Reynolds, I know we've been round the houses on this before, just to point out that the BMJ piece appears to be merely a focus group of paramedics saying that 8 mins depresses them, whilst I agree the 8 min bit of the target isn't science, neither is taping a bunch of moaning ambo staff (we all do it all the time with no encouragement). Your piece about the "administrative handover" fails to point out that about 30 mins of a 70 minute job cycle is spent at hospital, you're right the NHS should ensure that all patients are properly cared for and not lost to the system, my only question is, since we're just as busy as the nursing staff why should we be doing it? After all the patient is now the hospitals patient and I can't help feeling that by booking in all we are doing is re-inforcing the idea that you get special treatment in A&E if you go there by ambulance.