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an emergency service that's struggling to serve in emergencies growing with England's Hospital waiting lists are the stories of people who've called for an ambulance and waited hours like Mary Jane Lani whose 87 year old mum fell one evening and hit her head study arrived at quarter to eight the following morning um so I think that's the total of ten and a half hours he waited for the ambulance then there were another 10 hours inside the ambulance outside the hospital I believe the hospital the a e department is so pushed that they're used in the ambulances the back of the ambulances stretches as an extra Ward as well as individual stories like Mary Janes there are stories told by data so here's a stamp for you if I had fallen ill or got injured in England in November and taken myself off to accident and emergency there's a strong chance I would have been one of nearly 40 000 people that had to wait more than 12 hours to be admitted to a hospital department now that is a 355 increase on the same figure from the previous November ing to the Royal College of emergency medicine delays like this are costing 300 to 500 lives every week the causes hinge points and blockages two full Wards and staff shortages we also recognize the big pressure that we're seeing played through in terms of ambulance Handover delays is largely triggered by those who are fit to leave hospital but delayed in doing so we need to free up that big capacity but ask pretty much anyone involved with the NHS why this much cherished National Institution is so critically ill and they'll tell you this what we're seeing is the result of 10 years of of underfunding understaffing and under resourcing the NHS what the pandemic has done is it's aggravated the situation the system insiders say is now brittle and unable to flex with the seasons or surprises many many Winters have been challenging but what we've seen this year is that the usual level of winter pressure that we might see would usually Abate in the summer you'd get a bit of a respite you'd be able to do more work and then the winter pressures would come again but this year it became so pressured that the whole summer felt like winter level pressures so then when we got to Winter we were already at a much higher Baseline of pressure when will the NHS get better will it get better the doctor's prognosis is gloomy not for many months and not without serious financial help Rory challenge Al Jazeera London