In June 2005 the Department of Health launched their report on a strategic review of UK ambulance services at the annual ‘Ambex’ conference. The report is titled Taking healthcare to the patient, but perhaps its subtitle “Transforming ambulance services” more accurately indicates its content.¹ Its recommendations will result in the most profound change for ambulance services since the introduction of the national paramedic programme in 1990, and arguably the impact will be considerably greater.

The report’s proposals explicitly recognise the necessity for ambulance trusts to address the needs of the majority of the users of 999 services, who have neither life threatening or time critical emergencies. Over a decade ago it was reported that as many as 50% of 999 patients transported to emergency departments were discharged without significant treatment or referral,² suggesting that they could have been managed outside the hospital system.

Taking healthcare to the patient makes 70 …