Hundreds of patients are waiting for ambulances as paramedics plead for help.
This evening in Manchester a creaking system limps on with NHS staff under immense pressure, and no sign of things improving.
Last night, the medical director of North West Ambulance Service (NWAS) shared a sombre message as he stood outside in the freezing cold. Looking into the camera of a mobile phone, he admitted that 111 and 999 services were being overwhelmed.
