AbstractPrior to being referred to the emergency department (ED), patients such as the frail elderly often call their primary care physician. However, the on‐call primary care physician or covering provider does not always have the tools to make an accurate and safe assessment over the phone or to treat patients remotely. This often results in preventable transport to an ED, avoidable admissions and iatrogenic events. An opportunity exists to reduce unnecessary ED referrals by enhancing the capabilities of the on‐call primary care physician. In this communication, we describe the development of a community paramedicine programme that supports on‐call primary care providers managing a high‐risk patient population with the goal of reducing avoidable ED referrals.