Ministry of Health Announcements on Scope of Practice changes

December 3, 2021

Dear Members,

Re:  Ministry of Health Announcements on Scope of Practice changes

Today we saw a significant announcement by the Minister of Heath concerning the increased scope of practice for first responders and paramedics covered by the EMALB (view here). 

Following the tragedy of the heat-dome this summer, we have been working closely with the Ministry of Health, BCEHS and numerous stakeholders to strengthen the Paramedic service in BC and provide reliable, timely and quality care to British Columbians.

We acknowledge the Ministry of Health has made significant investments into Paramedic and dispatch services.  The addition of resources, a new governance model and a commitment to addressing systemic challenges within the Paramedic service have been critical steps forward in ensuring British Columbians have access to a high-performance Paramedic system that responds in a timely manner when they call 911.

In addition to commitments to reinforce the Paramedic service in response to the well-documented, staffing, workload and wellness issues, the heat dome and other significant emergencies we continue to face, Minister Dix directed the EMALB to examine first responders’ scope of practice.  The EMALB undertook this direction in consultation with stakeholders, and the Minister announced the long-awaited results today. Please see the Scope of Practice changes here.

The Provincial Executive Committee has been working on a comprehensive review of the changes announced today (which included modifications to all licence levels, not just first responders), including the impact to our members and our patients.  We have already expressed our concerns to the Minister that this announcement omits the necessary operational, administrative and governance infrastructure to implement the approved changes. With increased scope and responsibilities comes increased accountability and as such consistency, transparency, medical oversight, accredited training, licensure, continuing competency for all licence levels and the continuity of patient care (to name but a few considerations) should reside at the forefront of such critical decisions.  It is important to note, that throughout the consultation process, we advocated for evidenced-based clinical changes to practice that will not only improve patient care, but positively affect patient outcomes (view here).  At the end of the day, British Columbians deserve a timely response from paramedics, the definitive experts in prehospital care.

We are aware of the membership’s concerns regarding scope creep amongst the licence levels, particularly with first responder agencies.  We understand the frustration of members.  We know that during these trying times (that pre-date the heat dome tragedy), our members continually rise to the challenge, overcome obstacles and have prioritised patient care above all else. We recognize that these scope changes do not address many of the immediate and very tangible concerns and experiences of our members looking for relief in a crisis.

In addition to the scope changes the Minister announced several new measures in support of the initial announcement in July 2021 (background, news release, actions) they include:

  • To better support paramedics, dispatchers, and call-takers, the BCEHS and the Ambulance Paramedics and Dispatchers of BC (CUPE 873) have worked closely together on an immediate and a long-term plan to increase appropriate mental health supports and resources due to the nature of their work.
  • We need to help our emergency responders, who we all rely on when we need help most. We know our emergency service providers will come face to face with challenging situations, and we need to be there to support them through that. That is why in July, I gave direction to the BCEHS to provide dispatch staff and paramedics with the mental health and wellness support they need. I thank the BCEHS and the Ambulance Paramedics and Dispatchers of BC (CUPE 873) for working on immediate actions and on a long-term plan to best support them, Dix said. Immediate actions to support the wellness of B.C.????s front-line staff include:
  1. increasing clinical supports and resources through the critical incident stress management program to better support and help front-line staff and their families navigate resources available to them and to make it easier to access important mental health services in a timely manner;
  2. adding resources for all BCEHS staff and their families to the network of trauma informed and occupationally competent counsellors who provide psychological care; and
  3. creating a BCEHS and Ambulance Paramedics and Dispatchers of BC (CUPE 873) joint committee to implement collaborative recommendations on a comprehensive, short-, medium- and long-term psychological health and safety strategy.
  • In addition, as announced in July 2021, BCEHS will conduct a joint workload review, with the Ambulance Paramedics and Dispatchers of BC (CUPE 873), to better understand and address optimal resource and workload levels, to support greater patient care and the wellness of the front-line staff who provide that crucial care.
  • BCEHS has been working to strengthen its dedicated emergency preparedness capacity, to ensure proactive, ongoing and effective response and planning for major incidents and natural disasters going forward.

To support emergency management and preparedness BCEHS will be immediately establishing, with the Ambulance Paramedics and Dispatchers of BC (CUPE 873), an emergency management and planning review to better understand and address optimal special operations, public safety and emergency management and response by BCEHS.

While we have had already begun discussions on many of these items, further engagement is required to understand what exactly these commitments mean and how they will meaningfully make a difference to paramedics, dispatchers, the service we deliver and our patients.

We will continue to focus our efforts on matters that will ensure British Columbians receive the best possible care in an emergency.  We need to focus on dispatching paramedics, providing alternatives to 911 where appropriate and providing a well-staffed, high-performance Paramedic service throughout British Columbia. The solution remains more highly trained paramedics and dispatchers capable of responding quickly and transporting patients in a timely manner. 

Today’s announcement demonstrates the need to be resiled and regroup and to keep up the pressure. The new additions to our scope can be built upon and the work is not done.  We have been through many challenges and our resilience and professionalism has always guided and served us well. We will always put our members, our profession, our service, and patients first.

On behalf of the Executive Board, I commit we are working diligently to understand these changes and to fight for our service and each of you.


Troy Clifford
Provincial President
Ambulance Paramedics of BC
CUPE Local 873

Click HERE to view a PDF version