Patients are to be given a formal role in assessing the performance of NHS trusts in England, under new plans drawn up by the health watchdog.
Patients willl be directly involved in the inspection process
The Health Commission is to scrap the current star ratings system and reform the inspection process in an attempt to cut red tape and improve information.
Some hospitals and NHS bodies will not be subjected to random inspections.
Instead England's 572 trusts will produce yearly self-assessments, including comments from patient groups.
Inspections and random spot checks will only be carried out on trusts deemed to have problems.
BBC health correspondent Adam Brimelow says the commission regards the star ratings system, which requires trusts to be inspected every three years, as a crude way of assessing performance.
He says the watchdog believes the system is too narrowly focussed on government targets rather than what matters most to patients and clinicians.
Star ratings, introduced in 2001, proved unpopular with NHS staff as they required primary care, mental health, ambulance and hospital trusts to spend up to £150,000 compiling data on a range of targets.
Under the new system, due to start next year, it is estimated 20% of trusts will be inspected or undergo a spot check in the course of a year.
Trusts will be given a rating of either excellent, good, fair or weak from September 2006.
Targets will still matter - trusts will be judged against up to 39 government-set targets, a number Prime Minister Tony Blair said on Wednesday he was looking to reduce.
But they will also be assessed against a new range of core standards covering issues like safety, cleanliness, and accessible and responsive care.
It will be the first time patients have been directly involved in the inspection process.
The Healthcare Commission believes their role - along with inspections from bodies such as the Audit Commission - will flag up problems before they get too serious.
Commission chairman Sir Ian Kennedy said it was a "radical approach" which would cut down on bureaucracy.
"We have created a system to identify poor performance without fettering those doing well," he said.
The watchdog also said it would be looking to bring the independent sector into line over the next two years, but that would require new legislation.
Currently, independent health bodies are judged against national minimum standards and each provider has to be inspected.
The commission will also carry out national reviews to improve performance in areas including children's hospital services, hospital acquired infection, heart failure, substance misuse, tobacco control and mental health.
Patients Association chairman Michael Summers said the new system was an improvement on star ratings.
But he said while the idea of patient involvement through forums was good in principle, such bodies were not up and running across the country.
And John Appleby, chief economist at the Kings Fund, a health think tank, said the system of self assessment was "potentially" open to abuse, but he hoped the watchdog had got the balance right.
Health Minister Lord Warner said the changes would "provide a richer and more comprehensive assessment" for informing the public.
Nigel Edwards, director of policy at the NHS Confederation, which represents health service managers, said he hoped the new system would "reduce the heavy burden of regulation" on NHS organisations which existed under the current system.