The Australasian College of Paramedicine
The Australasian College of Paramedicine
Kerbside Conversations: Paul Reeves
Welcome to Kerbside Conversations – the College’s podcast capturing authentic voices and stories from across the world of paramedicine.
In this conversation, Paul Reeves, Principal Advisor for Pre-Hospital Care in the Northern Territory, shares his journey from frontline paramedic to a strategic role in healthcare policy. He discusses the importance of saying yes to opportunities, adapting to new challenges, and the critical role of healthcare policy in shaping paramedicine. Paul emphasizes the need for paramedics to be recognized as clinicians and advocates for their profession, highlighting the future of paramedicine beyond traditional ambulance services.
Laura Hirello: Okay. So the first thing that I'll get you to do is to just introduce yourself and tell me your name, where you're from, and what your current primary role is.
Paul Reeves: Okay, all right. So my name is Paul Reeves. I'm currently the Principal Advisor for Pre-Hospital Care for Northern Territory Department of Health. I'm based in Darwin, where I've lived for the last four five years and been in the territory for about 10, but originally came from the UK a few decades ago. And I've worked broadly within the UK and internationally over the last 20 years.
Laura Hirello: And I am getting the distinct impression that you're one of those people who's had a long and winding career path that's taken you through many roles and many countries. So the UK, Australia, did you start as frontline paramedic or sort of where did you start and how did you sort of end up where you are now?
Paul Reeves: Yeah, I started within ambulance services in UK, south of England. And I guess when I look back, there was no career path to actually sort of map how I got to here. But I think my career plan, as it turns out, was just saying yes to everything. And it didn't always work out well, but most of the time it did. And I think that's sort of my default approach. Most of the things I wasn't fully informed or aware of what I was saying yes to. So the constant familiarity of getting involved in things, being aware that that can be uncomfortable and out of your depth, and then working to strive through that takes you to quite amazing places, but also discovery and insight into life and also paramedicine.
Laura Hirello: Yeah, I think it's very much an extension of paramedicine, right? Like you get used to being maybe uncomfortable on a scene, but you have to sort of find your way through it. You could do the same thing in a macro sense with your career of like, here's a situation where I'm out of my element because I'm taking on a new skill, but I can sort find my way through and yeah, there's stuff on the other side of this.
Paul Reeves: Yeah, I think you have to, you find that you end up to survive or thrive in environments like that of changing your thinking that you may have developed in a at home setting, which was appropriate then. And that was certainly some of my experiences in my early international deployment, which was quite confronting. So I had to adapt my thinking to how to deal with that. But once working out how to do that and doing it just then completely transformed what came next. that stays with you.
Laura Hirello: Absolutely. And so just remind me one more time of your current title.
Paul Reeves: So I'm the principal advisor for pre-hospital care. OK. Yeah. is a paramedic seated at the strategic level as Department of Health. OK. Prior to the office of the chief paramedic, for which Shell Piercy is the chief paramedic officer, we report to the deputy chief executive as our next line of report and sit parallel to the other professional leads, so the chief medical officer, chief nursing midwifery, allied health, psychiatry, pharmacy, Aboriginal health practitioners and so on.
Laura Hirello: And so I felt like, particularly when I was a new paramedic, I was very far removed from the whole idea of healthcare policy and sort of what it was and why it was important and how it impacted my job, even though I later discovered that actually it has a huge impact. And so if you were sort of selling the importance of healthcare policy and getting involved in healthcare policy to frontline, how would you go about doing that or what would you say?
Paul Reeves: It's I'm not sure if I've got a full grasp on it. So I've been in the role for or at that level for the first time for the last two years. And it is really interesting to see and learn, understand how things get done, how things and also why things don't. You know, everything has a monetary value when you're looking at providing services especially in that service industry with the costs with that. So where you do have finite resources, deciding on where the resources, the funding, how that's allocated, a lot of it is to do with having a good argument, but that argument's backed up by data and research. proving that there's a benefit or a need. And then it's into the realms of prioritizing that, triaging that of sorts against the other competing needs when you're looking at the whole of health system. Some of those implementations have quite rapid benefits if it's introducing a service or something else. And then other things are part of a larger, slower benefit or return, particularly when you're looking at preventative health, public health and things like that. But I think probably the biggest impact is tapping into all of the service users with this or the service delivery end. I think that's important. And although in the Northern Territory, it's few in population with some quite unique challenges, particularly with geography and like that. The isolation is something that is really important to consider, but the value of tapping into the people that provide the services or receive the services is key. And again, in even more developed systems, those gaps are what can make it feel that there's a disconnect or actually prove that there is a disconnect. So I think engagement and experience and bridging the two ends of the spectrum are really important. And I think personally, Even from a operational management perspective or an organizational perspective, it needs to be focused on the patient, the individual, the community, the collective as well. And the care providers that deliver the health care, support the community in those settings need to be forward-facing to the priority. And the organization or the management, whether it's duty management, organizational strategy needs to really be able to support them. And the whole focus, the service is towards that original need. And I think that's important to understand how that works, but also how we need to communicate and how decisions are made. So with policy to support and endorse, with putting in proposals, with understanding the broad impact of things, so data and research and being able to put forward good arguments to try something. And I think that's the other thing, it's an important thing to try. It's hard to guarantee things we haven't done before, but it's really important to have the courage to be bold and try.
Laura Hirello: It's hard for organizations to take risks though. Yes, that's right. And there's a lot at stake and there's a lot of people watching. And yeah, a lot of time and money involved. yeah, think that paramedics often feel like their service is the thing that sort of constrains them to a specific scope. But what they may not realize is that their service is responding to this sort of broader policy and sort of functioning within that. And so sort of what the policy looks like shapes what the service looks like, shapes what the experience is.
Paul Reeves: I think, I mean, there's been a theme that's come up in the conference so but it's something I personally hold to through the various areas in which I work and particularly within Australia in the last 10 years how the profession has developed. But, and this is my personal view, but the future of paramedicine is not ambulance services. However, the future of ambulance services, I believe, is paramedicine And I say that with love. That's not a knock at ambulance services. But one of the hardest things, I think, to spread into different areas where there will be an absolute benefit to having a paramedic clinician involved within multidisciplinary approaches is to be able to be seen as that clinician not attached to another identity, which holds a lot of misconception in public, but also other professional settings. I think there's few people that are not within paramedicine that really understand it. And with it being a fairly new profession compared to the others, even those professions, if they don't work closely with, it's hard to fully understand how that and awareness of that. So I think we're really fortunate in the Northern Territory and I see there's an absolute value and need to have paramedicine represented to have chief paramedics at strategic levels in all jurisdictions to be able to influence the health systems, advocate for the power and the value of paramedicine, knowing it's not a be all end all solution. There's no one entity that's going to solve the challenges we have. Exactly. And the whole thing within the structure of medicine, if money wasn't a problem and resources weren't a problem, then it wouldn't necessarily be the answer to all of our issues if we just had doctors everywhere type of thing.
Laura Hirello: Yeah, it's not going to get fixed.
Paul Reeves: So it's very much the specialties that we have, but the importance of working together. Having that strategic influence for our profession is key. And at this stage, where we are breaking away from association with what a paramedic is in an ambulance service, because that's all anyone's generally known, it's going to be really important to be able to diversify into better healthcare systems and better models of care that will benefit everybody, including ambulance services or what they become.
Laura Hirello: Um I loved the phrasing of the future of paramedicine is in ambulance services.
Paul Reeves: The future of ambulance services is paramedicine. I think that's it. And I think it comes up again and funny little things of your ambulance are associated with a vehicle type of thing. I mean, that's a small thing, but some things link, form these connections in brains, whether it's with the public or in other areas. So there's a lot of education.
Laura Hirello: Exactly.
Paul Reeves: And advocacy that's needed and that needs to be in a space on its own. But it also needs to be at a level where the strategy and the future of health services is discussed. Because if it's too far down, the decisions are being made. And then it's like, well, I wish we were here at the beginning. And that's going to be really important thing. But yes, to do with that and what if ambulance services weren't called ambulance services? What if they were called paramedic services? Because the whole drive at the moment is to not transport the patients that don't or could be managed elsewhere. Transport is a real key. It's a specialty area, whoever's doing it and whatever the model is. But again, when you're looking at a profession, they need to have that recognition across the board in an independent way, but still be integrated and recognize that you are just a piece in a bigger system.
Laura Hirello: Exactly, and it all has to work together and there's room for all of us. So I have one final question. I imagine it might be a while since you've worked a night shift, but when you were working night shifts, what was your guilty pleasure to make you feel just a little more human in the middle of the night?
Paul Reeves: So, okay, must confess, fortunately, I'm still clinical. Yeah. So I do the occasional response unit shift. Yeah. And oddly, they tend to be nights.
Laura Hirello: It's so weird that other people don't want to work at night, so you're casually filling in there. I don't know why.
Paul Reeves: Yeah. health and fitness has been really key with regards to that. And it's difficult to maintain that and shift work and so on and get into routines. But I do enter into a little bit of fast food. Yes. And sort of, well, it's like a road trip type thing. Yeah. But I guess, you know, some things like that.
Laura Hirello: Health and fitness is a balance. If we're looking at a holistic person, then sometimes you need that 2am. Fast food to, you know, feed your soul.
Paul Reeves: Yeah, so no, I guess it's that. Yeah, I suppose.
Laura Hirello: No, it's a great answer. Well, thank you so much for talking to me today. I hope you have a great time at the conference.
Paul Reeves: Thank you.