Paramedic Jonathan Alexander has a ready reply: "It's simple. I take the kit out, fold you in half and put you in the panniers."

Nine years ago Jonathan had the idea of a cycling paramedic service in Sheffield city centre. (Plenty of time to hone ripostes to the wry comments he was expecting).

In 2000, paramedic and former BMX cycling champion Tom Lynch had launched the first 'Cycle Response Unit' in London and Jonathan, a teacher and keen competitive cyclist, was looking for a change of career.

"After seeing it happen in London, it had always been my dream to be a cycling paramedic after I joined the ambulance service."

He put his first proposal for the Sheffield scheme to management in 2001 but it took the merging of the Yorkshire services and the clear success of schemes in York and the pedestrian areas of Leeds before the Sheffield Cycle Response Unit was launched for a three-month trial last autumn.

Jonathan's preparatory work behind the scenes involved loading up his own bike until it was as heavy as a paramedic cycle, then setting off from Barker's Pool in every direction to judge the response time within the initial target area of the inside of the inner ring road.

The service aim is to reach 75% of life threatening incidents within eight minutes: Jonathan found he could get to the railway station in a little over 30 seconds and outside the ring road to Collegiate Crescent within five minutes.

The initial run of the CRU (as it's called – the Sheffield public seem to prefer 'ambulance bikes') has proved so successful that the trial has been extended to a year.

And now Jonathan and fellow cycling paramedic Tim Atkin are getting used to the requests for 'two 99s and a cornet, please' as they patrol the Peace Gardens in their summer shorts with their loaded yellow and orange mountain bikes.)

The response time for all call outs has averaged at four minutes and 39 seconds so far. For life-threatening calls, the average response time (during the first four months) was under four minutes – less than half the target time. And as all ambulance staff know, for a cardiac arrest patient every minute saved could make the difference between life or death.

"A typical call-out was when I was with a fast response vehicle in Barker's Pool," says Jonathan. (That is, a paramedic in a car). "We had a call to a person having an asthma attack in Charles Street. We set off at the same time and I was there in about 30 seconds but the car took four minutes."

And this is the idea. Jonathan or Tim arrive often within seconds, make an immediate assessment, carry out the initial treatment and call out other services as required, which may be an emergency GP, for example, or an ambulance.

One advantage of having a paramedic on the scene so quickly is that ambulances don't always have to be deployed, which saves resources and means the ambulance is available for calls further afield.

In the first months of the scheme almost a quarter of cases were dealt with by the cycling paramedics without needing to call on any other services.

And the CRU works in partnership with other services, including the police, the city centre ambassadors and even bus drivers, who help their passage through city streets.

"In a way the cycling paramedics are the missing link in the city centre," says Guy Biggin of the city centre ambassadors. "If we find someone laid out on the floor, for example, we don't know if they've had a cardiac arrest so we can call Jonathan or Tim and they're here fast. People see that it makes the city centre safer."

Jonathan hopes to expand this partnership working to include other agencies. "We'd like to combine our skills, so we can keep an eye on people regularly on the streets in the town centre and check them over when we're around. Our mobility around town raises awareness and people can come up to us if they need us."

And the mobility helps in other ways, too: "One day recently I saw police officers looking for a burglar in the city centre. I came upon him on a different street with police officers giving chase. So I rode ahead and pulled alongside him and explained I wasn't going to get out of breath like he was and that he may as well give himself up. So he stopped and the police arrested him."

It seems very likely now that the ambulance bikes will become a regular feature of Sheffield city centre. Alan Baranowski, assistant South Yorkshire operations director for the Yorkshire Ambulance Service Trust, said: "The unit is not only improving efficiency to 999 calls in the city centre but is giving the ambulance service a valuable opportunity to be more visible and responsive in the local community.

"Should the trial in Sheffield continue to prove beneficial to patients in the city we will be looking to make the Cycle Response Unit a permanent resource."

An ambition realised for Jonathan Alexander. His radio bursts into life and he's on his bike and away to High Street, where a man has fainted. Bystanders watch as the man is treated by Jonathan and after a few minutes taken away by ambulance for further checks.

"He was here almost straight away, three or four minutes before the ambulance," said one observer. "What a fantastic service."

Ambulance bikes are no joke, it's clear. As Jonathan packs up his breathing equipment, you get the feeling he's more likely to receive a round of applause than a request for a pineapple mivvi.

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