Australian Paramedics Association (NSW)

Our Position on MHCRT

1. WHY DO WE OPPOSE THE MHCRT PROGRAM AND WHAT ARE WE FIGHTING FOR?

Reasons for opposition to MHCRT

With SOT rosters barely able to be filled resources are already stretched thin.

SOTs are specifically trained for high-risk operations, including vertical access, overnight wilderness operations, CBRN and Hazmat operations, police tactical support, and active-armed offender scenarios. Diverting them to mental health cases risks leaving communities and paramedics alike without critical coverage during life-threatening emergencies.

Our patients experiencing mental health crises deserve to be more than an afterthought. They deserve a permanent expansion of the MHAAT model and better access to community mental healthcare across the State.

NSW Ambulance is proceeding with the program despite strong opposition from frontline paramedics and ongoing evidence in the Bondi Junction Coronial Inquest highlighting gaps in specialist response capability.

What we are fighting for:

A safe workplace for healthcare workers and the right care at the right time for our patients
Genuine investment in community mental healthcare, not half-baked plans
SOT resourcing commensurate with the needs of the community
A valuation of all Paramedics for the work they do, and skills they bring to the role

Where can I find more information

APA (NSW) put together a factsheet linked in the February member update relating to the program (now called MHCRT rather than MHAAT). We will keep members updated on developments.

2. HOW DOES THE BONDI JUNCTION CORONIAL INQUEST RELATE TO THE MHCRT?

Evidence provided to the Bondi Junction Coronial demonstrates the importance of having a well-resourced Special Operations Unit. Paramedics were put in an impossible position, do they enter a potentially dangerous scene to save the lives of their patients, or do they remain outside for their own safety and delay life-saving care. The decision that was made by Paramedics that day was to put the safety of their patients first. They entered a hot zone without the necessary training or equipment and in doing so saved lives. But Paramedics should never be put in this position, it’s why we train and equip Special Operations Paramedics.

Duties, Procedures and Training

3. I HAVE BEEN ROSTERED TO WORK ON THE MHCRT BUT I DON’T KNOW HOW TO UNDERTAKE THIS ROLE

We have received advice from SOT members rostered to work on the MHCRT that they have not been provided any guidance or instructions on day-to-day functions or operations of the MHCRT, including:

Whether SOT Paramedics are supposed to take the CNCs on:
1. SOT jobs with them
2. On non-mental health jobs with them
If on non-mental health jobs, what the CNCs are permitted / able to do to assist
How to address concerns of patients or their families arising out of a Nurse being on scene not assisting (due to being unable)
What (if any) manual handling tasks the CNCs are permitted to engage in

This is despite NSWA advising APA (NSW) that training, documents and guidance on these issues had been provided.

IF YOU ARE A SOT PARAMEDIC AND HAVE NOT BEEN PROVIDED THE TRAINING OUTLINED BELOW:

You should contact your managers, Mr Edgar and Mr Stevens to request this information.
Please let APA know ASAP (and if possible before you commence a shift on the MHCRT) by contacting Brett Simpson.

4. WHAT TRAINING WILL BE PROVIDED BEFORE I WORK ON THE MHCRT CAR?

Health representatives have advised that SOT Paramedics will undergo an onboarding which will cover:

Topic	Duration	Delivered by
Welcome and introductions	30 minutes	MHCRT project team
Introduction to MHCRT (logistics, Model of Care, Role Expectations, working with a MH clinician, MHCRT Patient Cohort, Clinical Escalation and Governance	90 minutes	MHCRT Project team, Senior Program Manager Mental Health, MHAAT Clinician
Mental health review (optional)	60 minutes	Clinical Lead, Mental Health

On Monday, NSW Ambulance provided evidence to the IRC that six SOTs were provided 90 minutes of this training occurring on Wednesday 7 May. APA (NSW) is aware of a 'SOT Orientation' that occurred at 10am on Wednesday. We have received advice from SOT Paramedics who participated that this orientation ran for 20 minutes.

5. I AM A SOT BEING TASKED TO WORK ON THE MHCRT BUT I HAVE NOT RECEIVED THE TRAINING OUTLINED IN THE TABLE AT QUESTION 4, WHAT SHOULD I DO?

The provision of training was included as a control in the risk assessment produced by NSW Ambulance for this program. If you have not been provided training but have been asked to work on the MHCRT program you should request in writing that this training be provided. If this request is declined, please notify APA (NSW) President Brett Simpson.

If NSW Ambulance declines this request, please get in touch.

6. WHAT TRAINING WILL THE CNC RECEIVE?

Health representatives have advised that CNCs will undergo a two-day onboarding where NSW Ambulance and WSLHD will each deliver one day. The NSW Ambulance-run session will cover:

Topic	Duration	Delivered by
Welcome and introductions	30 minutes	MHCRT project team
Introduction to MHCRT (logistics, Model of Care, Role Expectations, MHCRT Patient Cohort, Clinical Escelation, Scope of Practice, Governance)	90 minutes	MHCRT project team, Senior Program Manager Mental Health, MHAAT Clinician
Working in the out-of-hospital environment 1 (Introduction to NSW Ambulance’s clinical operations, Introduction to SOT, Communications)	120 minutes	Special Operations Unit educator
Working in the out-of-hospital environment 2 (Procedures in the event of SOT responses, Procedures in the event of Cat 1 and 2 responses, Dynamic risk assessment, scene awareness, and occupational violence prevention)	150 minutes	Special Operations Unit educator, Safety team member

SOT resourcing

7. WILL THIS NEW PROGRAM IMPACT THE AVAILABILITY OF SOT RESOURCES?

The MHCRT will utilise SOT Paramedics who are rostered on afternoon shift. This will reduce SOT availability, which is already significantly below the expected levels.

8. WILL SOT RESOURCES BE INCREASED TO ACCOUNT FOR THE ADDITIONAL WORKLOAD?

There will be no additional SOT resources nor are existing SOT rosters filled.

9. ARE THERE ENOUGH SOT RESOURCES AVAILABLE TO SUPPORT THIS PROGRAM?

APA’s position is that there are not, this is one of the reasons APA opposes the program.

Current SOT rosters (22/3/25 – 30/5/25) are filled to less than 50%. The MHCRT uses SOT Paramedics from existing rosters further depleting resourcing.

The APA’s position is that this program further strains chronically under-filled SOT rosters which creates risks to the safety of both SOT and ordinary Paramedics.

MHCRT Actions

On 12 May 2025, the Commission made orders that the bans communicated to members on 6 May 2025 must cease. We are therefore directing members to cease bans detailed in the Member Update sent to members on this date.

WHEN IS THE ACTION?

The action has been lifted due orders made by the Commission on 12 May 2025.

WHAT ARE THE ACTIONS?

The action has been lifted due orders made by the Commission on 12 May 2025.

General Industrial Action FAQs

1. HOW WILL APA (NSW) SUPPORT ME IN TAKING ACTION?

When there is directed industrial action, NSWA and APA (NSW) have a longstanding agreement that all matters relating to the action be raised with the union, not with the individuals. If you are spoken to by a manager, contact us on 0432 415 303.

2. A MANAGER HAS ASKED ME WHAT UNION I AM A MEMBER OF, WHAT ARE MY RIGHTS?

Your union affiliation is personal information that you are not required to disclose. Managers are not allowed to harass you to disclose your union membership. Discriminatory treatment because of union membership is unlawful.

If you are taking part in the Industrial Action, you should sign on at the start of your shift and say over the radio that you are taking part in the relevant APA (NSW) industrial actions. This shows the collective strength of the action we are taking, and allows NSWA to ensure adequate community coverage.

Importantly, however, you do not have to say which union you are a member of.

If you believe you are being treated unfairly or pressured due to your union membership, your refusal to provide your union affiliation, or because you are taking part in Industrial Action, please contact your local delegate or call APA (NSW) with urgent concerns on 0432 415 303.

3. MY MANAGER IS STATING THAT I AM REFUSING DUTY/STATING I MAY GET DISCIPLINARY ACTION AGAINST ME - WHAT SHOULD I DO?

There is a long-standing agreement between the unions and NSW Ambulance that if there are any issues with industrial action, they are raised with the union, not with individuals. There is no such thing as 'authorised' or 'legal' industrial action in NSW. There is no approval process to get industrial action endorsed by the Industrial Relations Commission. All industrial action therefore comes with some risk to members. We will always be honest with our members about that. If a manager does raise any issues with you, call 0432 415 303 immediately. Any time this has happened in the past it has been resolved immediately.

4. I’M BEING CALLED ON MY PERSONAL MOBILE BY NSW AMBULANCE, WHAT SHOULD I DO?

NSW Ambulance managers and NSWA Control should not contact you on your personal mobile for conversations about industrial action or staff movements. All of this contact should occur over the radio.

If you receive a call on your personal phone, politely say “Sorry, I’m not going to speak to you on my personal phone. If you’d like to speak to me, you can do so over the radio.” Do not continue the conversation past this point.

If you are in this situation, contact your local delegate or if you have urgent concerns call APA (NSW) at 0432 415 303.

5. I'M A PART TIMER OR A CASUAL - DOES THAT CHANGE ANYTHING?

No - you should participate in the actions as detailed above.

6. MY PARTNER IS AN HSU MEMBER, WHAT DO I DO?

If applicable, discuss at the commencement of your shift what industrial action you are/are not going to take together
Contact your local delegate or APA (NSW) if you’re confused on 0432 415 303.

Help - I need advice about action

I need clarity about our industrial action, who should I contact?

Call your local delegate or our industrial action hotline on 0432 415 303, or email admin@apansw.com.au.

Current Action

MHCRT Program