Some failing NHS hospitals are "in denial" about the inadequate care and services offered for patients, a top medical watchdog has said.
Chief inspector of hospitals Professor Sir Mike Richards, who was installed last year in the wake of the mid-Staffordshire crisis, also said some "have not realised the world has moved on" and that there are "unacceptable" discrepancies in care across the country.
Since May, 10 NHS Foundation Trusts have been rated inadequate overall under a new regime of inspections by the Care Quality Commission, which involves rating a service for safety, effectiveness, responsiveness, care and leadership.
In an interview with the Independent, Sir Mike said: "There is huge variation in the NHS and I would go further than that and say there is an unacceptable variation in what is a nationalised health service.
"There are those that are somewhat in denial about their current position. That's not a healthy state to be in. Some hospitals really haven't looked outside - they haven't looked at the rest of the world for what looks like decades.
"They haven't realised the world has moved on. It's not as if they are thousands of miles away from civilisation. They can be quite close to other hospitals but they haven't really looked to see what other people are doing. That's where we need much greater learning across hospitals."
In 2013, the independent Francis Report into the Mid-Staffs NHS Trust concluded there had been basic failings in standards of care at Stafford, with hundreds more patients dying than would have been expected between 2005 and 2008.
It prompted the Government to install the health service's first chief inspector of hospitals and inspection regime.
Before his appointment Sir Mike worked as a hospital physician for more than 20 years, including as a consultant medical oncologist and later became national cancer director at the Department of Health. He was knighted in 2010.