Thousands of 999 patients in England are being told to get a taxi to hospital, figures have showed.

The number of patients outside London who were refused an ambulance rose by 83 per cent in the past year as demand for services grows.

It comes after the pressures on paramedics were highlighted last week when a woman with a broken ankle spent six hours lying on a freezing pavement and later died in hospital.

In London, official figures obtained by The Times showed a 35 per cent fall in the the number of emergency patients who were to get a cabin the past year. However, the way the statistics are recorded in the capital changed this year.

The number of patients enduring long delays in ambulances also tripled in the past year, according to data from seven out of England’s 10 ambulance trusts.

NHS at 70: demonstration and celebration march to mark anniversary Show all 18 1 /18 NHS at 70: demonstration and celebration march to mark anniversary NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary Labour Party leader, Jeremy Corbyn, addresses demonstrators following the march AFP/Getty NHS at 70: demonstration and celebration march to mark anniversary A man stands with a coffin, used as a prop at a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary epa06851663 Thousands of people march, to mark 70 years of the British National Health Service (NHS), in central London, Britain, 30 June 2018. Reports state that the gathering is calling on the government for increased funding and staffing for the NHS, as well as a protest against privatisation of an organisation which turns 70 years old on 05 July 2018. EPA/ANDY RAIN ANDY RAIN EPA NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary A man wears an NHS themed hat during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON Reuters NHS at 70: demonstration and celebration march to mark anniversary Demonstrators hold placards during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary epa06851662 A man with a birthday placard as thousands of people march, to mark 70 years of the British National Health Service (NHS), in central London, Britain, 30 June 2018. Reports state that the gathering is calling on the government for increased funding and staffing for the NHS, as well as a protest against privatisation of an organisation which turns 70 years old on 05 July 2018. EPA/ANDY RAIN ANDY RAIN EPA NHS at 70: demonstration and celebration march to mark anniversary Demonstrators stand in Whitehall during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary People march in central London to mark the 70th anniversary of the NHS. PRESS ASSOCIATION Photo. Picture date: Saturday June 30, 2018. See PA story INDUSTRY Demonstration. Photo credit should read: John Stillwell/PA Wire John Stillwell PA NHS at 70: demonstration and celebration march to mark anniversary Demonstrators hold placards during of a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary Demonstrators hold placards during a march in support of the National Health Service, in central London, Britain, June 30, 2018. REUTERS/Simon Dawson SIMON DAWSON REUTERS NHS at 70: demonstration and celebration march to mark anniversary Jeremy Corbyn and Jon Ashworth speak during a march in central London, marking the 70th anniversary of the NHS. PRESS ASSOCIATION Photo. Picture date: Saturday June 30, 2018. See PA story INDUSTRY Demonstration. Photo credit should read: John Stillwell/PA Wire John Stillwell PA NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary People holding placards attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary People gather with placards to attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images NHS at 70: demonstration and celebration march to mark anniversary People gather with placards to attend a demonstration and celebration march to mark the 70th anniversary of the National Health Service (NHS), in central London on June 30, 2018. Organised by the Peoples Assembly, Health Campaigns Together, The TUC and 11 other health trade unions, tens of thousands are expected to attend the only national public event organised to mark the anniversary of the British Health Service. / AFP PHOTO / Tolga AKMENTOLGA AKMEN/AFP/Getty Images TOLGA AKMEN AFP/Getty Images

Last week 4,469 people had to wait an hour or more in ambulances outside A&E departments, the data showed.

The North West Ambulance Service advised 104 patients in the most seriously ill category and 2,305 in the second most serious to take taxis in 2018 – amounting to 0.7 per cent of calls. The service said it had strict guidelines on ensuring patients were “stable” before letting them make their own way to hospital.

At the North East Ambulance Service (NEAS), 1.5 per cent of calls resulted in the patient being taken to hospital by taxi.

London Ambulance Service reported 0.5 per cent of callers taking a taxi.

NEAS said 80 per cent of patients taken by taxi had a face-to-face assessment by a rapid response paramedic, who often arrives by motorbike, to ensure they were fit enough to travel by cab. The rest were assessed over the phone.

Some services said that they had approved taxi companies for such cases and some said they arranged the taxis rather than leaving it to the caller.

Separately, The Times also found that across nine ambulance trusts last year more than 305,000 emergency 999 calls were answered by private or volunteer ambulances. This accounted for about 3.5 per cent of calls, an increase from about 2.4 per cent in 2017.

In 2017 the Care Quality Commission warned that private ambulances risked patient safety after it found that some vehicles were dirty and some drivers lacked the appropriate training to drive under blue lights.