Ambulances will only go to 10 per cent of 999 calls

Single paramedics in cars will be despatched to all emergencies and then request an ambulance if the patient needs to go to hospital.

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It means more people will be treated at home rather than in over-stretched A&E departments but experts warn the plans could put patients at risk if serious conditions are misdiagnosed.

The shake-up is part of the seven-year plan for the future of London Ambulance Service.

Under the new scheme, paramedics will be expected to attend the majority of emergency cases alone in cars.

Control room staff will only automatically dispatch an ambulance alongside a car if it is obvious the patient will need to be transported on a stretcher or if the situation is dangerous for the crew.

But this is only expected to happen in 10 per cent of most cases.

At present ambulances are dispatched to almost all 999 calls and cars are sent to the most life-threatening cases to start treatment before the ambulance arrives.

Three-quarters of patients are taken to hospital.

The paper says more minor injuries should be treated in the community or in the patient's own home, under the "care closer to home" policy.

Health experts said today they feared patients' safety was being overlooked for the sake of hitting government targets.

Katherine Murphy, spokeswoman for the Patients' Association, said: "This is about hitting targets and not about the needs or safety of the patient. Savings the service may have to make should not cost a patient's life."

A union representative told said: "We are happy the changes mean our members will be trained to a higher degree and paid accordingly.

"But where we have concerns are over the safety of our members if the numbers of ambulances were reduced and staff were left to attend dangerous situations alone."

It comes amid growing numbers of attendances at A&E and increasing pressure on NHS trusts to cut costs.

The paper from London Ambulance says such pressures means the workforce will only increase marginally between now and 2012.

This means in order to meet response time targets with a growing workload, paramedics must be split up from double crewed ambulances into one-man cars.

Managers denied the move was a cost-cutting measure and said patient care will not be compromised.

Ian Todd, assistant director of operations at London Ambulance Service, said: "Ultimately the majority of our calls will not need an ambulance dispatched immediately.

"More people will get a faster response and that it is the thing they want. We expect to see a significant increase in the patients who don't go anywhere at all."

An estimated 10 per cent of patients are in a life-threatening condition, another 20 per cent are in no danger of dying but need urgent attention because they are in pain and the rest need telephone advice or attention fairly quickly.