Patients believe cleanliness levels in NHS hospitals are not improving, the health watchdog has said.
The Healthcare Commission also found wide variations in patients' experience of cleanliness between health trusts in England.
Its patient survey reported "striking" differences between health service trusts on some areas of patient care. The biggest variations came in waiting for admission to hospital, mixed-sex wards, help with eating meals and food quality.
Around 75,000 adult patients were questioned at 165 trusts in the biggest survey of its kind. And for the first time, patients can now compare scores for NHS trusts on topics such as hospital food, cleanliness and levels of privacy.
The results revealed those rating their care as "excellent" went up from 41% in 2006 to 42% last year. Patients also reported slight improvements in how quickly they were admitted to emergency departments.
The best-performing hospital trust rated on how patients saw their overall level of care was The Robert Jones and Agnes Hunt Orthopaedic and District Hospital Trust in Shropshire. Bottom of table was Ealing Hospital NHS Trust in London.
The survey found the number of patients reporting their hospital was "very clean" fell from 56% in 2002 to 53% in 2007 and has not improved since last year. The best-performing trusts found around 80% of those asked said their room or ward was "very clean".
Fewer than half of patients reported lavatories and bathrooms were very clean. In the best trusts this figure was as high as 81% but in the worst was as low as 22%.
The survey found fewer patients than last year believed doctors and nurses always washed their hands between patients. At the worst performing trust, a quarter of those asked said they thought doctors did not wash their hands after examinations.
Around a quarter of people reported being in a mixed-sex ward when first admitted to hospital, and around a fifth when they moved wards. The figures showed slight improvements compared to last year.
