Nearly two thirds of health staff would not be happy to be a patient in their own NHS trust, a survey shows.
More than 128,000 staff were surveyed
The Healthcare Commission poll of more than 128,000 workers also found just 45% felt patients were a top priority.
And the watchdog urged the NHS to "redouble efforts" to cut violence against staff with one in three reporting attacks in the last year.
Patient groups said views on patient care were "deeply worrying" and caused by the financial pressures in the NHS.
Just 39% agreed they would be happy with the care provided in their own trust, with 27% disagreeing and 33% neither agreeing or disagreeing - slightly worse than last year.
And 45% said patients were a top priority - down from 50% 12 months ago - with the rest either undecided or believing they were not a top priority.
Patients Association chairman Michael Summers said: "This is deeply worrying. I think what patients find is that the procedures they undergo and technology that is in the NHS now is wonderful.
"But the problem lies with the way patients are treated before and after they get treatment.
"Resources are being cut and this means that staff do not have the time to spend with patients."
A spokeswoman for the British Medical Association agreed the results were concerning.
She added: "Sufficient resources must be in place to ensure that patients receive good quality care when they go to hospital."
Healthcare Commission chief executive Anna Walker admitted there were areas needing improvement, but praised the positives.
The percentage of staff suffering work-related stress fell from 39% in 2003 to 33%, while the staff witnessing errors with potential harm for patients fell from 49% to 38% over the same period.
Ms Walker said: "It is a credit to trusts that during a period of change staff say they are less stressed. And the progress we have seen in safety is to be commended."
But she added trusts needed to "redouble their efforts" to protect staff - 31% of workers experienced violence or abuse from patients, a figure which has remained stable over recent years.
NHS Employers' Deputy Director Alastair Henderson said: "In comparison with many organisations, satisfaction with the NHS as an employer is still good, but we need to work hard to make sure the NHS remains a place people want to work.
"There is clearly work that still needs to be done particularly on tackling bullying and harassment."
And Unison health spokeswoman Karen Jennings added: "This survey confirms that a much more robust deterrent is needed to crack down completely on abuse and attacks on health staff."
The poll, carried out in 2006, will be fed into the Healthcare Commission's annual assessment of NHS trusts.