The ambulance service in the east of England is in an unprecedented state of crisis. It has just posted its worst ever response times and staff are warning “the wheels are going to come off.”

Whistleblowers, who work for the East of England Ambulance Service Trust (EEAST), said they were waiting several hours to unload patients at hospitals and data reveals staff are working shifts of up to 18 hours straight.

The findings come as part of this newspaper's NHS On The Brink series, exploring the state of the region's health service as it heads into winter.

Last week, EEAST publish its worst ever response times since comparable records began in November 2017.

For Category 1 (immediate threat to life) the NHS target is an average response time of seven minutes. EEAST managed an average response time of almost 10 minutes.

For Category 2 (threat to life) the target is 18 minutes, but EEAST clocked an average of 48 minutes.

For the least urgent calls the NHS target is nine out of 100 responses within three hours - EEAST took more than nine hours.

David Gardener had to wait 12 hours for an ambulance to arrive after suffering a stroke at his Ipswich home, despite being a category 2 call.

He was home alone on September 24 when he started to feel ill and his speech was slurred, so he called 999.

The 64-year old phoned at 7pm, but an ambulance didn't arrive until 7am the next day.

When he finally got to hospital, he was told he had suffered a mild stroke and he had to spend the next four and half days in a ward.

Meanwhile, one patient died last week at the James Paget University Hospital, after waiting for hours on the back of an ambulance at the hospital as no beds were free.

These hold-ups are called handover delays and cost the service thousands of hours in delays as vehicles and paramedics are stuck at hospitals rather than responding to the next call.

Latest figures show only a third of ambulances are getting away within the target of 15 minutes at Ipswich, Colchester and James Paget hospitals. At West Suffolk it was around half.

However, those numbers are for June and performance tends to dip during the winter when hospitals get busier.

'Trying our best'

EEAST Unison branch chairman Glenn Carrington warned things would only get worse as flu season bites.

Mr Carrington, who works as a paramedic, said: “Morale is at rock bottom. We go into hospitals and we’re queuing for five or six hours with a Covid patient on board.

“We’re all working hard, we’re all trying our best, but there’s a dwindling workforce and with the stress of it all, it is hard.

“There are people leaving, you can’t blame them. They’re burned out. We’ve been working through this pandemic like Trojans and you can only work like that for a certain amount of time before you’re burned out.”

Mr Carrington blamed “11 years of under-investment in the health service” for the severity of the crisis, warning the worst might be yet to come.

“This isn’t going anywhere soon," he said. "And we’ve got flu season next month, and then we’re going to know about it.

“I think the wheels are going to come off. I hope I’m wrong, but there’s no slack in the system.

“I can see tents going up in hospital car parks and special ambulances people can be left in.”

His comments were echoed by other paramedics who wished to remain anonymous.

'Tactics aren't working'

The service has been at its highest level of alert, Resource Escalation Action Plan (REAP) Level 4, since August.

This allows EEAST to increase use of private ambulances and consider requesting support from police and armed forces.

One member of staff told this newspaper: "For us it means breaks just don't happen and we are chronically late finishing shifts. It would be laughable if it was not so tragic."

Tom Burton, EEAST’s strategic planning director, told the Essex Health Overview and Scrutiny Committee on October 7 that the "unprecedented" situation was exacerbated by acute levels of staff sickness, with as many as 50 staff off at any one time.

He said: “Our response times are getting slower because that’s the knock-on effect of demand and our pressures.”

Meanwhile, a Freedom of Information request has revealed that staff are working shifts of 16, 17, and 18 hours straight.

One paramedic, who spoke on condition of anonymity, said: “The word pressure is an understatement.”

He said dozens of his colleagues had gone off with mental health issues and the longest shift he had worked was 18 hours.

"The system is breaking and winter hasn't started yet," he warned. "EEAST keeps trying the same old tactics but it has not worked."

EEAST chief executive Tom Abell said: "We have a range of support in place for our staff, including confidential counselling services, a wellbeing hub providing rapid assessment and access to local mental health services, as well as specific support for any colleagues who have experienced traumatic incidents.”

Tomorrow in our NHS On The Brink series: The struggle to see a dentist