A woman has died while waiting for an ambulance because the nearest ones were stuck in queues outside hospitals waiting to unload other patients.
The patient was waiting an hour for paramedics to arrive in Waveney, Suffolk, the Eastern Daily Press reported.
There were no available ambulances in nearly 50 miles as they were stuck outside James Paget University Hospital in Gorleston, Norfolk, waiting to unload patients, the newspaper added.
Papers regarding the incident last month went before East of England Ambulance Trust chiefs on Wednesday.
The report said an emergency vehicle was sent from Ipswich but arrived after the patient had died.
An urgent ambulance callout is meant to arrive in eight minutes but some emergency vehicles were stuck for hours at hospitals, according to the papers.
Patients who arrive at hospital by ambulance are supposed to be handed over from paramedics to staff within 15 minutes.
The death is the third similar incident in recent weeks and comes amid wider concerns about the pressures on the NHS and ambulance services in particular.
Last month, hospitals across England were ordered to “eliminate” ambulance queues outside hospitals after two deaths were linked to handover delays.
NHS bosses highlighted the “risk to patient safety” in the letter which tells trusts to end all handover delays and stop using ambulances as emergency department “cubicles”.
Ambulance leaders have described the “highest level of emergency activity in history” and reports from around the country paint a bleak picture of ambulances queuing for hours outside busy hospitals.
The warning was issued after it was reported a patient died at Worcestershire Royal Hospital following a five-hour wait in an ambulance at the doors of the emergency department.
It was also reported a woman died in the back of an ambulance following a handover delay at Addenbrookes hospital in Cambridgeshire.
England’s 10 ambulance trusts all have their alert levels raised to the highest level.
Last month, West Midlands Ambulance Service raised its risk rating for handover delays to the highest level for the first time in its history.
Documents from the trust board show one patient was cared for by ambulance staff for “over 13 hours” and on 4 October average handover times were “hours” instead of minutes.
A separate letter from NHS England bosses to all acute hospitals states that handover delays represent “unacceptable clinical risk” for both patients waiting in ambulance queues and those in the community whose emergency care is delayed.
An investigation by The Independent found patients were waiting nearly double the time they were at the pandemic’s peak.
NHS bosses have said hospitals in England are at peak levels for bed occupancy in the winter.
NHS Providers CEO Chris Hopson told Times Radio on Sunday: “We’ve not seen that before. That’s unprecedented. So, there’s a real sense that the NHS is going to be under real pressure.”
On Monday, the prime minister again resisted calls to move to Plan B for tackling COVID-19, saying booster vaccines are the “key thing” as the country enters the winter months.
On a visit to a Hexham General Hospital in Northumberland, Boris Johnson was asked whether he would heed calls from some public health officials on the need for action.
He said: “The key thing you want to do is to reduce those pressures, which are building, on the A&Es, on beds, by encouraging people, particularly the over-50s, to come forward and get your booster jab.”
EEAST chief executive Tom Abell wrote in the report: "I am extremely sorry to those patients, families and colleagues which have been affected.”
An NHS in Norfolk and Waveney spokesman said Norfolk & Norwich University Hospital (NNUH's) emergency department was being upgraded to increase its capacity.
Watch: Dominic Raab defends PM for not wearing a mask during hospital visit