Four ambulance staff and a hospital worker have been arrested by police after a man collapsed and died outside an accident and emergency department.

West Midlands Police has said five people have been arrested on suspicion of manslaughter by gross negligence and misconduct in a public office following the incident at Walsall Manor Hospital on 23 June this year.

The arrests follow an investigation by Walsall Healthcare Trust and West Midlands Ambulance Service into the death of 47-year-old Carl Cope who died after collapsing to the ground earlier this year.

Two nurses, a receptionist and a hospital porter were sacked by Walsall Healthcare Trust for failing to respond to Mr Cope while two other staff, a receptionist and a porter, received written warnings.

One paramedic from West Midlands Ambulance Service was sacked in August. Another resigned while two other ambulance staff received written warnings.

Now West Midlands Police has confirmed it is investigating the death and last week four ambulance workers aged 26, 34, 45 and 53 were arrested and have since been bailed pending further enquiries.

On 14 December a 44-year-old member of staff from Walsall Manor Hospital was also arrested and questioned by police.

Mr Cope was taken to the hospital by paramedics after dialling 999 complaining of chest pains. He had not been discharged when he went outside and collapsed. A post mortem revealed he died of a heart attack.

A formal joint review between the hospital and the ambulance service is underway and action has been taken to improve the way patients are tracked within the A&E department.

Walsall Manor Hospital has also had a £100,000 investment in more nurses and three new consultants in its A&E department.