Paramedics must not be put at risk if the way decisions are made on attending patients at dangerous emergency incidents are altered, ambulance staff have warned.

The Association of Professional Ambulance Personnel has warned that any changes made following the inquest into the Cumbrian shootings by Derrick Bird, must ensure that staff safety is paramount.

West Cumbria Coroner, David Roberts, has said he will write to health secretary Andrew Lansley, and the home secretary, under “rule 43” regulations, which require coroners to make recommendations where they believe future deaths could be avoided.

The coroner said he would make recommendations both on ambulance staff attending dangerous events, and on how communication between the police and ambulance services could be improved.

APAP spokesman Jonathan Fox, said he accepted that some of the delays in the Derrick Bird case were too long, and he said that “fine-tuning” could improve response times. But he said the key was that ambulance crews knew as early as possible that they could safely treat patients.

“We want to see better communication, using digital radios, to ensure that the all-clear is given as quickly and efficiently as possible,” he said.

The APAP is also calling for body armour to be issued to frontline ambulance staff.

NHS Confederation Ambulance Service Network spokeswoman Jo Webber said any planning for major incidents where staff could be put at risk should betaken on a national and systemic basis, and the Cumbrian shootings would be part of any evidence that would be considered.

North West Ambulance Service’s director of emergency service, Derek Cartwright, said after the inquest that there were “lessons to be learned on a national level” from the incident.

A spokeswoman for the service said it was not planning any unilateral action following the inquest, and that it would wait to hear the health secretary’s response to the coroner’s letter before deciding what action to take.

Mr Roberts said that the victims in this case died quickly, and ambulance crews arriving sooner would have been unlikely to have made a difference.