The NHS is failing to improve hygiene standards despite a major quality and patient safety push.
The lack of progress in implementing the hygiene code and infection control standards has been identified as a major concern by the Healthcare Commission as it unveils the latest annual health check.
NHS trusts failing to deliver the hygiene code risk being unable to register with the new regulator, the Care Quality Commission, next April.
Healthcare Commission chief executive Anna Walker said: "MRSA rates are coming down, but there are parts of the NHS which need to work particularly hard at getting infection rates down and systems in place to ensure rates remain low."
She singled out community services as needing to focus on battling infections.
Three core standards are linked to the hygiene code: covering clean environments, infection control and decontamination.
Nationally the proportion of trusts complying with all three has remained static for two years, at 69 per cent. Acute and specialist trusts have been stuck at around 75 per cent. Two standards have higher compliance rates compared with last year, but all three are only at or below the levels recorded two years ago.
Compliance with the standard for decontaminating medical devices is now at 77 per cent - the lowest level for any standard over the three assessment years. This represents a dive of 10 percentage points.
Infection control compliance was 92 per cent in 2005-06, rising to 84 per cent in 2006-07, and 88 per cent in 2007-08.
For clean environments, the figure was 90 per cent in 2005-06, 88 per cent in 2006-07, and 90 per cent again this year.
The infection control and decontamination standards are among the six worst for compliance.
Ms Walker said she doubted that the drive for quality, a central theme of the next stage review, would be lost amid tightening budgets and the credit crunch.
She said: "Systematic change has taken place that will stop things going badly wrong in particular trusts."