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Health Minister Lord Warner today announced sweeping improvements to England's ambulance service. The changes will revolutionise the way in which ambulances deliver care across the country and build on the significant advances already made over recent years.

A number of changes that patients can expect to see over the next five years were outlined:

Faster response times to save more lives - Improved technology and information, re-organisation of ambulance trusts and call-centres, and streamlining of response time targets and call categories will mean that ambulances can concentrate on reaching the most urgent cases where every second counts. This will save more lives.  The Category A response time for life threatening conditions will be measured from when the call is connected to avoid differences in measurement.

Better advice over the phone - non-urgent callers to 999 will be offered more advice over the phone and provided with the most appropriate local service that best meets their needs. This could be a referral to GP services, in or out of hours, or an emergency nurse service. This will give patients the best care for their condition and help them avoid an unnecessary  visit to A&E.  Ambulance services will work with other NHS services to ensure the right action in the right time.

More care in the home - Ambulance staff will be trained and equipped to carry out and interpret more diagnostic tests and undertake basic procedures in the home. They will also be able to refer patients to social care services, directly admit patients to specialist units, and prescribe a wider range of medications. This will be of particular benefit to patients in rural areas or with mobility problems.

More treatment at the scene - More patients with urgent, but not life-threatening, conditions will be treated at home rather than being taken to hospital. This could benefit, for example, older people who have had a fall and suffered cuts, bruises or other minor injuries and would prefer not to leave their home for treatment. At least one million people currently taken to A&E every year could be treated at the scene.

Home visits for better health - Ambulance staff will undertake routine assessments of patients with long-term conditions in their homes, in partnership with GP and nursing teams. This will help people with such conditions better manage their own health and avoid unnecessary visits to hospital.

Assisting all of these changes is an increase in the number of Emergency Care Practitioners (ECPs) across the country. ECPs are a new type of health professional, largely but not exclusively paramedics with extended training. They have greater assessment and examination skills and more training for the treatment of minor injuries and illnesses. ECPs are also trained in the management of long-term conditions.

There are currently more than 600 ECPs working in England. The Department of Health will work with Strategic Health Authorities and ambulance trusts to significantly increase the number of ECPs to help deliver these changes.  It will also ensure that the training and education of other ambulance clinicians is reviewed to ensure that they can best meet patient needs.

The review outlines the potential for efficiency savings that could be made to free-up resources for greater investment in the training and recruitment of front-line and control room staff.

Lord Warner said:

'Following a year long review we are announcing today a fundamental change in the way ambulance services provide care. We are going to develop and enhance the care that is available in our communities from the NHS by using ambulance services to take healthcare to the patient, to become a mobile healthcare system.

'We will make sure that the ambulance services are able to respond to life-threatening emergencies as quickly as possible. But at the same time we are going to extend the role of ambulances and ambulance staff, so that they can not only be there in an emergency, but be there at other times to help people maintain their health.  We believe that more than a million patients a year could avoid being taken to A&E by this new approach.

'People, by and large, would prefer to avoid a hospital visit, most would prefer to receive treatment at home. Across the NHS we are trying to give patients the chance to access care and treatment closer to their homes. We now want ambulances to play their full part in that process.

'The ambulance service has made excellent progress over the last ten years. The people most at risk are being reached quicker and more lives are being saved. We must now build on that success and will measure the response time for the life-threatening conditions from the time the call is answered.

'We will also streamline the number of ambulance trusts and improve efficiency, for example, through better procurement. This will mean we can save resources and channel them into frontline services.'

The changes announced by Lord Warner have been recommended in a strategic review of NHS ambulance services led by Peter Bradley CBE, National Ambulance Adviser and Chief Executive of London Ambulance Service NHS trust. Peter was supported by a stakeholder reference group consisting of ambulance trust chief executives, representatives of other NHS organisations and clinicians.  These recommendations have been published today and are endorsed by the Department of Health.

Peter Bradley said:

'We have an excellent ambulance service in England and there have been significant improvements already. During the course of this review we have seen many examples of good practice and excellence in patient care. But the service must secure further improvements.

'The recommendations set out in this review identify the key priorities for the service over the next five years. The successful implementation of these recommendations will result in a more advanced, efficient, and dynamic service delivering more personalised, high quality care to the people they serve.'

Nigel Edwards, Director of Policy at the NHS Confederation which represents more than 90% of the organisations that make up the NHS throughout the UK, said:

"Peter Bradley's strategic review of NHS ambulance services has taken a visionary approach to the future development of these services.

"His review is grounded in common sense and his ideas are driven by the desire to save more lives - not to cut costs. We need a faster, more efficient service that gets people the right help at the right time.

"In particular, Emergency Care Practitioners are highly skilled and save lives. They can treat people at home who don't need to go to hospital and that frees up ambulances to ensure that emergency patients get to hospital as quickly as possible."