The COVID-19 pandemic has strained Australia’s medical services and exposed systemic shortcomings in the health system. It has also provided insight into the potential ways paramedicine can address those deficits by capitalising on the broader role Paramedics can play in community healthcare beyond traditional ambulance-based duties.
The appointment of Chief Paramedic Officers across Commonwealth, state and territory governments is a much-needed step in realising this potential, providing leadership and oversight, and ensuring the profession has a seat at the table and is represented in decision-making processes.
Throughout Australia, governments have established roles within their respective Health Departments for Chief Clinical Officers. The role of these Senior Officers is to provide expert leadership, professional representation, strategic clinical advice, and advocacy on all aspects of government and the healthcare system.
The Victorian Government is the only jurisdiction in Australia that has a Chief Paramedic Officer specifically charged with providing oversight of the out-of-hospital care sector and advice related to the professional discipline of paramedicine. The absence of Chief Paramedic Officers across other jurisdictions means that the paramedic profession is absent from this high-level professional leadership. This highlights a lack of representation, perspective, and consideration regarding quality and safety matters related to paramedicine, and the role that Paramedics can play in the wider health sector and in the development of innovative solutions to meet community healthcare needs.
While the College acknowledges the role of Chief Executives of established emergency ambulance services in advising government, these service providers do not represent all Paramedics employed in their jurisdictions, are subject to commercial or policy/employer relationships with government, are bound by their industrial and operational environment, and do not have the breadth of perspectives that professional representation brings.
“A considerable and growing part of the Paramedic workforce is employed outside of these emergency service providers, and reliance on advice from statutory providers results in many Paramedics, in a variety of extended care roles, at risk of not being considered a part of broader health sector initiatives or solutions to improve health outcomes for the community,” said College Chair Ryan Lovett.
Since the introduction of paramedic registration in 2018, Paramedics are increasingly working across a variety of healthcare settings, not just jurisdictional ambulance services. The challenge for paramedicine is that regulation either impedes or does not support Paramedics working independently, or from taking up opportunities in other health care settings, such as primary care.
Increasingly, various primary, community or extended paramedic models of care are being implemented internationally and there are some limited trials in Australia. These models utilise the highly qualified paramedic workforce that is uniquely placed to support existing health infrastructure to deliver responsive, flexible, high-quality, and affordable primary and community healthcare services.
“With primary health in Australia under increasing pressure, and health workforce shortages seen across the country, Paramedics are a workforce the health system could be utilising beyond traditional ambulance-based roles to deliver connected, high-quality, community-based healthcare,” Mr Lovett said.
The role of the Chief Paramedic Officer would sit alongside other Chief Clinical Officers as part of the clinical leadership team for health, and is critical in ensuring that difficult problems facing health systems can be addressed with a co-designed, multidisciplinary, interprofessional approach. A Chief Paramedic Officer would enable governments to have an expert Paramedic available to advise how Paramedics could contribute to existing health systems through their unique clinical skill set, and help to address some of the health workforce challenges seen across the health system.
While the College acknowledges that the paramedicine workforce is currently small, the ability for Paramedics to play a vital role in the delivery of ad-hoc, responsive and diverse care makes the Chief Paramedic Officer a necessity, and is an important and needed step in health system reform and in holistically addressing the nation’s healthcare needs now and into the future.