On Monday 999 crews waited up to an hour and a half to transfer patients into the care of staff at the Manchester Royal Infirmary (MRI), in the city centre yesterday - increasing the time it took paramedics to reach emergencies.
At one point there were 10 ambulances parked outside as the paramedics queued inside.
Ambulance staff have to wait until their patients are admitted to hospital, caring for them in the vehicle or at the hospital's triage area.
MRI bosses asked for ambulances to be diverted to other units but staff at A&Es in Salford, south Manchester, Bolton, North Manchester and Oldham were too busy to help out until the early evening.
Paramedics representatives claim busy hospital staff sometimes delay admitting patients in a bid to meet Government waiting time targets, which kick in after patients are handed over.
Pressure
An emergency doctors leader called for more resources saying there is not enough slack in the system to cope with any extra pressure but regional health chiefs say the system is no busier than they would expect at this time of year.
A spokeswoman for Central Manchester and Manchester Children's hospitals trust which runs the MRI said: "Yesterday was a busy day across the region. We saw 448 patients within 24 hours, many of whom presented with serious conditions requiring urgent treatment and lengthy periods of assessment prior to admission.
"Whilst every effort is put in place during these busy times regarding bed management across the organisation significant rises in complicated admissions will inevitably have an impact on demand on hospital beds."
The MRI and the Royal Bolton are both struggling to meet their target for treating or admitting 98 per cent of emergency patients within four hours and Bolton health chiefs launched a public consultation on plans to radically improve urgent care in the town, earlier this week.
Craig Wilde, from Unison's NWAS branch said: "Turnaround times are a huge problem for our members, if crews are waiting at hospitals the service takes longer to reach emergencies it is not unusual for us to wait 40 or 50 minutes at Bolton or the MRI.
Frustrated
"It is not good for patients to be waiting on trolleys or in ambulances and staff get very frustrated because while they are off the road their colleagues are under more pressure.
"The hospitals are busy but sometimes they are making crews wait because they don't want patients to reflect on their waiting time targets - people don't count against their targets until they are triaged."
Don MacKechnie, chairman of the British Medical Association's Emergency Medicine Committee, who is based in Greater Manchester, said: "There is real pressure across the system, the problems we expect each winter seem to be occurring earlier this year than in the past, we are so full all the time there is no surplus space for when it gets really busy.
"When a hospital is busy it is usually the A&E which fills up first then ambulances have to wait outside or go elsewhere, there are problems with both systems."
Bob Williams, North West Ambulance Service Deputy Chief Executive explained: "Increases in demand across the NHS system will have an impact on the ambulance service. During periods of high demand, we work closely with all acute trusts in Greater Manchester, and across the North West, to minimise any delays as much as possible."
A spokesman for NHS North West said: "We expect hospitals to work together to deal with any particular pressures in the system, it is about using resources efficiently.
"It is busy at the moment but no more so than we would expect at this time of the year, it tends to be busier in winter and there are a few bugs going around."
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"Paramedics representatives claim busy hospital staff sometimes delay admitting patients in a bid to meet Government waiting time targets, which kick in after patients are handed over."
Theres a lesson in unintended consequenses there!
I was admitted to MRI earlier this year via an ambulance. The crew and hospital staff were clearly very busy but did a fine job of assessing and treating me as quickly as possible.
Thanks Guys!
And they want to close more local hospitals - making people travel further to these so called super hospitals. Whoever is in charge in the NHS should get booted out - the management is obviously a waste of money! We all get the offices jokes about the incompetance of bosses - this makes it scarily real! I for one would not like to be one of those waiting for treatment. Sack the chiefs, get more indians and lets get the NHS back on track!
They need to bring back supervisors - the time management at the MRI is appalling - the staff at the MRI have no idea how to prioritise they swan off for a natter with colleagues and please dont say they are hardworked, certainly not on the evening I visited, I thought the staff were on a go slow. There is no supervision no method of admittance the only ones who suffer are the inbound patients.
Paramedics at MRI don't need an excuse to cause "tailbacks" outside A+E. I assissited in the transfer of a patient from outside the area to MRI, firstly we ended up with a crew from Standish, and when we got to MRI there were 10 paramedic ambulances there doing NOTHING!!!! Having delivered our patient to the appropriate ward, the same crews were standing around talking, drinking coffe and smoking.
Ambulance control need to get on top of these skivers, they give the whole of North West Ambulance Service a bad name!!!!