Code Chronicles  |  Paramedic Shop  |  May 2026

Out of the Ambulance, Into the Clinic

How paramedics are moving into Australia's urgent care system, what has changed in the past twelve months, and why the 2026–27 Federal Budget may be the clearest signal yet that the profession's place in primary care is no longer a theory.

For years, the image of an ambulance parked in a hospital corridor has been one of the most recognisable signs of a health system under strain. Ramping, the practice of holding patients in ambulances outside emergency departments because there are no available beds, became a fixture of Australian healthcare news in the early 2020s and has not gone away. But the pressure does not stop at the hospital door. Emergency departments are crowded with presentations that are genuine in their urgency but do not require emergency level care. GP wait times in many parts of the country stretch into days. And ambulance services, designed and funded around life threatening emergencies, find themselves fielding calls for chronic condition management, minor injuries, and non-emergency needs that should, in a well functioning system, have been handled somewhere else entirely.

Something is starting to shift. And paramedics are at the centre of it.

A Budget That Changes the Conversation

The 2026–27 Federal Budget, handed down on 13 May, committed $1.8 billion to make Australia's network of Medicare Urgent Care Clinics a permanent feature of the health system. The network has grown to 137 clinics across the country. By July 2026, four in five Australians will live within a 20 minute drive of one. Close to three million free visits have already been delivered — no appointment, no gap fee, just a Medicare card.

The Australasian College of Paramedicine (ACP) welcomed the investment. But for the paramedic profession, the more significant story is not the size of the network or the dollar figure. It is what is happening inside those clinics, and what has quietly changed in the twelve months leading up to this budget.

The Policy Win That Mattered Most

In July 2025, after more than a year of sustained advocacy from the ACP, the Australian Government's Department of Health, Disability and Ageing amended the operational guidance governing Medicare Urgent Care Clinics to formally recognise paramedics as part of the minimum staffing model. It was a change years in the making.

The updated guidance lists paramedics alongside GPs, registered nurses, and nurse practitioners as clinicians who can constitute part of the minimum staffing team, provided they hold relevant training and skills in urgent care and emergency medicine. Before the amendment, paramedics working in or seeking roles in UCCs operated without explicit recognition in the program's staffing framework. That ambiguity was a real barrier for employers and for paramedics trying to build a practice outside the ambulance service.

Bruning described the amendment as affirming the valuable role paramedics play in urgent care settings beyond ambulance services. The ACP had been engaging with the Department constructively for well over a year before the change was made, and the College viewed the outcome as a direct reflection of that sustained advocacy effort.

From Policy to Practice: What the Pilots Show

While policy debates ground on, some services were not waiting. In October 2024, paramedic Joseph Wood took up a full-time position at Bankstown Medicare Urgent Care Clinic in south west Sydney, joining the clinic team as part of a collaborative initiative between the ACP, South West Sydney Primary Health Network, and COORDINARE. It was one of the first appointments of its kind in the country, and it attracted attention precisely because it was still uncommon enough to be newsworthy.

By December 2025, the model had expanded. A collaboration between the ACP, COORDINARE (the South Eastern NSW Primary Health Network), South West Sydney Primary Health Network, and ForHealth Group had embedded paramedics in five of south-east NSW's seven Medicare Urgent Care Clinics. Paramedic Meagan Dawson, who spent nine years working with NSW and Queensland ambulance services before making the move to the Dapto clinic, put the clinical argument plainly. "I think the benefit of having us here is we are able to identify patients who are very unwell or rapidly deteriorating quite quickly and redirect them for more appropriate care."

COORDINARE's Acting CEO Juanita Murphy framed the pilot as a workforce response to record demand. Innovative staffing models, she said, had become essential to maintaining high-quality care as the healthcare system faced unprecedented pressure. The clinics needed people who could manage complexity quickly, and paramedics trained specifically in rapid assessment of acute and urgent presentations were well placed to do exactly that.

What the Research Says

The evidence base for paramedics in primary and urgent care has been building for some time. A landmark 2020 systematic review led by Georgette Eaton and colleagues at Oxford University's Nuffield Department of Primary Care Health Sciences, published in the British Journal of General Practice, found that paramedics were already working across a range of clinical roles in primary and urgent care settings, and that the profession held clear potential to address mounting workforce shortages in these areas. The review identified paramedic-led consultations as safe and effective for a wide range of non-emergency presentations, and noted patient satisfaction comparable to GP led care for the same types of conditions.

A more recent 2025 study published in BMC Health Services Research examined stakeholder views on Paramedic Practitioner models in Australian ambulance services and found broad support from consumers, policymakers, and health professionals for expanding the paramedic scope of practice into primary and urgent care. Led by Wilkinson-Stokes and colleagues, the research drew on 56 participants including government executives, industry leaders, members of parliament, and consumers. The consistent theme was recognition that ambulance services were managing a growing volume of presentations that were better suited to primary and urgent care models, and that paramedics with appropriate advanced training were an obvious part of the solution.

The numbers behind the problem are striking. Australian Institute of Health and Welfare data showed that in 2020-21, more than 3.2 million emergency department presentations, representing 36.7 per cent of all ED presentations, involved patients who were neither admitted nor referred after being assessed. These were people who sought care in the wrong part of the system, at a cost to that system of approximately $2.78 billion per year. Redirecting even a portion of those presentations to community-based urgent care staffed in part by paramedics represents a substantial saving, and arguably a better experience for patients who should not have been in an emergency department at all.

The Structural Problem That Remains

Progress is real, but the structural barriers that have limited the integration of paramedics into primary care have not been resolved. Australia's health funding model creates a tension that sits at the heart of the challenge. Emergency ambulance services are funded by state and territory governments. Primary care, including Medicare funded services, is a Commonwealth responsibility. A paramedic working in a community or urgent care setting falls directly into the gap between those two funding streams, and neither system was designed with that arrangement in mind.

The ACP's position statement on paramedics in primary and urgent care describes this as a blind spot between state and federal governments. The fee-for-service model that underpins most of Australia's primary care system does not promote team-based care in GP or clinic settings, and it creates practical barriers for paramedics seeking to contribute in those environments. Employers who want to hire a paramedic for a UCC role can now point to the amended operational guidance as authority for doing so. What they still cannot do, in most cases, is access Commonwealth funding to support that employment in the same way they could for a GP or a nurse practitioner.

The 2024 Scope of Practice Review, commissioned by the Department of Health and Aged Care, acknowledged this problem explicitly. Its final report identified paramedics among the key health workforces with the potential to work at the top of their scope of practice, and called for flexible funding that supports multidisciplinary team-based models. The 2026–27 Budget does not resolve the funding model gap directly. But making the UCC network permanent and committing almost $2 billion to sustain it changes the calculus. These clinics are no longer a pilot or a political gesture. They are part of the architecture of Australian primary care. And that makes the question of who staffs them a more urgent policy question than it was before Tuesday.

What It Means for Working Paramedics

For paramedics thinking about their own careers, the current landscape is a mixture of genuine opportunity and remaining uncertainty. The amended UCC operational guidance gives employers clear authority to hire paramedics into those settings. The NSW pilot is generating ground level evidence on what the role looks like in practice. And the permanency of the UCC network signals that these are not temporary positions that will disappear with a change of government.

What remains unresolved is the broader workforce and funding framework that would allow the model to scale. The ACP continues to advocate for access to workforce incentive programs, including relocation, training, and rural and remote packages, for paramedics seeking to fill gaps in communities that desperately need them. The profession has made the case to the Commonwealth for years. The 2024 budget called the situation "a bitter pill." The 2025 budget barely mentioned paramedics at all. The 2026–27 budget has not delivered the full reforms the ACP has called for, but the investment in the UCC network, combined with the recognition milestone in the operational guidance, creates a platform that was not there two years ago.

The paramedics already working in UCCs in south east NSW are, in one sense, the proof of concept. They are demonstrating what it looks like when a registered, degree-qualified health professional with a background in rapid assessment and acute care works alongside GPs, nurses, and allied health in a community clinic setting. The evidence from those placements will matter. Policy tends to follow proof, and the proof is accumulating.

The ambulance is no longer the only address.