Patients arriving by ambulance left waiting outside A&E for up to an hour at Blackpool Victoria Hospital

Some 563 patients arrived at the Vic by ambulance between December 21 and 27.

Forty-six of them were left waiting outside A&E between 30 and 60 minutes, and seven had to wait longer than an hour, NHS England figures revealed.

In the past four weeks, Blackpool Teaching Hospitals Trust saw a total 283 delays.

It comes after The Nuffield Trust said the NHS was under "enormous pressure," with the queues of ambulances seen across England in recent weeks likely caused by the surge in coronavirus cases and reduced capacity.

National guidance states patients arriving at an emergency department by ambulance must be handed over to the care of A&E staff within 15 minutes.

The delays did not necessarily mean the patient waited in the ambulance itself, but staff were not available to complete the handover.

An NHS spokesman said: "NHS staff are now caring for record numbers of seriously ill Covid patients requiring hospital treatment. But they are doing so while also caring for substantially more emergency patients with other conditions than were in hospital during the first Covid peak in April.

"The pandemic has required changes to the way the NHS delivers care, with hospitals having to split services into separate Covid and non-Covid zones, so to protect individual patients some beds and ward bays have to be taken out of use."

On Christmas Eve, the hospital's busiest day for ambulance admissions, 14 people waited over half an hour to enter the hospital.

Christmas Day saw five people who were unable to be admitted to A&E.

Across England, 789 patients who arrived in ambulances to A&E had to wait for over half an hour on Christmas Day – among 9,283 across the whole week.

This was down from 13,050 who were delayed the week before and the 13,139 in the week of December 7-13.

Helen Buckingham, director of strategy at health researchers The Nuffield Trust, said: "The queues of ambulances that we have seen are likely to be the result of both the surge in Covid cases and reduced capacity in hospitals caused by staff shortages and infection control measures.

"This reduced capacity means that a similar or even a slightly lower number of ambulance arrivals can still result in a longer queue when they can’t offload."

The British Medical Association said the move for most local authorities into higher tier restrictions was the only way to keep us safe and "ensure more people don’t become seriously ill or die."

BMA council chair Dr Chaand Nagpaul said: “As we hear more reports of hospitals declaring major incidents, ICU beds reaching 100 per cent capacity in parts of the country, and patients having to be transferred to other hospitals for care, it is vital that everything possible is done to bring down the spread of the virus.

“If we continue at this trajectory, the health service will struggle to get patients in urgent need of care, the care they need – we must all be able to depend upon the NHS."