The Act of April 24, 2025, amending the State Emergency Medical Services Act entered into force in May 2025. The new regulations formalize three-person emergency medical services (EMS) teams, introduce motorcycle rescue units, and change the rules for system planning at the provincial level. For operators ordering ambulances in 2025 and 2026, one aspect is the most important — the composition of the team, which directly changes the requirements for the interior configuration of the vehicle.
When the New Regulations Enter into Force
The Act is being implemented in stages. Operators need to know which regulations are already in force and which require preparation over a longer horizon.
| Deadline | Scope of Changes |
| May 2025 (14 days from publication) | New types and compositions of EMS teams, MRUs, dispatch centers, financial allowances, expanded definition of first aid |
| August 16, 2025 | Courses and training in qualified first aid (QFA) |
| January 1, 2026 | Art. 26e — obligation to provide EMS team members with access to psychological support |
The changes from May 2025 are in force and have both operational and financial consequences. The regulations entering into force on January 1, 2026, do not apply to equipment — but they generate new organizational and budgetary obligations for the providers, which are worth planning in advance.
New Types and Compositions of Emergency Medical Services Teams
Formal Recognition of Three-Person EMS Teams
The amendment does not create something completely new — three-person teams have functioned in the system before. Until now, the law only specified a minimum team composition at the level of two people; it was the contract with the National Health Fund (NFZ) and the decision of the system organizer that determined whether the ordering party required three. Now, this distinction becomes formal and is written directly into provincial plans.
In the two-person variant, basic EMS teams (ZRM P) generally consist of a driver acting as a paramedic and one paramedic working in the patient compartment. In the three-person variant — a dedicated driver and two paramedics fully focused on the patient. The difference is not semantic. In an incident requiring simultaneous ventilation, chest compressions, and intravenous drug administration, a third person in the compartment changes the team’s capabilities in a way that no equipment can replace.
For specialist EMS teams (ZRM S), the composition is multi-person by definition — a system physician, a driver, and paramedics. The regulations on the formal division into two- and three-person teams apply primarily to basic EMS teams (ZRM P), where the discrepancies between provinces were the greatest.
| Type of EMS Team | EN 1789 | Composition in the Regulations | New Changes |
| T (transport) | Type A | Driver (QFA) + paramedic or QFA rescuer | No changes |
| P (basic) — 2-person | Type B | Driver-paramedic + 1 paramedic | Formal recognition of the composition |
| P (basic) — 3-person | Type B | Dedicated driver + 2 paramedics | Formal recognition of the composition |
| S (specialist) | Type C | Driver + system physician + paramedics | No changes |
(QFA — Qualified First Aid)
The number and distribution of individual types are specified in the provincial action plan for the EMS system. This means that within a single tender for a given province, ambulances adapted to different compositions may be required — two-person in some areas and three-person in others.
Motorcycle Rescue Units — A New Element of the System
The Act introduces a completely new type of unit — the motorcycle rescue unit (MRU). Rescuers on rescue motorcycles are intended to reach places an ambulance cannot reach in the required time — during mass gatherings, in traffic jams, or in hard-to-reach rural terrain.
The MRU is a rescue unit, not a transport unit. The rescuer arrives at the scene of the incident, assesses the patient’s condition, and performs rescue activities until the ambulance arrives — stabilization, airway clearance, defibrillation, bleeding control. They do not transport the patient. The ambulance remains the only vehicle that transports the patient, performs advanced procedures in the medical compartment, and has a full set of diagnostic and therapeutic equipment.
The MRU parameters specified in the regulations are precise:
- MRUs operate seasonally — from May 1 to September 30
- The unit’s working time cannot exceed 12 hours a day
- Planning standard: one MRU per 400,000 residents of the province
- Units are entered into the provincial EMS plan and contracted by branches of the National Health Fund (NFZ) separately from ambulance EMS teams
- An MRU may consist of two or three people
For ambulance providers, the MRU means one practical question — will the units planned in their operational area relieve the ambulances in specific scenarios? Yes, but only seasonally and in situations with limited access. The ambulance remains the core of the system.
What the Change in EMS Team Composition Means When Choosing a Vehicle
The formal distinction between two- and three-person compositions changes not only the content of the contract with the NFZ — it changes the parameters that become indispensable when purchasing an ambulance. The composition of the team is an input parameter of the vehicle’s specification, not its consequence. A mistake in this sequence means a vehicle that does not provide working conditions consistent with the ordered type of EMS team.
Workspace and Ergonomics in the Medical Compartment
EN 1789:2024 specifies the minimum interior dimensions to ensure the simultaneous work of at least two paramedics on a patient on a stretcher — this is the base standard. With a three-person basic EMS team (ZRM P), the third person must have simultaneous access to the patient without blocking the other two, which means requirements exceeding the minimum EN 1789 standards regarding the width of the workspace and the arrangement of medical cabinets.
This is where a practical difference between vehicle bases appears. The internal width of the cargo space of the Volkswagen Crafter is 1870 mm; the Mercedes-Benz Sprinter offers approximately 1787 mm in the same dimension. The difference of 83 mm seems marginal. In an ambulance where three paramedics must work simultaneously on both sides of the stretcher, this difference directly affects the arrangement of cabinets, the placement of seating for personnel, and the actual comfort of work in a sudden emergency. Neither of these vehicles is inherently better — the choice of the base should result from the planned team composition and the body configuration, not from purchasing habits.
Access to Systems and the Control Point
With a three-person composition, the arrangement of control systems has a direct impact on work efficiency. If a paramedic has to move through the compartment to adjust the lighting or check the oxygen installation, during an action with a critical patient, every such movement interferes with the work of the others. A solution where all systems are operated from a single control point eliminates this problem at the source. KG Special Performance has implemented this approach — access to oxygen monitoring and control of all systems from a single control point, and lighting remotely regulated from outside the vehicle — this is not a convenience, but an element of the team’s work ergonomics.
Organization of External Equipment Compartments
With a three-person EMS team, the organization of access to immobilization and patient handling equipment becomes particularly important. If a paramedic has to enter the medical compartment for immobilization equipment, they block the workspace of the other two people. A left-hand compartment accessible from the outside — with the possibility of removing each element separately, including oxygen cylinders — shortens preparation time and does not engage the space of the interior compartment. This is a standard that remains a convenience for a two-person composition; for a three-person one, it becomes an operational requirement.
Practical Table for Buyers
| EMS Team Composition | Ambulance Type | What to Check in the Specification |
| 2 people | Type B | Minimum dimensions EN 1789:2024, one-sided cabinet layout is permissible |
| 3 people | Type B | Interior width, bilateral access to the stretcher, non-blocking cabinets, one control point, lighting adjustable from the outside |
| Physician + 2 paramedics | Type C | Space for the physician to work at the patient’s head, installation of specialized equipment (ventilator, syringe pump), acoustic insulation from the cabin |
Organizational Changes — Dispatch Centers and System Planning
The amendment changes the rules for creating medical dispatch centers. In provinces with a population of over 3 million, a second dispatch center can be organized; over 4 million — a third. This is a response to the chronic overload of dispatch centers in the largest agglomerations, where the time to accept a call directly translates into the EMS team’s response time.
For EMS providers, however, the planning element may be more important. The number of teams and their distribution — both ambulance EMS teams and MRUs — are now formally defined in the provincial plan. In practice, this means that technical specifications in public tenders will indicate the required type of vehicle and team composition for a given operational area more precisely than before. A provider entering a tender for a three-person basic EMS team (ZRM P) should demonstrate that their vehicle meets the ergonomic requirements for this composition — which, with three people working simultaneously, usually means requirements that go beyond the EN 1789 minimum.
Working Conditions of Paramedics — Changes in 2025 and 2026
The Act grants, retroactively from July 1, 2023, the right to financial allowances for EMS team members practicing a medical profession: 45% of the base salary for each hour of work on Sundays and holidays, and 65% for night work. The entitlement covers paramedics and system nurses. During the proceedings in the Senate, an amendment also included EMS aviation pilots — despite the government’s negative stance, the Sejm adopted the amendment.
The retroactivity from July 1, 2023, is a financial obligation that providers must include in their current budget planning. The method and schedule for settling the arrears are an organizational matter for each provider, but the dues themselves are now legal claims, not a matter of voluntary payout. The amount to be compensated depends on the number of night and holiday hours worked throughout the entire covered period.
From January 1, 2026, the obligations of providers will expand by two new items. The first — providing psychological support for EMS team members (Art. 26e); this is a new budget line that most providers have not had in their plans so far. The second — training in self-defense and de-escalation techniques, not less frequently than once every five years, financed from public funds. Paramedics will also receive stab-proof vests. For providers planning budgets for 2026, these obligations are worth introducing into plans now — the date of entry into force is known and unpostponed.
Other Changes
The Act expands the definition of first aid: people without medical education can now administer medications to the injured person that the person has with them — e.g., during an epileptic seizure, anaphylactic shock, or hypoglycemia. Teachers and caregivers in educational institutions have obtained analogous rights regarding chronically ill children.
The required professional experience for candidates for a medical dispatcher has been shortened from three years to two.
The 2025 PRM amendment changes the composition of EMS teams from optional to regulated, introduces MRUs as a seasonal element of the system, and shifts the burden of planning to the level of the provincial plan. For providers planning to purchase a vehicle, there is one consequence — the team composition determines the specification, not the other way around. The public budget for implementation is PLN 187 million in 2025 and PLN 382 million in 2026.
FAQ
The regulations do not mandate the replacement of vehicles. However, if an operator transitions from a two-person to a three-person basic EMS team (ZRM P) composition, the existing vehicle may not provide ergonomic conditions for three people working simultaneously on the patient. Verification of the existing configuration is worth conducting before signing a new contract with the National Health Fund (NFZ) — not after.
The Volkswagen Crafter offers 1870 mm of cargo space width; the Mercedes-Benz Sprinter approximately 1787 mm — a difference of 83 mm. With a three-person EMS team, this difference can affect the layout of medical cabinets and access to the patient from both sides of the stretcher. The choice of the base should stem from the body specification and the planned team composition.
Art. 26e, imposing on providers the obligation to provide EMS team members with access to psychological support, enters into force on January 1, 2026. Providers should include this obligation in their budget planning for 2026.
MRUs operate seasonally — from May 1 to September 30, for a maximum of 12 hours a day. They are intervention units, not transport units; they do not transport patients. The ambulance remains the primary means of transport and performing advanced medical procedures.
Not directly. The change concerns staffing requirements for medical dispatchers, not the technical parameters of rescue vehicles.
