South Central Ambulance Service has been hit by "challenging" hospital handovers leading to the service missing vital response targets by hours, according to the service's chief executive.
The ambulance service covers a population of seven million residents across Buckinghamshire, Oxfordshire, Berkshire and Hampshire.
Category 3 calls - for urgent problems which requires treatment and transport to an acute setting - have a target for nine out of ten ambulances arriving within two hours.
But SCAS saw 14,000 calls take longer than five hours and 22 minutes - with the remaining 127,000 responses occurring quicker than this time in the financial year to 2024.
This is a deterioration from the preceding period when nine out of 10 ambulances arrived quicker than five hours and 14 minutes.
Speaking at the service's annual general meeting, chief executive David Eltringham highlighted the figure for Category 2 calls, saying that the service's responses were "clearly not where we want it to be."
The vast majority of calls to South Central Ambulance Service (SCAS) are in Category 2, which includes serious conditions such as stroke or chest pain, requiring rapid assessment.
The average response time is supposed to be 18 minutes - but in the last financial year, the SCAS response times saw an average of 34 minutes and 14 seconds.
This was across 320,326 calls for help.
The average response time is just a 16 second improvement on the previous period's average.
More than 32,000 responses took more than one hour and eight minutes - against a target of 40 minutes.
Chief executive David Eltringham said the ambulance service had been hit by "some difficult periods with hospital handover delays."
He said: "We are working really closely with our acute hospital partners
"That is probably the thing that has been most challenging for us most recently - rather than upticks in demand."
But demand has also increased - with 999 calls jumping 19 percent in last financial year compared with the preceding period.
Increased demand was being met through "stable contracts with private partners" - leading to a reduction in overtime for paramedics, according to Mr Eltringham
He said: "We set out to move away from, short term solutions to temporary staffing issues, like overtime. We've been working very hard to recruit into substantive roles and trying to match demand for our services."
It comes amid "significant" financial difficulties facing the ambulance service, according to its chief executive.
He said: "The financial challenge that we face is quite significant.
"Last year we finished the year with a £25 million overspend. Putting that in context that is against a budget of around 350 million pounds.
"Being in a deficit is not something that SCAS has historically been used to.
"We do have a three year financial recovery plan in place, which we are 18 months through."
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