General overview
In March 2025, the Slovak Government approved the most significant reforms to the emergency medical services (EMS) system in over two decades. Although the initial implementation date was set for 1 January 2025, the new legislation will be introduced in phases, and commenced on 15 April 2025. It includes structural changes to ambulance services, the development of a new ambulance network and the introduction of a new professional role.
Structural changes to ambulance services
Several new types of ambulance crews will be deployed. One of the most notable is the hybrid rapid medical assistance (RLP)/rapid medical aid (RZP) model, whereby a physician-staffed RLP unit will operate during daytime hours, and an RZP crew without a physician at night. This measure is designed to optimize the use of physicians, whose availability in the Slovak health system is limited.
Another innovation is the RZP crew with extended-scope specialist paramedics. These paramedics will be authorized to perform advanced medical interventions previously reserved for physicians, with the intention of accelerating care delivery, particularly in remote or underserved areas.
The reform also introduces specialized ambulance types, including:
- Planned transport ambulances for non-emergency inter-hospital transfers and selected low-acuity primary calls, freeing doctors and paramedics for acute cases.
- Mobile paediatric intensive care unit ambulances, operated by tertiary paediatric healthcare facilities, to ensure critically ill children are transported by personnel trained in paediatric emergency medicine.
- Emergency medical assistance ambulances for repatriation (if a patient is abroad and needs transport back to Slovakia) and other non-insurance-covered transport needs, such as medical coverage at social, cultural and sporting events.
Development of a new ambulance network
The EMS network will be redesigned based on a mathematical optimization model that uses historical data on response times, call volumes, call types and geographic distribution of incidents. This model will propose optimal crew deployment to minimise response times and maximize coverage.
As a result, the number of ground ambulance service stations in Slovakia will increase from 321 to 344 from the next tendering period, beginning in Autumn 2025. Additionally, the reform specifies more precise regulations for the location of EMS stations in regional capitals to improve equitable access across urban areas and surrounding municipalities.
A commission within the Ministry of Health will monitor compliance with newly established quality indicators for both EMS providers and emergency dispatch centres. The first set of indicators was published in the Official Gazette in mid-2025, with systematic measurement scheduled to commence in 2026.
Introduction of a New Healthcare Professional Role
The legislation also creates a new category of healthcare worker: the transport assistant. Transport assistants, similar in status to nurses within the EMS system, will be formally registered with the Slovak Chamber of Emergency Medical Technicians. This ensures both professional representation and access to continuous professional development opportunities.
Another key feature of the reform is the planned introduction of a new emergency telephone number, 116117, in January 2026. This number will handle non-urgent medical inquiries, thereby alleviating the workload on the existing emergency number 155, which will continue to be reserved for urgent, life-threatening cases. The aim is to enable EMS teams to concentrate their resources on critical incidents requiring immediate intervention.