Extended Care Paramedics (ECPs) are becoming a vital part of New Zealand’s health system, helping patients receive treatment in their own homes while reducing unnecessary pressure on busy emergency departments.
Hato Hone St John currently employs 46 ECPs nationwide, with about a third based in the South Island. Unlike traditional ambulance crews, ECPs are dispatched by car to patients who can be safely managed in the community. Their advanced postgraduate training allows them to provide a wider range of interventions than standard paramedics – including prescribing short courses of antibiotics, placing urinary catheters, closing wounds, and supporting end-of-life care.
The model was introduced during the Covid-19 pandemic to better manage less urgent cases outside of hospitals and has since become an essential part of ambulance response. Hato Hone St John estimates car-based ECPs are five times more likely to treat patients at home rather than transporting them to hospital, with patient safety outcomes comparable to traditional paramedic services.
Christchurch-based ECP Connor Inkster-Robinson, who has worked in paramedicine for more than a decade, says the most rewarding part of the role is knowing he is directly helping to reduce strain on the wider health system.
“Although you’re only one person, you’re able to make a real difference for patients and the health service by treating people in their homes and keeping them out of ED when it’s safe to do so,” he says.
ECPs typically support patients with minor injuries, infections, and palliative needs, often liaising directly with GPs to ensure follow-up care when necessary. For many patients, the ability to stay at home while receiving appropriate treatment brings a sense of relief.
“This is a new way of healthcare,” Inkster-Robinson says. “When patients learn they can be treated without going to ED, you often see the relief on their faces. That’s the rewarding part.”
Hato Hone St John says the work of its ECPs is becoming increasingly valuable, particularly in rural communities where they are helping to reduce avoidable hospital transfers, relieve pressure on emergency departments and rural health centres and make better use of busy health resources.
Patients consistently report high satisfaction with ECP care, especially when it saves them long, stressful journeys to distant hospitals and allows them to remain close to their support networks. Both New Zealand and international evidence shows that ECPs can safely manage a wide range of urgent, primary, and palliative care needs on scene, improving patient outcomes while reducing unnecessary travel.
ECPs operate across urban, rural, and primary care settings. Vehicle-based ECPs are stationed in Auckland, Hamilton, Levin, Horowhenua, Christchurch and Rangiora, while clinic-based ECPs work from rural health facilities in Hokianga and on the West Coast.
“For rural New Zealand, Extended Care Paramedics offer a practical way to extend access to healthcare, integrate services with primary care, and build a more sustainable system,” says Johnny Mulheron, Head of Clinical Improvement and Engagement, Hato Hone St John. “They provide safe, clinically effective care that patients value highly, while easing the load on hospitals and frontline ambulance crews.”
ECPs are now a vital part of Hato Hone St John’s whole-of-system response to rising lower acuity demand. Alongside strengthened communications centre triage, which resolves many calls over the phone, ECPs provide the next layer of care for patients who require a face-to-face response but not hospital admission. Together, these approaches are reducing unnecessary transports, matching patients with the right care the first time, and freeing frontline emergency crews to focus on high-acuity incidents.
ENDS
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Hato Hone St John media team
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