Norfolk's biggest hospital will be fined if ambulances are kept waiting outside its accident and emergency department.

The new agreement means the Norfolk and Norwich University Hospital will be fined �70 per hour for ambulance handover delays, which are aimed to be completed within 15 minutes.

The financial penalties have been introduced in an attempt to put pressure on the hospital to improve its times, with commissioners saying the N&N's poor performance in this area is severely hampering the East of England Ambulance Service NHS Trust's ability to meet its response time targets.

A recent report showed that in the four weeks to September 16, the N&N was accountable for 144 out of 378 of the instances when there were excessive handover delays.

This represented 7pc of patients arriving by ambulance at the N&N during those four weeks. At the James Paget University Hospital in Gorleston there were 20 excessive delays, which was 1.7pc of recorded patients.

The ambulance service says handover delays in Norfolk and Suffolk have cost it more than �400,000 in lost resources, nearly double the costs incurred elsewhere in the region.

The new contract, which applies from this month, says that as a minimum, 80pc of patients in any given month should be 'handed over' from an ambulance to the N&N within 15 minutes.

If the hospital meets or exceeds the 80pc standard then there are no penalties.

If performance does not meet 80pc then the 'additional' time it took to hand over all of the patients in that month (the time over 15 minutes per patient) will be added up and a penalty can be imposed at the rate of �70 per 60 minutes.

The penalties can be waived in special circumstances.

A spokesman for NHS Norfolk and Waveney said: 'This agreement is part of a whole health and social care system working together to ensure prompt discharge for hospitals and the avoidance of admission to hospital where more appropriate alternative care can be provided.'

Anna Dugdale, chief executive of the N&N, said: 'We are pleased to have reached agreement on the contract.

'This agreement recognises the interdependent nature of the health and social care system and we are working hard with our health partners to ensure patients receive the best possible care and outstanding issues in the system are resolved.'