Advocacy Statement re: Funding Models for NPs

There has been a significant amount of discussion about Nurse Practitioners (NPs) in Ontario over the past few years; primarily around how NPs can help address patient access to health care. Recent estimates indicate there are currently over 2 million patients in Ontario without regular access to a primary healthcare provider (Family Physician or NP) (Reference). Without access to a primary care provider, patients turn to walk-in clinics and emergency rooms for their care, or go without care altogether. This is not efficient, effective, nor sustainable health care for Ontarians.

There is so much more that NPs can do to alleviate the pressures on the health care system. However, the limiting factor is the availability of flexible funding models that allow them to contribute in the areas of greatest need (See Reference). 

Currently, NPs in primary care are funded through salaries paid by the Ministry of Health (MoH). You can find these salaried NPs in Nurse Practitioner-Led Clinics, Family Health Teams, Community Health Centres, and some other areas. However, where there is no funding available from the MoH, there is no opportunity for NPs to contribute to patient care. 

The Nurse Practitioners’ Association of Ontario (NPAO) fields calls weekly from physicians wishing to hire NPs into their clinics, but with no funding available they are unable to hire them.  A growing number of NPs are opening up independent clinics and charging patients for the care provided, because of the demand for healthcare and the fact that there is no funding available from the MoH. NPs are under-employed in Acute Care settings also as their salaries are paid out of the hospital budget, which limits the number of NPs in hospital settings.

Ontario needs to better utilize NPs to improve healthcare for Ontarians. Funding Models are the most significant barrier to integrating NPs more across all health care settings. Nurse Practitioners are calling for your assistance to raise the need for more flexible funding models so they can contribute more to patient care and help address the challenges our health care system faces.

Within the last few years, British Columbia has led the country in the integration of NPs into the primary health care system by establishing a contracted funding model for NPs to access to establish a new team-based care clinic or join an existing one. Here is a backgrounder on that initiative: Nurse Practitioners in British Columbia PCN.

There are additional funding model options that can be extended to NPs including:

·        fee-for-service for the provision of specific health care procedures (i.e. mental health and addictions, MAID, etc.)

·        capitation payments for a roster of patients

·        blended model of salary and incentive payments

The critical point is that the Government of Ontario has options at its disposal to better utilize NPs to address the health care challenges faced by Ontarians but new funding models are required. Now is the time to make bold decisions to improve patient access and the quality of care.

NPAO is currently running a letter writing campaign to advocate for more funding models for NPs. Add your voice to this advocacy: https://www.supportnursepractitioners.ca/send-a-letter-to-your-mpp