New Extended Care Paramedics

Extended Care Paramedics (ECPs) support patients with urgent, unscheduled primary healthcare needs. An ECP specialises in assessing patients with low acuity conditions and providing treatment for common minor illnesses and injuries at home, referring back to the patient's GP wherever appropriate. The ECP then closes the loop with the patient's GP by sending an ambulance care summary after seeing the patient and can also refer the patient to other health providers if needed.

For the past nine years, St John has been contracted by several DHBs and PHOs to provide additional support (for example, for after hours care) by visiting and treating patients with minor conditions. St John has also deployed car-based paramedics to low acuity 111 calls with a high likelihood of transport not being required.

St John has recently formalised the ECP role and expanded the range of skills and medicines available to treat patients. During the COVID-19 pandemic we trained 20 ECPs to work in Auckland, Christchurch, Horowhenua and South Taranaki.

The ECP role as part of the ambulance workforce

An ECP is a paramedic that is passionate about community medicine and has completed postgraduate education and training to specialise in treating patients with non-urgent illnesses and injuries.

The team of ECPs form part of St John's workforce skill mix and will be sent to patients where they can best use their skills. Some St John ECPs will work in a designated ECP car, equipped with all the kit and medicines that they need to treat low acuity patients. Others will work on ambulance treating patients with both life-threatening conditions and minor illnesses.

St John has developed a comprehensive set of Extended Care Paramedic Clinical Procedures and Guidelines (which function as standing orders) to enable ECPs to safely treat patients with common minor illnesses and injuries. Examples of assessments and treatments that ECPs can provide include ear, nose and throat examination, suturing basic wounds, administering oral antibiotics, administering an enema for constipation and replacing a blocked urinary catheter.

How can I best work with the ECPs in my area?

As a key part of New Zealand's health system we want to work more closely with all health providers to provide patients with the best care, and we believe that ECPs are an essential part of this. We encourage you to develop a collegial relationship with your local ECPs to understand how you can best work together.

You may have already worked alongside an ECP during their clinical placement. ECPs will undertake regular clinical placements, so if you are interested in hosting them, please contact us.

What are the future opportunities for ECPs?

St John intends to increase the number of car-based ECPs across New Zealand, to enable patients who call 111 with a non-urgent condition to access the care they need and to free up emergency ambulances for patients who need them the most.

While ECPs are currently based mainly in urban areas, there may be future opportunities for ECPs to work in rural areas to support both rural medical facilities where there is a need (working alongside clinicians in a GP clinic, integrated family health centre or rural hospital), while also supporting local ambulance responses in smaller communities which rely on volunteer crewing.

More information

If you'd like to find out more about St John's ECPs, please contact the St John Clinical Directorate on 0800 ST JOHN or email

View our ECP prospectus to find out whether an ECP could support your local health system

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