Patients want more engagement in the NHS and more control over their own care and treatment, patient reports show.
A Picker Institute and the Health Foundation report collating 1.4 million patient experiences has concluded that the NHS is still far from "patient centred" and needs to change to secure important benefits for future NHS sustainability.
Between a third and a half of all patients said they were not as involved as they wanted to be in decisions about their own care and treatment.
These figures have not changed over time.
"Despite positive readouts in many areas of care, patient engagement in decisions has flatlined," says the Picker Institute's Chief Executive Angela Coutler.
"It means the rhetoric of 'patient centredness' has a hollow core. If the Darzi review is really aiming at a patient centred service this must become a burning issue for him and for the healthcare system as a whole.
In 2004, 59% of patients said they were involved in medication decisions as much as they wanted to be and in 2005 this fell to 55%.
"We know from the best international evidence that involving patients in decisions can create more satisfied patients, better health outcomes, and a more appropriate use of healthcare resources.
"Engaged patients will, for example, stick to their chosen treatments better, take up appropriate screening, and on the whole choose less interventionist and therefore less costly treatment paths."