Derriford Hospital in Plymouth has "not made enough progress" in the past few months and has been warned it must make further improvements.
Inspectors from the Care Quality Commission say some progress has been made since the summer 2019 inspections, but identified four key areas which are not up to standard.
Overall the health trust is rated as "requires improvement", with particular focus on emergency services, medical care, surgery and diagnostic imaging.
Meanwhile critical care, maternity, children's services and outpatients have made progress and are now rated as good.
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The maternity department has been rated as good. Credit: ITV News The inspectorate said there was "always more that can be done" but that it was "disappointing" more had not.
Although we have seen real improvements in maternity, which is now rated good overall, it is disappointing to report that since our previous inspections University Hospitals Plymouth NHS Trust has still not made enough progress.
We have made it clear that we require further work to address the issues we had found in surgical services where we have seen a decline in ratings.
The trust has a strong and engaged workforce but I am concerned that the leadership team despite having the integrity to lead the trust were not always visible for patients and staff.
The trust needs to sustain the improvement we have found and address the issues which we have again identified. We will return in due course to ensure that the necessary improvements have been made.
Dr Nigel Acheson, deputy chief inspector of hospitals in the south Read more: Top doctor's warning over 'long delays' at Derriford Hospital emergency department
Chief executive Ann James says the hospital feels 'very busy'. Credit: ITV News The hospital is feeling very busy at the moment and we know right across our services, whether that's the emergency department, outpatients or planned operations, we are in a very busy time at the moment.
Our staff have responded very well to those pressures, but as the CQC report identifies, the demand for our services is outstripping our capacity.
And while we're doing everything we can to meet all of those demands, it's not always possible to do so.
Ann James, chief executive of University Hospitals Plymouth NHS Trust Alternatives to A&E:
Patients are instead advised to consider visiting a minor injury unit, a pharmacist or their local GP.
The NHS 111 number is also available for people who urgently need medical help or advice but are not in a life-threatening situation.