NHS trusts should be required to provide changing and laundry facilities for staff to improve cleanliness in hospitals, David Cameron said today.

Health service professionals needed more help maintaining hygiene standards to stop the spread of MRSA, the Tory leader told a nursing conference.

A survey by the Royal College of Nursing recently found that access to changing facilities in hospitals had declined.

Mr Cameron said: "Only a third of nurses have access to showers and a similar proportion are able to get their uniforms cleaned at work.

"Without changing rooms or laundry facilities, nurses have to travel home in their uniforms. That's not good enough.

"We need to change the code of practice in the 2006 Health Act.

"The code should ensure that NHS trusts are under an obligation to provide changing and laundry facilities for staff."

Mr Cameron reiterated his commitment to freeing the NHS from "top-down" Whitehall interference.

A Conservative government would end the "pointless" rounds of NHS reorganisation which previous governments "of all colours" had been guilty of.

"A distinctive Conservative health policy is now emerging that will be a real tonic for the NHS," the Tory leader said today.

"No more pointless reorganisations. Scrapping top-down targets. Making sense of Labour's reforms.

"All hospitals to be foundation hospitals. Proper commissioning by GPs, to make sure the NHS puts patients first.

"And next, our proposals for making the NHS independent, taking politics and politicians out of the day-to-day running of the NHS."

The Conservative party believed nurses and other healthcare professionals should be in the driving seat of NHS care, he said.

"First, most important of all, we need more trust," he said.

"It's extraordinary that we train doctors and nurses for years, we give them a wealth of clinical experience - and then we second-guess their every judgement.

"We need to trust the professionals who deliver healthcare at the front line, and the local managers who ensure the service works for patients.

"That means scrapping the top-down targets which distort clinical priorities."

A Conservative government would hold back from imposing any further changes on the NHS structure, he added.

"We will accept and maintain the basic local arrangements of the NHS we inherit.

"No more pointless reorganisations. No more restructuring at the expense of the people who work in the system."

The Tory leader also pledged to address workforce planning and end the "curious paradox" which saw a surplus of staff just a couple of years after the government had been faced with a shortage.

Around 14,000 nursing graduates are leaving training this year with no job to go to.

Mr Cameron blamed the problem on the government's "ill-considered management of reform" which had imposed major cost pressures on trusts.

"So a whole cohort of new nurses is leaving the first stage of their training without work to go to.

"Meanwhile, behind them, the number of nurses entering training is being reduced."

Mr Cameron said that his party would explore a scheme in Scotland, where health policy is devolved, which guaranteed graduates a year of employment to consolidate their skills.

"It also means that, if no appropriate jobs are available for them after the first year ends, they have the skills to fill them.

"If only we could send today's unemployed nurses four years into the future."

In a separate speech made in Bristol yesterday, Mr Cameron signalled a shift of emphasis in healthcare which would see the target regime scrapped in favour of a focus on outcomes, such as the life expectancy of cancer patients, instead of national limits for hospital waiting.