Ambulance patient's 20-hour wait at Worcestershire Royal
A patient had to wait 20 hours in the back of an ambulance as NHS pressures saw acute handover delays at hospitals.
Sunday's ordeal at Worcestershire Royal came amid West Midlands backlogs that one ambulance worker called a "car crash".
Meanwhile, the average response time for ambulances to reach emergency patients hit nearly 11 minutes locally. Guidelines say it should be seven.
region's ambulance service said it was working hard to prevent delays.
Worcestershire Royal Hospital - which has recently opened a new multi million-pound extension to its emergency department - was forced for more than seven hours on Sunday to divert ambulances to Alexandra Hospital in the same county.
rust which runs the sites has been contacted for comment.
Elsewhere in the region, on Monday morning, 80% of the ambulances in Shropshire's fleet were outside Royal Shrewsbury Hospital and Princess Royal Hospital, Telford.
One ambulance had been waiting at Shrewsbury since 13:39 GMT the day before, with a total of eight patients collected on Sunday still not admitted.
Scores of patients across the region have had to wait outside hospitals for more than one hour - with 37 such delays at Royal Stoke alone.
A spokesperson for West Midlands Ambulance Service said: "The ambulance service relies on each part of the health and social care system working together so that our ambulances can get to patients in the community quickly.
"Sadly, the pressures we are seeing in health and social care lead to long hospital handover delays, with our crews left caring for patients that need admitting to hospital rather than responding to the next call.  The result is that our crews are delayed reaching patients.
"We are working incredibly hard with all of our NHS and social care partners to prevent these delays; looking at new ways to safely hand over patients quickly so that our crews can respond more rapidly and save more lives."
Sara Biffen, acting chief operating officer for Shrewsbury and Telford Hospital NHS Trust, which runs the Royal Shrewsbury and Princess Royal sites, said: "We along with other hospitals continue to experience severe pressure.
"We are sorry that patients are having to wait long times as we continue to prioritise patients with the most critical needs.
"We are doing everything we can, alongside partners, to improve flow in and out of hospitals for all our patients."
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