A SPOT check of the accident and emergency department at Bradford Royal Infirmary found almost a third of patients thought waiting times were very poor.
But two-thirds of those questioned said staff's attitude was excellent and 56 per cent rated their treatment as highly.
A team from Healthwatch Bradford and District visited the hospital's A&E department for a 12-hour night shift in December, speaking 85 patients, families and staff and making observations.
The organisation found 30 per cent of patients said the waiting times were very poor.
Its report said: "We witnessed growing anxiety and frustration of patients who were having to wait long periods with no information, no update and given no explanation of why they were having to wait, some for more than four hours."
In response, Bradford Teaching Hospitals NHS Foundation Trust, which runs BRI said the visit coincided with a very busy period and it was committed to making continuous improvements.
Healthwatch has made nine recommendations about how the A&E department could be improved, including the Trust using volunteers to help keep patients updated and direct people.
It also calls for a review of security arrangements for reception staff and access to interpreting services.
The independent Healthwatch collects and shares patients' experiences of health and social care to improve services.
The organisation's manger, Andrew Jones, said: "Waiting times were a major issue with nearly a third of those who took part in our survey saying these were very poor, and many others saying they were not told about how long they would have to wait.
"We witnessed particular difficulties late in the day with A&E unable to admit very sick people from treatment bays into the hospital which caused the flow of patients through A&E to slow.
"Healthwatch has a good relationship with the Trust and we’ll continue to work with them to secure a better experience for everyone who relies on their services."
Almost 70 per cent of people surveyed were positive about staff's attitudes on arrival at the department and 56 per cent said the investigation and treatment they received was excellent.
Healthwatch found people were not inappropriately using A&E as 61 per cent of respondents had sought advice about their condition and been directed to the hospital, mainly by their GP practice or NHS 111.
A Bradford Teaching Hospitals NHS Foundation Trust spokesman said: "The 12-hour visit by Healthwatch coincided with a period of very high attendance in the emergency department.
"Overall last year we treated more than 95 per cent of patients within four hours, one of only 35 Trusts to achieve this standard.
"We are committed to making continuous improvements and will use the findings from this report to make further enhancements within the emergency department."
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