A driver died when his car and an ambulance collided in a Shropshire village.
The crash happened on the A458 in Cross Houses, near Shrewsbury, shortly after 1050 GMT, a West Midlands Ambulance Service spokesman said.
The ambulance was on non-emergency duty transporting a woman patient to the Royal Shrewsbury Hospital and was not using sirens or blue lights, he said.
The service and police have begun investigations into the crash.
A passing doctor stopped to help after the crash and confirmed the death of the driver of the Nissan Micra at the scene.
The female patient was shaken but not injured and continued her journey in another ambulance, the spokesman added.
Two members of staff in the ambulance involved in the crash were also taken to the hospital.
Richard Topping, senior divisional commander with West Midlands Ambulance Service, said: "Our thoughts are with the families of all those involved in this tragic crash.
"We have launched an internal investigation to examine the circumstances of this incident. We are also co-operating fully with West Mercia Police."
West Mercia Police said the A458 was closed for several hours after the incident.
A force helicopter took aerial photographs of the scene and a collision investigation team were on site trying to establish what happened.