Medics should ditch ties in a bid to combat hospital superbugs such as MRSA, doctors' leaders say.
Superbugs can be carried on ties, the BMA says
The British Medical Association has urged its members to shun the neckwear as they are rarely cleaned and could be a source of infections.
The report also said catheters and tubes could be a problem because they breached the body's natural defences.
Researchers called for less use of antibiotics and improved hygiene for patients, staff and visitors.
But the BMA said hygiene standards had been compromised as the number of cleaners in the NHS has fallen over the past 20 years from 100,000 to a low of 55,000 in 2003-4.
The report said reduced bed numbers and higher patient turnover to meet performance targets had also made good infection control more difficult.
It said the most important measure that could be taken was for patients, staff and visitors to clean their hands regularly.
Hospital infections are linked to the deaths of up to 5,000 people in the UK every year, and cost the NHS up to £1bn annually.
In England, the report said, 300,000 patients acquire infections in hospitals every year and at any given time some 9% of hospital patients are infected.
A 15% reduction in the incidence of hospital infections would free up around £150m a year for other NHS resources, the BMA said.
Dr Vivienne Nathanson, the BMA's head of ethics and science, said: "It is unlikely that any health service will ever be completely free of hospital infections but there is a lot more that doctors, nurses, cleaners, patients and their visitors could be doing to reduce infections spreading - the fact is around 15% to 30% are preventable.
"A lot of the solutions like hand-washing may sound simple. While strict guidelines are in place about how health professionals need to wash their hands, there are barriers to compliance.
"One of the major barriers to doctors following these guidelines is time and the pressure to treat patients and meet targets.
"Another can be the layout of clinical areas and access to washing facilities."
Shadow Health Secretary Andrew Lansley said: "The level of healthcare associated infections is unacceptably high and the government have failed to curb the rising number of cases.
"Patient confidence in the NHS needs to be restored. But this can only happen if there are clear and workable guidelines for staff."
But Health Minister Jane Kennedy said reducing MRSA was one of the key priority for hospitals.
She highlighted the measures already taken to improve hospital cleanliness and the Health Bill going through Parliament, which includes plans for a hygiene code and tougher inspections to tackle infections.