Ok, I need to try and keep the patient's confidentiality, I wrote this post fairly ambiguously because if I mention the condition then there is the risk of breaching that confidentiality... The patient's 'own' hospital was across the other side of London and it was during rush hour that this call happened. The condition doesn't really need specialised equipment, the ability to deal with it is available in all hospitals. The condition isn't *that* rare, in that the Consultant at the A&E we took the patient to understood the condition and the possible effects that the condition can have and has the treatment to hand there. I took the patient to the nearest hospital under blue lights because, while I wasn't *sure* I suspected that the reason why we were called had little to o with the condition, but as I wasn't *sure* I made the decision to take the patient to the nearest A&E. If the patient had been suffering from something that would have benefited from treatment at a specialist centre I would have taken them there (e.g. the Neuro centre) So in this case of a patient calling us for something probably not serious, but with a complicated underlying condition and not needing specialist treatment (except perhaps from one doctor calling another on the phone) I think that the right thing was to take the patient to the nearest hospital. (And it was the start of our shift, so a 'jolly' to another hospital outside our area would have been quite fun actually...)