Almost 23 percent of patients picked up by an East of England ambulance, including those from the Shotley peninsula, waited more than one hour between getting to hospital and moving to A&E last year.

Response times by East of England Ambulance Service NHS Trust (EEAST) ambulances have also increased for serious cases – to almost 11 minutes for the most urgent incidents.

At Suffolk County Council's health scrutiny committee meeting last Wednesday, Nick Hulme, chief executive of East Suffolk and North Essex Foundation Trust (ESNEFT), said: "For me, the question around delayed handovers is one of how to manage risk.

"The greatest risk is a patient not being able to access an ambulance if one is required quickly.

"The way to mitigate and reduce that risk is to have ambulances available. When you've got handover delays, this means admitting a patient to a less-than-optimal space in the hospital such as a corridor or a converted outpatient area.

"This is a really difficult decision to make. We've been challenged with balancing this risk every winter – but particularly this winter.

"We've been working with ambulance colleagues daily to look at where the greatest risk is and share it across the entire system."

Nick Hulme

Across England, the average proportion of handover delays of more than one hour was 26 percent in the week ending January 1. The national target is fifteen minutes.

EEAST has been working with NHS colleagues to create ambulance handover units at hospitals – safe spaces for people to be cared for outside the ambulance and A&E department.

The trust and other NHS bodies in the area have also been developing initiatives to enable less urgent patients to receive care at home rather than being taken to hospital.

This includes the creation of urgent community response services as part of the trust's clinical strategy. These will have electronic access to less urgent incidents and notify EEAST when they attend a patient at home.

Kate Vaughton, director of integration and deputy chief executive at EEAST, said: "We've had significant issues with handover delays being much longer than they have been historically.

"All parts of the system have been working together closer than they ever have in the past to improve the situation.

"We're having conversations about using paramedics in the communities and helping them to work with urgent community response teams.

"We've got over 1,000 community first responders in the East of England, and we have recently started to pay for their training and expenses.

"We're also looking at how we can link first responders in with their local community teams to respond to accidents such as falls."

Community first responders are trained volunteers who attend certain types of emergency calls in the area they live or work.

Numbers of 999 calls and cases of life-threatening conditions has increased in the East of England. On December 19, 2022, EEAST took 2,000 more 999 calls than the same day in 2021.

It is expected that around eight percent of calls will be for the most serious category of patient, but between October and December 2022 this proportion for EEAST was 16 percent.

On December 20 and 28, 2022, EEAST declared critical incidents due to the strain the ambulance service was under from a sustained increase in demand, seriousness of patients' condition and handover delays.

A Care Quality Commission (CQC) inspection between April and May last year rated the trust 'requires improvement'. It was put on a mandated recovery support programme in 2020 due to CQC's concerns around leadership and safeguarding.

Across England, the average handover time in December 2022 for the least urgent cases (C4) was four hours and 35 minutes; for the third most urgent (C3) it was four hours and 19 minutes; for the second most urgent (C2) it was one hour and 33 minutes and for the most urgent cases (C1) it was 11 minutes.

More than 19 in 20 NHS England beds were occupied across adult general and acute hospital wards in the week ending January 15, 2023.