The Australian and Western Australian Governments have launched a new pilot program that will increase the number of nurse practitioners providing primary care in WA.
The Nurse Practitioner and Team Based Care Pilot will fund 20 nurse practitioners (NPs) over two years, who will work both autonomously and in collaboration with other health practitioners to diagnose and treat a wide range of health conditions – and their services will be free to patients.
WA will receive $11.7 million from the Federal Government’s $100 million commitment in the 2022-23 October Budget to work collaboratively with states and territories to co-develop and pilot new ways to improve primary care pathways and reduce pressure on GPs and EDs.
Minister for Health and Aged Care, Mr Mark Butler, said that The Strengthening Medicare Taskforce report made it clear that Australia needs to encourage local practices to offer more comprehensive, team-based services using NPs.
“I think one of the things we need to do is use the full range of our healthcare workers much more effectively, much smarter than we do here in Australia. There are too many artificial limits on the work that specialist nurses, for example, can do,” Minister Butler said.
“The Prime Minister put $100 million dollars on the table of National Cabinet a few months ago and asked for innovative proposals from state governments on how we can make it easier for people to see a health professional.
“This clever proposal from Amber-Jade Sanderson, the Health Minister here in WA, seeks to really explore the ways in which we can use these specialist nurses much more effectively out in the community.
“The proposal is to have them out in the sort of settings where you might see a GP, but it is hard to see one – [instead], you get in to see a NP who is able to diagnose, make referrals to x-rays and various other tests, and to prescribe some medication.”
“The aim of this pilot is to provide greater access to coordinated long-term care that addresses the needs of priority cohorts with chronic and complex needs such as older Australians and people with a disability,” Minister Sanderson added.
“We know access to primary care continues to be a problem in some areas, including in regional and remote WA, and this pilot will supplement the GP workforce.
“If we can improve community access to preventative, multidisciplinary care we will take the pressure off our hospital emergency departments and improve the health of Western Australians.”
NPs engaged through the pilot will be based in primary care services throughout WA, with the precise locations subject to an Expression of Interest process.
The program will work closely with primary care providers and NPs to successfully design the new models of care, and provide governance, change management, community education and clinical coaching support, with evaluation of the program used to inform future policy.
Minister Butler said that the current situation begs the question, “Why would you bother going out and getting a master’s degree if there is not the opportunity to use those skills, either here in WA or in other parts of the country?”
“These are highly specialised people who have done their basic nursing degrees but in addition to that, they have done a master’s degree, got very substantial clinical experience, but are not able to use those skills, are not able to use their training and their experience because of limits at state level, and there are limits on the Medicare system at a federal level,” he said.
“And it is clear to me that we are just not using them properly, we are not using them to the full extent of their skills and their very substantial training.”
Minister Butler pointed out that under the former Rudd and Gillard Governments Australia had about 2,000 NPs across the country.
“[However], we do not have many more than that now 10 years on, because we are just not utilising them well enough,” he said.
“But particularly here in WA, there are several dozen NPs who are not working as nurse practitioners – they are working as general registered nurses – so they are not using all those additional skills that they have picked up with a master’s degree.
“We want to give them the opportunity not just to work in the hospital system, where there are some opportunities now, but to work out in the community.”
The Australian Nursing and Midwifery Federation (ANMF) has welcomed the new initiative, with ANMF Federal Secretary, Ms Annie Butler, noting that the program will deliver more efficient and effective care and improved chronic disease management and health outcomes for those communities.
“NPs have already been extremely successful in providing quality-care and improving health outcomes for many across the community, particularly in rural and remote regions, where there is a dire shortage of GPs and other health professionals,” Ms Butler said.
“Currently, NPs are a significantly underutilised workforce which is why the ANMF and our members have long been calling on Governments to increase the number of NPs working in health and aged care and urgently expand these models of care.
“This pilot will allow NPs to work to their full scope of practice and provide people in WA with quality, timely care – at no cost to the patient.”
Ms Butler noted that nurse-led, walk-in clinics in several regions have already allowed people to be provided with safe, quality care without the need to wait in overcrowded EDs.
“We believe that NPs are critical to creating a stronger, sustainable Australian healthcare system and the ANMF commends the Federal and WA Health Ministers for implementing this new model of team-based care for the community,” Ms Butler said.
“We look forward to the expansion of this program to other states and territories.”