A paramedic has denied sexually assaulting a patient in the back of his ambulance, telling jurors that he may have made a smutty remark to "lighten the mood".

Andrew Wheeler, 46, told Peterborough Crown Court that it was "quite compact" in the back of the emergency vehicle.

Asked by Jennifer Dempster QC, defending, if he had groped the woman's breasts, he replied: "No."

She went on: "Might you have come into contact with her breasts at any point?"

Wheeler responded: "Yes. When you're sat on a trolley it's quite compact.

"You've got a wall next to you."

He told the court that he had had consensual sex with the woman on previous occasions, when she was not a patient.

Asked if there was a protocol when called out to someone you already know, Wheeler said: "It's an emergency service.

"You deal with what's in front of you."

Wheeler said "it's possible" he made a remark when injecting the woman with adrenaline, such as "it's not the first time I've jabbed you".

Asked by Ms Dempster if he made a further "smutty remark", he said: "I was trying to lighten the mood."

Asked if he ever raped the woman, Wheeler replied: "No I did not."

Wheeler, of Mill Green, Warboys, Cambridgeshire, is accused, in an updated indictment, of 18 sexual offences against five alleged victims, three of them patients, spanning 2002 to 2018.

He denies all the charges.

He is accused of raping a woman in 2009 and sexually assaulting her in the back of an ambulance in 2010.

He is accused of raping a patient in her Cambridgeshire home and sexually assaulting her in 2018.

He allegedly placed the hand of a woman patient on his genitals over his clothing in 2010.

Wheeler is also accused of 11 counts of rape against another woman, who was not a patient, between 2002 and 2011, and of two counts of sexual assault of a child under the age of 13, who was not a patient.

He denies 13 counts of rape, two counts of sexual assault, one of causing sexual activity without consent and two counts of sexual assault of a child under the age of 13.

The trial continues.