I have to ask Tom.....why are you taking these people to hospital? I've hunted high & low in the Patient's Charter & elsewhere for the definitive indication that you HAVE to convey if the patient wants a ride in the big white taxi - but can't find it. Would love to see a link if you have one. I know we're very lucky down here in rural-ish Devon.....a few numpty jobs but not nearly as many as you, but I can't remember a patient insisting on being taken against our advice. I've asked a few of my more experienced colleagues too, & they seem to believe that there is no such obligation if there clinical judgement suggests an alternative. I'll try a get a proper answer out of our chief exec next time he runs a chat-room session! And from a management point of view.....with Call Connect startting (officially) in a couple of days, how do they expect you to hit those all-important targets if you're picking up rubbish like this?