New mandatory National Standards of Healthcare Cleanliness

All Trusts will be aware of the new National Standards of Healthcare Cleanliness, issued by NHS England in April 2021. Unlike previous National Standards, implementation is mandatory and will be enforced by NHS Improvement. For the majority of Trusts, implementation was expected before May 2022, and Trusts which have not yet been implemented will be required to request an extension and provide monthly progress updates.

The new Standards have been developed over several years by multi-disciplinary teams including Infection Prevention and Control specialists, independent cleaning experts, NHS Facilities Managers, and provider organisations. The new Standards were preceded by a lengthy and inclusive consultation process, and by training sessions and webinars.

The new Standards build upon the preceding 2007 National Specifications, and the NHS Cleaning Manual. Unlike its predecessors, implementation of the new Standards is mandatory, and it is expected that this will result in cleanliness outcomes being driven up, and in a marked reduction of differences in performance between Trusts.

Key requirements of the implementation of the new Standard are:

  • Review of the Risk Rating of all rooms and Functional Areas, with change from the previous four risk categories to six, and consideration of more accurate local calculation of risk in Functional areas by use of “Blending” of risk. The method for assessing risk, and responsibility for such assessment, should be clear and auditable
  • Change in the “elements” (items needing cleaning which must be inspected for cleanliness reporting). Both the number of elements and their content have been changed
  • Change in guidance on cleaning methods
  • The requirement to review cleaning responsibilities by staff group (such as cleaners, nurses, estates staff, and others), and to establish the process for ongoing annual review of cleaning responsibilities
  • Review of requirements for enhanced cleaning in light of lessons learned from the pandemic
  • New frequencies for technical audit of cleanliness, and rectification of faults
  • Change in reporting of cleanliness scores from percentages to Star Ratings, on the analogy of Local Authority “five-star” system ratings for retail food premises
  • New requirements for prominent display of Star Ratings and Cleanliness Charters for each Functional Area
  • Introduction of a new type of audit, the Efficacy Checks, under which observation of the actual performance of cleaning tasks in real-time will be required
  • Creation of a new Trust Cleaning Policy, which will include a Strategic Cleaning Plan for the Trust
  • Review of Governance structures and reporting to the Trust Board.


The requirement to publicly display Star Ratings, at the entrances to each ward or department, has caused some concern, and Trusts will be permitted to delay public display (but not calculation) of the Star Ratings for a further six months.

Many Trusts are progressing towards implementation or have already achieved it, but many others have experienced difficulty in doing so as part of “business as usual”. Litmus Partnership is able to provide assistance to Trusts requiring it.

Litmus Partnership has extensive expertise and experience in the healthcare sector and has worked with a number of NHS Trusts to help them with their non-clinical challenges over many years, including catering, portering, cleaning and other FM services.

With particular regard to the new National Cleaning Standards, David Griffiths, an associate consultant of Litmus, is one of the UK’s leading healthcare cleaning experts. He was the lead author of the NHS Cleaning Manual, and of PAS 5748, the British Standard for Healthcare Cleanliness, and his work on the new National Standards received a lead acknowledgement.

To discuss how Litmus Partnership can assist with the implementation of the new mandatory National Cleaning Standards, or any other matters relating to healthcare non-clinical services please email or call us on 01276 673880.