Cleanliness levels in hospital casualty departments have worsened despite Government pledges to improve standards, according to the largest survey of NHS patients.

Cleanliness levels in hospital casualty departments have worsened despite Government pledges to improve standards, according to the largest survey of NHS patients.

Less than half of visitors to A&E units last year rated them as "very clean" and satisfaction levels are falling, the poll of 140,000 people found.

The findings come as a blow to the Government, just weeks before the election when the NHS is expected to be a central issue for all parties. The survey for the Healthcare Commission, the independent NHS inspection body, found just 45 per cent of patients rated their A&E department as "very clean", a 4 per cent decrease on the previous year.

Cleanliness ratings for hospital outpatient departments also fell, from 59 per cent in 2003 to 53 per cent last year.

The Government has vowed to tackle the problem of hospital cleanliness amid rising rates of hospital infections. Up to 5,000 people each year are killed by the "superbug" MRSA.

However, the survey also found that patients were being seen faster in both A&E departments and for outpatient appointments: 77 per cent said they had waited in casualty for less than the government target of four hours, compared with 69 per cent in 2003.

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