Paul trained as an accountant on the NHS training scheme and spent his first 17 years after university working for the NHS in London, Kent and Sussex. Ten of those years were as Finance Director in three provider trusts spanning acute, community and mental health.

He led the merger of the finance functions as the first Finance Director of East Kent Hospitals NHS Trust.

In 2002, he relocated to the area and worked as an advisor to the NHS and also in other public services including education, local government, central government and housing.

He developed a strong interest in the social enterprise sector, and created and ran a successful primary care Community Interest Company.

Paul returned to the NHS in 2018 as a Chief Finance Officer for eight clinical commissioning groups (CCGs) in North West London, before joining the six Staffordshire and Stoke-on-Trent CCGs in 2020 and then joining the NHS Integrated Care Board (ICB) in 2022.