NHS boards in Greater London are top heavy with white, middle-aged men, says a survey by the Greater London Association of Community Health Councils.
GLACHC says recruitment procedures should be reviewed so local people can make a more 'meaningful' contribution.
There has been some progress in opening up non-executive board appointments and conducting business in public, says GLACHC director Sue Towns.
'But there is a long way to go before local people can join in and take part in a truly open and transparent decision making process,' she claims.
GLACHC surveyed all 16 HAs, 68 trusts and 29 CHCs in Greater London. Three-quarters of HAs and CHCs and two-thirds of trusts responded.
The survey found that women, black and ethnic minorities and young people are 'greatly under-represented'. Seven trusts had no black or ethnic minority people on the board.
Only one HA member and three trust board members had a physical or sensory disability.
Most HA and trust executive and non-executive directors are aged between 40 and 60.
Women executives often find they are the only woman on the board, while men are 'never in this position', says the survey.
Behind Open Doors. GLACHC, 356 Holloway Road, London N7. 10.