ES News email The latest headlines in your inbox twice a day Monday - Friday plus breaking news updates Enter your email address Continue Please enter an email address Email address is invalid Fill out this field Email address is invalid You already have an account. Please log in Register with your social account or click here to log in I would like to receive lunchtime headlines Monday - Friday plus breaking news alerts, by email Update newsletter preferences

Half of Londoners calling 999 will be treated at the scene of an emergency and not taken to hospital under a planned care revolution.

London Ambulance Service wants to slash the number of patients it sends to A&E in an attempt to speed up treatment and save the NHS up to £36.5 million a year.

Ambulances will be prioritised for those in need of critical care in hospital, such as patients of cardiac arrest, heart attacks, strokes or major trauma.

LAS chiefs want to capitalise on technology advances so frontline staff can share photographs while out on call or hold video consultations with colleagues based in “clinical hubs” in the control room. All 4,000 frontline staff already have iPads to access patient records.

Sources said the move was not intended to reduce trips to hospital at any cost, but to work “smarter and better” to ensure the best possible care.

LAS received 1.8 million calls and responded to about 1.2 million incidents last year — up nine per cent on the previous year — and took 760,000 patients to hospital. Its five-year strategy is looking to reduce this by 122,000, meaning the proportion conveyed to hospital will fall from 63 per cent to 53 per cent.

Under the plans thousands of patients would receive advice over the phone, known as “hear and treat”, or at the scene from an advanced paramedic, known as “see and treat”. LAS chief executive Garrett Emmerson said the aim was to “transform” the service, which was upgraded last week to “good” by NHS inspectors.

“This will both improve the speed and quality of the care we provide and reduce pressure on the wider system,” Mr Emmerson said.

“We know that if we did nothing, pressures on A&E will mount and the strain that the system faces every day will worsen. This is our response to those challenges and represents a fundamental shift in how we have operated in the past.”

“Pioneer” initiatives providing treatment at the scene will be introduced for maternity patients, with midwives dispatched in fast-response cars, as well as for elderly fallers, mental health calls and end-of-life care.

This follows a pilot scheme in Croydon that dispatched an advanced paramedic practitioner rather than two medics in a conventional ambulance.

It resulted in the “vast majority” of patients treated at the scene or referred to another service rather than being taken to A&E.

Another initiative, the physician response unit (PRU) — in which a hospital doctor and paramedic respond to calls in a fast car — prevented more than 300 admissions to A&E in its first 111 days, saving the NHS £411,000.

The PRU, a partnership with London’s Air Ambulance and Barts Health NHS Trust, carries advanced medication and equipment usually found only in hospital, such as instant blood and urine tests and sutures to stitch serious wounds.

The latest announcement was criticised by one patients’ group.

Malcolm Alexander, chairman of the LAS Patients’ Forum, said: “This is undoubletly a fine aspiration but it doesn’t seem to be based on reality.

"If you have an 80-year-old who has fallen but not broken her hip, the idea is that the paramedic will be able to phone up someone who will provide alternative care. Without evidence that there is an alternative system available, there are considerable risks to patient safety.”