Target times for ambulances to reach some seriously ill patients could be lengthened, the BBC has learned.
A leaked NHS document includes plans to change the response time for some Red 2 patients - those with "serious but not the most life-threatening" conditions - from eight to 19 minutes in England.
It said the plans had been approved by Health Secretary Jeremy Hunt, subject to approval by ambulance trust bosses.
The Department of Health said no decisions had been made.
"The secretary of state would only agree to proposed changes that improve response times for urgent cases," it added in a statement.
Shadow health secretary Andy Burnham told the BBC Mr Hunt had urgent questions to answer, adding: "We need to hear from the health secretary today."
One ambulance service director criticised the plans - which it is proposed would be brought in within weeks - saying they were about "political expediency rather than patient safety".
The document, drawn up by the Association of Ambulance Chief Executives (AACE) and dated 16 December, said NHS England had "explicitly stressed" the plans were confidential.
Details of the proposals "should not be disseminated beyond the group" involved in the discussions, it added.
The document said there were existing plans for changes "after the general election" in May.
But it said Prof Keith Willett, of NHS England, made an "urgent request" for discussions due to "unprecedented demand" on health services - and now the "target for implementing these changes is the first week of January 2015".
AnalysisBy BBC home affairs correspondent Sally Chidzoy
A whistleblower leaked the memo to the BBC because of serious concerns over patient safety, fears the plans were rushed at the height of winter when the service is under unprecedented pressure, and anger over the secrecy involved.
To many in the service, the general ideas are good - but there this concern it should have been a more thoughtful exercise where time was taken to consult widely and the public was involved in the process.
Paramedics say response times distort their ability to treat patients because they have to chase the clock.
They say some illnesses such as strokes, should be moved up a category.
The target for these changes was early January, according to the document, but it seems unlikely the proposals will now go ahead by then.
One ambulance service director, who asked not to be named, told the BBC: "This is being done for political expediency rather than patient safety and it's being done with the full blessing of Jeremy Hunt.
"This is being pushed through with limited consultation with the chief executives and the health service as a whole.
"There has been no consultation with the wider health system, which is required when you are making such a major change which could impact on patient safety."
Call types:- Red 1: Respiratory or cardiac arrest - response in eight minutes
- Red 2: All other life-threatening emergencies, such as stroke and fits - response in eight minutes
- Other response times are agreed locally
There are no plans in the document to change the response targets for Red 1 patients - those with life-threatening conditions where response time "may be critical", such as heart attacks and serious bleeding.
The national target is for ambulance trusts to reach 75% of Red 1 patients within eight minutes, and 95% within 19 minutes. The time starts as soon as an emergency call is connected.
Red 2 targets are currently the same, except that the "clock start" can be up to 60 seconds after a call is connected.
The changes proposed in the AACE document for current Red 2 situations are:
- A "small number" to be moved to Red 1 - those where a short extra wait "could have a potentially serious detrimental impact"
- Just under half will keep the 75% within eight minutes target, but trusts will have up to three minutes from receiving a call before the clock starts
- About 40% to have a 19-minute response target, as well as three minutes before the clock must start
The Red 2 category includes conditions such as strokes and fits, but the document does not say which conditions would be put in each of the new categories.
Lower grades of call-out - known as "Category C" and "Hear and treat" - are dealt with by locally agreed targets.
The document said the proposed changes could bring "substantial improvements".
One line in it said ambulance trusts would be able to cut the number of fast-response cars being used in favour of deploying more double-crewed ambulances.
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Andy Burnham: "I brought Jeremy Hunt to the House of Commons on Thursday... and he made no mention of it at all"
The AACE document acknowledges that details of the new response arrangements have not had the "breadth of exposure that would normally be expected".
Mr Burnham said: "This has all the hallmarks of a panic move and suggests Jeremy Hunt's only solution to the A&E crisis is to give up and move the goalposts.
"Rather than getting ambulance response times back up to established standards, it looks like he is running up the white flag.
"The situation in the NHS is now serious and Jeremy Hunt is failing to provide the leadership it desperately needs.
"While there may be a case for reviewing these rules, this is not the way to do it. It is nothing short of dangerous to make a snap decision at the start of the most difficult winter in the NHS for years."
What is your experience of the ambulance service? You can email haveyoursay@bbc.co.uk. If you are willing to speak to a BBC journalist, please leave a contact number.
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