A radical overhaul of accident and emergency services which would see more nurses treating patients at home or work was announced today by the government.
The plan is to create a small network of regional specialist centres with 24 hour consultant cover.
More nurses and paramedics would be needed to stabilise patients for the longer journey by road or air ambulance.
Only very sick patients would use the centres, while other patients would be treated at home or work by nurses, paramedics and emergency care practitioners.
Sir George Alberti, national director for emergency care, said the centres would 'give the best possible treatment to the sickest people'.
But Unison's head of health Karen Jennings said: 'We are extremely concerned that these policies may be being driven by deficits, not what is best for patient care.'