Nurse skills, experience being wasted despite nursing shortage - national survey

One third of all primary health care nurses are not being used to their full potential 

Media Release 13 June 2023 

One third (32%) of all primary health care (PHC) nurses are not being utilised most of the time, according to a new national survey of Australia’s PHC nursing workforce. 

Nursing experience made no difference to this finding. Nearly four in ten (37%) of all experienced nurses new to PHC and more than a third (34%) of all experienced nurses skilled in PHC said they were not working to their full scope of practice often or most of the time1. 

The 2022 APNA Workforce Survey was conducted by the Australian Primary Health Care Nurse Association (APNA). It is the only national survey focusing exclusively on the nearly 100,000 nurses who work in primary health care in Australia. The survey recorded ~4000 responses, the biggest response in the 15-year history of the survey. 

According to the 2022 APNA Workforce Survey: 

• One third (32%) of all primary health care nurse say their skills are not utilised often or most of the time 
  • Note: PHC Nurses have an average of 21 years nursing experience including 11 years in primary health care  
• More than half (53%) of under-utilised nurses had requested to use more skills or experience.  Of these:  
  • Less than four in ten (39%) successfully negotiated a change 
  • More than a quarter (26%) were denied a request to use more of their skills and experience  
  • Of those denied, more than four in ten (43%) said it was because they were told there was no financial benefit to their employer  
• Nurses remain underutilised regardless of their level of experience.  
  • Nearly four in ten (37%) of all experienced nurses new to PHC are not utilised often or most of the time 
  • More than a third (34%) of all experienced nurses skilled in PHC are not utilised often or most of the time 

PHC nurses account for around one in seven of the 640,000 registered health professionals in Australia. The Australian Department of Health and Aged Care predicts a shortage of 85,000 nurses by 2025 and 123,000 nurses in Australia by 2030. Given Australia’s ageing population, and subsequent rise in chronic disease prevalence, it is critical that nurses be empowered to work to do more to meet the healthcare needs of the nation. 

Nurses are prevented from working independently to their full scope of practice by outdated Medicare billing protocols. Many patients are managed by nurses for chronic disease management, lifestyle and self-care support visits, immunisation, dressings, and care coordination catch-ups.  

However, under the current system, delegation and signing of Medicare Benefits Schedule billing lies with the doctor. Under Medicare, apart from a $12 chronic care item number, general practices cannot claim payment from the government for a service provided in their clinic by a nurse unless a GP is on the premises to physically sight the patient, despite the fact the care was managed by the nurse. 

The Albanese Government’s Federal Budget announcement of Medicare reforms around a multidisciplinary model of care lays the groundwork for structural change, but there is more work to be done. Adequately funded bundled payments for individuals with chronic and complex health issues would allow flexible use of nurses within a multidisciplinary team. Such models free up GP time to focus on the higher level and acute needs of their patients, while the nurse provides support through planned care activities. 

Quotes from APNA President Karen Booth 

“Despite the nurse shortage currently affecting general practice and other non-hospital settings, one third of all primary health care nurses are not being used to their full potential.” 

“This waste of nursing skill, knowledge, and enthusiasm occurs at all stages in a nurse’s career, regardless of their experience. This underutilisation of nurse skills represents a missed opportunity for the Australian health system, patients, and employers.” 

“Australia’s health system can’t afford to have highly skilled, experienced and motivated PHC nurses sitting underutilised when there is so much more they could be doing. Nurses care can include cardiovascular education, vaccinations, wound care, and preventative health approaches such as primary health care screening and advising people on self-care to keep them well.”  

“Primary health care nurses are ready, willing, and able to do more. They are highly motivated, highly educated, and highly experienced.  

“The Albanese Government’s Federal Budget announcement of Medicare reforms around a multidisciplinary model of care lays the groundwork for structural change, but there is more work to be done.”  

“APNA looks forward to working with Health Minister Mark Butler to implement these Medicare reforms as efficiently and quickly as possible.”