The urgent and emergency care system in the NHS is under pressure and struggling to meet a number of key targets. Over the last 30 years there has been an increase in emergency ambulance service calls from 1.5 million to over 6 million a year, with only about 10% of these calls being for truly life-threatening conditions. The 2005 report from the English Department of Health, ‘Taking Healthcare to the Patient: Transforming NHS Ambulance Services’, described ongoing concerns about the proportion of patients who are transported without a clear clinical indication for emergency hospital admission.2 Estimation of avoidable emergency ambulance use ranges from 30% to 52%.3.