This notice is issued by the Paramedic Council | Te Kaunihera Manapou (“Te Kaunihera”) pursuant to sections 11 and 12 of the Health Practitioners Competence Assurance Act 2003 (“HPCA Act”) and comes into effect on the date of publication.

Paramedic Scope of Practice

Under section 11 of the HPCA Act, Te Kaunihera has specified the scope of practice for Paramedics as follows:

1. Paramedics are registered health practitioners who use their clinical knowledge, skills, and judgement to provide healthcare services primarily in the provision of urgent and/or emergency assessment, diagnosis and treatment of patients, including provision of clinical advice, referral and, where required, transport. All patient care is, ethically, safely and effectively carried out in accordance with Aotearoa New Zealand law, the principles of Te Tiriti ō Waitangi, Kaunihera standards of clinical competence and cultural competence (including competencies that will enable effective and respectful interactions with Māori), clinical guidelines, documented protocols, and standing orders issued by the employer/organisation’s clinical governance framework. Paramedics liaise and cooperate with other healthcare providers and clinical personnel to foster a team approach, provide leadership, provide supervision, support and oversight of non-regulated members of the clinical team, and ensure services are provided in a timely and integrated fashion in partnership with individuals, families, whānau and communities.
2. Paramedics may also perform a variety of functions including policy development, leadership, management, research, training and education, and public liaison and communication roles.
3. Paramedics are individually accountable for ensuring all health services they provide are consistent with their education and skill level, meet legislative requirements and are supported by appropriate standards.

Specialist Paramedic Practice Endorsements

Paramedics with additional qualifications and/or experience may apply for a Specialist Paramedic Practice endorsement on their paramedic scope of practice to recognise an extended area of practice. Only paramedics who hold the relevant Specialist Paramedic Practice Endorsement can use these specialist titles. The Specialist Paramedic Practice endorsements that may be applied to the paramedic scope of practice, at Te Kaunihera’s complete discretion, are:

1. Critical Care Paramedic

A Critical Care Paramedic is a registered paramedic with an expanded scope of paramedic practice specialising in the care of the critically ill or the critically injured. A Critical Care Paramedic has advanced knowledge and skills beyond that of a paramedic, with a focus on patients with high acuity and often life-threatening clinical conditions. This includes providing advanced airway management and medications and interventions, including (where necessary) invasive procedures below the gingival margin or the surface of the skin, mucous membranes or teeth, including during interfacility transfer. A Critical Care Paramedic may practise autonomously or collaboratively with other health professionals in various clinical settings.

2. Extended Care Paramedic

An Extended Care Paramedic is a registered paramedic with an expanded scope of paramedic practice specialising in primary and preventive care in the community. An Extended Care Paramedic has advanced knowledge and skills beyond that of a paramedic, with a focus on patients with low acuity and often high-complexity clinical conditions. This includes providing advanced medications and interventions, including (where necessary) invasive procedures below the gingival margin or the surface of the skin, mucous membranes or teeth. An Extended Care Paramedic practises with an emphasis on positively impacting health disparities and helping patients/family/whānau navigate the healthcare system and may practise autonomously or collaboratively with other health professionals in various clinical settings.

3. Intensive Care Paramedic

This will be a closed endorsement, and applications for this endorsement will close 18 months after the date of the execution of this notice.

An Intensive Care Paramedic is a registered paramedic with an expanded scope of paramedic practice specialising in the care of the critically ill or the critically injured. An Intensive Care Paramedic has advanced knowledge and skills beyond that of a paramedic, with a focus on patients with high acuity and often life-threatening clinical conditions. This includes providing advanced airway management and medications and interventions, including (where necessary) invasive procedures below the gingival margin or the surface of the skin, mucous membranes or teeth, including during interfacility transfer. An intensive care paramedic may practise autonomously or collaboratively with other health professionals in various clinical settings. An Intensive Care Paramedic cannot provide drug assisted intubation also known as Rapid Sequence Intubation (RSI).

Prescribed Qualifications for Registration in the Paramedic Scope of Practice

Under section 12 of the HPCA Act Te Kaunihera has prescribed the following qualifications for registration in the Paramedic scope of practice:

Aotearoa | New Zealand qualified:

1. In accordance with section 12(2)(a) of the HPCA Act, a Bachelor of Health Science majoring in Paramedicine, conferred by an educational institution accredited by Te Kaunihera.

All applicants for registration as a Paramedic are also required to successfully complete a cultural safety education course set by an organisation approved by Te Kaunihera under section 12(2)(b).

Prescribed qualifications for Registration in a Specialist Practice Paramedic Endorsement

Under section 12 of the HPCA Act, Te Kaunihera has prescribed the following qualifications for registration in the Paramedic scope of practice with a specialist paramedic practice endorsement:

Pathway 1: Auckland University of Technology Qualification – Extended Care Paramedic and/or Critical Care Paramedic

Paramedics who are registered in Aotearoa New Zealand under the general paramedic scope of practice and who have completed an approved qualification can apply for a specialist paramedic practice endorsement as a Critical Care and/or Extended Care Paramedic with one or more of the following qualifications from Te Wānanga Aronui o Tāmaki Makau Rau | Auckland University of Technology:

1. Postgraduate Diploma in Health Science in Paramedicine – Extended Care Paramedicine (for Extended Care Paramedic endorsement);
2. Postgraduate Diploma in Health Science in Paramedicine – Critical Care Paramedicine (for Critical Care Paramedic endorsement);
3. Master of Health Practice in Paramedicine (MHPrac) with a transcript providing evidence of completion of the same papers required for the Postgraduate Diploma in Health Science in Paramedicine – Critical Care Paramedicine (for Critical Care Paramedic endorsement) or Postgraduate Diploma in Health Science in Paramedicine – Extended Care Paramedicine (for Extended Care Paramedic endorsement);
4. Master of Health Science (MHSc) with a transcript providing evidence of completion of the same papers required for the Postgraduate Diploma in Health Science in Paramedicine – Critical Care Paramedicine (for Critical Care Paramedic endorsement) or Postgraduate Diploma in Health Science in Paramedicine – Extended Care Paramedicine (for Extended Care Paramedic endorsement).

Pathway 2: Grandparenting pathway Extended Care Paramedic and/or Critical Care Paramedic

This pathway to obtain a specialist paramedic practice endorsement as an Extended Care Paramedic or Critical Care Paramedic will only be open for 18 months from the date this Notice is executed.

Paramedics registered in the general paramedic scope of practice who have not completed an approved qualification, but have current practise experience in Aotearoa New Zealand as a Critical Care and/or Extended Care paramedic, and/or have other qualifications and can demonstrate training and experience relevant to a Critical Care and/or Extended Care endorsement may apply for a specialist endorsement under this pathway. The grandparenting pathway requires the following:

1. The provision of a portfolio containing the following evidence:
1. a current authority to practise as an Extended Care Paramedic and/or Critical Care Paramedic, and/or evidence of their current role and skills performed including any standing orders; and
2. support letters, particularly from current employer(s), confirming the period of time the Paramedic has practised as an Extended Care Paramedic and/or Critical Care Paramedic and that they have been assessed by a provider organisation (by way of an authority to practise process or similar assessment process) at an Extended Care Paramedic and/or Critical Care Paramedic practice level; and
3. CV outlining relevant specialist qualifications, employment, knowledge, and experience; and
4. any other relevant evidence relating to their practice as an Extended Care Paramedic and/or Critical Care Paramedic; and
2. If, following an assessment of the portfolio, Te Kaunihera is not satisfied that there is sufficient evidence that the paramedic is competent to receive a Specialist Paramedic Practice endorsement, Te Kaunihera may require the applicant to successfully complete an Extended Care Paramedic and/or Critical Care Paramedic clinical assessment day through Auckland University of Technology or another provider approved by Te Kaunihera before considering the application further.

Pathway 3: Grandparenting pathway Intensive Care Paramedic

This pathway to obtain a specialist paramedic practice endorsement as an Intensive Care Paramedic will only be open for 18 months from the date this notice is executed.

Paramedics registered in the general paramedic scope of practice who have not completed an approved qualification, but have current practise experience in Aotearoa New Zealand as an Intensive Care Paramedic, and/or have other qualifications and can demonstrate training and experience relevant to an Intensive Care Paramedic endorsement may apply for a specialist endorsement under this pathway.

The grandparenting pathway requires one or both of the following qualifications:

1. Postgraduate Certificate in Health Science in Resuscitation from the Auckland University of Technology; and/or
2. Postgraduate Certificate in Specialty Care (Advanced Paramedic Practice) from Whitireia;

or

1. The provision of a portfolio containing the following evidence:
1. a current authority to practise as an Intensive Care Paramedic, and/or evidence of their current role and skills performed including any standing orders; and
2. support letters, particularly from current employer(s), confirming the period of time the Paramedic has practised as an Intensive Care Paramedic and that they have been assessed by a provider organisation (by way of an authority to practise process or similar assessment process) at an Intensive Care Paramedic practice level; and
3. CV outlining relevant specialist qualifications, employment, knowledge, and experience; and
4. any other relevant evidence relating to practice as an Intensive Care Paramedic; and
2. If, following an assessment of the portfolio, Te Kaunihera is not satisfied that there is sufficient evidence that the paramedic is competent to receive a Specialist Paramedic Practice endorsement, Te Kaunihera may require the applicant to successfully complete an Intensive Care Paramedic clinical assessment day through Auckland University of Technology or another provider approved by Te Kaunihera before considering the application further.

Applications for the closed Intensive Care Paramedic endorsement and the grandparenting pathway for prescribed qualifications for an endorsement as a specialist practice paramedic close 18 months from the date of the execution of this notice.

Dated at Wellington this 17th day of Āperira | April 2025.

JACQUELYN MANLEY, Registrar, Te Kaunihera Manapou | Paramedic Council.