Many of Scotland's hospitals need to improve their standards of hygiene, according to a watchdog study.

Audit Scotland found that only half of the 74 hospitals it carried out spot checks on had high levels of cleanliness in their wards.

Its report, published on Thursday, said that one fifth of the hospitals involved showed a clear need for improvement while others were in need of minor improvements.

Concern about the rise of Hospital Acquired Infections (HAI) - which is costing the health service millions of pounds every year - has seen ward cleanliness put under scrutiny.

Hospitals giving cause for concern

Bonnybridge Hospital Caithness General, Wick Dunoon General Dykebar, Paisley Falkirk Royal Glasgow Royal Hairmyres, East Kilbride Inverclyde Royal, Greenock Monklands, Airdrie New Craigs, Inverness Ravenscraig, Greenock Royal Alexandra, Paisley Stirling Royal Victoria Infirmary, Glasgow Aberdeen Royal Gartnavel General, Glasgow Southern General, Glasgow State Hospital, Carstairs Stobhill Hospital, Glasgow Western Infirmary, Glasgow Whyteman's Brae, Kirkcaldy, Fife

The audit body's reviewers checked and rated the cleanliness of floors, walls, beds and lockers, screens and wash basins in wards and public areas.

Auditor General Robert Black said: "One in five hospitals show a clear need for improvement.

"Patients rightly expect to be treated in clean hospitals and this is a priority for the health department.

"It is important that the concerns raised in the report are addressed at the highest levels in trusts."

Reviewers found staff spent less time than planned on cleaning in a quarter of wards.

The watchdog warned that many hospitals had high levels of sickness as well as absences, vacancies and turnover of staff.

It also said poorly defined contracts at hospitals using outside cleaning companies added to the problem.

Poor maintenance at some hospitals was also said to be hampering efforts to keep wards and public spaces clean.

Health Minister Malcolm Chisholm said a lot had been done to tackle the issue but added there was no room for complacency.

He said: "I commend Audit Scotland on their report. It provides the public and patients with a thorough and independent assessment of the state of Scotland's hospital wards and public areas.

Malcolm Chisholm warned against complacency

"The report makes clear that since Audit Scotland's previous report 'A Clean Bill of Health', significant work to implement the cleaning standards is taking place in many trusts and boards.

"It also found considerable progress against a number of the recommendations in the earlier report."

The minister added: "However, it is not acceptable that one in five wards are not up to standard. It is clear that in a substantial minority of hospitals improvements must be made."

Shona Robison MSP, the Scottish National Party's health spokeswoman, said the report showed half of hospitals were failing to meet cleanliness targets.

She said: "Only last week, a report from NHS Quality Improvement Scotland said that a lack of cleanliness was one of the main causes of hospital acquired infections.

"This report today from Audit Scotland makes worrying reading as it highlights that 50% of hospitals need to improve their standards of cleanliness."

Ms Robison added: "This is a clear result of the Scottish Executive's lack of judgement about privatisation through the contracting out of cleaning in hospitals."