(From someone who works in control) I was rather surprised to read here that there's an average 4.5 minute delay before "starting the clock" -- the "ambulance service spokesperson"'s figure of 83 seconds seems closer to what I would estimate. The "clock" starts after the call taker has been given the address and a brief description of what the problem is ("Not breathing" "Cut finger" "Decapitation" etc) -- the call taker then goes on to ask all the questions about is he breathing normally and what part of the body is injured while the people on the dispatch desks send out an ambulance if they have one knocking around. Reasons why it might take four and a half minutes for the clock to get started: 1) People not knowing their address. A minimum of a road name and postal area is needed to get a map reference and without a map reference the computer system can't send the call to an ambulance. If the person really doesn't know and can't find out, the call taker will then spend the next ten minutes scrabbling about in the back of a map book and/or ringing the police (who have a better, more expensive mapping system which includes names of shops and pubs) to track down where they are. 2) Language barriers -- getting an interpreter takes a while (depending on how awake Language Line are feeling) and don't even get me started on those people who insist they can speak English but blatently do not understand a word you are saying. 3) People who do not let you get a word in edgeways and insist on telling you their entire life story before giving you the address. 4) People who shout, in the style of Eastenders, "29 Albert Square! Get an ambulance here now!" and then hang up before telling you what is actually wrong. These people then have to be called back which takes time, especially if they continue telling you to "stop wasting time and send an ambulance". I think these people think there is just one person working in CAC who takes the calls and after hanging up walks round to the ambulance station and knocks on the window of the ambulance to give them the details. 5) Psychiatric patients who just want to spend half an hour telling you that they are Hitler and that ambulances are made of ice cream. We are not allowed to hang up on them unless they explicitly state that they do not want an ambulance and thus can spend hours listening to them ramble without ever giving an address and getting the clock started. Ways of solving these problems: 1) A better computer system for finding addresses. One like the police have with shops and pubs listed would be very helpful. It would also be nice if you could use area names as well as postcodes (Walthamstow and Leyton instead of E17 and E10) and it would be wonderful if you could search for similar sounding road names and list all the roads of a particular name in London. 2) General public should stop being rude and stupid. 3) All members of ambulance control to become fluent in Punjabi, Arabic and Turkish. 4) Eastenders scriptwriters to write script where Pauline rings for ambulance, gives address, says what is wrong and then speaks calmly and politely to person on other end of phone until it arrives.