Emergency call handlers could be told to stop referring to people as Sir and Madam in a drive to be more inclusive, it has emerged.

The London Ambulance Service is considering whether to introduce a new policy on the way callers are addressed, after transgender campaigners suggested the current system was outdated and could cause offense.

At the moment there are no hard and fast rules on how a 999 call handler should refer to members of the public.

Staff are simply told to be polite and use their common sense when talking to people.

But sources at the London Ambulance Service said bosses had not ruled out bringing in changes, which would see the use of Mrs and Mrs or Sir and Madam dropped in favour of more gender neutral terms.

The issue was raised at a conference of ambulance services organised by Lesbian, Gay, Bisexual and Transgender campaigners.