Community paramedics: Helping to bridge the gap 

You wouldn’t expect primary health care and health promotion would fit into the job description of a paramedic.  

But community paramedics – an emerging position in Ambulance Tasmania – are helping create a much-needed bridge between emergency services and primary care.  

These specialised paramedics focus on non-urgent, low-acuity (less severe) and complex, chronic cases, allowing patients to receive care in their homes or communities without needing to visit a hospital.  

This not only alleviates pressure on hospitals but also offers a person-centred approach that gives people a better experience of the healthcare system.  

All paramedics are required to hold accountability for their practice and professional development and are regulated by the Paramedicine Board. They must practice in accordance with AHPRA shared Code of Conduct and Paramedicine Board Professional Capabilities for Registered Paramedics. Most paramedics are tertiary educated with community paramedics receiving additional training to extend their knowledge and professional capabilities in caring for a wide range of low-acuity medical issues that traditionally required transportation to hospital.   

Community paramedics can provide care and therapeutic intervention and support with referral pathway navigation, to connect people in with primary care services where required.  

This helps reduce unnecessary hospital admissions and provides more accessible care, with the aim of keeping people well in the community, which is particularly important in remote or underserved areas of Tasmania. 

“We can treat conditions like epistaxis (nose bleeds), back pain, and minor injuries without sending the patient to the hospital,” says Nancy Di Grande, a community paramedic with Ambulance Tasmania.  

“Our role is to ensure that patients who don’t need urgent care are treated in the community, improving outcomes for both the patient and the broader healthcare system.” 

Community paramedic role also means more flexibility, and this allows for a more tailored approach to patient care and better resource management says Nancy.  

“We are able to self-dispatch to certain jobs by reviewing the call board and identify cases where our intervention might be more appropriate than a standard ambulance response, unlike a paramedic on a vehicle” she says. 

Community paramedics act as an important link between patients and GPs, especially when patients cannot secure timely appointments.  

Although the system is still evolving, the goal is to establish a more formalised process for information sharing between paramedics and GPs, Nancy says.  

“At the moment, we write down our findings on a piece of paper, and the patient takes them to their GP,” explains Nancy.  

“However, we now have access to the eReferral system and Ambulance Tasmania is exploring other information sharing technology that we can access, to ensure that our interactions with patients are communicated directly and efficiently to their primary health care team, to improve continuity of care.” 

Nancy also emphasises that the role of community paramedics is not to replace GPs but to support them by helping patients who might otherwise fall through the cracks.  

“We’re not here to step on anyone’s toes,” she says.  

“We’re trying to fill the gaps—these patients are calling 000 anyway, and we’re here to help them navigate the health system, including getting them connected to GPs or hospital-at-home services.” 

“Our organisation partners with key stakeholders to develop Infield Referral Pathways that provide patients with the right care, in the right place at the right time.  

The community paramedic program also works closely with hospital-at-home and Care@Home iniaitives, referring patients who need more extensive in-home care, as a hospital avoidance strategy.  

“We’ve built strong relationships with hospital-at-home,” Nancy says.  

“For complex cases like chronic wound care which often require a course of intravenous antibiotics, we refer patients and coordinate their care to ensure they get the help they need without going to the hospital.” 

The introduction of community paramedics in Tasmania is to address some of the current shortfalls in the healthcare system, says Nancy.  

With GPs under increasing pressure and many patients struggling to access timely care, community paramedics play a key role in reducing strain on both emergency services and primary care providers.  

By managing minor cases in the community and offering health literacy support, they help patients better understand and navigate the healthcare system, says Nancy. 

“For some patients, it’s about health literacy,” Nancy explains. “They don’t always know what services are available or how to access them.  

“A lot of the time, we’re helping them navigate the system—whether it’s finding a GP or connecting them with hospital-at-home or social supports. Sometimes its the patient’s carer that requires our support.” 

The scope of practice for community paramedics is continuing to expand.  

There are plans to enable community paramedics to act as a direct referral service from GPs and hospital-at-home programs and emergency departments, further integrating them into the broader healthcare system. 

For paramedics like Nancy, the community paramedic role offers a different career pathway outside of traditional emergency services.  

With paramedic graduate positions often limited, the community paramedic model provides an alternative for paramedics seeking to move away from shift work and emergency response, while still using their skills to benefit the community. 

“When I finished uni, there were more paramedic students than there were graduate positions in ambulance services,” Nancy says.  

“Having more options outside of emergency work gives paramedics the chance to continue in health care, even if they don’t want to keep doing emergency response.” 

“Community paramedicine allows paramedics to build stronger relationships with their patients, take a more holistic approach to care, and spend more time addressing the underlying health and biopsychosocial needs of people in the community” says Dr Angela Martin PhD, Manager Clinical Practice, Integrated Care, Ambulance Tasmania. 

For Nancy, the most rewarding part of her role is the time she gets to spend with patients and the problem-solving involved in managing chronic conditions and coordinating care. 

“My favourite thing about being a community paramedic is that I actually get to spend more time with patients,” Nancy says.  

“I’m not rushed out of the house like I was in emergency care.  

“I get to know the patient, understand the bigger picture of their health, and figure out what they really need—whether it’s long-term services at home or help navigating the system.” 

Nancy also values the opportunity to follow up with patients.  

“If we’ve treated someone, we can call them back in a few days to see how they’re doing, or even visit them again.  

“That’s something I never had time for in emergency work, and it makes a real difference in patient care.” 

This story features in Issue 19 of our Primary Health Matters magazine. Click here to read the rest of the issue.