EMAS staff will now decide which callers will receive an ambulance.

Staff will make decisions on who deserves an ambulance in Notts, Derbys, Leics and Rutland from Friday.

Those who have only cut a finger or have an earache will be passed on to NHS Direct or their doctor.

The changes comes after it was found 15% of the 1,000 daily calls are not real emergencies and staff are now allowed to prioritise calls.

The change will see a triage nurse in the control room assessing calls which are not judged to need an emergency ambulance.

This is the most significant change ever in the way ambulance services are delivered David Whiting, East Midlands Ambulance Service

Previously, the trust was not able to refuse to send an ambulance regardless of the level of injury.

The Department of Health now allows ambulance services not to give an immediate ambulance to minor injuries.

David Whiting, East Midlands Ambulance Service (EMAS) director of operations, said: "We have to deal with 120 such cases each day. That equates to over 43,000 a year.

"These calls have a big impact on our ability to provide an appropriate response and follow-up treatment to life-threatening calls such such as cardiac arrests and serious road traffic accidents.

"I believe this is the most significant change ever in the way ambulance services are delivered and that our nurse triage scheme is unique."

The change is supported by the 22 pirmary care trusts serving 2.6m people in the four counties across the region.