Nurse practitioners in New Zealand

Nurse practitioners are highly skilled autonomous health practitioners who have advanced education, clinical training and demonstrated competency. They have the legal authority to practice beyond the level of a registered nurse.

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Nurse practitioners combine their advanced nursing knowledge and skills with diagnostic reasoning and therapeutic knowledge. They provide care for people with both common and complex conditions.

Many nurse practitioners work in primary care where, like general practitioners, they may be the lead health care provider for health consumers and their families/whānau. Some nurse practitioners own their own practice. Others work for district health boards, non-governmental organisations, or for Māori and iwi providers. Nurse practitioners are more likely to work in rural areas and in underserved communities. 

Guidance for employers

1. Nurse practitioners provide a wide range of assessment and treatment interventions

Nurse practitioners make diagnoses and differential diagnoses, and order and interpret diagnostic and laboratory tests. They prescribe medicines within their area of competence with the same authority as medical practitioners.

There has been ongoing work at the Ministry of Health since 2010 to remove the legislative, funding, custom and practice barriers that prevent nurse practitioners practising to the full breadth of their scope of practice. For example:

  • changes to eight acts of Parliament will enable nurse practitioners (and, in some cases, other health practitioners) to carry out activities previously done by medical practitioners, including issuing death certificates and sickness certificates
  • nurse practitioners can issue Standing Orders (as permitted under the Medicines Act)
  • a change to the Coroner’s rules to allow nurse practitioners (and other nurses, ambulance personnel and midwives to verify death)
  • nurse practitioners can supervise registered nurses who are training to become designated registered nurse prescribers

2. Nurse practitioners work across health care settings and can influence health services and the wider profession

Nurse practitioners may admit and discharge people from hospital and other health care services. They are involved in research, have leadership roles, and supervise and mentor other senior nurses.

3. Nurse practitioners have a broad scope of practice and have the same prescribing authority as medical practitioners

The Nursing Council established the broad scope of nurse practitioners to enable them to safely and appropriately meet changing health needs. 

4. Nurse practitioners are funded and subsidised for the treatment they provide

Nurse practitioners can claim General Medical Services (GMS) subsidies to help reduce patient fees for children and subsidy card holders. See Provider payments.

Nurse practitioners receive funding from the Accident Compensation Corporation (ACC) for providing treatment for a person after an injury. See Invoicing us on the ACC website.

Nurse practitioners are funded to provide primary medical treatment to residents under the Aged Residential Care (ARC) Service Agreement. See National agreements on the TAS website.

Nurse practitioners have access to flexible funding and capitation funding streams through Primary Health Organisations (PHOs).

Nurse practitioner training

To register in the nurse practitioner scope of practice the following qualifications are required.

  • Registration with the Nursing Council in the registered nurse scope of practice.
  • A minimum of four years’ experience in a specific area of practice.
  • The completion of an approved clinical master’s degree which includes the demonstration of the competencies for advanced practice and prescribing applied within a defined area of practice of the nurse practitioner. The programme must include relevant theory or concurrent practice or the completion of an overseas clinically focused master’s degree qualification which meets the requirements specified above.
  • Passing an assessment by an approved panel against the nurse practitioner’s competencies.
  • A minimum of 300 hours’ clinical supervision.

Funding for registered nurses training to become a nurse practitioner is available through Health Workforce New Zealand. Applications can be made locally through district health boards.

Feedback on nurse practitioner training and development

To help develop the Nurse Practitioner role in New Zealand, feedback is welcome on the findings of the Evaluation of Nurse Practitioner Training Programme. Please provide feedback to info@healthworkforce.govt.nz before Friday 27 April 2018.

Some questions to consider include:

Training programme

  • To what extent do you think the nurse practitioner training programme should be expanded?  What are the barriers/challenges?
  • What are the potential positive benefits of expanding the programme?
  • What should be done to encourage wider participation by Maori and Pacific nurses in Nurse Practitioner Training Programmes?
  • What should be done to ensure viability of current Nurse Practitioner Training Programmes?
  • What could be done to improve the selection process?

Nurse practitioner role

  • What should be done to raise awareness of the role of nurse practitioners and the benefit of employing nurse practitioners?
  • What should be done to encourage understanding of the nurse practitioner scope of practice?

Career development

What should be done to support ongoing career development for nurse practitioners?

Feedback will be received at info@healthworkforce.govt.nz until Friday, 27 April 2018.

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