It will help address staffing issues, and it’s in line with the government’s own commitments and plans, the nursing college says.
The Australian College of Nursing is calling on the federal government to allow nurse practitioners to independently lead Medicare urgent care clinics – a move the RACGP has already voiced opposition to.
More specifically, the nursing college wants the federal government to change the current Medicare Urgent Care Clinic Program Operational Guidance which stipulates that clinics have to be GP-led.
Nurse practitioners already lead the ACT’s walk-in centres and some remote UCCs.
Published in February, the second interim report into the federally funded Urgent Care Clinics said that recruitment remained a “significant” issue – for both GPs and nurses.
“Recruitment of appropriately qualified GPs and nurses to achieve the minimum workforce requirements outlined in the Operational Guidance across extended hours remains an ongoing challenge for providers and is particularly significant in regional and rural areas,” the report said.
The report also mentioned MBS billing restrictions as a “systemic barrier” to successfully implementing flexible workforce models.
“The promise of UCCs – to reduce pressure on hospital emergency departments and deliver timely care in communities – is being undermined by the staffing and MBS rules that ignore the proven capabilities of the nurse practitioner workforce,” ACN CEO Adjunct Professor Kathryn Zeitz said.
“Nurse practitioners are perfectly positioned to help take pressure off our strained emergency departments and hospital systems – which is the very point of Medicare urgent care clinics.
“But outdated staffing and MBS provisions are preventing UCCs from operating at extended hours and blocking access to safe, high-quality urgent care.”
It should be noted that, while nurses and midwives represent the largest group of health practitioners in Australia, nurse practitioners are few and far between.
AHPRA’s most recent annual report put the total number of endorsed nurse practitioners in Australia at 3194.
The current rules governing UCCs are, however, inconsistent with the government’s own Nurse Practitioner Workforce Plan 2024-2034, which committed to expanding nurse practitioner led services, supporting nurse practitioners to work to the top of their scope and improving access to under-served communities, the nursing college said.
UCCs were created prior to the collaborative arrangements’ legislation – which required all nurse practitioners to have a collaborative care arrangement with a medical practitioner in order to access the MBS – being removed in 2024.
“ACN urges the government to ensure its operational policy catches up with its own legislative reform,” Professor Zeitz said.
“Making this move would underscore the government’s commitment to equitable, timely care access for all Australians.”
The RACGP was not on board with the ACN’s plan.
“Urgent Care Clinics should be GP-led and must be staffed by highly trained GPs and nurses working together collaboratively to provide high quality emergency care to patients,” college president Dr Michael Wright told The Medical Republic.
“The clinics must be well-connected to general practice to avoid fragmented care and ensure best practice clinical handover.
“When urgent care clinics are built within existing general practices, it strengthens existing community health services and avoids duplication and wastage of public funds.”
The best value model for urgent care, Dr Wright said, was when GPs worked collaboratively with nurses.
As reported by TMR in February, the interim report into UCCs found that, so far, patients and staff are happy, but that UCCs only reduced equivalent emergency department presentations by around 10%.
It recommended that UCCs engage more proactively with general practice management to support appropriate referrals to UCCs.
The report said the cost of a UCC presentation was $206, about five times what it costs government for a standard GP consultation.
GP peak bodies and many GPs continued to be concerned about potential redirection of workforce funding away from general practice, de-skilling and fragmentation of care, the report noted.
