The Australian College of Nursing (ACN) is calling for significant changes to Australia's model of primary healthcare delivery to reflect the changing healthcare needs of an ageing population and supply issues affecting sections of the health workforce.
In its submission to the Unleashing the Potential of our Health Workforce Review (the Cormack Review), ACN provides evidence that empowering and rewarding nurses to work to the full scope of their practice will provide patients and communities with more high quality and safe primary care options, more readily, and more affordably.
ACN CEO, Adjunct Professor Kylie Ward FACN, said nurses are the largest and most geographically dispersed health profession in Australia.
"There are around 450,000 nurses and midwives working across Australia in cities, suburbs, regional centres, towns, villages, and rural and remote communities, including isolated First Nations communities.
"Nurses are often the most qualified health professional in many communities. In some communities, nurses are the only health professionals.
"On top of these numbers, the Nursing and Midwifery Board estimates that there are more than 75,000 registered nurses and midwives who are currently not working as nurses.
"Primary care reform will help encourage many of these nurses return to the profession.
"Empowering nurses to work at their full scope of practice will ensure that more Australians will have access to the right care in the right place at the right time.
"Australia has a growing and ageing population, there is higher incidence of complex and chronic disease, and we are still emerging from the worst of the Covid-19 pandemic and its impact on health services.
"There are also ongoing health workforce concerns across many professions, with the shortage of GPs, especially in rural and remote areas, being a major catalyst for change.
"The AMA reports that Australia is facing a shortage of more than 10,600 GPs by 2031 [AMA media release, AMA report confirms staggering undersupply of GPs in next two decades, 25/11/22].
"Wherever and whenever there is a problem of GP shortages, nurses are a solution – and Health Minister Mark Butler agrees.
"Minister Butler said on ABC Radio AM yesterday:
'So, at a time of constrained supply and increasing demand, I've said many times it doesn't make sense not to have every single one of our health workers operating to what they describe as the top of their scope of practice, which is utilising all of their skills, all of their training, and all of their experience.
That's what I want to see for our nurses, Nurse Practitioners, pharmacists, allied health workers, and general practitioners as well.
There's been this glass ceiling, particularly on nurses, that has not allowed them to utilise all of their skills and training that I want to see removed. I want to see their potential unleashed and that's what this review (the Cormack Review) is all about.'
"Minister Butler also confirmed that the Government is committed to removing the requirements for Nurse Practitioners to work under the supervision of a GP under 'collaborative arrangements'.
"Removing collaborative arrangements will allow Nurse Practitioners to work more independently and expand nurse-led services in many more settings across Australia.
"ACN supports multidisciplinary teams of health professionals working together in primary care settings in models that demonstrate a break from the traditional GP-led models through the introduction and expansion of innovative, contemporary nurse-led models.
"Quality and safe leadership can be provided by nurses or allied health professionals in keeping with the staffing or geographic circumstances of individual services.
"This will benefit patients but, to be fully effective, significant investment will be needed to increase the numbers of Nurse Practitioners, who are very highly qualified nurses, and the broader nursing workforce."
Adjunct Professor Ward said primary care nurses support many diverse groups within the community including in aged care, palliative care, mental health, people from CALD backgrounds, First Nations peoples, and people with disabilities.
"Allowing primary care nurses to work to their full scope of practice will provide better patient access to care, particularly for people who do not access care due to fear, lack of money, homelessness, or other factors," Adjunct Professor Ward said.
"Nurses working in the highly successful nurse-led walk-in clinics and mobile clinics need the ability to work to their full scope of practice to improve health outcomes in the community, especially for people in marginalised groups.
"The shortage of doctors should be viewed as a chance to re-design and rethink how nurses work to benefit patients and communities to support all clinicians currently carrying the excess load.
"Nurses can create positive, productive, and interdisciplinary care with doctors and other health professionals all playing complementary and mutually supportive roles," Adjunct Professor Ward said. The ACN submission to the Unleashing the Potential of our Health Workforce Review is at https://www.acn.edu.au/wp-content/uploads/acn-submission-unleashing-the-potential-of-our-health-workforce-review.pdf
