Paramedics in Oxfordshire are in dispute with their managers over new work rules that they claim could put patients at risk.

Ambulance crews are angry about a new stand-by policy, which means they are stationed at garages and lay-bys across the county without adequate hand-washing facilities or lunch breaks.

Unison is now talking to Oxfordshire Ambulance Service staff and managers before considering further action.

Convenor Philip Bolley said: "We are in garages and lay-bys, and none of these places have adequate toilet or hand-washing facilities. We may go for four hours without seeing a toilet.

"This is coupled with the fact that we have to take our lunch with us and there are not enough resources to cover breaks, so we are on call during meals and struggle to get 30 minutes. It would seem all of our staff are for dispute. They believe enough is enough."

Mr Bolley said the system - brought in six months ago - meant crews could no longer wait for calls at Oxfordshire's ten ambulance stations but were positioned strategically to make sure they could respond to life-threatening calls quickly.

Paramedics had already voiced their concerns at two meetings, in Kidlington and Banbury, and although they were not against the stand-by system in principle, they had voted "virtually unanimously" against the work changes, according to Mr Bolley.

Unison has now asked each member of staff to fill in a comprehensive survey to highlight particular problems.

Oxfordshire Ambulance Service developed the stand-by system in a bid to meet Government response targets, which order all UK ambulance trusts to get to life-threatening calls within eight minutes.

The time limit means patients with symptoms of cardiac arrest have a better chance of being resuscitated.

John Nichols, Oxfordshire Ambulance Service's chief executive, said managers were re-negotiating the shift plans and operational deployment policies currently used to help save lives. In a statement he said:

"Unfortunately, life-threatening emergency calls do not come into our control room to order. Life-threatening emergency calls happen when someone's life is at real risk and whenever and wherever they occur we have a duty to respond. There may be occasions when the nearest crew to this life-threatening emergency call is on a lunch break.

"We are all trying our best to do the best for the population that we serve. Equally, we are trying to find the best balance between responding to life threatening emergency calls and staff welfare. We follow all national guidance on statutory matters such as Health and Safety at Work and Health and Hygiene."

An Oxford Mail street survey revealed there was sympathy for the paramedics.

David Williams, a 34-year-old mature student, of St Clements, Oxford, said: "I would have thought their job was difficult enough, without causing more tension and stress."