Abstract: It is generally agreed that Australia enjoys a world class standard of health care, however major challenges to maintaining equitable access to health care and ensuring an adequate and equitably distributed workforce face us nationally. This problem is particularly pertinent to rural and remote areas where access to health resources lags significantly behind that of metropolitan centres. Maintaining an adequate health workforce has been receiving increasing attention at national and state level in recent years. The growing financial pressure on the health system, and a significant shortage of health professionals especially in the public health sector, has forced a consideration of alternative models of providing health care. Notably, the issue of a shortage of health workers is of greatest concern in some rural, remote and Indigenous communities. This maldistribution of available health care resources has tended to disadvantage people living in these communities and attempts at addressing this inequity has been the focus of both state and federal jurisdictions for some time. Federal and state government documents have recognised the need for health reforms, and have instigated strategies to examine opportunities for expansion of health care roles, accelerated recruitment programs, and institution of new training places for medical and nursing students to help deal with the shortage of health workers. A number of health policy position papers, and numerous health care reform analysts, have supported the expansion of health workforce capacity by developing generic health workers, and further widening traditional health roles to capitalise on under-utilised segments of the workforce. In Queensland, the Ambulance Service has made a timely and significant response to this call and is currently training, through partnership with James Cook University, the first cohort of 20 Isolated Practice Paramedics who will graduate in late 2007 with expanded scope skill sets in chronic disease management and public health. This paper describes this initiative, its drivers and the development of an evidence base to support curriculum development and evaluation strategies for this program.