Nearly two thirds of health staff would not be happy to be a patient in their own NHS trust, a survey shows.
The Healthcare Commission poll of more than 128,000 workers also found just 45% felt patients were a top priority.
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 comments: "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.