Oxfordshire's ambulance service has been voted third best in England and Wales - and a Government review promises to improve performance further.

It marks a dramatic turnaround for the service, which just four years ago was voted the second worst.

The Audit Commission, which compiled today's report, wants the ambulance service to lower emergency response times further and make it even more efficient.

The changes include extra training for paramedics to treat patients with minor injuries at home, rather than unnecessarily cluttering accident and emergency wards at Oxford's John Radcliffe Hospital.

The report also recommends prioritising ambulance call-outs so crews can divert to emergencies if they have to, making the system quicker.

It is hoped the new plans, welcomed by Oxfordshire Ambulance NHS Trust, will be in place by the year 2001 They should improve response times, which stand at eight minutes for emergency 999 calls, with the added spin-off of reducing the number of patients admitted to the overloaded A and E.

This year, 95 per cent of all emergency responses in the county were within 19 minutes, placing it third best in the country compared to the cost of the service to run. But the trust insists more money must be made available from Oxfordshire Health Authority to pay for the proposed changes. The trust received just over £4m last year - when it says it should have got about £5m.

Trust chief executive John Nichols said the proposed review would reduce confusion and bewilderment amongst patients.

He said: "We can become a 'guardian gateway' helping ensure patients go through the correct 'gate' for treatment, rather than on a round trip to eventually end up with the right person, such as a district nurse."

Trust chairman Terry Elms explained why Oxfordshire fared so well.

"The staff here are absolutely superb - it is not because we have oodles of money. We have not received any extra funding for several years," he said.

Four years ago, the service was the second worst of all rural regions in the country, with 92.5 per cent of ambulances arriving within 19 minutes.

Today's review also recommends an investigation into whether a fully-equipped ambulance and crew is needed at every case, however minor.

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