From his vantage point in a hospital bed, Andrew Reilly has been conducting his own cleanliness audit. The 70-year-old patient was rushed into the Western General in Edinburgh two weeks ago and received emergency surgery for a colon blockage caused by cancer.

"The operation was finished at 4am and I went straight to the high-dependency unit," he says. "Quite frankly, the quality there was just amazing, but if you are sitting in a bed you can see where the problems are.

"When someone comes in, they put on a pair of gloves, but they do not do anything about their shoes or the trousers they were wearing yesterday or the day before. It is a bit hit-and-miss."

Now recovering on a ward, he says he remains very aware of hygiene and would not like to be charged with preventing the spread of infections in Scotland's hospitals.

"I love having visitors, but visitors are obviously a source of infection," he says. "I do not know how you do it. It is a big job. There is a lot to be achieved."

The latest tactic, unveiled by Health Secretary Nicola Sturgeon yesterday, is a system of unannounced inspections scrutinising cleanliness and hand hygiene.

Although independent checks have been carried out in England's hospitals for some time, Scotland has relied on its health boards to assess their own performance.

Families who lost relatives in a fatal outbreak of the bug Clostridium Difficile at the Vale of Leven Hospital in Dunbartonshire earlier this year say that sending in external inspectors was one of their suggestions in the wake of the deaths.

Michelle Stewart, who lost her mother-in-law in the outbreak and is now secretary for the C Diff Justice Group, explained: "We came up with the idea of an independent inspectorate for hospitals like HM Inspector of Schools and put it to Nicola Sturgeon when we met her.

"We think she keeps announcing things we suggest to shut the families up and stop us campaigning for a public inquiry. But every time she announces one of our ideas, it just shows how much was wrong and underlines the need for a public inquiry."

The new inspection system is certainly more independent than the current system, although it will be based within the health service's internal watchdog, NHS Quality Improvement Scotland. Its findings will be made public, as demanded by Ms Stewart, and every acute hospital will be covered every three years.

Unveiling the system's details, Ms Sturgeon admitted that fear of catching a bug in hospital was the most common concern undermining public confidence in the NHS.

"The launch of the inspectorate demonstrates my commitment to tackling the serious problem of healthcare-associated infection," she said. "I want to assure the public and further boost their confidence in the NHS by ensuring robust processes are in place to prevent avoidable infections."

Presumably, however, the level of reassurance may rather depend on what the inspectors find when they visit. The results of the first independent audit of cleaning and cleaning monitoring systems in a sample of Scottish hospitals and health centres was also published yesterday and the report did not make entirely reassuring reading.

While there was praise for Glasgow Royal Infirmary, despite the age of the building giving a poor first impression, issues were raised in hospitals from the Borders to Aberdeen to Orkney.

Asked about the findings, Ms Sturgeon was quick to point out that not all health boards had failings, but added: "I am always disappointed when I hear reports of standards in hospitals not meeting the standards the public expect them to meet."

On a number of occasions, the auditors, from Health Facilities Scotland, blamed staff absence for poorer cleanliness - flagging up another problem the NHS has struggled to reduce.

Old fixtures and fittings and a lack of suitable storage space were also highlighted in more than one part of the country in their report.

But Ms Sturgeon said: "There are no excuses for poor standards of cleanliness or hygiene in our hospitals. That is the central message I have made clear since I have been in post."

Nevertheless, traditional wards will gradually be phased out in Scotland in another scheme to slash healthcare-associated infections that was also announced yesterday.

From now on, the presumption will be that new hospitals will consist purely of single rooms and, when wards are refurbished, at least 50% of the beds will be in single quarters.

The measure is based on the recommendations of experts, although its implications go beyond extra bricks and mortar.

Jacqueline Campbell, a ward sister at the Western General, weighed the pros and cons when the change was put to her, noting that it took more nurses to observe patients when they were not grouped together.

"I was a sister in the old Edinburgh Royal Infirmary and the new Royal and then moved here," she said. "I went from the old Florence Nightingale wards to the new environment. In the older wards you can see the patients better."

Mr Reilly, from Broxburn, began his recovery in a single room but is now sharing with other patients. He certainly appreciated the relative peace and quiet at first, but said that now, he was feeling a bit better, the opportunity to talk with neighbouring patients could be helpful.

His feelings about the new inspection regime were also mixed. "Anything is good if it is properly managed and controlled," he said. "If it is a face-saving exercise, it does nothing for anyone."

Key audit concerns

Borders General
"Dust levels were higher than expected in most areas visited, which generally indicates the frequencies for daily dust-removal cleaning were not being adhered to.

"When the audit was carried out in the A&E department, it was approximately eight hours after the last full daily clean. This was reflected in the audit result, which was much lower than expected."

Falkirk Royal Hospital
"Dirt on porous floors, old paintwork (which can be difficult to clean) and other areas shows that suitable effort was not given to detailed cleaning over a period of time and this has produced a built up of dirt. Although audits were not carried out in the circulation areas, public toilets and main dining room, it should be noted that the standards were very poor."

Aberdeen Royal Infirmary
"Visual observations recorded a lower-than-acceptable level of cleanliness in many of the corridor, circulation, and public lift areas."

St John's Hospital, Livingston
"Many of the circulation areas of St John's could have been cleaner, although none of these areas was formally audited. The reason given for the poorer visual standard was reallocation of staff from these areas to the patient areas during the current 9% employee sickness level."

NHS Orkney
"The main health centre did fall below the standards required. The area was in need of refurbishment, but there could have been a far higher cleaning standard than was presented on the day of audit."

NHS Shetland
"The Lerwick Health Centre is one of the newest locations at the health board and it was disappointing to see the standards as poor as they were.

"There was a great deal of building work ongoing at the Gilbert Bain Hospital and many of the circulation areas were untidy and dirty."