Women are having breast screenings in "degrading" conditions and emergency patients waiting up to 23 hours, it was claimed today.

One patient likened the casualty department to "the start of World War III," its corridors lined with patients on stretchers.

Other failings highlighted in a study of Brighton Health Care NHS Trust include dirty toilets, late cancellations of operations and lights left on late at night when patients are trying to sleep.

However the Commission for Health Improvement report praises the friendly and dedicated staff and commends some of the trust's work with bereaved families.

The trust will work with the commission on an action plan to solve problems identified in the report.

The document, which follows a six-month review of the trust, found accident and emergency patients have to wait some time before staff meet them to carry out an initial assessment.

The report said: "Rather than be greeted by a member of staff who can allay any concerns, they are told to 'take a number'."

Patient agitation increases as they wait for their number to be called and reception staff take the brunt of their anger, said the report.

It highlights the long accident and emergency waits and the lack of privacy and dignity for patients in the A&E triage area.

In a diary, one patient wrote: "Sunday 14.30. Not an auspicious time to go to casualty. On entry it appeared to be the start of World War III, with corridors lined with patients on stretchers."

The report said: "Waiting times of 23 hours in accident and emergency despite having a doctor's letter were reported to CHI."

Inspectors also found a patient who arrived in accident and emergency on Monday at 9.45am was still waiting to be transferred to a ward on Wednesday at 11pm.

Patients in Brighton General Hospital have to endure poor furnishings and patients are kept on trolleys in the medical admission ward for four hours or more.

Of the breast care unit, the report said: "The physical environment in the breast screening unit is degrading for patients."

There are no single sex toilets, corridors are so narrow two people cannot pass through side by side, and the room where patients' results are given is very cramped.

The trust's system for admitting patients for elective surgery was criticised.

Some patients are left waiting by the phone until 9pm to find out whether they will be admitted that evening.

The standard of the environment within the trust was called "variable."

At the Royal Sussex County Hospital and the Royal Alexandra children's hospital the environment is welcoming.

But the environment at Brighton General Hospital was rated poor, with dirty toilets and inadequate furniture.

The review team praised the trust's bereavement support group, child-minding facilities for staff and "tasty and well-presented" hospital food.

The trust was praised for its "friendly and highly dedicated" staff and its good training and development programmes.

Trust chairman Professor Michael Whiting said the report's recommendations would be used for the new Brighton and Sussex University Hospitals NHS Trust.

Trust chief executive Stuart Welling said: "Plans to address these issues are either already in train or are being developed."