An ambulance crew refused to treat a dying woman until police arrived, an inquest heard.

The paramedics parked around the corner from Susan Tyler’s home in Grain after husband Hugh dialled 999.

The medics, on being told Mrs Tyler was having a psychotic episode and was lashing out at her husband, waited for 15 minutes for back-up to arrive.

The patient, who by this time was unconscious and not breathing, eventually received treatment 35 minutes after the call but later died in hospital.

Mr Tyler and church pastor Michael Broad had earlier being trying to restrain 53-year-old Mrs Tyler.

Mr Tyler, who was his wife’s carer, told the inquest: "If only you were visible or hooted your siren, one of us would have come out. But we had no idea you were there."

The case prompted coroner Patricia Harding to call for new guidelines on how emergency crews respond to violent incidents.

David Dixon, from the ambulance service’s security management team, said he was working with the NHS on clarifying procedure in similar instances.

He said while the crew took it to the "upper limit" by not finding out from their control room what was going on for so long, they had a duty of care to staff.

He said: "An update should have been forthcoming. There seems to have been an awful lot of people sitting around doing nothing."

"if only you were visible or hooted your siren, one of us would have come out…” – hugh tyler

When Mrs Harding asked paramedic Lisa Geddes: "Is it not the case that the preservation of life is paramount consideration?", she replied that NHS guidelines prohibited them from getting involved in a violent situation without a police presence.

A transcript of the 999 call Mr Tyler made repeatedly heard Mrs Tyler say "stab him" while he pleaded with the operator "She’s been very violent, very violent, please hurry".

Police escorted the crew on the 30-second journey to the Tylers’ home in Pannell Road.

Attempts to resuscitate Mrs Tyler were made before she was taken to intensive care at Medway Maritime Hospital, where she died the following day.

Mrs Tyler had a history of mental illness having suffered from post-natal depression after the birth of her first daughter.

Mrs Harding recorded a verdict of accidental death.