Australia’s peak nursing and midwifery organisations have welcomed the release of the Scope of Practice Review: Issues Paper Two – saying it presents a considered, evidence-based approach that pinpoints four key challenges to the delivery of primary health care (PHC) in Australia.
These include:
1. Poor recognition of the skills that primary care health professionals have
2. Inadequate preparation [of health professionals] for primary care
3. Legislation that impedes health professionals working to their full scope
4. Funding and payment arrangements that impede health professionals working to their full scope
The country’s peak nursing and midwifery organisations consist of the major associations, colleges and unions, and include the Australian Nursing and Midwifery Federation (ANMF), Australian Primary Health Care Nurses Association (APNA), the Australian College of Nurse Practitioners (ACNP), and the Australian College of Midwives (ACM). Combined, they represent the 448,000 nurses and midwives registered to work in Australia.
About 96,000 nurses and midwives working in multiple primary healthcare settings. According to the nursing and midwifery peaks, the four major issues identified by the Review are preventing nurses and midwives from working to their full scope of practice, which is known to restrict consumer access to optimal care.
To address the challenges, the Review outlines a series of options for reform with the aim of improving primary health care by allowing health professionals to work to their full scope of practice.
Potential solutions proposed include developing a national skills and capability framework matrix that sets out the skills and capabilities of health professionals, thereby contributing to better recognition of health professional skills and strengthening the system by informing workforce planning. Other options on the table include improving early career and ongoing professional development, removing legislative barriers that restrict health professionals from working to their full scope, and implementing flexible funding models that support primary care teams to work together more effectively.
The nursing and midwifery peaks describe the Scope of Practice Review as a once in a generation opportunity to:
Realise the full value of using every health profession
“To improve Australia’s health, the health system must utilise the skills, expertise and experience of the whole health workforce. Australia trains excellent health workers but many barriers persist which prevent this critical workforce from using their full skill set. The 2023 APNA Workforce Survey shows that 31% of PHC nurses are only occasionally or rarely working to their full scope of practice. This same survey shows that nurses who cannot work to their full scope are more likely to leave PHC. Using our health care workforce well also helps retain them.”
Enable modern models of health delivery
“The Health System requires more than funding. It also needs changes to how the health system works. Access must be improved. General practitioners are the gatekeepers of the system, but RACGP data shows that around 1 in 5 Australians (5.4 million people) do not have a regular general practitioner. Given this, it is rational to explore different funding and clinical models to ensure all Australians have access to high quality care.”
Embed evidence-based workforce decisions in Australia’s health system
“Health policy often diverges from the evidence. We urge the government to continue to focus on evidence rather than politics as it reforms the health system. The Scope of Practice review provides a strong, evidence-based foundation for this process.
We encourage Australia’s health leaders to continue to be bold. Australia’s health system needs change. This issues paper represents another step towards reform. Our organisations will continue to work constructively with Minister for Health and Aged Care Mark Butler and Assistant Minister for Health and Aged Care Ged Kearney, and Professor Mark Cormack and all those supporting reform of Australia’s health system.”
“It’s time for change. It’s time to be bold. Australia’s health depends on it,” the peaks said.
