Health reporter, BBC News
Ambulances in the North-East are freed up to quickly deal with emergencies
A health watchdog has raised serious concerns about the state of emergency care in England.
But there is much variation and services in the North-East have been singled out by the Healthcare Commission for consistently high quality of care.
A pilot scheme to better direct ambulance services to those who really need them has substantially contributed to these glowing reports.
Operators at the ambulance control centre use specialist computer systems called Pathway to determine who needs an ambulance and who could be treated nearer to home, for example in a walk-in centre.
Paul Benstead, aged 39, has worked as a paramedic since 1992 and is currently a one-man rapid response unit with a high speed car, based in South Shields.
The control centre place him and his colleagues at "hot spots" around the North-East so they can quickly get to the scene of a traffic accident or heart attack.
"It's like they've got a crystal ball sometimes - we're never more than a couple of minutes away," he says.
Because the control centre can direct the non-life-threatening cases to other parts of the health service, the ambulances are free to attend the emergencies they are designed for.
"If you think back to the 1980s you would have fleets of ambulances outside casualty because they didn't have enough beds - you could be waiting 20 minutes to half an hour before you could even deliver your patient."
He added he had heard of other ambulance trusts which were really struggling to meet response times simply because the system was "clogged up".
"If the NHS is to have a viable future, things like this are essential - we can't be stuck in the old days of working."
Calls to the ambulance service in the North East have doubled in recent years and are set to increase further.
Those managing the service say they had two choices - either provide more ambulances or use existing services more efficiently.
Paul Liversidge, director of ambulance operations said only 65% of people calling 999 are now transported by ambulance to hospital.
The others are dealt with by walk-in centres, GPs, mental health teams, or even home visits from nurses.
"We can identify the life-threatening calls immediately and then as the questions progress we can determine whether there's an alternative."
Detailed analysis of the Pathway pilot will be done before it is rolled out to any other services.
"There will be an evaluation process to make sure that clinically there's no weaknesses.
"We can look at particular questions, change the wording if necessary.
"We're not sending ambulances in 35% of cases and that's of benefit to the ambulances and the whole healthcare community as well as the patients."
Members of the public were initially reticent about the scheme because the culture had always been to bring everyone who called 999 into hospital.
But staff report once people get used to the system they are often happy they do not have to go to casualty.
"The walk-in centres have been a big hit," adds Paul, one paramedic who is "100%" behind the new system.
"They're oversubscribed so they actually need more of them."