The lack of women and ethnic minorities in senior NHS roles has been branded "disgraceful".
Just 2% of NHS trusts are chaired by people from a black and minority ethnic (BME) background, while under 30% are chaired by women, a report shows.
A "radical transformation" to redress the balance has now been called for by the study, entitled "Action not words - Making NHS boards more representative".
The figures have also been criticised by shadow health minister Lord Grant in the Guardian newspaper.
The report looked at information from around 1,450 board members at 114 trusts, the Guardian said.
Findings showed three-quarters of those chairing NHS trusts are aged 60 or older, less than half of trust executive directors are female, and a mere 4% of executive directors are from a BME background.
The report said: "This is a serious weakness which needs to be rectified as a matter of priority.
"Good intentions and platitudes are not sufficient. There is a clear need for the Government to step in and insist that NHS trust boards undertake a radical transformation to reflect the communities they serve".