A hospital has been ordered to make "significant and immediate improvements" to its emergency department by an NHS watchdog.
The Care Quality Commission (CQC) found during an inspection delays in patients being transferred from ambulances to Medway Maritime Hospital, and poor infection risk control.
Overall, the hospital's emergency department was rated as "inadequate".
The Medway NHS Foundation Trust said it had rolled out an "improvement plan".
The Commission carried out its inspection in December, amid rising Covid rates in south-east England.
It found "significant" delays in patients being admitted or discharged, poor record-keeping of patients' care and treatment, and infection risks not being properly controlled.
The trust had previously been told that some patients waited eight hours before being admitted.
The CQC's deputy chief inspector hospitals for London and the South, Nigel Acheson, said he recognised that staff at the hospital were facing "very challenging conditions" at the time of the inspection.
But he added: "We had significant concerns from reviewing our own data, the views of healthcare system partners and information shared by people who worked for and used the service.
"We had a duty to inspect, to support the trust and identify where improvements needed to be made."
The emergency department was rated "inadequate" for being safe, responsive to people's needs and well-led, but "good" for being effective and caring.
James Devine, chief executive of Medway NHS Foundation Trust, said an "improvement plan" had been implemented which was "already making a positive difference to patients' care".
He added: "Actions we have put in place include working with health partners to reduce the number of patients waiting in ambulances, introducing processes to quickly identify and prioritise patients who deteriorate in ambulances, and opening more beds so that patients don't wait so long to be admitted."