The region's ambulance service has been told it must address the challenges it faces in responding quickly in very rural areas of Norfolk, Suffolk and Cambridgeshire.

The Care Quality Commission inspected the East of England Ambulance Service and said it also needed to improve turnaround times at hospitals, in particular at the Norfolk and Norwich University Hospital, as delays at hospitals of more than 60 minutes were having an impact on response times.

The CQC's report found the trust to be compliant in all areas it inspected, despite acknowledging that the service is not meeting key performance standards in relation to response times. The report said there are large variations in geographical areas, with Norfolk, Suffolk and Cambridgeshire all areas suffering from under performance in the most urgent eight-minute response target and also for the target to provide a back-up ambulance for transport within 19 minutes.

However, the inspectors recognised that the service had only limited control over certain aspects of its own performance, and had 'taken satisfactory measures to address the shortfalls within the areas of its control'.

The report said: 'Ambulance staff we spoke with identified Norfolk and Norwich University Hospital NHS Foundation Trust as being particularly bad and one paramedic told us he had seen as many as 12 ambulances queuing outside the hospital. Another paramedic told us of a man with chest pains he had attended to having to wait 30 minutes for an ambulance and then waited an hour and a half at Norfolk and Norwich University Hospital NHS Foundation Trust.'

A spokeswoman for the service said: 'We are delighted to have received a fully compliant report. As with any comprehensive inspection points have been raised but the CQC clearly recognises that we are working very hard on all those within our control. This is a reflection of the commitment of our staff, managers and volunteers in all areas of the trust. We're already looking at what we can do now to make further progress and working to build on the care we provide to our patients.

'We know that hospital turnaround times are an issue and we continue to work with our partners to address this.'

Anna Dugdale, chief executive at the N&N, said: 'Our hospital covers a large rural area with an elderly population and we have a larger proportion of emergency admissions than other trusts.

'We are working hand in hand with the ambulance trust to make those transfers as smooth as possible, reducing turnaround times and managing the risk presented by peaks in demand with the ambulance trust and other members of the health and social care community.'

North Norfolk MP Norman Lamb said: 'Our concerns about response times in rural areas have been endorsed by the CQC and the reason why I wrote to the CQC asking them to investigate was because I felt the situation in rural areas isn't acceptable.

'I do think there is a clear link between response times in Norfolk and what's happening at the N&N.

'It's got to be a priority for the ambulance trust and hospital trust to work together very urgently on this issue as having professional people spend an hour at a hospital when they could be out on the next job is wasting a valuable resource and we are talking about potential life and death situations.'