Some 414,137 patients are estimated to have experienced some level of harm in the past year because they spent so long in the back of ambulances waiting to get into hospital. Of those, 44,409 - more than 850 a week - suffered "severe potential harm", with delays causing permanent or long-term harm or death.
In total, ambulances spent more than 1.5m hours - equivalent to 187 years - stuck outside A&Es waiting to offload patients in the year to November 2024, the Guardian found.
Experts said the figures were "staggering" and showed how the NHS was in a more "fragile" state than ever, with a "perfect storm" of record demand for A&E, soaring 999 calls, and an increasingly sicker and ageing population.
The analysis of NHS data by the Guardian and the Association of Ambulance Chief Executives (AACE) highlights the huge scale of the challenge facing Keir Starmer as he prepares to set out today how he plans to rescue the NHS.
Anna Parry, the managing director of AACE, which represents the bosses of England's 10 regional NHS ambulance services, said the data "speaks for itself". She added: "These figures underline what the ambulance sector has been saying for a long time - that thousands of patients are potentially being harmed every month as a direct result of hospital handover delays." These occur when ambulances arrive at A&E but are unable to hand patients over to staff because of units being busy. It also means paramedics are unable to get back on the road to attend to other patients.
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