The operations centre at West Midlands ambulance service is a busy place. Three thousand calls a day at busy times.
Vickie Whorton, whose job is to take a strategic view of every day's activities, says that this week they're very stretched. And one of their biggest problems is that local hospitals just can't receive the patients ambulances bring to A&E fast enough. They're already chockablock.
The ambulance service budgets 30 minutes for that handover to take place. But in the last week, that target is being regularly exceeded.
Vickie tells me that amounts to 100 hours of ambulance time a day. That's like parking 8 emergency ambulances fully crewed in a car park and leaving them there all day.
The pressure on ambulance services is also shown by figures released to ITV News by the Labour Party. After more than 50 freedom of information requests, they say more and more ambulances are being diverted because hospital A&E departments can't take patients, and that ambulance response times have been rising for the last two years.
- See how your local service is coping with the full list of times.
For serious, life-threatening incidents, the target is for ambulances to arrive within 8 minutes. Most do. But the average time it takes to respond has been going up in nearly all areas for the last two years - in the worst area, the East of England by a minute and a half.
Andy Burnham, the shadow health secretary says "chaos" is spreading from A&E departments to the ambulance service.
And tonight NHS England recognised this disturbing trend and announced an extra £15 million to try to reverse the rise in response times
And winter has barely begun.