Dani Neal, APNA Communications Manager
For 10 years, APNA's Nursing in Primary Health Care Program has empowered nurses, transformed careers, and improved health outcomes across Australia. As we celebrate a decade of innovation, we reflect on its lasting impact on primary health care (PHC) nursing.
Australia's PHC system is constantly under pressure. Some of the challenges – an ageing population, higher rates of chronic illness, and workforce shortages – are pretty universal. Others are uniquely Australian, such as the vast distances between services and the specific health needs of our First Nations communities.
So, how do we tackle all that and ensure everyone gets the care they need? One big part of the answer is supporting and empowering our PHC nurses. That's exactly what APNA's federally funded Nursing in Primary Health Care Program (NiPHC) has been doing for the past 10 years.
NiPHC grew out of the government-funded Nursing in General Practice (NiGP) initiative, which ran from 2001 and was ultimately delivered by the Australian Medicare Local Alliance (AMLA) until it was disbanded in 2014. As APNA had actively supported the NiGP program while it was under the AMLA, it was clear that continuity of the program under APNA would benefit the nursing community.
‘NiGP was hugely successful at increasing the number of nurses working in general practice,’ says Ken Griffin, APNA's CEO for most of the duration of NiPHC. ‘But we felt there was an opportunity to do so much more.’
By the end of 2014, APNA had secured government funding to launch NiPHC. That first tranche (2015–2018) included four key projects, three of which continued through to the second tranche (2019–2023) and the third tranche, which began in 2023 and will end mid-2026. These four key projects are:
‘There was no clear career pathway for nurses when they left tertiary institutions and the sense was that they were leaving [PHC] entirely,’ says Bronwyn Morris-Donovan, former APNA CEO and the original project director.
‘So, to stem that tide, the Federal Government funded this piece of work for us to develop this career framework with the intention of strengthening the role of what it is to be a practice nurse.’
APNA developed and launched the Career and Education Framework, alongside the My Nursing Future website, in 2017. While these are not part of the current NiPHC program, the framework lives on – it's now the backbone of APNA’s Florence app.
APNA’s TPP supports nurses transitioning into PHC through mentorship and education. So far, 508 nurses have taken part, backed by 319 mentors, with most reporting increased confidence and retention.
One of those mentors is Victoria 'Tori' Vanin, who works at HealthMint Medical Centre in Cranbourne, Melbourne. She is currently guiding Danru 'Hedy' Hong, who recently moved to PHC but felt she needed more support to better fulfil her new role.
Tori herself took part in TPP when she started her first job in PHC in September 2019.
‘I got a lot out of the program when I did it, and it was something that I wanted to then pass back to someone who was transitioning themselves into general practice and a bit unfamiliar with the things that we tend to do on a day-to-day basis,’ she says.
Hedy welcomes Tori's support through weekly meetings, goal setting and help with resolving the challenges she faces. ‘She's very friendly and very genuine, and she is willing to support me throughout this journey.’
Tori adds, ‘We talk about highlights too, because there's lots of things that we do in practice nursing that don't always get recognised.’
Tori is one of the unexpected benefits of TPP – it's leading to high long-term retention rates not only for nurses new to TPP but also for mentors.
‘It really has reignited a passion that I've got for nursing and helping others in the future,’ says Tori.
Working to their full scope of practice and access to education and training are two factors associated with nurses intending to remain in PHC.1 APNA’s CDMHA helps meet these needs through an online program accessible to nurses working in even the most remote parts of Australia.
Initially, the program helped new PHC nurses gain skills and confidence in chronic disease management and healthy ageing, before being optimised to focus on upskilling more experienced nurses.
One of those nurses is Robyn O'Brien, who began working at Plaza Medical Centre in Coffs Harbour three years ago after 25 years in emergency nursing. She joined CDMHA to strengthen her existing knowledge to suit her new environment and ways of working.
Robyn says the program, particularly the cardiac module, has helped her become a more thorough questioner, attentive listener and better observer of her patients.
‘The course has helped influence my assessments to make them more appropriate for practice nursing,’ says Robyn.
Over 1,200 nurses have completed the program, with 81% saying they plan to stay in PHC for at least two more years after finishing.
Experienced nurses further into their careers often wonder, 'What next?' How can they better support their communities? Enhanced Nurse Clinics, which evolved into Building Nurse Capacity, was established to provide a supportive environment for nurses and their workplaces to develop their own nurse-led models of care.
So far, the program has supported 99 nurse-led clinics around the country, including the Teen Clinics launched by Bega Valley Medical Practice in NSW (see case study below) and a cancer-screening clinic at the Newman Community Centre in WA.
Building Nurse Capacity program participants have reported a measurable increase in their knowledge, skills and confidence in delivering nurse-led clinics, as well as their research and leadership abilities. Their programs have also boosted health access, patient satisfaction and health outcomes.
The Kyabram Skin Cancer Nurse Clinic is a shining example of the above. Registered nurse Leanne James became alarmed at the high rates of skin cancer affecting the local farming community and decided to take action. Local residents are now offered skin checks close to home in her nurse-led clinic, removing barriers to early detection and prevention caused by cost and distance (see pages 24 to 27).
Leanne praised the emotional, financial, and clinical support she received from the program: ‘If it wasn't for APNA, it wouldn't have happened.’
As this phase of NiPHC wraps up, what's next?
‘The Department of Health, Disability and Ageing has long recognised that nurses working to their full scope are key to better health care,’ says Ken.
Bronwyn agrees: ‘There's strong support to grow nurse-led models and make sure we have enough nurses in all areas, working at top of scope. If NiPHC isn't re-funded, we risk losing the momentum we've built.’
Ten years in, NiPHC has supported thousands of nurses and has helped improve care for countless Australians. It's proof that when nurses are supported, communities thrive. Here's to the next decade!
Transition to Practice Program
After 10 years of working in health promotion, Susan Edmonstone decided to study to become a nurse. After leaving university, she worked in a hospital but gravitated towards primary health care.
‘I was more interested in what the discharge planner was doing,’ she recalls. ‘Having a community health background, I realised that was my passion.’
When she joined a busy general practice, she felt somewhat out of her depth. Thanks to APNA’s Transition to Practice Program (TPP), she found the support she needed and credits it with giving her a foundation for her entire career.
Seven years later, Susan now works at Ochre Medical Centre in Maleny, QLD, and has come full circle as a program mentor, helping other nurses like Carissa Beddows find their way in primary health care.
‘I didn't realise how much there was to learn in primary health care until I started doing TPP,’ says Carissa, who works at Kingaroy General Practice in Kingaroy, QLD.
‘I know Susan's there if I need her. ... Sometimes I'm in the practice on my own, and just having someone to bounce off is so helpful.’
Both nurses say TPP has inspired them to do more. ‘It really reignites your passion,’ says Carissa. ‘There's just so much more out there to learn.’
Susan shares that passion with her mentee. ‘It's pulled me out of my comfort zone and reminded me why I love what I do.’
Susan has since joined the APNA Nurse Advisory Panel and is now focused on making further contributions to the sector.
Chronic Disease Management and Healthy Ageing – Kyabram Regional Clinic
The Chronic Disease Management and Healthy Ageing (CDMHA) program is a godsend for busy registered nurses like Erica Maguire, who works at Kyabram Regional Clinic in north central Victoria.
‘It can be difficult for nurses working in rural locations to access education. Sometimes travel can be an issue.’
When Erica heard about CDMHA, she joined the six-month education and support program without hesitation.
‘Having CDMHA online made it quite easy,’ she says. ‘It was great to refresh my skills. ... Doing [the program] has made me more aware of the needs of our patients, with the management of their day-to-day life.’
Practice manager Amelia Caroll also praises the program and how it's helped her nurses.
‘It gave them a deeper understanding of chronic disease. It was able to give a boost of support when they saw patients for their care plans.’
‘The bulk of their work is chronic disease plan, so we found that really beneficial for them,’ added Amelia. ‘It just gave us a bit more comprehensive care for the patients.’
Building Nurse Capacity – Bega Teen Clinic
Susan MacKinnon and Jodie Meaker joined the first Building Nurse Capacity program in 2016 when they were trying to establish a nurse-led clinic within the Bega Valley Medical Practice in Bega, NSW.
There had been a spate of youth suicides in the region. Teens needed easily accessible mental and sexual health services, and some barriers kept them from reaching out to their family doctors.
‘The kids probably wouldn’t be comfortable talking to their family GP who might play tennis with their dad,’ says Jodie, ‘and making appointments on their own is a big daunting change.’
Their participation in the program resulted in the first Teen Clinic, with others opening across southern NSW, including the latest in Temora in September this year.
After almost 10 years in operation, the free service has helped young people navigate mental health crises, prevent unwanted pregnancies and much more.
‘They come for acne, ingrown toenails, or they want to talk about sleep hygiene, eating issues, and there’s no stigma attached. They just come in and have a chat,’ says Jodie.
Acknowledgement
APNA received funding from the Australian Government Department of Health, Disability and Ageing to deliver all three Nursing in Primary Health Care (NiPHC) Program tranches.
Learn more about the impact of NiPHC and the nurses who have taken part.
You can add APNA-Member Professional Indemnity Insurance to your membership, when you join APNA.
