Following the launch of our Ambulance Watch campaign, we outline some of the chief concerns which have been voiced by the public, MPs and staff about the ambulance service:

Rural response times

The ambulance service has been heavily criticised in the past couple of years for its under performance in meeting response times in rural areas. While the service has a target to get to 75pc of the most serious category A calls within eight minutes, over performance in counties such as Bedfordshire, Hertfordshire and Essex means that it still reaches the regional target, however, it fell slightly short in May and June with 74.61pc and 74.41pc respectively.

It also narrowly missed the 95pc regional target for responding within 19 minutes for less serious emergency calls in May, June and August this year.

For the first time in 2012-13 the ambulance service has been set a contracted floor of reaching 68pc of the most serious category A calls within eight minutes in Norfolk, excluding Yarmouth.

From April to August this year it managed to get to only 65pc in time, and to 88.65pc of the less serious emergency calls within 19 minutes.

The times are better for Great Yarmouth and Waveney, Suffolk and Cambridgeshire, but only Yarmouth and Waveney's category A8 calls met the required regional standard.

Back-up ambulance delays

Concerns have been raised over back-up delays in Norfolk and Suffolk. An example of this is when a rapid response vehicle, or cycle response unit is sent out to a 999 call, but on attendance the paramedic decides the patient needs to be transported to hospital. They will then request an ambulance. In some instances it can take a long time for an ambulance to arrive, particularly if available ambulances have to be diverted to other emergency calls. Patients have also expressed concerns about the time it can take for ambulances to arrive after they have been requested by a GP.

Rota redesign

Earlier this year the ambulance service unveiled plans for a redesign of its staffing and cover rota, which has been unpopular with staff. Plans to reduce certain types of cover in North Walsham, Cromer, Thetford and Diss have also proved controversial with the public. The service argues the changes are to ensure the right cover is in the right place at the right time, as in Norfolk and Suffolk there is too much cover during the week and not enough at weekends. An unprecedented rise in 999 calls since April means the service will get an extra �3m and bosses have made some concessions and changes to the rota redesign as a result of the extra investment.

Ambulance turnaround times at hospitals

Ambulances backing up outside hospital A&Es have been a problem for the service over the past year.

The Norfolk and Norwich University Hospital has been highlighted as one of the poorest performing hospitals in the region in terms of the amount of time it takes for ambulances taking patients there to be able to return to duty.

The hospital is planning to take on extra A&E consultants and is looking at a refurbishment of the department next summer to help improve patient flows.

The ambulance service believes its rota redesign will also help with hospital turnaround times, for example by staggering crews' meal breaks and shift times so there is no backlog of calls waiting. One example of this would be staff coming off meal breaks at the same time to a backlog of cases where GPs have been out visiting patients and have requested a long list of patients that need to go to the local hospital. This can lead to seven or eight ambulances turning up at the same time, which can cause delays.