Dr Louise Reynolds is Victoria’s Chief Paramedic Officer, Associate Professor in Paramedicine (ACU) and adjunct Professor (La Trobe University). Beginning her paramedicine career as a student paramedic with SA Ambulance Service, she has then transitioned to academic, research and leadership roles in Australia, UK and SE Asia. She is recognised as Australia’s first female paramedic with a doctoral degree that focused on paramedicine workplace culture. She is a five-time co-editor of ‘Understanding the Australian Health Care System’ and co-authored the paramedicine chapter. She is actively involved in professional bodies such as the Australasian Council of Paramedicine Deans and the Australasian College of Paramedicine.
Policy perspectives on integrating community paramedics into rural primary care settings
Authors: Ruth Hardman1,2, Louise Reynolds2,3,4, Alicia Turnbull5 and Lauren Rudd5
Affiliations:
1 Sunraysia Community Health Services, Mildura, Victoria, Australia
2 Violet Vines Marshman Centre for Rural Health Research, Rural Health School, La Trobe University, Bendigo, Victoria, Australia
3 Safer Care Victoria, Melbourne, Victoria, Australia
4 Australian Catholic University, Melbourne, Victoria, Australia
5 Gateway Health, Wodonga, Victoria, Australia
Background
In Australia, Community paramedicine (CP) has the potential to address primary care needs in vulnerable populations. Given that registered paramedics are currently the only health workforce in oversupply, CP roles offer an alternative career opportunity outside of jurisdictional ambulance service settings. Transitioning their skills from the ‘ambulance health’ model of care provides a much-needed boost to the primary care workforce; however, despite strong evidence for the CP role and Scope of Practice review recommendations, this appears to be a complex undertaking.
Actions
We are currently implementing and evaluating a community paramedic service, ‘CP@clinic’, across four rural Victoria community health service sites. CP@clinic provides free drop-in access to community-based paramedics for those facing health inequities due to social isolation and healthcare access. Paramedics screen and monitor health conditions, provide education, and link to relevant resources. This undertaking is one of the first CP initiatives that employs paramedics outside a jurisdictional ambulance service.
Results
The implementation evaluation demonstrated high levels of feasibility and acceptability amongst participants, other health providers and paramedics. The program has expanded rapidly and has successfully targeted priority population groups who experience poor healthcare access. Ongoing evaluation will explore the impact on health outcomes and service utilisation. A key challenge has been the paramedic transition from their jurisdictional roles to the community health environment, including terms of employment, access to funding and negotiating flexible work agreements.
Conclusion
Embedding paramedics into primary care settings in Australia requires policy, employment and individual considerations. This presentation will explore these issues from several perspectives (policy, research, paramedic experience) and discuss possible ways forward to manage these challenges.