A team of facilities managers could be sent into 'dirty' hospitals within the next few weeks after 35 per cent of hospitals failed inspections for cleanliness.

Patient environment action teams, including infection control nurses and patient representatives, inspected 699 hospitals during the autumn.

Of these, 250 were graded red, indicating they were failing to meet core standards, 291 yellow (42 per cent) and just 158 green (23 per cent).

Hospitals will be reinspected - this time without warning - in the next two months. But a small number - between 10 and 20 - have caused such concern that action to improve them could be taken within weeks.

Health secretary Alan Milburn has given the go-ahead to an NHS Estates plan to send teams of senior facilities managers from green hospitals to advise poorly performing trusts which were given a 'red' rating. However, it is expected that a small number of trusts will be specifically targeted.

'They have asked a number of us to form groups to go into the very small number of 'deep red' hospitals that are perceived to need some sort of support urgently, ' said one manager, who asked not to be named.

'We would go in with the expectation that our advice would be taken and implemented urgently.

If that does not happen it is possible that some other course of action would be considered.'

At the moment there is no suggestion the managers' groups would run services on the ground - although this could be done if the hospitals failed to improve or take advice. This is very much a supportive initiative - it is not about big brother, ' the manager told HSJ. 'It is to provide support to the local management and help them identify a strategy to improve things.'

A spokesman for NHS Estates said all 'red' trusts would be offered the support of the action teams. 'It is like a resource tool available to all of those who are red, ' he added. He could not confirm a timetable for the work, though action is expected imminently to tackle problem trusts.

The teams look at many aspects of the patient environment, including decor and tidiness of patient and visitor areas, but it is believed a need for basic cleanliness is the main reason why action is being contemplated so soon.

As part of the£31m NHS hospital clean-up initiative trusts were originally asked to draw up action plans which would be implemented by 31 March.