Patients with non-urgent conditions who dial 999 will no longer automatically be sent an ambulance, health minister Rosie Winterton announced today.
The national target response times for "category C" 999 calls, which cover conditions that are not immediately life threatening or serious, will be axed.
The target has been an awkward one for the government: last year, nearly two-thirds of ambulance trusts failed to hit the target - to respond to 95% of non-urgent category B and C calls within 14 minutes in urban areas and 19 minutes in rural districts.
In May, Ms Winterton announced a review of ambulance services, to be headed by London Ambulance Service's chief executive, Peter Bradley, to look at how response times to 999 calls are measured and implementation of a Department of Health (DoH) review - still unpublished - of the way calls are categorised.
From October 1, responsibility for deciding how category C calls are handled will rest with local ambulance services but they will be able to liaise with other healthcare providers to redirect non-urgent cases such as a cut finger or earache which could be treated at home or by other healthcare providers where appropriate.
This could mean treatment from community paramedics or nurses.
Ms Winterton said: "We are now giving strategic health authorities, primary care trusts (PCTs) and local ambulance trusts the freedom to work together so they can decide how best to care for patients with non-urgent healthcare needs."
PCTs and ambulance trusts will work with other local health organisations to agree how to deliver the best possible, clinically safe response for patients and how local performance will be measured.
The change would mean "efficient use" was made of ambulance technicians, paramedics and emergency care practitioner skills, Ms Winterton added.
She praised ambulance staff for reaching more than 75% of patients with life-threatening conditions - category A cases - in under eight minutes.
Mr Bradley, who now spends two days a week working as the government's national ambulance advisor, said: "Today's move is about providing the most appropriate care to patients. Flexibility to provide alternative care pathways for patients with non-urgent conditions means that ambulance trusts can provide a better service to these patients without the need to follow a national response time.
"This can range from treating patients at home to prevent unnecessary admission to hospital or attendance at A&E to making sure they get specialist care more quickly through prompt referral to other organisations."
Around the country, ambulance trusts are taking new approaches to patients with non-urgent conditions. In Staffordshire mental health patients are assessed in conjunction with mental health advisors and, when necessary, referred to other services such as crisis intervention teams.
In some areas patients are being treated at home by a nurse, paramedic or emergency care practitioner so that they do not have to go to hospital. Other ambulance services are linking with NHS Direct call centres so advice can be given to callers over the phone.
The Ambulance Service Association's (ASA) president, Paul Phillips, welcomed the announcement. "The ASA has worked closely with the Department of Health and our member services on the issue of category C responses," he said.
"This development will ensure the effective deployment of resources to patients requiring urgent medical intervention while extending the appropriate level of care for less urgent cases."
