Nurses have issued a call to run urgent care clinics in a bid to plug staffing gaps, but GP leaders have spoken against the proposal.
The Australian College of Nursing (ACN) has called on the federal government to revise guidelines to allow nurse practitioners to lead care independently in the clinics, however the head of the RACGP told Medical Forum the Medicare UCC model should always involve a GP.
RACGP President Dr Michael Wright said while the member body valued the work nurse practitioners do, UCCs must remain a collaborative model.
The ACN said the move could help address some of the challenge of recruiting appropriately qualified staff to the clinics, a key issue identified in the latest evaluation of UCCs.
Dr Wright said that while there had been workforce pressures around having enough trained GPs, this also extended to nurses and other health professionals.
“We really have to make sure that we’re working together to make the most of the workforce that we do have,” he said.
Current operational guidance mandates that clinics must be GP-led, with a vocationally registered general practitioner required at a minimum, however the ACT and some remote areas are exempt from the GP-only leadership model.
ACN chief executive officer Adjunct Professor Kathryn Zeitz said the fact that clinics in the nation’s capital could be led by nurse practitioners was evidence that nurse practitioner-led care was safe and effective, and kept people out of emergency departments.
“Further, the mandatory GP presence requirement echoes the now-abolished ‘collaborative arrangements’ legislation – a regulatory relic dismantled in 2023 because it was recognised as an outdated barrier to patient access that hampered nurse practitioners’ ability to work autonomously,” she said.
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Dr Wright said the RACGP did not believe that was an ideal way to deliver such a service.
“That has that’s never been our our preferred model. We don’t think that’s the best use of resources and the best way to collaborate to make sure that the work that’s done in those urgent care centres flows through back to a patient’s regular GP and practice,” he said.
“Nurses and and GPs working together collaboratively is the best way to provide high quality care through these clinics. They’ve got to be well connected to general practice because that’s how we avoid them fragmenting care, wasting resources and duplicating services.”
Adjunct Professor Zeitz said changing the operational guidance and granting nurse practitioners access to after-hours MBS items would help address the issue of UCCs not operating at extended hours or on weekends.
“The promise of UCCs – to reduce pressure on hospital emergency departments and deliver timely care in communities – is being undermined by the staffing and MBS rules that ignore the proven capabilities of the nurse practitioner workforce,” she said.
“Nurse practitioners are perfectly positioned to help take pressure off our strained emergency departments and hospital systems – which is the very point of Medicare Urgent Care Clinics,” she said.
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