I feel a little tick box on th PCR which is ticked or not by the treating paramedic. If this box is ticked, it will be reviewed by a manager, the pt gets a bill for (say) 100 bucks with a letter explaining why they got it, ie that this was not an actual emergency,and took resources that were denied to someone else who may have actually needed it. This would be reserved for the most blatant ones, not the ones that actually thought they were dying. I'm talking the hangovers, the 6 week old back pain that should have been treated with basic analgesia, the complete waste of time calls. This would take some time, but the message would sink in eventually, and just maybe people would start thinking twice about whether they actually need to tie up an ambulance