The Alberta government is rolling out a new compensation model for nurse practitioners, one that it says will give Albertans greater access to a regular primary care provider when they need it.
Nurse Practitioners (NPs) are registered nurses (RNs) with at least 4,500 hours of clinical RN practice and a graduate degree — at least a Master’s degree in nursing, although Alberta Health Services says some also hold a doctorate — and advanced knowledge and skills.
They can diagnose and treat common health conditions and minor injuries, as well as order and interpret laboratory tests, prescribe drugs and make referrals to specialists.
The province is still working out the details of the payment model but said it would include allowing nurse practitioners to open their own clinics and take on patients, beginning as early as next year.
Health Minister Adriana LaGrange did say, however, Alberta is not looking at a fee-for-service model. The model is expected to include payment for a specified number of clinical hours and other commitments, such as caring for a certain number of patients.
The province is providing the Nurse Practitioner Association of Alberta with a $2-million grant over three years to implement the new model, recruit more NPs and set up clinics.
Nurse practitioners can provide about 80 per cent of the medical services a family physician can, the province said.
“We are looking to see what makes sense and how we can make sure nurse practitioners are compensated for their skill set, their knowledge, the work they are doing,” LaGrange said.
The model will be in place for at least five years, at which time it will then be reviewed, the minister said.
“This grant will help to prepare nurse practitioners as they take on more responsibilities and it will support them as they move toward independent practice and take on more patients,” Premier Danielle Smith said in a statement.
“Nurse practitioners are highly skilled, primary care providers with advance training. They can assess patients, provide diagnosis and treatment, order tests and prescribe medication. They are a key part of the solution to ease pressure on the health-care system.”
The compensation model is part of a three-year, $57-million support program announced in October that will help primary health-care providers manage increasing patient loads.
NPs who opt into the compensation model will also qualify for supports of up to $10,000 once their patient caseloads are established.
The Nurse Practitioner Association of Alberta said it is thrilled for the expanded opportunity to provide care.
“Until now, accessing a nurse practitioner has been challenging. This announcement ends those challenges,” said Nurse Practitioner Association of Alberta president Susan Prendergast.
“The NPAA looks forward to working with Alberta Health to get clinics open and to support NPs in being able to do the work that they are trained to do.”
However not everyone is thrilled with the news, including the association that represents about 14,000 Alberta doctors.
“To be very blunt — having heard this announcement and talked to some of my colleagues, the government definitely missed the mark on this one,” said Paul Parks, president of the Alberta Medical Association.
“I can’t criticize the government and the minister for wanting to add more resources to primary care and try to help the system — that’s what we need, we need more resources, retention and recruitment — but I can say this missed the mark.”
Parks said more attention needs to be paid to getting more family medicine specialists into the community.
“They can do a full scope and are the heart and soul, the foundation of primary care and the last thing we need is ‘siloed,’ more non-team independent type practice from different practitioners. We need to integrate them. We need to build teams and we need to work together and if this announcement was to have nurse practitioners out in the community, working independently, there’s a fair amount of evidence that that won’t work.
“They cannot practice to the full scope that the family medicine specialist can.”
NDP health critic David Shepherd said the announcement pushes the primary care access problem further down the road, while action is needed immediately.
“Nurse practitioners are important partners and will play an essential role in addressing the crisis in primary care. But at a time when hundreds of thousands of Albertans do not have access to a primary care professional, the UCP continues to ignore the urgency of the crisis we face.”
“There is nothing in today’s announcement that will help any primary care professional serve a single more Albertan any time soon.”
The Nurse Practitioner Association of Alberta said the goal is see more than 300 nurse practitioners enter primary care practice.
Over 700,000 Albertans are currently without a family doctor, according to the province.
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