The areas of England with the longest ambulance delays

The number of patients waiting in ambulances outside hospitals is at a record high - with fears this is leading to worse care and even deaths.

NHS England data show that last week, 28 November to 4 December, 15% of ambulances - more than 11,000 - waited more than an hour outside A&E.

Meanwhile in the same week, 31% of ambulances - nearly 24,000 - waited more than 30 minutes.

The figures are far higher than in previous years, and are expected to get worse in the coming months.

The NHS standard is for the handover of patients between ambulances and A&E to take place within 15 minutes.

The delays have raised fears of a deadly winter crisis as temperatures plummet, with the UK Health Security Agency (UKHSA) having issued a Level 3 cold weather alert for England warning of potential “serious consequences for health”.

Which areas have been worst hit?

The South West was the worst affected last week, with more than half - 53% - of its ambulances waiting more than 30 minutes outside A&E, compared to the nationwide average outlined above of 31%.

Of those ambulances, a third - 33% - waited more than an hour, compared to the 15% average across England.

The East of England was the second worst hit (47% waiting more than 30 minutes) while the South East was the least affected (17% waiting more than 30 minutes).

Among the trusts reporting at least 500 ambulance arrivals last week, the highest proportion of patients waiting more than an hour to be handed over was 56% at Royal Cornwall Hospitals (361 out of 639 patients).

This was followed by University Hospitals of North Midlands at 52% (384 out of 739 patients); Northern Lincolnshire and Goole, also at 52% (335 out of 643); University Hospitals Bristol and Weston at 42% (339 out of 805); Gloucestershire Hospitals at 41% (308 out of 756); and University Hospitals of Leicester at 38% (386 out of 1,023).

Sarah Scobie, deputy director of research at independent health think tank The Nuffield Trust, warned it is too late to solve the “desperate struggle” for the NHS to transfer patients quickly enough.

Read more: How to find out if you're eligible for a cold weather payment as temperatures plunge

“The situation continues to deteriorate as the temperature drops and we head into the most challenging winter months,” she said, adding the delays are causing an average daily loss of 3,400 hours of ambulance staff time "which could be used for patient care".

Scobie added: “Ambulances are one of the most visible and vital cogs of the emergency care machine, and it is becoming more painfully visible that they are under severe strain. The government has confirmed additional funding to tackle the delayed discharges behind some of these problems, but it is far too late in the day to have a meaningful impact this winter.”

Watch: 'We will protect lives through winter strikes' - Rishi Sunak

The dire figures come as ambulance workers in England and Wales are set to strike in less than two weeks' time, on 21 December, amid a pay row.

The GMB, which is coordinating the industrial action with Unison and Unite, said more than 10,000 ambulance workers across nine trusts will strike.

The unions have said their members will only respond to life-threatening incidents, known as category one calls. Soldiers from the army are now preparing to cover for striking crews.