Inspectors have found safety was "not a sufficient priority" at a hospital which they recommended should be placed in special measures.
The Care Quality Commission (CQC) said three services at Kettering General Hospital were inadequate, including children's services and emergency care.
The CQC's chief inspector said there were "a number of serious problems", with staff struggling under pressure.
The hospital said it had already taken steps to improve its services.
Outpatients and diagnostic imaging were also rated as inadequate, with medical care, surgery, maternity and gynaecology requiring improvement.
CQC inspectors identified concerns across a number of services. They said:
- Opportunities to prevent or minimise harm were missed.
- Some patients experienced long delays - in some cases 52 weeks - waiting for treatment, specifically for urology, maxillofacial and ear, nose and throat treatment.
- There were not enough registrars and junior doctors to cover wards out of hours and at weekends.
- Complaints were not always handled quickly enough in almost all services.
- The children's waiting area did not provide adequate space for patients waiting to be seen.
Chief Inspector Prof Sir Mike Richards recommended the trust be placed into special measures on the basis of the inspection last October.
He said: "My team found that the majority of staff were hard working, passionate and caring but had to struggle against the pressures they faced.
"One of the reasons we rated the trust as inadequate for being well-led and safe was because risks to patients were not always identified and, when they were identified, there was a lack of adequate management of these."
The report said: "All staff were passionate about providing high quality patient care - patients we spoke to described staff as caring and professional."
The trust said the recommendation to put the hospital in special measures would enable it "to receive additional expert support".
Kettering General Hospital's director of nursing and quality Leanne Hackshall said: "We welcome the CQC's very detailed inspection of the trust and are disappointed that we did not do better in it.
"We have an improvement plan underway which is addressing the areas highlighted by the CQC.
"Some actions are already complete and others are in process.
"Clearly it will take some time to address all of the issues listed in the report and bring them up to standard."