PARAMEDICS on emergency calls will be asked to decide whether patients should be treated at home instead of being taken to hospital.
The controversial plans, aimed at speeding up paramedic response times, means patients who need hospital treatment may also be transported by car rather than ambulance.
Last night, unions raised concerns people could be left waiting even longer to be seen by medics and raised fears too much responsibility was being placed on paramedics shoulders.
The North West Ambulance Service is preparing to pilot the scheme in Wirral in August.
Under the proposals lone paramedics in emergency response vehicles will be the first to the scene and will then call for a back-up ambulance if required.
A substantial portion of patients are taken into hospital as a matter of precaution, said NWAS deputy chief executive Bob Williams.
Paramedics are very professional people and capable in some cases of dealing with things then and there.
If the patient does need to go to hospital, they might not necessarily require a yellow ambulance. The paramedic can assess what is the best method of transporting them.
Response times across the region have improved greatly in the past 12 months and this scheme will build on that.
During the pilot scheme, expected to last until at least the end of the year before being introduced across the region, more emergency response cars will be based in Wirral.
Mr Williams said ambulances would still automatically be deployed to higher category 999 emergencies such as road accidents.
He said Wirral was chosen for the pilot for a number of reasons: The paramedics there are trained to a very high standard, a legacy from the Mersey Regional Ambulance Service and the geography means that the area is easy to isolate, he said.
It only serves one accident and emergency unit and it means we will best be able to monitor patient flow.
The pilot scheme will begin in August and details of the plans will be presented to patient forum groups later this week.
Last night, Steve Rice, a spokesman for the Ambulance Service Union (ASU) said staff were waiting for more information about the scheme.
Our concern is that it will mean patients waiting even longer, he said. It will have a positive impact on response times if they are based on emergency response vehicles.
What if a paramedic arrives and decides an ambulance is required? Will the patient then have to wait twice as long for an ambulance to come? That will not be reflected in the response times.Mr Rice said unions would be concerned about the extra responsibility being placed on paramedics. He added: As a paramedic myself, I would be worried about turning up somewhere on my own and having to make a decision about whether they should be taken to hospital.