A big variation in the performance of NHS trusts across England is revealed today in the health inspectorate's annual survey of patients' experiences.
In some hospitals more than three-quarters of inpatients said the standard of care was excellent, compared with less than one quarter in others.
In the best trusts, staff almost invariably helped frail patients to eat, but in the worst nearly half the people who needed assistance at mealtimes said they did not get it.
There was also a wide variation between hospitals in the quality of food, cleanliness, responsiveness to call buttons and the proportion of patients expected to share bathrooms and toilets with members of the opposite sex.
The figures were compiled by the Healthcare Commission from a survey of 76,000 patients at 165 NHS trusts.
For the first time, the commission scored hospitals to show how they compared on 62 aspects of patient care. The scoresheets, which will become available today on the commission's website, may encourage patients to travel further afield for an operation if they are unimpressed by the performance of the local hospital. Since last month people have had the right to choose between any NHS hospital in England and any private clinic meeting the Department of Health's standards on quality and cost.
The commission's chief executive, Anna Walker, said the survey showed encouraging progress. The proportion of patients describing their care as "excellent" increased from 38% in 2002 to 42% last year. The proportion saying the quality of hospital food was "very good" rose from 18% to 19%.
But she added: "There are striking variations in performance on key areas such as providing single-sex accommodation and giving people help when they need it. Those performing poorly must learn from those who perform well."
The scoresheets showed hospitals in London did badly on many of the key indicators. Only 24% of patients at Ealing hospital in west London said the quality of care was excellent, compared with 77% at Robert Jones and Agnes Hunt Orthopaedic hospital in Oswestry, Shropshire.
Ealing scored 65% on the commission's measurement of overall performance. It came in the bottom fifth of trusts on 44 of the 62 aspects of patients' experience.
Robert Jones and Agnes Hunt scored 92% for overall performance and was in the top fifth on 40 aspects. Nearly two-thirds of its patients said the quality of food was "very good", compared with 8% at Royal Liverpool and Broadgreen University hospitals.
The commission found progress towards the government's goal of eliminating mixed-sex accommodation remained patchy. Across England, 30% of patients said they had to use a bathroom or shower area that was shared with the opposite sex.
At Nuffield Orthopaedic Centre in Oxford only 3% of patients had to share, but this rose to 53% at Norfolk and Norwich University hospital.
Andrew Lansley, the shadow health secretary, said: "Labour's record shows that they've completely lacked the political will to give patients the privacy they deserve."
Norman Lamb, the Liberal Democrat health spokesman, said: "These results will make worrying reading for a government that claims to be committed to infection control and patient dignity. The key indicators of effective infection control - good basic hygiene - have got worse rather than better."
The Department of Health responded by publishing research from last year showing patients were more concerned about hospital cleanliness than single-sex accommodation. A Mori poll showed 58% of patients thought staying clean in hospital was most important, compared with 17% who wanted single-sex wards.
Ann Keen, the health minister, said the commission's survey showed that "the high standard and quality of care patients can expect is being maintained across the NHS". But the number of trusts with mixed-sex accommodation was unacceptable. She said: "The NHS should be in no doubt about how seriously we take this issue."
