A third of Australia’s primary health care (PHC) nurses believe their skills are not being fully utilised most of the time, according to a new survey.

More than half (53%) of ‘under-utilised’ nurses had requested to use their skills and experience more. Of these, less than four in 10 successfully negotiated a change, while more than a quarter had their requests denied, with four in 10 saying they were told it was because it was of no financial benefit to their employer.

The survey found nurses remained underutilised regardless of their level of experience, with nearly four in 10 (37%) of all experienced nurses new to PHC not utilised often or most of the time, and more than a third (34%) of all experienced nurses skilled in PHC not utilised often or most of the time.

Conducted by the Australian Primary Health Care Nurses Association (APNA), the 2022 Workforce Survey canvassed the views of 4,000 PHC nurses, the most in its 15-year history.

Amid a looming workforce shortage of 85,000 nurses by 2025 and 123,000 nurses in Australia by 2030, and given the ageing population, and subsequent rise in chronic disease prevalence, APNA argues it is critical that nurses are empowered to work to do more to meet the country’s healthcare needs.

Yet in the current system, delegation and signing of Medicare Benefits Schedule billing lies with the doctor, says APNA. Under Medicare, apart from a $12 chronic care item number, general practices cannot claim payment from the government for a service provided in their clinic by a nurse unless a GP is on the premises to physically sight the patient, despite the fact the care was managed by the nurse.

APNA says the federal government’s Budget announcement of Medicare reforms around a multidisciplinary model of care lays the groundwork for structural change, but there is more work to be done. This includes adequately funded bundled payments for individuals with chronic and complex health issues that would allow flexible use of nurses within a multidisciplinary team. Such models would free up GP time to focus on the higher level and acute needs of their patients, while the nurse provides support through planned care activities, APNA suggests.

“This waste of nursing skill, knowledge, and enthusiasm occurs at all stages in a nurse’s career, regardless of their experience. This underutilisation of nurse skills represents a missed opportunity for the Australian health system, patients, and employers,” APNA President Karen Booth said.

“Australia’s health system can’t afford to have highly skilled, experienced and motivated PHC nurses sitting underutilised when there is so much more they could be doing. Nurse care can include cardiovascular education, vaccinations, wound care, and preventative health approaches such as primary health care screening and advising people on self-care to keep them well.

“Primary health care nurses are ready, willing, and able to do more. They are highly motivated, highly educated, and highly experienced.”