Despite pushing to contribute to Australia’s COVID-19 vaccination rollout, nurse practitioners, the country’s most experienced nurses, say they continue to be excluded.

Leanne Boase, president of the Australian College of Nurse Practitioners (ACNP), began raising concerns with the federal government about the omission back in January after it emerged nurse practitioners would only be able to administer the vaccine if supervised by a general practitioner or “suitably qualified health professional”.

Additionally, NPs working outside the public health system were not be covered by the Medicare Benefits Schedule (MBS) for the vaccines, meaning they could not access a rebate.

By excluding nurse practitioners, who can prescribe and administer vaccines, Ms Boase believes the government missed an ideal to increase access to vaccinations in settings such as aged care and rural and remote, where NPs already play a major role in healthcare delivery.

The lack of recognition for NPs has undoubtedly exacerbated the slowness of Australia’s rollout, she argues.

“We envisaged being able to prescribe and administer it [the vaccine] without any barriers,” Ms Boase says.

With many nurse practitioners already providing in-reach care in residential aged care, Ms Boase suggests they could have easily vaccinated residents and staff in stages, if they had been given the resources and opportunity.

After raising initial concerns over the exclusion, ACNP has continued to lobby the government over the issue. But NPs continue to be left out.

Despite sitting on various committees related to COVID-19 and the vaccines in the lead-up to the rollout, Ms Boase say the federal government gave no indication on how NPs might be utilised, nor that they would effectively be locked out from being involved.

“It was absolute disbelief and disappointment because we’ve been so engaged and frankly working our backsides off to contribute to this response as best we can, not just from a clinical sense, but also around the policy table as well. It was extraordinarily disappointing to be excluded in such a way,” she says.

Ms Boase suspects the absence of nurse practitioners from many important discussions regarding the vaccine rollout reflects a broader lack of recognition of the profession.

“We are engaged in many ways but there’s a lot of meetings that go on without us that we find out about after the fact.”

Numerous meetings about the COVID-19 vaccines have been held between medical groups and the government, often at the exclusion of other groups, she says.

“When you don’t include all of the stakeholders and all of the health professionals that can contribute to a response then, naturally, speaking with only one group you end up with one pathway or only one option and I think that’s what’s happened.”

For NPs, the most disheartening part about being overlooked remains not being able to contribute.

“We want to help, we can help, and we think we could make a big difference. It’s the patients that suffer.”

If the Morrison Government had utilised the expertise of nurse practitioners, Ms Boase believes the vaccine rollout would have progressed more rapidly and efficiently. NPs would have also made greater impact through their education and follow-up care.

“It’s incredibly frustrating because we all saw what happened in aged care in NSW and in Victoria and we know from experience that they [aged care residents] are our most vulnerable during this pandemic,” Ms Boase says.

“We know there’s supply issues, and we know that’s going to improve, but we should have actually achieved a lot more with those vulnerable people by now and it’s incredibly frustrating to be told that we have no choice but to sit on the sidelines and watch.”

In the face of ongoing barriers, Ms Boase says NPs will have no plan to give up and will continue to push to be activated in the vaccine rollout.

Some of her suggestions to the federal government have included a single MBS item number for NPs to deliver the COVID-19 vaccine, and allowing NP owned practices to lodge expressions of interest to become vaccination hubs.

“I think the government needs to look past different professional groups and just say right ‘how do we actually meet the needs of the consumer?’, ‘how do we actually protect the public here?’, ‘what resources do we need and have?’. Nurses are a huge part of the health resource in this country; we just need to recognise that they have a lot to contribute to policy and planning, in addition to healthcare delivery.”