Space Efficiency
Aim: To relate the estate and its annual occupancy cost to the output of the
Trust.
130
108
115
130
Target Performance
Trust Data
Income £10/m²
90
94
47
86 Occupancy Cost £/m²
Activity/100m²
Income £10/m2
Activity/100m2
Asset Value £10/m2
Occupancy Cost
£/m2
121
71
87
94
90
43
31
75
Asset Value £10/m²
This PI indicates that the Trust is generally using floor space efficiently, because
its income, activity levels and asset values are all good, relative to the gross
internal floor area, when compared with similar NHS Trusts.
There is however a concern that the Trust is not investing sufficient in occupancy
costs, which, if not reviewed, may lead to increasing financial pressures in future
years (for example from backlog maintenance expenditure requirements or lack of
capital for reinvestment from capital charges).
Asset Productivity
Aim: To demonstrate the actual cost of owning/renting assets.
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2012-13 Built Environment Key Performance Indicators (KPIs)
Target Performance
Trust Data
Asset Value £10/m²
Premsies Costs £/10m²
Capital Charges £/m²
Total Backlog £/m²
Asset Value £10/m2
Capital Charges £/m2
Total Backlog £/m2
Premises Costs £/10m2
This PI suggests that the Trust needs to improve its performance with respect to
capital charges and backlog. It should aim to increase spending on capital
charges, possibly by rationalisation, to achieve a more modern and functionally
suitable estate. Similarly, their backlog PI, which is relatively high, suggests an
estate which may be near the end of its designed life with an increasing number of
backlog failure and replacement pressures.
While premises costs figures are relatively low, this could also be a reflection of
an older estate, which may be less appropriate for the provision of modern
healthcare.
Despite the PI comments noted above, there is also a suggestion in these PIs that
the value of the Trust’s assets is high when compared with the rest of the cluster
group.
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2012-13 Built Environment Key Performance Indicators (KPIs)
Asset Deployment
Aim: To compare the makeup of the asset base.
Target Performance
Trust Data
Land £/m²
Capital Charges £/m²
Land £/m2
Building £10/m2
Equipment £/m2
Capital Charges
£/m2
Building £10/m²
Equipment £/m²
These PIs suggest that the Trust utilises an ‘average’ quantity of land for its
needs, but the value of its buildings and equipment are generally higher than the
cluster group. The reason for this is not immediately clear and requires local
knowledge and interpretation.
The capital charges PI suggests that the Trust needs to improve its performance.
They should aim to increase spending on capital charges possibly by rationalising
their estate to achieve a more modern and functionally suitable estate.
Estate Quality
Aim: To give a balanced view of the overall condition of the estate relative to
value and age.
Target Performance
Trust Data
Asset Value £10/m²
Risk Adjusted Backlog
£/m²
Asset Value £10/m2
Depreciation £/m2
Critical Backlog £/m2
Risk Adjusted Backlog
£/m2
Depreciation £/m²
Critical Backlog £/m²
The poor critical backlog position (high and significant risk backlog) indicates
urgent attention and investment is necessary to avoid serious risk to patient safety
and business continuity. This is also reflected in the relatively poor risk adjusted
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2012-13 Built Environment Key Performance Indicators (KPIs)
backlog performance figures. Low asset values and depreciation costs suggest
this is a relatively old estate which has suffered from long term underinvestment
and is now in need of priority refurbishment/replacement.
Cost of Occupancy
Aim: To identify the profile of occupancy costs (revenue).
Target Performance
Trust Data
Premises Costs £/10m²
Capital Charges £/m²
Energy/Utility £/10m²
Maintenance Costs £/10m²
Premises Costs £/10m2
Energy & Utility Costs £/10m2
Maintenance Costs £/10m2
Capital Charges £/m2
The PIs for maintenance, energy and utilities suggest that the Trust is performing
well. However, in context of the high backlog maintenance costs the Trust’s it
would be recommended that spending on maintenance should be increased so as
to minimise the risk of backlog maintenance expenditure worsening in future
years.
The capital charges PI suggests that the Trust needs to improve its performance.
They should aim to increase spending on capital charges possibly by
rationalisation to achieve a more modern and functionally suitable estate.
Similarly, while their premises costs figures are relatively low, this could also be a
reflection of an older estate, which may be less appropriate for the provision of
modern healthcare.
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2012-13 Built Environment Key Performance Indicators (KPIs)
Annex A - Methodology for collecting and preparing the data for the 2012-13
Performance Indicators
Trust Floor Area
Source: Estates Return Information Collection (ERIC)/Compulsory for all Trusts
including FTs.
Activity (FCE)
Source: The Information Centre (England), Hospital Episode Statistics – 2012-13
Ungrossed data. – Finished Consultant Episodes
Only applies to those Trusts who actually have Finished Consultant Episodes
(FCEs) i.e. not all Mental Health Trusts.
Occupancy Costs
Source: ERIC/Finance
Made up of Capital Charges + Premises Costs+ Maintenance + Energy/Utility
below.
Income
Source: Non-FTs taken from DH Finance data collection. FT data taken from
Financial Accounts as collected by Monitor.

NHS Trusts = “Total operating income”

FTs = “Total Income”.
Asset Value
Made up of Land + Buildings + Equipment below.
Capital Charges
Source: Non-FTs taken from DH Finance data collection. FT data taken from
Financial Accounts as collected by Monitor.
Built up of “Depreciation” below and:

Non FT Trusts = “Dividends Payable on Public Dividend Capital (PDC)”

FTs = “PDC Dividend”
Both of these figures are negative in the accounts and therefore need their sign
changed before adding to the Depreciation.
Premises Costs
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2012-13 Built Environment Key Performance Indicators (KPIs)
Source: Non-FTs taken from DH Finance data collection. FT data taken from
Financial Accounts as collected by Monitor.

Non FT Trusts = “Premises”

FTs = “Premises”
Note: In previous versions of the KPIs this data item was “Rent and Rates”.
In NHS financial accounts, the “Rent and Rates” figure has been replaced
by “Premises” and this change has therefore been made in the KPIs.
Total Backlog
Source: ERIC/Compulsory for all Trusts including FTs.
Sum of High Risk + Significant Risk + Moderate Risk + Low Risk Backlog.
Critical Risk Backlog
Source: ERIC/Compulsory for all Trusts including FTs.
Sum of High Risk + Significant Risk Backlog.
Risk Adjusted Backlog
Source: ERIC/Compulsory for all Trusts including FTs.
Directly as from ERIC.
Depreciation
Source: Non-FTs taken from DH Finance data collection. FT data taken from
2011-12 Accounts as published on Monitor website.

NHS Trusts = “Depreciation”

FTs = “Depreciation & Amortization”
Land
Source: Non-FTs taken from DH Finance data collection. FT data taken from
Financial Accounts as collected by Monitor.
Net Book Value as at 31st March

NHS Trusts = “Land”

FTs = “Land”
Buildings
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2012-13 Built Environment Key Performance Indicators (KPIs)
Source: Non-FTs taken from DH Finance data collection. FT data taken from
Financial Accounts as collected by Monitor.
Net Book Value as at 31st March

NHS Trusts = “Buildings excluding Dwellings”

FTs = “Buildings excluding Dwellings”
Equipment
Source: Non-FTs taken from DH Finance data collection. FT data taken from
Financial Accounts as collected by Monitor.
Net Book Value as at 31st March

NHS Trusts = “Plant and Machinery” +”Transport Equipment” +
“Information technology” +”Furniture & Fittings”

FTs = “Plant and Machinery”+”Transport Equipment”+Information
technology”+”Furniture & Fittings”
Maintenance
Source: ERIC
Made up of “Building and engineering maintenance costs” and “Grounds and
gardens maintenance costs” which are compulsory for all Trusts including FTs.
Energy/Utility
Source: ERIC
Made up of “Total Energy Cost (all energy supplies)” + “Water services cost”
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