999 delays that cost lives A second target stipulates that an ambulance must arrive to take a patient to hospital within 19 minutes in 95 per cent of all such cases. But a look at March, the latest month for which data is available, reveals that six of the 10 English trusts failed to reach the first target: East Midlands, East of England, North West, South Western, Yorkshire, and South East Coast. The first four also missed the second target. It was the third busiest month in the past three years, according to NHS England. In all, 430,182 emergency journeys were made, compared with 417,892 in March 2012, a rise of 3 per cent mainly caused by a combination of a reduction in GP out-of-hours services, the failure of the new 111 helpline to cope with calls, and an ageing population. Figures analysed by The Telegraph show that for the year ending March 31 the East of England Ambulance Service, which caters for a population of six million, was the only one to miss both targets. The failures are being blamed on understaffing and mismanagement. East Midlands missed its target for reaching 95 per cent of cases within 19 minutes over the past 12 months and was fined £3.5 million. Things are worst in Norfolk, with East of England reaching a little over 60 per cent of "life threatening" cases in eight minutes. It is being fined about £2.2 million. A Care Quality Commission report in March said the trust had "fallen short" of national standards, concluding: "Since our last inspection the trust's performance in relation to its ambulance response times had deteriorated and people could not be assured they would receive care in a timely and effective manner." The report suggested the times between sending "solo responders" who could then call for ambulance back-up varied widely. An ambulance could take as long as 100 minutes to arrive once a paramedic, on a motorcycle or in a car, had requested emergency transport to hospital. The report prompted Maria Ball, the ambulance trust's chairman, to resign immediately. Its chief executive, Hayden Newton, left in October. Bella, who was born prematurely, had a congenital heart problem. It took 26 minutes for an ambulance to arrive at her home in Thetford after the driver - relying on a satnav - got lost. On the way to hospital in Bury St Edmunds in Suffolk, Miss Carter yelled directions from the back of the ambulance. But it is alleged the driver still got lost after twice driving around a roundabout, then taking a wrong turn. Miss Carter said: "The people who were meant to help failed Bella." In the month Bella died, four adults also died in incidents where delays by East of England - which also covers Suffolk, Cambridgeshire, Essex, Hertfordshire and Bedfordshire - in reaching them were a possible factor. The trust has also faced criticism over delays in non emergency cases. In April, an inquest heard how Isabel Carter, 74, from Wymondham, Norfolk, died in 2011 after waiting four hours for an ambulance. By the time it arrived, the grandmother, who had originally complained of stomach pains, had gone into cardiac arrest. She died within minutes of reaching hospital. An internal investigation found control room procedures were not followed, so the call was not upgraded from "urgent" to "emergency." Sharon Allison, a medical negligence lawyer at Ashton KCJ, representing Bella's parents, said: "The plight of the ambulance service has been known for months, if not years ... Yet the same excuses are still being trotted out. The service was warned of dire consequences if it didn't recruit more staff. It refused to do so. Patients died. East of England published a "turnaround" plan in April, including hiring 350 specialist staff and new "tough" sickness absence targets. Andrew Morgan, its new chief executive, said: "We need to improve the service we give to patients and better support our dedicated and committed staff. Transforming the organisation will take time, but we have the staff and the focus to turn things around together. Stephen Dorrell, the Conservative chairman of the health select committee, which is carrying out a review of emergency services and emergency care, said: "I think it is a cause for concern. It is another symptom of the same issue that arises when we look at 111 and A&E care. The ability of the health service to deliver urgent and emergency high quality care is one of the things increasingly coming into focus.