The NHS National Standards of Healthcare Cleanliness 2025 assign every healthcare area a functional-risk category from FR1 to FR6, which sets its cleaning frequency, audit frequency and target score. Results are published as a five-star rating against that target. The standards apply to all healthcare settings, however the cleaning is provided.
What the standards are
The National Standards of Healthcare Cleanliness 2025, published by NHS England, are the current benchmark for cleanliness in healthcare. They supersede the 2021 version (which replaced the 2007 specifications), though the target scores and star bands are unchanged between the 2021 and 2025 versions. They apply to all healthcare environments — acute hospitals, mental-health and community settings, primary care, dental, ambulance services, GP surgeries, clinics and care homes — regardless of who provides the cleaning.
Functional Risk categories FR1 to FR6
Every functional area is assessed and assigned a Functional Risk (FR) category from FR1 to FR6. The category drives everything: cleaning frequency, monitoring, audit frequency and the target audit score. High-risk clinical areas such as operating theatres sit at FR1 and are cleaned and audited most often with the highest target; low-risk areas such as store rooms sit at FR6. Which area falls into which category is decided locally, guided by the standard's examples.
Target scores and audit frequencies
Each FR category has a target audit score and an audit frequency, from FR1 at 98% audited weekly down to FR6 at 75% audited annually. The table below sets them out. Adopting all six categories is good practice but not mandatory; any deviation requires a written rationale.
The five-star rating
Results are expressed as a public-facing five-star rating relative to the FR target: five stars for achieving the target or above, down to one star for 10% or more below. Any functional area at three stars or fewer must have an improvement or action plan with agreed timescales. The 2025 standard also requires an annual efficacy audit and a Commitment to Cleanliness Charter displayed where the public can see it.
How we clean to NHS standards
On healthcare and clinical contracts we clean to these standards: areas are cleaned at the frequency their FR category demands, equipment follows BICSc colour-coding, products carry COSHH assessments, and audit results are recorded against the star rating. For CQC-registered providers this dovetails with CQC Regulations 12 and 15.
NHS Functional Risk categories (National Standards of Healthcare Cleanliness 2025)
| FR category | Target audit score | Audit frequency | Typical area |
|---|---|---|---|
| FR1 | 98% and above | Weekly | Operating theatres (very high risk) |
| FR2 | 95% and above | Monthly | Wards (high risk) |
| FR3 | 90% and above | Every 2 months | Medium-risk clinical areas |
| FR4 | 85% and above | Every 3 months | Significant-risk areas |
| FR5 | 80% and above | Every 6 months | Lower-risk areas |
| FR6 | 75% and above | Every 12 months | Store / filing rooms (low risk) |