The NHS is still not putting patients first despite improvements in several services, a report says.
NHS has room for improvement
The Healthcare Commission said the health service could often seem to be designed around the needs of NHS staff rather than patients.
Researchers found many patients were left confused about diagnostic tests and medication.
But it praised the progress made on reducing cancer and heart disease death rates.
NHS NOT DOING WELL
Dentistry: Nearly 60% of NHS dental practices not taking on new patients - up from 40% four years ago
Sexual health: More than a quarter of people who need urgent treatment have to wait over 48 hours. Only a half of clinics were open more than 21 hours a week
Maternity care: Three investigations into maternity services have highlighted over crowding, poor cleanliness, weak leadership and staff shortages
Mental health: Many people with depression were not receiving proper care. A quarter of people on mental health wards and learning disability wards reported having to share rooms with opposite sex
GPs: One in three patients have trouble making advanced and out-of-hours GP appointments
Commission chairman Sir Ian Kennedy said there was much for the health service to celebrate.
But he added: "The government has set itself the aim of a 'patient-led NHS'.
"But our health services still have a long way to go before we can say that they are really putting patients first.
"Being an NHS patient is too often a frustrating experience."
The State of Healthcare 2005 report, compiled from the commission's investigations, surveys and focus groups, found a third of patients' diagnostic tests were not explained in a way that was understandable.
It also revealed a fifth left hospital confused about what their drugs were for.
And other surveys had showed only 22% of coronary heart bypass surgery patients were told of alternative treatments.
The report also highlighted a range of services where there were concerns about the quality of service.
It said many people were having difficulty making dental appointments and there were also long waits for sexual health services.
Many maternity units were not meeting the needs of women and some patients were unable to make advanced GP bookings as doctors strived to meet the 48-hour waiting target, the report said.
And mental health services were falling short of expected standards - half of people needing crisis care or treatment for depression were not receiving it.
Presenting the report to an audience of NHS staff, commission chief executive Anna Walker said patients needed more information on treatment options, medications and their side effects and advice on after care following treatment.
She also said services were "fragmented".
NHS DOING WELL
Heart disease: Heart disease death rates falling and more people receiving clot-busting drugs within an hour of calling for help
Cancer: Mortality rates for all types of cancer have gradually decreased over recent years
Waiting times: The number waiting for more than six months for hospital treatment down 224,000 to 41,000 in last five years
Smoking: The number quitting smoking after using NHS services up by two thirds last year compared to the previous 12 months
Simon Williams, director of policy at the Patients Association, said in too many cases patients were "invisible" in the NHS.
"Why in the 21st century are we still so poor at involving patients in their care?"
Beverly Malone, general secretary of the Royal College of Nursing, said one of the main causes of the problems were shortages of nurses.
"When there is not adequate staffing how can we have time to listen to what patients have to say?"
And Edward Coyle, a member of the British Medical Association's council, said it was important the profession reflected on the "deficiencies" highlighted by the report.
But Dr Gill Morgan, chief executive of the NHS Confederation, said there was much for the NHS to be proud of in the report - as well as praising cancer and heart disease progress, the report said hospital waiting had fallen and more and more people were giving up smoking.
"For most patients in most places the services being delivered are of a high quality. That does not mean we should be complacent."
Shadow Health Secretary Andrew Lansley added: "There is a high level of satisfaction and that is great credit to the NHS staff."
But he warned there were still inequalities in outcome in the health service and, despite funding to address the problems, they were still persisting in some areas of the country.
Health Secretary Patricia Hewitt said: "The report clearly shows that NHS patients are seeing improvements across a broad range of services."
But she said there was still more to do to make the NHS "truly patient-led", adding all four services highlighted were undergoing reforms.