APNA’s Workforce Survey - The times they are a’ changing

By Nick Buchan, Primary Times Chief Writer 

Source: APNA Primary Times Summer 2023-24 (Volume 23 Issue 2)



Primary health care (PHC) nurses are finally finding their voice. APNA’s Workforce Survey is being heard in all the right places. Things will never be the same again. 

Few surveys have as much impact as APNA’s Workforce Survey. It is playing an increasingly important role in improving the careers and professional opportunities for PHC nurses across the country. 

For 15 years, APNA’s Workforce Survey has been the only national survey focusing exclusively on nurses who work in PHC. In 2022, it saw more than 4,000 responses, the biggest response ever, highlighting the depth of feeling from nurses as to the issues they confront in the workplace. 

For example, the nurse utilisation data from the 2022 Workforce Survey speaks for itself. According to the survey, one-third (32%) of all PHC nurses are not utilised often or most of the time. Meanwhile, more than a quarter (26%) of respondents were denied a request to use more of their skills and experience in their job. 

What does all this data mean? Despite the nurse shortage currently affecting general practice, and other non-hospital settings, nurses at all levels of experience are not being used to their full potential, and their nursing skill, knowledge, and enthusiasm is being wasted, leading to many nurses looking at greener pastures. 

‘This underutilisation of nurse skills represents a missed opportunity for the Australian health system, patients, and employers,’ says APNA President Karen Booth. 

‘Nurses are prevented from working independently to their full scope of practice by outdated Medicare billing protocols. Under the Medicare Benefits Schedule, apart from a $12 chronic care item number, practices can’t claim payment from the government for a service provided in their clinic by a nurse unless a GP is on the premises to supervise.’ 

‘PHC nurses are ready, willing, and able to do more. They are highly motivated, highly educated, and highly experienced. 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, including cardiovascular education, vaccinations, wound care, and a preventative health approach, such as primary health care screening.’ 

The Workforce Survey is making a difference. For example, survey data played a significant role in the establishment this year of the Commonwealth’s Scope of Practice Review, which could potentially see many more nurses working to their full scope of practice. How do we know? Just ask Peter Breadon, Health Program Director at the Grattan Institute.  

‘We released a report1 on general practice at the end of last year,’ Mr Breadon says. ‘It recommended workforce and funding reforms to improve chronic disease management. APNA gave us access to their Workforce Survey data to help with our research.’ 

‘These insights shaped our recommendations to government. Many of our recommendations have been accepted and funded, including the national primary care Scope of Practice Review.’ 

The Grattan Institute is a heavy hitter when it comes to influencing public debate. It produces high-quality public policy recommendations for Australia’s future and is taken seriously by decision-makers in governments and health departments at a state, territory and federal level. Since it was established in 2008, its independent research has helped shape the Australian policy conversation, from childcare to the COVID-19 response. 

Data from surveys like APNA's Workforce Survey are vital for organisations such as Grattan to be able to give PHC nurses more of a voice. 

‘The Workforce Survey is one of the best ways to help researchers like us understand the perspective of primary health nurses.’ — Peter Breadon, Grattan Institute Health Program Director 

‘The Workforce Survey is one of the best ways to help researchers like us understand the perspective of primary health nurses,’ Mr Breadon says. ‘The data showed that a vast number of nurses don’t feel that they can use all their skills, with many seeking to expand the scope of their work.’ 

‘Nurses also reported a wide range of barriers holding them back, including regulation, training, funding, and management practices. We could see what kind of work nurses do, don’t do, and want to do.’ 

When it comes to survey data around nurse wellbeing and intent to leave the workplace, the numbers are even more compelling. More than one in four (26.2%) PHC nurses are planning to leave their current job within the next 2 to 5 years, with nearly one in 10 (9.75%) planning to leave their current job within the next 12 months. In addition, three-quarters of PHC nurse respondents said they felt exhausted or stressed at work.  

‘The reasons for this vary from sector to sector,’ Karen Booth says. ‘Aged care nurses feel overwhelmed by constant change and uncertainty over whether they will receive the 15% pay increase ordered by the Fair Work Commission. Nurses in general practice are poorly utilised. Nurse Practitioners are restricted from using the additional skills they have learned through their advanced training and experience.’ 

‘This unrelenting pressure has created a crisis in meeting Australia’s primary health care needs,’ Karen says. ‘Australia is at risk of not having enough suitably trained PHC nurses to staff aged care homes, general practices, and other primary health care settings in coming years.’  

‘Primary health nurses are one of the most affordable and effective ways of keeping patients with cardiovascular disease healthy and out of hospital,’ Karen says. ‘Patients deserve to receive treatment and education from nurses who are well-resourced and aren’t run off their feet with too much else to do.’ 

Karen says the survey’s figures demonstrated the urgency behind APNA’s efforts to establish sustainable recruitment and training pipelines to bring through Australia’s next generation of PHC nurses to not only sustain but build the workforce. She also says the survey has played a role in shaping the Albanese Government’s reform focus on a multidisciplinary model of care, revising scope of practice and funding PHC clinical placements.  

‘Adequately funded bundled payments for individuals with chronic and complex health issues would allow flexible use of nurses within a multidisciplinary team,’ Karen says. ‘Such models free up GP time to focus on their patients, while the nurse provides support through planned care activities.’ 

‘Albanese Government initiatives, such as the national Scope of Practice Review, 6,000 additional PHC clinical placements, 1,850 graduate Nurse Practitioner scholarships, and incentives to get PHC nurses back into the workforce, will make a difference to PHC nurse retention,’ Karen says. 

‘The Government’s talk of reforming Medicare around a multidisciplinary model of care is welcome and may also go some way to alleviating this situation. The Government must now build on this progress by accelerating and committing to funding delivery of the Nursing Workforce Strategy.’ 

However, data from the Workforce Survey is not just valuable to governments. Northern Queensland Primary Health Network (NQPHN) Interim CEO Karin Barron says that the data are also useful with workforce planning. 

‘NQPHN has delivered targeted education and training events on topics, specific to regions in North Queensland, that were highlighted from data collected in the APNA Workforce Survey,’ Ms Barron says.  

‘From this data, we have identified opportunities to expand the Transition to Professional Practice primary care nursing program and are looking at similar options for nurse practitioners to assist career progression with support from their peers.’  

‘The data collected in the APNA Workforce Survey are integral to the planning and delivery of customised training and education, and without it NQPHN would be unable to provide support and training to priority regions,’ Ms Barron says. 

None of this vital work would be possible if PHC nurses do not complete the survey in sufficient numbers. 

‘If there’s only one survey you do this year, make it this one,’ Karen Booth says. ‘The more nurses that complete the Workforce Survey, the better placed we are to lobby for changes to ensure nurses are valued, visible and respected.’ 

The Grattan’s Peter Breadon agrees: ‘Even for busy people, taking the time to share your experience by filling out the survey is a great investment. People making decisions about how to fund and manage the health system need to understand what is working for the workforce, and what isn’t.’ 

‘We can learn a lot from trials, evaluations, talking to individual nurses, or focus groups. But there is no real substitute for a large, well-designed survey.’ 


Click here to access the Reference List for this article. 


The APNA Workforce Survey Hub collects data snapshots, media coverage, and historical data all in one convenient place. To see just what the Survey can do, head to: https://www.apna.asn.au/hub/APNA-workforce-survey 

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