Patient satisfaction has fallen for the third year in a row at the Calderdale and Huddersfield NHS Foundation Trust, with doctors warning of "relentless pressure" building across the NHS.
Each year, the Care Quality Commission asks patients who spent at least one night in hospital about their care.
The most recent results, which cover 2018-19, show patients at the Calderdale and Huddersfield NHS Foundation Trust ranked their experience 76.8 out of 100, compared to 77.3 the previous year.
That's the lowest score since 2013-14.
It put the trust below the average for England, where more than 76,000 patients gave an average score of 76.2 – the lowest level in eight years.
Dr Nick Striven, president of the Society for Acute Medicine, said the national results "absolutely reflect the everyday realities" of care in the NHS.
"Despite the often heroic efforts of staff on the ground, the relentless pressures building in the system for years on end are starting to take a toll," he said.
"This is the result of the massive rise in the number of people coming to our emergency departments, but also the even higher increase in the number of people needing a hospital bed.
"The dissatisfaction expressed might reflect the growing realism amongst the population that the NHS is struggling – and not only in winter – and people are no longer prepared to put up with things that are not good enough."
Questions in the survey are split into five categories: access and waiting, information and choice, building relationships, safe and high quality coordinated care, and cleanliness, friendliness and comfort.
The biggest decline in Calderdale and Huddersfield NHS Foundation Trust's performance this year was in the information category, which covers whether patients were involved in decisions about their care, or given an explanation about medicines they would take at home and their possible side effects.
Patients gave these aspects a 64.7 out of 100, down from 68.2 the previous year.
Across the country, the CQC found a particular increase in patients reporting lengthy delays, dissatisfaction with the amount of information given to them when leaving hospital, and a feeling of not being involved in their care.
Professor Ted Baker, chief inspector of hospitals, said: "Most people continue to report positively about their interaction with staff, reflecting the significant efforts of healthcare professionals working tirelessly to meet increasing levels of demand in hospitals across the country.
"However, I am disappointed to see the overall lack of progress this year.
"Last year’s survey showed a healthcare system still delivering improvements despite growing pressure. But this year, the improvement trend we have seen for the past six years has not been sustained.
“Staff are working incredibly hard, but it is clear we have reached a point where this alone is not enough."
A spokeswoman for NHS England said: "This survey is further evidence that in the vast majority of cases patients are happy with the care they received, but also that the NHS and its local partners need to continue to join up services around the needs of patients, as set out in the NHS Long Term Plan."