May 18, 2024

Empower Service Hub

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A vital shift for health care: Empowering nurse practitioners

3 min read

The Hub’s first annual Hunter Prize for Public Policy, generously supported by the Hunter Family Foundation, focused on solving the problem of long wait times in Canada’s health-care system. A diverse group of ten finalists have been chosen from nearly 200 entries, with the finalists and winners chosen by an esteemed panel of judges, including Robert Asselin, Dr. Adam Kassam, Amanda Lang, Karen Restoule, and Trevor Tombe. The Hub is pleased to run essays from each finalist this week that lay out their plans to help solve this persistent policy problem. The winners of the first-ever Hunter Prize for Public Policy will be announced on Friday, September 29.

As our population ages and the prevalence of chronic conditions continues to rise, the need for specialized and accessible care is more critical than ever. Cardiovascular diseases, cancer, chronic respiratory diseases, diabetes, and kidney disease account for a staggering 17.9 million lives lost annually worldwide. Canada’s health-care landscape faces two critical challenges: a shortage of family physicians and a daunting surgical backlog. To bridge the access gap, relieve mounting pressures on emergency departments, and address prolonged wait times for surgeries, we must maximize the capabilities of nurse practitioners (NPs).  

The shortage of family physicians in Canada has left millions without a primary care provider. Moreover, an additional backlog of surgical cases calls for a paradigm shift in our approach to expanding capacity to see new patients more quickly. Our proposed policy seeks to address the shortage of primary care providers, reduce the strain on emergency departments, and improve surgical follow-up care. 

We must tap into the full potential of NPs, allowing them to practice autonomously within their scope to independently assess, diagnose, and manage patients. Such a policy will not only increase health-care access and reduce wait times but also enhance health-care efficiency and patient satisfaction. To tackle wait time challenges, we must fully utilize the skills of NPs. By having governments fund NP-led clinics in primary care we can improve capacity for more patients to be managed in the community. In post-surgical settings, NPs can enhance patient care, reduce emergency room congestion, and improve surgical wait times by creating capacity for newly referred patients to be seen quicker. NPs, with their advanced education, autonomy, and comprehensive care approach, are the linchpin of this transformative solution. 

A comparative analysis of health-care systems in high-income countries has shown that countries with NP models of care, including the Netherlands, Norway, and Australia, excel in equity, access, and outcomes. They also support NP-led care teams. It’s time for Canada to embrace this approach, enabling NPs to contribute fully to our healthcare system, just as they have in these successful nations. By creating NP-led primary care clinics, urgent care centres,  and specialized post-surgical follow-up clinics, we can improve healthcare access, prevent unnecessary emergency department visits, and reduce hospital stays. 

In Ontario, NPs receive comprehensive compensation covering salary, benefits, and overhead costs, and NP-led clinics play a vital role in enhancing care quality, offering health promotion, mental health care, chronic disease management, and health service coordination. These models provide a blueprint for unleashing NPs’ potential, and the benefits are clear: timely appointments and effective management. 

Research underscores the efficacy of NPs in diverse clinics. For cancer survivors, NP-led clinics provide essential follow-up care, enhancing quality of life and easing the burden on specialists. In lung cancer screening, NP-led clinics increase screenings and overcome barriers. NP-led clinics for diabetes management offer timely, structured care, simplifying complex regimens and reducing emergency department visits. 

It’s essential to revise existing legislation, promote private insurance coverage for NP services, and grant NPs the ability to negotiate directly with the government for a salaried payment plan. To implement this policy effectively, we need policy decisions that support adequate government funding, the removal of barriers preventing NPs from practicing to their full scope, and the transition of NPs to autonomous healthcare providers. Regulatory oversight ensures high standards, and collaboration with governing bodies ensures the credibility and professionalism of NPs while aligning with evolving health-care needs.

The time for change is now. Empowering NPs is not only a practical solution to our health-care crisis, but a step towards a more efficient, accessible, and patient-centered health-care system. It’s time to invest in our NPs, who have the knowledge, and dedication to revolutionize health-care delivery in Canada. Let’s take this bold step, ensuring better care for all Canadians and building a healthier, more vibrant future.

Read the policy paper:


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