Strategies for a stronger primary health care workforce

By Shanthi Gardiner, APNA Advocacy Manager

Source: APNA Primary Times Summer 2021 (Volume 21, Issue 2)

There have been several recent developments on the nursing workforce front and the APNA team, including APNA President Karen Booth, has been busy advocating for primary health care nurses at various levels of government.  

National Primary Health Care 10 Year Plan 

The consultation draft for the national Primary Health Care (PHC) 10 Year Plan was released in October to obtain feedback from individuals and organisations with an interest in primary health care. The plan’s overarching objectives are based on the ‘Quadruple Aim’ framework: improved experiences for patients, improved health for populations, improved cost-efficiency and improved work life for health practitioners.¹ 

Karen has been a member of the Primary Health Reform Steering Group since it was established in 2019 and says that the group has consulted widely with diverse populations in order to make recommendations for the PHC 10 Year Plan.² The group has called for a National Primary Health Care Nursing Workforce Strategy that includes planning for innovative models of care and better utilisation of nurses, nurse practitioners (NPs) and midwives.² 

The group’s recommendations for the strategy also emphasise the importance of workforce planning. ‘There is an acute recognition that there has to be targeted planning for all health workforces, most especially for primary care,’ Karen says. ‘We can no longer just hope and wait for health professionals, especially nurses, to “fall into primary health care”. Nationally, we need a focused effort on including PHC in undergraduate curricula and on creating attractive opportunities for nurses to extend their PHC skills as part of their career plan.’  

The draft PHC 10 Year Plan sets out to boost multidisciplinary team-based primary health care and to address gaps in access to quality care. It recognises the shortage of healthcare practitioners in rural and remote areas and highlights the need for more sustainable local-communityled approaches to addressing these PHC workforce issues.¹ 

  

National Rural and Remote Nursing Generalist Framework 

As part of the recommendations for the national PHC 10 Year Plan, work has started on the National Rural and Remote Nursing Generalist (NRRNG) Framework. The NRRNG Steering Committee is providing professional and clinical advice to the Deputy National Rural Health Commissioner to develop a framework to guide nursing services in regional, rural and remote nursing. APNA is represented on this steering committee, and we will provide updates on the group’s progress as soon as possible. 

  

Nurse Practitioner 10 Year Plan and National Nursing Strategy  

In May, the National Nursing Peaks Strategy Group – a coalition that includes APNA, the Australian College of Nurse Practitioners, CRANAplus (the peak body for remote health), the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, the Australian Nursing and Midwifery Federation and the Australian College of Nursing – met with Health Minister Greg Hunt to address the lack of a national nursing workforce strategy and to advocate for improved access to the Medicare Benefits Schedule (MBS) for primary care NPs.

Karen attended this meeting and says that Minister Hunt acknowledged the need for greater understanding of highly skilled nurses’ roles and for a more cohesive national approach to building and supporting the NP workforce. The key outcome from the meeting was the development of the Nurse Practitioner Steering Committee (NPSC), with high-level representation from members of the National Nursing Peaks Strategy Group, including Karen. The NPSC held its first meeting on 31 August and will facilitate collaboration between government and non-government stakeholders on development of the Nurse Practitioner 10 Year Plan. This plan will be based on extensive stakeholder consultation and will define the necessary actions for addressing NP workforce issues and improving the care that NPs can provide for the Australian community. 

A National Nursing Strategy will also be developed to address workforce sustainability, the profession’s diversity and the challenges that regional, rural and remote nurses face.¹ This strategy will be designed to enable nurses and midwives to work to their full scope of practice in primary care, mental health and aged care. 

  

Federal government’s response to ‘Educating the Nurse of the Future’ report 

The long-awaited government response to the independent review by Professor Steven Schwartz, ‘Educating the Nurse of the Future’, has been handed down.^3,4 Whilst there were some very strong recommendations in the report by Professor Schwartz, the government’s response is underwhelming. Only 2 of the 26 recommendations have been accepted:  

• Recommendation 9 – The Health Department should review the Rural Health Multidisciplinary Training Program guidelines to ensure that nursing education benefits from longer regional placements, interdisciplinary training, and travel subsidies. 
• Recommendation 26 – The National Nursing and Midwifery Education Advisory Network should be responsible for monitoring the recommendations’ realisation and a follow-up review should be held.⁴ 

Recommendation 23 (the need to sponsor research on nursing education and clinical placements) is given ‘in-principle’ support, and the remaining 23 recommendations have been ‘noted’.⁴ This is particularly disappointing given that, in 2014, Health Workforce Australia’s modelling forecast a nursing shortage in Australia of about 85,000 nurses by 2025 and that this shortage would grow to 123,000 nurses by 2030.⁵ At the time of writing this article, APNA is preparing a response to the government, and this will be uploaded to the policy and submissions link on the APNA website when ready.  

 

References 

1. Department of Health, ‘Consultation draft: future focused primary health care: Australia’s Primary Health Care 10 Year Plan 2022-2032’, 2021, accessed 29 October 2021. https://consultations.health.gov.au 

2. Primary Health Reform Steering Group, ‘Recommendations on the Australian Government’s Primary Health Care 10 Year Plan’, September 2021, accessed 29 October 2021. https://consultations.health.gov.au 

3. S Schwartz, ‘Educating the nurse of the future: report of the independent review of nursing education’, 2019, accessed 30 October 2021. https://www.health.gov.au4. Department of Health, ‘Australian Government response to the independent review of nursing education: educating the nurse of the future’, 2021, accessed 30 October 2021. https://www.health.gov.au 

4. Department of Health, ‘Australian Government response to the independent review of nursing education: educating the nurse of the future’, 2021, accessed 30 October 2021. https://www.health.gov.au 

5. Health Workforce Australia, ‘Australia’s future health workforce: nurses detailed’, 2014, accessed 29 October 2021. https://www.health.gov.au