The performance of the Welsh ambulance trust in Wales is continuing to deteriorate, according to new figures.
In November 2008, 57.1% of category A emergencies received a response within the eight minute target - down 1.6% on the previous month.
This is also short of the 65% target introduced in April.
The trust blamed a combination of factors - rising demand, hospital delays and the need to limit overtime, which has since been reinstated.
Before Christmas, Health Minister Edwina Hart criticised the performance of the Welsh Ambulance Trust.
There also remains a variation in performance between different parts of Wales with 38.8% of emergency responses arriving within eight minutes in Torfaen compared to 77.8% in Conwy.
There has also been a reduction in the number of ambulances arriving within the specified time with 81.8% of Category A calls arriving in time - again short of the 95% target and down 7.4% on the previous year.
'Overtime'
An ambulance trust spokesman said: "A combination of factors affected the trust's emergency response times in November, including increased demand, delays at hospitals and the need to limit the number of overtime shifts to remain within budget; which is a statutory requirement placed upon the trust.
"We are continuing to work with hospital trusts and other NHS partners to streamline admissions to A&E departments and to manage demand in different ways by developing alternative care pathways to meet the needs of patients.
"In support of this, overtime shifts have been reinstated since late December".
The trust said it wanted to ensure that response times were reaching or exceeding targets across Wales and was working on plans to achieve this.
In December, Ms Hart said the ambulance service must "raise its game and work with its staff and partner organisations to improve services for patients" after statistics showed that the service's performance in reaching category A calls had worsened since June.
'Worrying'
The service had promised to make improvements after a review in June found evidence of poor staff morale and a "bullying culture".
Liberal Democrat health spokesman Peter Black AM said the lack of improvement was a cause for "grave concern".
"The continuing failure of the ambulance service to reach its 65% target rate of arriving at a scene within eight minutes is very worrying," he said.
"Yet there has been no improvement, in fact they are getting further and further from that target each month."
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