The Australian College of Nursing is calling on the Federal Government to revise guidelines to allow nurse practitioners to lead care independently in Medicare Urgent Care Clinics (UCCs), with GP recruitment an ongoing challenge for the program.
Nurse practitioners are among the most highly qualified clinicians in our health system, capable of leading UCCs, but the current Medicare Urgent Care Clinic Program Operational Guidance mandates that clinics will be GP-led, with a vocationally registered general practitioner required at a minimum.
The latest evaluation of the program noted recruitment of appropriately qualified doctors remains an issue, and that Medicare Benefits Schedule (MBS) billing restrictions need to be overcome to enable flexible workforce models.
Changing the operational guidance and granting nurse practitioners access to after-hours MBS items would help address the issue of UCCs not operating at extended hours or on weekends.
ACN Chief Executive Officer, Adjunct Profession Kathryn Zeitz FACN, said that more strategic use of nurse practitioners and nurses would significantly improve access to urgent care.
“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.”
Nurse practitioners hold a Masters-level qualification, complete a minimum of 5,000 hours of advanced clinical experience before endorsement, and are nationally regulated by the Nursing and Midwifery Board of Australia to practice autonomously.
They are authorised to assess, diagnose, treat, and prescribe – and they do so safely every day across Australia’s hospitals, aged care facilities, remote health services, and primary care settings.
“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,” Adjunct Professor Zeitz said.
“But outdated staffing and MBS provisions are preventing Urgent Care Clinics from operating at extended hours and blocking access to safe, high-quality urgent care.”
The ACT’s nurse-led urgent care clinics and some remote urgent care clinics are exempt from the GP-only leadership model, providing the evidence that nurse practitioner-led care is safe and effective, and keeps people out of emergency departments.
“ACN calls for what is working in the ACT to become the national standard,” Adjunct Professor Zeitz said.
“Further, the mandatory GP presence requirement echoes the now-abolished ‘collaborative arrangements’ legislation – a regulatory relic dismantled in 2023 because it was recognised as an outdated barrier to patient access that hampered nurse practitioners’ ability to work autonomously.”
The Urgent Care Clinic Operational Guidance is also inconsistent with the Government’s own Nurse Practitioner Workforce Plan 2024-2034.
“This reform represents a logical next step. The Nurse Practitioner Workforce Plan sets explicit priorities to expand NP-led services, support NPs to work to their full scope of practice and improve access for underserved communities facing medical workforce shortages,” Adjunct Professor Zeitz said.
“ACN urges the Government to ensure its operational policy catches up with its own legislative reform.
“Making this move would underscore the Government’s commitment to equitable, timely care access for all Australians.”
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