Hospitals in two Kent NHS trust areas are among the top 25 per cent in the country and two other trusts are in the bottom 25 per cent. And it’s the patients who say so.

The survey, carried out for the Healthcare Commission, asked in-patients a series of questions which ranged from cleanliness to food quality, staff performance to mixed ward accommodation.

The performance of hospitals in the Medway Trust area was judged worst in Kent, coming 148th out of 169 trusts. Medway and Tunbridge Wells Trust, which was at the centre of the c-diff deaths scandal, was 148th.

But at the top end of the scale was the Dartford and Gravesham Trust, which was 18th best in the country. The East Kent Hospitals Trust was 22nd.

The survey, conducted in the autumn, was the biggest survey of patients’ views to be carried out in hospitals in England.

Anna Walker, the Commission's Chief Executive, said the survey gave a comprehensive picture of how patients feel about NHS hospitals. "Overall, it's encouraging that a steadily increasing percentage of patients say care is ‘excellent’, she said

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Hospitals face more criticism>>>

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While it was encouraging that an increasing number of patients say care is 'excellent' she said the survey also showed that some hospitals were struggling to deliver the basics.

She added: "There are striking variations in performance in key areas such as providing single-sex accommodation and giving people help when they need it. Those performing poorly must learn from those who perform well."

Health chiefs in Medway insist they are listening to patients and improvements were on the way, including six new matrons to boost ward nursing teams,

A trust spokesman said: "We realise with 21st century lifestyles, choice and flexibility are paramount and we will continue to work hard to deliver these."

Hospitals in Maidstone and Tunbridge Wells got poor ratings for cleanliness, availability of nurses and the standard of food although 85 five per cent of patients said their care was either excellent, very good or good.

Glenn Douglas, trust chief executive, was disappointed that the survey showed "mixed perceptions" and said it did not reflect the ongoing improvements that were reducing infection rates, raising standards of care and rebuilding patient confidence.