Quality improvement statement 5: Environmental cleanliness


Trusts ensure standards of environmental cleanliness are maintained and improved beyond current national guidance.

What does this mean for: people visiting, or receiving treatment in, hospitals?

People visiting, or receiving treatment in, hospitals can expect secondary care settings to meet high standards of cleanliness, with each trust monitoring the condition of its premises to ensure levels exceed the minimum required standard.

What does it mean for trust boards?

Boards ensure policies, procedures and resources are in place to maintain and continuously raise the level of cleanliness across the trust.

Evidence of achievement

1. Evidence that the trust clearly sets out, and adheres to, a standard of cleanliness that is beyond current national guidance (for example, British Standards Institution PAS 5748 and/or National Patient Safety Agency specifications).

2. Evidence of clear and accessible local policies on cleaning and environmental decontamination. This includes evidence that they take into account the needs of different patient care areas and allow for flexibility in the deployment of resources. There should be evidence, for example, that individual staff understand their role and responsibilities.

3. Evidence of local arrangements for a risk-based, cleaning responsibility matrix and frequency schedule for each patient care area.

4. Evidence of a local framework for monitoring of environmental cleanliness routinely and in an 'outbreak' situation. This includes evidence of a patient feedback system.

5. Evidence that the results of routine and outbreak monitoring are reviewed and cleaning arrangements updated, where appropriate

6. Evidence of local arrangements to ensure awareness of health and safety and environmental issues regarding the use of disinfectant preparations for decontamination purposes.

7. Evidence of regular, appropriate training and education of staff with responsibility for cleaning in the use of equipment, disinfection and decontamination.

8. Evidence that the trust incorporates patient feedback and involves patients and carers in its cleanliness monitoring programmes, with evidence that this impacts on standards.

Practical examples

  • Mechanism is in place to ensure rapid response cleaning is initiated within appropriate timeframe.

  • Clearly defined policy for cleaning and environmental decontamination (including roles, responsibilities and accountability).

  • Trust collects visual and/or objective environmental monitoring data for different clinical areas. Visual and scientific methods are used for both routine and outbreak environmental assessment and the findings are used to inform improvements to the cleanliness programme.

Health and Social Care Act code of practice

Criterion 1: Guidance for compliance 1.1

Criterion 2: Guidance for compliance 2.1, 2.3, 2.4, 2.5, 2.6

Relevant national indicators

None identified.

  • National Institute for Health and Care Excellence (NICE)