GP surgery cleaning: what CQC and the NHS cleanliness standards expect

Which rules and standards apply to cleaning a GP surgery?

Regulation 15 of the Regulated Activities Regulations 2014 requires premises and equipment to be clean and hygienic. CQC judges this using the statutory Code of Practice on preventing and controlling infections, and points practices to the NHS National Standards of Healthcare Cleanliness 2025.

• Regulation 15 (Health and Social Care Act 2008 (Regulated Activities) Regulations 2014): premises and equipment must be clean, secure, suitable, properly used and maintained, with hygiene standards appropriate to their use. CQC also inspects IPC under Regulation 12 (safe care and treatment).
• The Code of Practice on the prevention and control of infections (updated December 2022): statutory guidance that providers must have regard to. Criterion 2 covers a clean environment. CQC applies it in proportion to the risk, so a practice isn't held to a hospital's set-up.
• CQC GP mythbuster 99: CQC's plain summary of what it expects from practices on IPC and cleaning.
• National Standards of Healthcare Cleanliness 2025 (NHS England): risk categories, cleaning frequencies, audits and star ratings. Written mainly for NHS trusts, but CQC refers GP practices to them.
• National IPC Manual for England: standard precautions, including spillages and waste. Mandatory in NHS settings and wherever NHS services are delivered.
• Workplace Regulations 1992 and COSHH 2002: keep the workplace clean, and control the risks from cleaning chemicals.

None of these says whether to use a contractor or your own staff. They expect whoever cleans to work to a written standard you can show is being met.

What does CQC expect a GP practice to have in place?

An IPC policy relevant to the practice, a named IPC lead, an IPC audit programme with evidence that issues were fixed, and a contractor's cleaning schedule that sets frequencies for areas and touch points and is checked regularly.

CQC's GP mythbuster 99 (updated September 2023) says a practice should have:

• An IPC policy, accessible and regularly updated, covering the local IPC specialist team's contact details, higher-risk procedures such as minor surgery, training, PPE, and responsibilities for cleaning specific clinical equipment.
• An IPC lead with authority to make changes.
• An IPC audit programme, with evidence of issues found and how they were dealt with.
• A contractor's schedule of general cleaning with frequencies for specific areas, fixtures and fittings, including high-touch items, checked regularly and in line with what the public expect in healthcare premises.

The Code of Practice adds that cleaning arrangements should define roles and responsibilities, have agreed routines and enough resources, and include a way for staff to request extra cleaning, routinely and urgently. A schedule of cleaning responsibility and frequency should be available on request.

How do the NHS functional risk categories apply to a GP surgery?

The 2025 standards put each area into one of six functional risk (FR) categories. The category sets cleaning frequency, audit frequency and target score. The standards don't name GP practices, so you decide, but consulting rooms and waiting areas appear in the FR4 suggestions.

Source: Table 1, section 8.5. Appendix 3 suggests areas for each category. Those closest to a typical practice:

• FR2: treatment rooms where invasive procedures take place.
• FR4: treatment rooms without invasive procedures, consulting rooms, waiting areas, entrances, receptions and public corridors.
• FR6: offices and medical records.

Public toilets and corridors serving an area are recommended to share its category. Rooms can also be categorised by what happens in them: an office used by clinicians in a clinical area may need the clinical frequency. The standards ask for a written rationale for each area, reviewed at least yearly or when clinical activity changes. Your IPC lead signs it off; the contractor prices and cleans to it.

How often should each part of a GP surgery be cleaned?

Appendix 2 of the 2025 standards sets a minimum frequency for each item in each risk category. In FR4 areas, hard floors, toilets, sinks and taps get a full clean daily. In FR6 offices, toilets and sinks are still daily but hard floors drop to fortnightly.

The standards call these frequencies a required baseline: if you adapt them, don't go below them.

FR2 rooms, such as a minor surgery room, have higher frequencies: check the full appendix.

The standards define five types of clean: full, spot (specific marks), check (look, and clean if it falls short), periodic (fortnightly or longer) and touch point. Carpet washing, floor sealing and external windows go in a planned annual programme. Touch points get more attention than the item they're on: in public areas, door handles and push plates, light switches, grab rails, taps, flush handles, dispensers, and the arms and seats of waiting room chairs. A busy practice may need daytime toilet checks between contractor visits.

Who cleans what: practice staff or the contractor?

Usually clinical staff clean medical equipment between patients and the contractor cleans the building and fixtures. But there's no national split: the standards say each organisation must produce its own schedule of who cleans every item.

The 2025 standards warn that patient equipment can easily "fall through the gaps" and require a local schedule of cleaning responsibilities, agreed with clinical and non-clinical staff. Appendix 1 has an example you can adapt. A common split for a practice, to confirm in your own:

The National IPC Manual says all blood and body fluid spills are hazardous, must be dealt with immediately by trained staff, and responsibilities must be clear in each area. The cleanliness standards add that your local policy should say whose job it is, and whoever does it must be trained and follow a written method. In practice that means a spill kit and trained staff on site in surgery hours.

How should clinical rooms, waiting areas and toilets be cleaned?

Use separate colour-coded equipment for toilets and general areas, clean top to bottom and clean to dirty, keep clinical rooms uncarpeted and uncluttered, and focus on touch points. The National IPC Manual recommends detergent for routine cleaning and 1,000ppm available chlorine routinely on sanitary fittings.

Colour coding. Cloths, mops, buckets and reusable gloves follow the national code: red for toilets, washrooms and basins in them; blue for general areas, offices and public basins; green for kitchens; yellow for isolation areas. Chemicals don't need colour coding. Ask a contractor to show you their kit on the first visit.

Method and products. The standards say clean top to bottom and clean to dirty, use damp cloths, clean floors last, and remove wet floor signs once dry. Change solutions when dirty and straight after a spill. The National IPC Manual recommends neutral detergent in warm water, or detergent wipes, for routine cleaning, and says routine disinfection of the environment isn't recommended, except 1,000ppm available chlorine on sanitary fittings. Your IPC lead should approve products.

• Clinical rooms: no carpets (CQC); visibly clean and free of non-essential items so they can be cleaned (NIPCM). Clutter is a common reason rooms fail.
• Waiting areas and reception: chair arms and seats, push plates, the check-in screen and counter. The standards note that clean public floors matter to public confidence even where infection risk is low.
• Toilets: daily full clean plus checks, red equipment only, consumables refilled.
• Carpeted consulting rooms and communal areas: CQC wants a policy on how often carpets are cleaned and what happens if they're contaminated with body fluids.

Should cleaners handle clinical waste and sharps bins?

The practice is responsible for its waste from production to disposal. Segregating clinical waste and filling, labelling and closing sharps bins are jobs for trained practice staff. Whether cleaners move sealed bags to the store should be written into your waste policy and contract.

CQC's mythbuster says practices must deal with waste appropriately from production to final disposal, using HTM 07-01 as the best-practice framework. It expects:

• Lidded, foot-operated clinical waste bins at point of use in clinical areas.
• Bags no more than two-thirds full, tied, labelled with address and date, and stored securely until collection.
• Sharps in the right container (orange, yellow or purple lid), labelled when assembled and locked, and disposed of at the fill line.
• Patient-identifiable documents treated as confidential waste.

We haven't found a national rule banning cleaners from moving a sealed bag. But each step needs training and a judgement about the waste, so practice cleaning contracts normally exclude them. A sensible split: clinical staff segregate, tie, label and close; the contractor empties general and recycling bins and, only if your policy says so, moves sealed, labelled bags to the store. Cleaners should never open or press down sharps bins, and should know the practice's sharps injury procedure.

What checks and records should a GP practice keep?

Keep the schedule, the responsibilities split, evidence of regular checks, IPC audit results and what was done about failures. The standards describe technical audits (is it clean?), efficacy audits (is it cleaned the right way?) and an annual external check.

• Technical audit: each element in each room scores pass or fail, with the reason for every fail. Do them at random times. In areas of 10 rooms or fewer, audit every room. One scuff mark in an otherwise clean room shouldn't fail.
• Efficacy audit: watching cleaning to check colour coding, method, PPE and chemical use. Recommended annually in patient-facing areas.
• External audit: an independent check, recommended annually. Neighbouring organisations can audit each other, which could suit practices in a primary care network.

Fix times: any health and safety, patient safety or IPC issue should be assessed within 20 minutes and fixed within an hour. For FR4, assess within an hour and fix at the next clean or within 72 hours, whichever is sooner.

What about out-of-hours access, confidentiality and COSHH?

Agree key holding, alarm codes, locked rooms and lone working in writing. Lock screens and records away and put confidentiality in the contract. The contractor must hold COSHH assessments for its products.

Access. Practices are usually cleaned early or late, often by one person in an empty building. Agree who holds keys and codes, how they change when staff change, which rooms stay locked (drug stores, fridges, server rooms) and how problems are reported out of hours.

Confidentiality. Cleaners work in rooms with records, prescriptions and screens. Lock screens, lock away paper records, keep confidential waste separate so it isn't emptied with general waste, and include a confidentiality clause in the contract.

COSHH. COSHH requires employers to plan, manage and monitor hazardous substances, including many cleaning chemicals. The contractor should hold COSHH assessments and safety data sheets for every product it uses on site, and the National IPC Manual says COSHH assessments must be followed when decontaminating the care environment. Store chemicals away from patient areas.

What should a GP surgery cleaning specification include?

Each area's risk category, the items to clean, frequency and type of clean, and who is responsible. The contract adds products, colour coding, audits, fix times, waste and spillage boundaries, access, confidentiality, training and absence cover.

The standards say compliance and audit should be written into contracts with cleaning providers. A practice specification can be short if it covers:

Ask a contractor: which healthcare premises do you clean now? How do you train staff on colour coding and spillages? Will the same cleaners come each time? How will you share audit results? Can you work to our IPC policy and products?

For how contractors build a price, see office cleaning costs: the method is the same, though healthcare frequencies usually mean more hours. Practice offices can follow our office cleaning guide. If you change contractor, existing cleaners may transfer under TUPE.

Related guides

GP surgery cleaning: frequently asked questions

Sources

We checked the facts on this page against these sources on 12 November 2026:

• CQC: GP mythbuster 99, Infection prevention and control in general practice
• NHS England: National standards of healthcare cleanliness 2025
• NHS England: National standards of healthcare cleanliness 2025, appendices (Appendix 2: cleaning frequencies)
• NHS England: National infection prevention and control manual, chapter 1
• GOV.UK: Health and Social Care Act 2008 code of practice on the prevention and control of infections
• legislation.gov.uk: Regulated Activities Regulations 2014, regulation 15
• HSE: COSHH, the law

This guide is general information for UK organisations, not legal, health and safety, infection control or employment advice. Business Cleaning Hub is an independent guide. We don't provide cleaning services ourselves. If you ask us to, we'll put you in touch with one commercial cleaning company from our partners that covers your area.

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