It was the Secretary of State's concerns about the state of some of our hospitals that led him to call in Virgin in the first place

Department of Health spokeswoman

Findings

They are reported to have found corridors strewn with cigarette ends, wards where no one knew who was in charge, bleak waiting rooms and stifling bureaucracy.

They said staff communicated with patients inefficiently, choosing to write letters rather than the phone or e-mail.

They also suggest that morale among NHS staff is at its lowest ever, with workers more used to being criticised than praised.

It suggested that the NHS was overburdened with managers and said there was one administrator for every two clinical members of staff.

The Virgin group experts are reported to have made a raft of recommendations to improve the NHS, ranging from legible nametags for nurses to leadership courses for managers.

The study was commissioned by Health Secretary Alan Milburn and was leaked less than a week before he unveils the government's national plan to modernise the NHS.

A Department of Health spokeswoman said: "It was the Secretary of State's concerns about the state of some of our hospitals that led him to call in Virgin in the first place."

She added: "Next week's national plan will set out a serious of fundamental and far reaching reforms to transform the NHS into a personalised health service where patients come first."

The NHS Confederation, which represents managers in the health service, rejected the report's findings concerning bureaucracy and management.

The fundamental problem is the NHS is a system which focuses managers far too much on administration rather than patient care

John Lister, Health Emergency Campaign

But its chief executive Stephen Thornton acknowledged that hospitals could be cleaner.

"In our evidence to the government for the national plan we have said that there is a need to get the basics right. This includes cleaning," he said.

John Lister, from the Health Emergency Campaign, said: "There definitely are a number of poor managers but i think the fundamental problem is the NHS is a system which focuses managers far too much on administration rather than patient care."

Mike Stone, director of the Patients' Association, added: "It is something we have been calling for for years. We need a thorough review of food and cleanliness. It really needs to be looked at."