According to recent research commissioned by the Liberal Democrats, NHS estates lost over 600 days of clinical time in 2023/24 due to infrastructure issues, including crumbling roofs, water leaks, and HVAC faults. At the time of the study, the figures also revealed that, in the past year, the NHS estate experienced an average of 22 infrastructure risk incidents a day. Notably, 1,584 of these risks were classed as critical.

As NHS facilities continue to face the pressure of maintaining safe, compliant, and operational buildings, annual PAM submissions are crucial to ensuring healthcare estates meet stringent regulations and safety standards. The PAM framework serves as a self-assessment, guiding NHS organisations to assess their compliance with essential health building notes and technical memoranda. For facilities managers, preparing for the PAM assessment is an ongoing process that requires strategic planning and meticulous execution.

Key areas to focus on for PAM readiness

While the checklist for PAM readiness is comprehensive, the following areas are pivotal for facilities managers as they prepare for their assessment in 2026:

1. Policies and procedures
   Ensure your Quality Management System (QMS) is in place, ideally based on recognised standards like ISO 9001. Key areas should also include environmental and health safety management (ISO 14001 and ISO 45001). Regular reviews of maintenance processes and the creation of clear, documented maintenance strategies are essential for maintaining compliance.
2. Maintenance strategies and risk management
   A clear maintenance strategy is key to effective PAM preparation. Consider including planned, reactive, statutory and condition-based maintenance within your strategy, while assessing risk appetite across multiple areas such as financial, governance and safety. The integration of these strategies with existing estate and facilities management systems will streamline operations and reduce risk.
3. Asset management and compliance audits
   Regular asset audits and condition surveys help identify critical maintenance requirements. For NHS buildings, ensure that statutory and mandatory maintenance tasks are clearly identified and prioritised. A forward maintenance register (FMR) should be established to track lifecycle replacements and support budget allocations for future needs.
4. Staff training & communication
   Effective PAM compliance starts with well-trained staff. Ensure key personnel understand the framework and the importance of risk management. This involves ongoing training and clear communication of roles, responsibilities and risk assessments.
5. Planning and resource allocation
   Resource planning is essential in meeting strategic goals. Assess the resource allocation for maintenance tasks, ensuring the right materials and personnel are available. Use documented plans for resource levelling and co-ordination across departments to optimise maintenance efforts.
6. Evidence and audit trail
   Ensure all strategic decisions, risk assessments and maintenance processes are clearly documented and accessible for audit. This will help demonstrate compliance during the PAM assessment and maintain transparency in operations.

Bewick concluded: ‘Preparing for the PAM assessment isn't a one-time event—it is a continuous process that requires consistent attention to detail and a proactive approach to risk management. By focusing on these key areas, NHS facilities can ensure they remain compliant, reduce the risk of non-compliance, and optimise their maintenance operations.'