The inter-hospital transfers that want you there lights and sirens, but then spend over an hour organising things once you are there. It was becoming a problem down here until we started telling the hospital, if the patient isn't ready in the next 15 minutes, we're clearing and you can call for another ambulance when he is ready. This went on for 3-4months with a few complaints being issued from the hospitals against the crews. Our clinicians backed us up, and now the system works well most of the time. It basically means the hospital have the patient nearly ready when they call for an ambulance.