Paramedics are spending hours queueing outside Leicester hospitals while their patients deteriorate or even die in the back of their ambulances, inspectors have revealed. The Care Quality Commission, (CQC), has released a series of reports into emergency care in Leicestershire – and the findings are stark.

Patients in cardiac arrest – where the heart stops pumping blood – are dying because ambulances are stuck outside hospitals unable to reach them in time.

And when they have, they cannot hand them over to medical staff, the healthcare watchdog found.

Elderly patients and people in care homes are also waiting hours for help following common emergencies, such as falls.

Ambulance resources are stretched to a point where, at times, none are available to respond to 999 calls.

Crews have said the system is failing NHS staff and patients, telling the CQC they are frustrated when they hear on their radios of patients in need of help but are unable to go to them because they are stuck outside a hospital, including Leicester Royal Infirmary.

One call for help came in for a patient in cardiac arrest 10 minutes down the road from where full ambulances were waiting to hand over their patients, the CQC said – meanwhile the closest team available to respond was 30 minutes away. Ambulances are supposed to respond to the most serious incidents in seven minutes on average.

Staff are demoralised, disempowered and afraid of this shift in their duties from dealing with multiple calls for help to providing care in the back of their vehicles for those who cannot get a bed in one of the city's hospitals. They say they have not been trained for this.

Ambulances are waiting so long outside of hospitals – eight to 12 hours in some cases – that paramedics are spending entire shifts queuing to get their patients admitted and not out in the communities responding to those in crisis. Some even start work in these queues having had to relieve still waiting colleagues whose shifts are over.

The CQC said patients waiting for care in ambulances risk skin damage, delays in testing and treatment which can cause their conditions to worsen. Also, without immediate access to toilets or washing facilities, some patients were being wheeled on trolleys from the ambulance to the hospital toilets and then back out again.

Ambulance crews told the watchdog of three separate serious incidents that had happened in the back of their vehicles in three days prior to the April inspection due to lengthy delays. In one case, a patient died after suffering a cardiac arrest.

The CQC said the NHS and its partners are under immense pressure from a lack of bed-capacity, staff shortages and the rise in the number of people using services.

In Leicester Royal Infirmary's emergency department, they estimated 45 to 60 extra beds were needed to deal with the strain. It added crews are 'doing their best in difficult circumstances'.

Almost 15,000 hours were lost between January and the end of March this year while ambulance teams in Leicester, Leicestershire and Rutland were unable to respond to calls because they were stuck outside emergency departments.

And crews are consistently unable to meet response time targets. In March this year, category one patients, the most seriously ill, were reached on average in eight minutes 45 seconds compared to the seven minute target. Category two patients, in one hour 10 minutes – the target is 18 minutes.

Andy Williams, chief executive of the NHS Integrated Care Board, said on behalf of all the healthcare services that they have an action plan in place to alleviate the pressure on emergency teams. The services are focusing reducing unnecessary attendances, improving 'patient flow' across the system, and enabling patients to be seen in the right place first time. He added this has been strengthened following the CQC report

Mr Williams said: "The report acknowledges the challenges we face and recognises the hard work of health and care staff and those in care homes and other services in response to significantly increased levels of demand faced by urgent and emergency care services.

"Importantly it emphasises the need for a system response with all organisations involved in urgent and emergency care needing to play their part to make the necessary improvements. We have an action plan in place which focuses on reducing unnecessary attendances; improving patient flow across the system; and enabling patients to be seen in the right place first time, which we have further strengthened to address the recommendations in the CQC report.

"Patients rightly expect high standards and quality of care and we, as a system, are fully aware of the need to drive the necessary improvements for patients. Our priority is that local people should be confident that their journey through the services should be as smooth as possible from the moment they access them."

The CQC said the challenges in Leicestershire are affecting all East Midlands Ambulance Service crews across the region. To respond to the rising pressure on services, the trust has been significantly reducing the number of patients crews are taking to hospital by referring them to other services or treating them themselves.