Stories from the heart Margaret Dempsey, APNA Program Solutions Officer, Health Care Solutions (left)
Linda Govan, APNA NiPHC Senior Program Manager (right)
Over the last 10 years, APNA’s Building Nurse Capacity program has supported almost 100 primary health care organisations around Australia to set up team-based, nurse-delivered clinics that improve access to health care for their local communities.
The most recent intake of organisations joined the program in April 2024. We’ve been visiting current program participants to check on their progress and to identify the enabling factors that support the long-term viability of nurse clinics.
APNA’s Building Nurse Capacity (BNC) program is funded by the Australian Government Department of Health, Disability and Ageing under APNA’s Nursing in Primary Health Care (NiPHC) Program. As well as improving access to care in under-serviced settings, the program has targeted optimising the roles of nurses in response to the health needs of the local population. APNA supports each program participant to plan and establish a clinic. We provide group workshops and individualised support over an 18-month period and each participating organisation receives an incentive payment to set up the clinic.
During 2025, we’ve visited 24 current program participants around the country to check on their progress, to identify what’s working well and to discuss any challenges they might be facing. Each visit was full of nurse enthusiasm – it was palpable! At times, it can be hard to stay motivated, but these nurses continually showed a passion to improve health outcomes for people in their community by establishing nurse clinics.
Person-centred care
Each nurse clinic in the current BNC program focuses on one of Australia's five priority health care areas: cardiovascular health, diabetes mellitus, cancer control (screening and prevention focus), injury prevention (healthy aging) or mental health. Some clinics target a specific health area, such as skin cancer screening. Many of the clinics tailor their care to meet specific population health needs, which often relate to the geographic location and/or demographic characteristics of their region.
One example of this person-centred care is offered at the Kyabram Regional Clinic in rural Victoria. Lead nurse Leanne James has set up a skin cancer clinic to address the high rates of skin cancer in this large farming community. Leanne has upskilled to complete a Certificate of Dermoscopy and includes skin checks as part of the clinic’s Medicare-funded annual health assessments for people aged 45–49 years and 75+ years. If Leanne notices an unusual lesion during a skin check, she refers the patient to the GP. This nurse-delivered service is improving skin cancer awareness, prevention and care in the rural community and locals no longer need to travel to a larger town for a skin check.
In the Northern Territory, Nurse Practitioner Kylie Straube runs a mental health clinic as part of her NP-led primary health care service at Remote Territory Healthcare in Berry Springs. Berry Springs is located in bushland 40 kilometres south of Darwin. The clinic is rurally based, with patients travelling long distances from isolated properties to attend. This isolation, combined with an older population, a higher than average representation of veterans, and widespread drug and alcohol use, has resulted in high rates of mental health issues in the community. However, Kylie has observed that most patients are not comfortable talking directly about their mental health. Instead, Kylie and her team provide group activities, such as tai chi and leather workshops, as a way of bringing people together and improving their mental wellbeing. Their motto is ‘Keep the mind active and the hands nimble.’
Anna Buchanan is the only nurse working at the Community Centre in Newman, Western Australia. Located in the East Pilbara region, Newman has a population of around 6,500 and primary health care services are sparse, with only one GP and an Aboriginal Medical Service in town. The Community Centre provides a range of services, including childcare and fitness classes, to address social isolation and enable a strong community. The region records lower than average cancer screening rates. In response, Anna established a cancer screening nurse clinic to improve access to bowel, cervical and skin cancer screening. Bowel cancer and cervical cancer self-collection kits are provided to eligible people, and Anna provides education about the self-collection process. With the hot temperatures encountered in the Pilbara for much of the year, there is only a brief period during the cooler months for specimens to be posted for laboratory testing. Anna works hard to promote the service via word of mouth and the Community Centre’s social media accounts.
Teamwork and multidisciplinary care
Another enabling factor in the establishment of nurse clinics is collaboration. A team approach to supporting a new service is vital. Nurses cannot do it alone. The whole organisation needs to be on board, including the GPs, the practice manager, other nurses, and administrative/reception staff because a new service needs to be supported and promoted.
We spoke to participants who described regular practice meetings where the nurse clinic is a standard agenda item. The teams discuss what they’re doing, how they could improve the service, and how different perspectives and skill sets within the staff can contribute to the ongoing improvement of the clinic model.
We also heard from participants whose clinics were benefitting from multidisciplinary collaboration. Lead nurse Tara O’Connor runs a cancer screening clinic in Mullumbimby, NSW, with a particular focus on cervical screening. Mullumbimby, located in the Byron Shire, is known for lower engagement with conventional medical services and a strong preference for natural health approaches. Tara noted that the local naturopath is a highly trusted healthcare figure in the community. She observed that patients may be more likely to attend screening appointments after discussing it with the naturopath, whose involvement helps build trust in preventive care. Tara highlighted this collaborative relationship as a key factor in improving participation in cancer screening, particularly in a community that can be hesitant about mainstream health care.
Nurses’ commitment
Nurses’ motivation, passion and commitment are key drivers in supporting nurse clinic establishment. Several nurses involved in the program were motivated to set up their clinics due to lived experience of specific diseases. One lead nurse had lost a family member to a cardiac-related death at the age of just 30 years and had promised herself to promote heart checks in memory of this loved one. Another lead nurse with type 1 diabetes has set up a diabetes clinic to care for and educate patients. During consultations, she shares her own experience with the burden of illness, and this increases her credibility with patients and their trust in the care she provides.
All of the clinics we visited demonstrate that when a healthcare team is embedded within and trusted by its community, it can address the community’s needs in ways that are most effective and sustainable. Nurses and nurse practitioners are well placed to lead these innovative multidisciplinary models because they are qualified, skilled and passionate about keeping people well and out of hospital.
As shown in the examples we’ve described, a nurse’s intrinsic motivation is a key driver of success for a nurse clinic; however, vocational passion is not enough to sustain a healthcare initiative in the long term. The risk of nurses burning out increases if other enabling factors are missing.
Many of the nurses we spoke to felt that their knowledge, time and expertise were not valued by the current funding models. Increased remuneration was at the top of their wish lists, along with having more autonomy to make clinical decisions about patient care.
Michelle Gilbert runs an injury-prevention nurse clinic at Kingscliff Health in NSW. She is frustrated by the barriers that prevent nurses from using all their capabilities and has enrolled in a Master of Nurse Practitioner program. She says, ‘Nurses can provide a lot more health care than what the government gives us credit for!’
We are grateful for the warm welcomes that we received from program participants and we feel privileged to have heard the heartfelt stories they shared with us about their passion and determination to provide care. APNA is committed to maintaining and nurturing our long-term relationships with primary health care teams around the country. This is at the heart of what we do and it is invaluable.
To learn more about nurse clinics and to view interviews with Building Nurse Capacity participants, click here.
You can add APNA-Member Professional Indemnity Insurance to your membership, when you join APNA.
