There are still huge variations in the standard of care given to patients at NHS hospitals, according to a government watchdog.
Care can vary between and within hospitals, the report says
A report from the Commission for Health Improvement says patients receive different levels of care depending on where they live.
The report says that while standards have improved overall, there are still some areas of "unacceptable quality".
Health Minister John Hutton said the NHS was improving.
The report comes just weeks before the CHI is due to be replaced by a new Commission for Audit and Healthcare Inspection.
It says hospital care across England and Wales has significantly improved over the last four years and is now more focused on the needs of patients.
It says progress has been made in reducing waiting times in A&E and for outpatients appointments.
However, it says there has been much less progress in areas that matter to patients, such as being treated in safe and clean environments, having privacy and dignity and having a good experience of care.
"Not enough is being done to ensure patients have privacy and are treated with dignity and some services are of an unacceptable quality," said Jocelyn Cornwall, acting chief executive of CHI.
"We are most concerned that there is still too much variation in the care provided within hospitals and across hospital departments depending on where a patient gets treated."
Ms Cornwall also criticised government targets and said the NHS should now focus on improving quality of care.
"Performance targets have driven improvements to care but should not replace local responses to patients needs.
"It is important that the service now concentrates on redesigning services with quality in mind."
Mr Hutton said: "We have always recognised that there is more work to do to tackle the variation in quality of services that some patients receive.
"We are tackling this in many ways - unprecedented levels of investment, more staff than ever before, increased patient choice, national and local performance targets, new NHS standards and new financial systems will all drive further improvements."
But he added: "Today's report clearly shows that the dedication and hard work of NHS staff has paid off and hospital care has significantly improved over the last four years and is now more focused on the needs of patients."
Andrew Lansley, Shadow Secretary of State for Health, said: "As record levels of money have been spent on the NHS, it is a relief that some improvements have been made but it is the dedication of hard working NHS staff that are to be thanked for this rather than this meddling government.
"The report is hugely revealing showing how little progress has been made in areas that we were led to believe were in hand.
"Although the government had assured us that mixed sex wards were a thing of the past, they, and unassigned toilets, were found in around a sixth of all acute trusts.
"It is therefore not surprising that 21% of patients did not feel they had enough privacy when they were being examined or treated and 30% did not have enough privacy when discussing their treatment."
Paul Burstow, for the Liberal Democrats, said: "The reason that some health services are still struggling is because of the governments' obsession with micromanaging every hospital.
"Until real local control is given to local health services, there will be too much waste and red tape."