HEALTH officials are getting tough with the area's ambulance service because too many casualties are waiting too long for help.

North Staffordshire Primary Care Trust (PCT) has issued West Midland Ambulance Service (WMAS) with a formal warning notice to stop falling standards in the south of region spreading closer to home.

It will also run a daily check on the service's 999 response performance.

The PCT's chairman has said further action will be considered against ambulance bosses if service dips below the level expected in Newcastle and the Moorlands.

PCT chairman George Wiskin, pictured, added: "We are in an area which was used to a high-standard ambulance performance before the Staffordshire trust was amalgamated into the West Midlands.

"I don't know exactly why standards have dropped but I have confidence that, as we still have the same people in post, things will improve."

Since April, WMAS has managed to meet the eight-minute target for getting an ambulance to a casualty in less than 70 per cent of 999 calls received. The target is 75 per cent.

And, although it is meeting the eight-minute figure in 77.6 per cent of the 200 calls made each day in Staffordshire, county health bosses are determined the service their patients get will not deteriorate.

Mr Wiskin said: "As with all providers of services, we commission on behalf of the public and we have the ultimate sanction of removing them from the contract. But we are a long way from that and one wonders what alternative suppliers of an emergency ambulance service are out there."

NHS North Staffordshire's directors will this afternoon be told WMAS's performance fell in June, July and August. While it had since improved, the standard from March to September was only 69.88 per cent.

A report says regional performance had been hit by ferrying swine flu patients to hospital in Birmingham and the Black Country. Another factor was the launch of a computerised ambulance dispatch system.

Two hundred 999 calls are made each day in Staffordshire and the eight-minute deadline is hit in 77.6 per cent of those cases.

Ian Syme, of North Staffordshire Healthwatch, said: "We are delighted they are getting tough on these plummeting standards."

WMAS has been granted a £10 million payment to cope with demand, up by seven per cent this year. A spokesman said: "We have been working closely for some time to address this and have responded to the PCT's performance notice with an action plan to recover performance.

"Performance within Staffordshire continues to remain strong and that is a testament to the staff who have been working incredibly hard."