National Standards of Healthcare Cleanliness for Clinics

If you're writing a cleaning specification for a clinic and have come across the NHS cleanliness standards of 2021, you'll want to know whether this NHS document binds a private dental practice or physio clinic, and if not, whether it's still worth using. This page answers both from the document itself and from the CQC.

What the document is now, and who it covers

Who do the national standards of healthcare cleanliness apply to?

NHS England published the National Standards of Healthcare Cleanliness 2025 on 5 February 2025, and the document says these standards replace those published in 2021. The old 2021 publication address now forwards to the 2025 page, so a specification that cites "NSHC 2021" is citing a superseded version.

The 2025 document describes its scope in two different ways. The summary says the standards apply to all healthcare organisations and combine guidance, recommendations and good practice across all healthcare settings. The introduction is narrower: the standards apply to all NHS trust settings, regardless of the way cleaning services are provided. Neither sentence mentions private dental practices or physiotherapy clinics, and there is no primary care or dental appendix.

The summary also says meeting aspects of the standards is mandatory, and that compliance with the standards and their audit process should be written into contracts with cleaning service providers. The document does not say whether either sentence reaches a private clinic.

What the CQC says about them

The CQC's dental mythbuster on infection prevention and control refers to "the 2021 standards" once, without naming them in full. It notes that they reference a star rating system, then says there is no expectation that dental practices display star ratings or logos. Its GP mythbuster says the 2025 standards replace the 2021 specifications for cleanliness in NHS services, and that it does not expect GP practices to display star ratings either.

For a dental practice, the CQC says it uses the code of practice on infection prevention and control and related guidance when assessing whether a provider is meeting the regulations. That code applies to independent healthcare providers in England, including primary dental care and primary medical care. Providers must have regard to it when deciding how they will meet the regulations, but the code itself is not mandatory: a registered provider can meet the regulations in a different way, equivalent or better.

If your clinic isn't registered with the CQC

All of that reaches a clinic through CQC registration. A clinic that isn't registered with the CQC isn't reached by the code, and for it the national standards are a model to borrow. Whether a physio clinic needs to register is covered in the physiotherapy clinic cleaning guide.

The premises duty, HTM 01-05's room frequencies and the CQC's schedule request for dental contractors are covered in the dental practice cleaning guide.

The parts worth borrowing

Functional risk categories

The standards sort every area of a building into one of six functional risk (FR) categories, and the category drives how often it is cleaned and audited and what score counts as a pass. Table 1 sets the audit target and frequency for each: FR1 98% and above, weekly; FR2 95%, monthly; FR3 90%, every 2 months; FR4 85%, every 3 months; FR5 80%, every 6 months; FR6 75%, every 12 months. Using all six is described as good practice but not mandatory.

Appendix 3 suggests which areas go where. The table includes only the Appendix 3 rows that resemble rooms in a small clinic. Appendix 3 calls itself a guide, and says risk identification must ultimately be locally decided.

Where rooms in one area are given different categories, the standards say the choice must be based on activity, not the type of room. An office used by clinical staff inside a clinical area is likely to need the same frequency of cleaning as the rest of that area.

Frequencies, audits and sign-off

The standards then ask for a cleaning specification listing each element, the standard it should meet after cleaning (the performance parameter) and how often it is cleaned in each FR category. They define five routine frequencies: full clean, spot clean, check clean, periodic clean and touch point clean. A check clean is a look to see if an element meets its parameter, followed by a full or spot clean if it doesn't. Separately, a schedule of cleaning responsibilities records who cleans each item.

Two kinds of audit follow. A technical audit scores each element pass or fail. An efficacy audit watches the cleaning itself, including colour coding, equipment, materials and method, and an area scoring below 80% should be re-audited after remedial action. The standards call it good practice for a technical audit to be signed off by someone on the team responsible for the area. In NHS settings, the results feed a displayed star rating and a Commitment to Cleanliness Charter showing each area's tasks, frequencies and who does them.

Writing a clinic specification on the NSHC model

Nothing here makes the model compulsory for a private clinic, but it gives a specification a structure that an inspector, auditor or new contractor can read quickly.

The responsibility column is where the clinic and the contractor split the work. A cleaning contractor cleans the environment. Instrument decontamination and anything to do with clinical waste stay with the clinic and its own procedures. Equipment cleaned between patients needs a named owner too, and the schedule should say who in writing.

How a contract clean is set up, with the specification, visit times and keys, is on the office and commercial cleaning page. Crystal Clear Cleans works in Uxbridge and across the London Boroughs of Hillingdon, Ealing and Hounslow, and visits can be booked between 6am and 10pm, seven days a week. Send your room list and opening hours through the quote form.