A regional ambulance service is being put 'under pressure' over its vehicles waiting outside some hospitals 'because of the fumes' from their exhausts, a meeting heard.

Members of the West Midlands Ambulance Service board revealed their thoughts on the amount of time that their staff have to wait outside 'many' of the region's emergency departments.

The University NHS Foundation Trust's board heard that there are some 'very, very good' examples of hospitals, but overall the West Midlands 'remains the worst affected by handover delays in the country by far'.

Dr Richard Steyn, the WMAS executive medical director, told the board meeting on Wednesday (March 25) that in January alone some 50,071 ambulance hours were 'lost' in waiting to offload patients.

He added that he thinks the system is 'papering over the cracks'. No hospitals were named as either good or bad at the meeting held at Brierley Hill and on Microsoft Teams.

Dr Steyn said: "There has been a huge amount of pressure on us to think about how we park ambulances outside by parking at a distance, and creating more parking spots for ambulances because of the fumes." He added that the reality is to "offload the ambulances."

Dr Steyn said overall the region is a "major outlier as to the ability of the hospitals to take our patients."

He added that the lost hours in January amounted to losing 151 ambulances off a full 12 hour shift " every single day of the month."

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Aidan Brown, the service transformation and patient safety director, added: "There are some areas of improvement but we still remain the worst affected by handover delays in the country by far."

The meeting was told that WMAS is again budgeting to spend 400,000 'lost hours' outside hospitals next year.

The service serves a population of six-million people in Shropshire, Herefordshire, Worcestershire, Staffordshire, Warwickshire, Coventry, Birmingham and the Black Country conurbation.

Dr Steyn also revealed that a target of offloading ambulances in an average of 45 minutes is a "long way off".

But he added that it is a "very poor measure" when some patients wait up to seven or eight hours.

"To get to a maximum of 45 minutes in an ambulance we have got to get down to an average of 15 minutes," he added.

The meeting also heard that some unnamed hospitals balance "corridor care" and "car park care" when emergency departments are under pressure.

Dr Steyn added that it is "hiding the reality with figures.

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"There are a wide selection of patients in the community who are not even assessed because the ambulances and resources are not getting to them.

"The solution is not to put pressure on the emergency department but putting the pressure on the executive of the hospitals for getting the flow of patients out of the hospital and into the community, and getting patients out of ED," he said.

With new rules coming into force covering corridor care, Anthony Marsh, the WMAS chief executive, said: "There shouldn't be a trade off with patients waiting in ambulances or in corridors but that is the reality of life in many hospitals.

"What we don't want to see is corridor care exported into car park care. It is not something that we would find acceptable."

The board was told that the trust is doing better than national targets for getting to category 2 emergency calls despite ambulances being held up at hospitals.

Those calls emergency situations that are serious but not immediately life-threatening.

Anthony Marsh, the chief executive, said they will end the year on a 24 and a half minutes response time, beating an agreed target of 28 minutes.

He said this was due to the "extraordinary efforts of everyone in our organisation."

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Professor Ian Cumming OBE, the chairman, said it was "truly remarkable given the level of handover delays."

WMAS has a target of 25 minutes next financial year and is 'continuing to drive to 18 minutes."

The meeting was also told that it is answering 999 calls in "0.01 seconds on average" which is "better than any other emergency service in the country, and it has been like that for years."