I'm a protocol driven automaton working for a provincial service, and it appears our way of operating when a doctor requests an ambulance differs substantially from the LAS. The AMPDS script that everyone appears to love so much is completely changed (the 'conscious' and 'breathing' questions are omitted for example), and the questions we ask take into account we are speaking to a professional. If the patient is in a surgery and there is a defibrillator available and staff trained to use it (I assumed this would always be the case, but sadly not), we don't send a vehicle that cannot transport the patient. As Tom mentioned above, AMPDS is meant to be followed without discretion when dealing with members of the public. It's far from perfect and often results in completely unsuitable responses because people blatantly bend the truth when answering the questions. I'm sure the 'A' stands for 'Advanced' by the way... "It's frankly irresponsible to have a system that can't take account of the assessment of a doctor on the scene to grade a call into anything other than "blues and twos" response or "whenever". That isn't the case. The timescales do vary from emergency to whenever possible, but there is a within one, two or three hour option in between. Generally the only 'whenever possible' calls we take are transfers and discharges. Of course these timescales, much like ORCON, are not always met. "Generating a blues and twos response puts other road users and ambulance crews at risk" I took a call from a doctor recently wanting to book a blue light ambulance at 2pm, however there was no bed available until 5pm so he wanted it delayed until then. The hospital in question is in the centre of a large city and travelling into it at rush hour is not for the faint of heart at normal speed. I tried explaining that blue lights were not appropriate but was met with a garbled shout about whether I knew how serious the patients condition was. Luckily he saw sense eventually.