People will no longer have an automatic right to an ambulance when they dial 999, as part of government plans to deal with time-wasters and the explosion in demand for the service.
People who phone up are to be assessed quickly by operators, and ambulances will be sent only to those considered to be in genuine medical need. Others will either be passed on to the NHS Direct helpline, told to see their GP or a chemist, or put in touch with social services.
Ministers and health authorities have become alarmed as demand for ambulances has almost doubled in the past decade - calls rose by 6 per cent last year to 4.4 million. Yet a growing number of calls are from people abusing the service, which means that it takes longer to respond to genuine emergencies.
A Norwich pensioner, Dina Pascoe-Stevens, was exposed last week for having called for an ambulance 40 times in one month - her 'emergencies' ranged from needing milk from the fridge to shopping for groceries. Paramedics from Sussex Ambulance Service were recently summoned by a woman who wanted her orange peeled.
Many ambulance drivers joke that they should be called '999 cabs' because so many people use them as a free taxi service. Paramedics are annoyed that the most common jobs on Friday and Saturday nights are calls from people who live near hospitals phoning for an ambulance for a ride home. A fully kitted ambulance costs about £250,000, and each journey costs the NHS about £115.
More than 70 per cent of people taken by ambulance to hospital have so little wrong with them that they are discharged without any treatment. But paramedics say many who get treatment could have made their own way to hospital. One said: 'Out of 20 calls I do in a day, I reckon there's only one where we need an ambulance.'
To combat the problem, computer software is being developed to help operators to send out ambulances more appropriately. Callers not in obvious distress will be asked a series of questions, enabling operators to determine within one minute if an ambulance should be sent.
People have no legal right to an ambulance, but ambulance services automatically send one if people ask for it, and they take all callers to the nearest A&E hospital. More than 30 ambulance services have introduced prioritisation systems to distinguish genuine emergencies - such as heart attacks - from those where time is less critical, but the computer software they currrently use does not enable operators to divert the call and stand down the ambulance.
Richard Diment, chief executive of the Ambulance Service Association, said: 'We need the option to divert calls to a more appropriate part of the health service, such as NHS Direct or social services. We want to be able to make decisions in seconds, but it has to over-classify to make sure we don't miss any cases where ambulances are needed.'
The ultimate aim is to provide a single phone number for access to the health service, with operators quickly deciding how to process it. At present NHS Direct, emergencies and phoning an out-of-hours GP are all on different numbers.
Richard Lane, chairman of the British Paramedic Association, said: 'It will make a big difference if it's an integrated system, and an identified access point to the health service for unscheduled care.'
The Department of Health is playing down the plans because it is worried about adverse publicity from denying people an ambulance. It is particularly worried about headlines it will receive if a life is lost because an ambulance isn't sent to what turns out to be a genuine emergency.
However, it alluded to the plans in last month's paper, Reforming Emergency Care, in which it proposed changes that will 'mean that emergency ambulance services will respond faster to immediately life-threatening calls because they will be freed from having to transport those patients who dialled 999 but did not need emergency care'.
