In conclusion, NHS QIS recommends that:
1. as the use of FRVs to respond to appropriate emergency calls more quickly is valid, SAS should continue to develop the use of FRVs as part of its service to meet the clinical needs of patients
2. the use of the term FLM is avoided within the service because, although the principles are sound, there has been no clear definition of term within SAS and its use leads to confusion. A more productive approach to the implementation of the principles will be to ensure that the New Ways of Clinical Working project aims are widely articulated across the service and beyond
3. in advance of further service development, strategies are established for effective engagement and communication with staff, healthcare professionals in primary care, out of hours services, emergency departments, the public and other relevant organisations, such as the police
4. staff receive the necessary training, ongoing development opportunities, managerial and clinical support to ensure their competence and confidence to adapt to these new ways of working
5. operational aspects of delivering New Ways of Clinical Working, including addressing perceived personal safety concerns and governance of clinical decision making, should be developed in partnership with staff
6. work should be initiated on the public needs and expectations of the ambulance service to ensure the provision of clinically effective patient- centred care.