The standards are published by NHS England. Healthcare bodies in Scotland, Wales and Northern Ireland publish their own guidance.
What changed from the 2021 standards
According to NHS England, the 2025 standards replace those published in 2021 and now include specific responsibilities for ambulance facilities, with bespoke vehicle cleaning frequencies.
NHS England states that healthcare establishments can decide how their cleaning resources are organised, but that meeting aspects of the standards is mandatory. A compliance grid sets out which parts are mandatory. The standards also state that compliance with the standards and the auditing processes should be written into contracts with cleaning service providers.
Functional risk categories in the national standards of healthcare cleanliness
The standards place each functional area into a risk category, from FR1 (highest risk) to FR6. NHS England explains that different areas carry different levels of risk, giving the example that a records storeroom will not require as frequent cleaning as an intensive care unit. Each category has a target audit score and an audit frequency:
| Category | Target audit score | Audit frequency |
|---|---|---|
| FR1 | 98% and above | Weekly |
| FR2 | 95% and above | Monthly |
| FR3 | 90% and above | Every 2 months |
| FR4 | 85% and above | Every 3 months |
| FR5 | 80% and above | Every 6 months |
| FR6 | 75% and above | Every 12 months |
NHS England states that adopting all six categories is good practice but not mandatory. Organisations that do not adopt all six must have a sound written rationale.
Types of cleaning in the standards
The standards recommend that cleaning specifications distinguish between five types of cleaning:
- Full clean: cleaning all elements to remove all visible dust, dirt, marks and contamination
- Spot clean: cleaning specific elements to the same standard
- Check clean: checking whether an element meets the required standard, followed by a full or spot clean if it does not
- Periodic clean: a full clean at a set interval, such as monthly, quarterly or annually, where daily or weekly cleaning is not required
- Touch point clean: a full clean of items that are frequently touched
NHS England states that the safe cleaning frequencies in Appendix 2 of the standards are a required baseline.
Star ratings and the Commitment to Cleanliness Charter
Each functional area receives a star rating based on its audit score. The standards describe the ratings as a visual score for patients, staff and the public, reflecting the cleanliness of the whole area regardless of which staff group cleans each element:
- 5 stars: the area has achieved its target score or above
- 4 stars: 1 to 3% below the target score
- 3 stars: 4 to 6% below the target score
- 2 stars: 7 to 9% below the target score
- 1 star: 10% or more below the target score
Areas rated 3 stars or fewer must be subject to an improvement plan. The star rating is taken from the original audit score and can only be updated after the next full re-audit.
The standards also require organisations to display the Commitment to Cleanliness Charter where it will be seen, for example near ward and department entrances, outside lifts used by the public, and in waiting rooms. The charter sets out cleaning tasks, frequencies and who is responsible for them.
Cleaning responsibilities and efficacy audits
The standards state that different staff groups, both clinical and non-clinical, are responsible for cleaning different elements within an area, and that each establishment must produce a local schedule of cleaning responsibilities.
Alongside technical audits of the cleaning outcome, the standards describe efficacy audits. These observe cleaning as it happens, to check that staff use colour coding correctly, follow cleaning methods, wear the correct uniform and PPE, use chemicals appropriately and work safely. Our guide to colour coded cleaning explains the national colour-coding scheme in more detail.
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We provide healthcare cleaning for surgeries, clinics and care homes in Bristol and the surrounding area, along with disinfection cleaning for high-touch areas. Contact our team to arrange a site visit and a tailored quote.