The BBC Fergus Walsh on the Patient's Charter

A survey by the King's Fund and the NHS Executive found that the charter had had little impact on patients.

Staff felt it had been politically imposed and had not made much difference to quality of care.

Doctors were sceptical about whether it had improved clinical standards and said it had sometimes unrealistically raised patients' expectations.

But managers were more positive about the charter, saying it had helped raise performance, make outpatients services more patient-focused and increased staff awareness of patients' rights.

Scheduled appointments

The charter was set up seven years ago under the Conservatives with the aim of improving the standard of care offered to patients.

Tory health spokesperson Ann Widdecombe says it has brought improvements such as scheduled appointments with specialists.

The charter sets out patient rights, for example, that they should be assessed within 30 minutes of arriving in accident and emergency and that no-one should wait more than 30 minutes for an outpatients appointment.

Millionaire television executive and firm Labour supporter Greg Dyke, who has been charged with reviewing the charter, calls it "a ragbag of rights and service aspirations".

He has been visiting hospitals around the country. His proposals, many of which will be based on the King's Fund report, should be presented to the government before Christmas for consultation with staff and patients.

The one-year King's Fund study recommends that the new charter be more clear about its purpose.

It proposes, for example, setting standards for what patients should expect from their GPs, hospital treatment and staff attitudes and laying down standards for equal access to services, with special emphasis on the needs of vulnerable groups.

It also proposes that copies of the charter to be available to patients at the time they are using NHS services.

Responsibilities

Christine Farrell, one of the authors of the report, said: "Although few patients knew about the charter, they had strong views about how a new one could help them.

"They were clear it should be developed by patients, carers and staff to avoid the controversies attached to the existing charter."

The government claims the charter may have played a part in the rise in violence against NHS staff because it has increased patients' expectations without spelling out their responsibilities.

It has been suggested that the charter be renamed the NHS charter to reflect that it should cover both staff's and patient's rights and responsibilities.

The King's Fund report proposes a code of conduct for both patients and staff, but Christine Farrell argues that the NHS does not always help patients to use services responsibly.

Patients do not know much about their rights, says the report

For example, patients have been blamed for wasting doctors' time by failing to turn up for appointments.

"Appointment systems are often not run for the convenience of patients, so they fail to turn up or inform the clinic of their non-attendance," she said.

The Patients' Association backed the report's findings.

It called for focus groups of patients and clinical staff to help implement the new charter.