Story from New Zealand Doctor

Op-ed: Potential waits to be realised: Paramedicine – a growing force for good in the health system

Written by John Bruning CEO, Australasian College of Paramedicine

The Paramedicine Clinical Practice Framework will help to realise Aotearoa New Zealand’s new health strategy, writes John Bruning

Until now, career pathways for paramedics have been largely defined, and limited, by their role in emergency services.

Unlike other health professionals, paramedics have lacked an overarching clinical practice framework reflecting the many dimensions of practice and supporting their broader utilisation across the health sector in the provision of more comprehensive and equitable health service delivery nationwide.

Since paramedic registration in Aotearoa New Zealand in 2021, and in the wake of the COVID-19 pandemic, paramedics by necessity are increasingly being employed in areas of the health system beyond emergency services, from general medical practices to more specialised roles in health clinics.

Clarity on career paths

However, this is being done without an accompanying framework and on an unsustainable, ad hoc basis. The Australasian College of Paramedicine is developing the first Clinical Practice Framework for paramedics in New Zealand and Australia.

The four-tier model we are developing is modelled on the UK clinical practice framework and will culminate in a complete career framework for paramedicine in line with those of other health professions. The framework will cover clinical practice, education, research, leadership and management in a manner that represents the most beneficial future structure for the clinical arm of the profession and, more broadly, for the health sector in ensuring paramedics are more effectively utilised.

This framework supports the objectives of the New Zealand Health Strategy | Rautaki Hauora o Aotearoa released by the Ministry of Health for the coming decade and marking a substantial shift in how we conceptualise healthcare provision, deliver improved person-centred care, and bridge gaps in health equity nationally.

The strategy paves the way for the broader integration of paramedics, a vital and often underutilised health workforce, in primary and community care.

As reflected in the strategy, team-based care and multidisciplinary models are now being recognised as the future direction for the health sector, with the emphasis no longer on individual siloed professions, but rather on the skills and capabilities required to ensure the safe delivery of high-quality care. This is an important distinction, and one that enables the transition from scopes of practice, in which health practitioners operate in accordance with permitted tasks and responsibilities outlined by an employer, to a more integrated framework that encompasses the knowledge, capabilities and professional attributes required for competent and safe practice.

Benefits for the sector

For paramedics, this provides ample scope for the health sector to benefit from their knowledge, education and unique capabilities by broadening paramedic practice, enabling them to work across different health settings as part of multidisciplinary teams, and capitalising on the many opportunities that exist for the profession to continue to grow and contribute in a greater capacity to the overall health of the nation.

The framework supports the objectives of the new strategy, particularly in terms of provision of flexible and appropriate care, workforce retention and wellbeing, and building a resilient and sustainable system while also serving as a blueprint to futureproof paramedicine.

And, with an ageing population and existing inequities in health service access and provision in rural areas and Maori and Pasifika communities, we also have the opportunity to support the Government in bridging those gaps by enabling the versatile, highly capable paramedic workforce to operate more widely in a range of expanded capacities across the country.

The New Zealand Health Strategy urges us to think “radically and differently about the types of skills we need to care for our future population”.

This is precisely the type of forward planning we are undertaking at the college with our new framework, in laying the groundwork for a more responsive, flexible and equitable health landscape, and ensuring that multiskilled and versatile paramedics can provide much-needed support for the country’s overburdened health system and workforce.

Read the article at New Zealand Doctor