General practice attachment 215 -and the prioritisation of calls according to the urgency of patient need is introduced, the opportunity exists to improve care across the spectrum of 999 callers. At the most urgent end, appropriately skilled and staffed ambulances can be dispatched without delay. At the less urgent end, there is the opportunity to explore other, possibly more appropriate responses than the current obligatory "lights and sirens" paramedic vehicle. The question of appropriateness of use recedes as not only difficult to measure but also of little relevance. The question becomes: "how can ambulance services best plan the cost effective provision of prehospital care so that varied healthcare needs expressed by the general public through 999 calls receive an appropriate response?" This requires ambulance services to understand their workload and factors which affect all types of demand, not in terms of appropriateness or otherwise, but in terms of patient type and condition, and social as well as clinical need.
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