A patients' watchdog is doing spot cleanliness checks at Kingston hospital which has been revealed as having the dirtiest toilets and bathrooms of any hospital in the country.

The 2004 NHS National Patients' Survey found that compared with a national average of 13 per cent unhappy with the condition of toilets and bathrooms in hospitals, the Kingston figure was 38 per cent unhappy. Nationally, 80,000 people were surveyed.

Last month, the independent health inspectorate the Healthcare Commission for the third year running awarded the hospital two stars in its annual performance ratings as it was not up to scratch on cleanliness. It was also judged to be below standard for its food and the way it communicates with patients.

The Kingston Patient and Public Involvement Forum (PPIF) which has replaced the Community Health Council has started spot checks at the hospital - only giving two hours warning of a visit.

Mr Dennis Berry chairman of the forum, said: "We have started doing fortnightly spot checks in the hospital checking cleanliness and to see if there are any problems.

"We did our own patients' survey about three weeks ago on a couple of wards and there were no concerns at all. I think the hospital has got a hold of this."

Kingston and Surbiton MP Edward Davey said there are short-term improvements in cleanliness at the hospital but they do not last for long.

He said: "There is a big problem with cleanliness and they have to get to grips with it. I have been raising this with them for three or four years. In the past they have changed contractors, respecified contracts and improved monitoring so there have been short-term improvements, but they always seem to fall back. What I want is sustained improvement."

He added: "Many things are going right at Kingston Hospital, the accident and emergency performance has turned around and overall there is good medical care, but there are shortcomings on cleanliness."

Janet Shepherd, director of nursing at Kingston Hospital NHS Trus,t said: "The survey found that 58 per cent of patients thought the toilets and bathrooms were clean. Standards of cleanliness have improved since the survey was conducted eight months ago.

"Matrons and nursing leads have been working with our cleaning contractor to improve levels of cleanliness in patient areas. These are monitored regularly and have shown consistent improvement. However, we recognise that there is still more for us to do.

"In June, the local Public and Patient Involvement Forum (PPIF) carried out a cleanliness spot check on our main wards including the bathroom facilities.

"The PPIF were generally satisfied with the levels of cleanliness but have highlighted areas for improvement such as replacing older basins and toilets.

"We are aware that these often appear dirty because of their age and condition so there are plans in place to refurbish some of the main wards including the older bathrooms and toilet facilities.

"We will be making the cleaning schedule more prominent so that staff, visitors and patients know when an area is going to be cleaned. We will also be talking to those who provide our cleaning services about how we can improve the standards of cleanliness on site.

"Cleanliness is a hugely important area for us. We value patient feedback enormously and we know we need to do more to improve this important issue to provide our patients with the high quality hospital they deserve."

She added: "Despite these issues we are pleased that the recently published national MRSA figures show that there has been a 38 per cent reduction in cases of MRSA at Kingston Hospital over the past year. We now have the fifth lowest MRSA rate in London amongst general acute trusts."