Nurse practitioner clinics to improve access to primary health-care
More opportunities are being created for nurse practitioners in Saskatchewan.
A 2022 study revealed that nurse practitioners are under-utilized in Saskatchewan and that the equivalent of 30 NPS could be immediately available to provide health-care services.
A new pilot project being launched by the government of Saskatchewan will increase access to primary health-care in the province. The initiative will see an enhanced role for nurse practitioners (NPS).
“By creating more opportunities for nurse practitioners throughout the health-care system, we can improve access to primary health-care services for Saskatchewan patients and their families,” Premier Scott Moe said in a media release discussing the provincial budget.
It’s a new model for independently-operated, publicly-funded nurse practitioner clinics that will provide a new avenue for patients to seek care. Twenty-five new NP positions will be added over this year in rural, regional and northern communities.
Johanne Rust, president of the Saskatchewan Association of Nurse Practitioners (SANP), says their organization has been lobbying the government for many years to expand the use of NPS in all areas of health-care. The province will now pay for visits to NP’S, as they do with physicians.
“We believe that the cost for a person to see a NP should be publicly funded. In this province there are a few NP clinics that are private. They charge the patient directly,” she says. “There’s no mechanism to bill the government for services provided so it’s billed directly to the patient at the time of care. If we remove that barrier for accessing NP services, that improves care for patients.”
Nurse practitioners have been trained as registered nurses and then follow that up with three additional years of training at the Masters’ level. They have a broad scope of practice and can do things like assess patients, order diagnostic labs, interpret those labs, make decisions about care, write prescriptions and refer to specialists or other services. They can also follow up and adjust care as needed.
Later this year, that scope will widen still more. “This fall, nurse practitioner legislation under the Hospital Standards Act is going to be amended so that we can do admissions and discharges,” says Rust. “That will be very helpful in lots of places such as long-term care, where we will be able to admit a patient into a facility or discharge them to another facility, or admit them to emergency services, if we’re working in the emergency room.” This creates greater efficiencies within the system.
In Saskatchewan, one in five people do not have a family doctor or a nurse practitioner. That’s 200,000 people who could be sitting at home with worsening conditions, possibly heading for a crisis and ending up in the emergency room. “Putting more people on the ground in primary care strengthens care overall, reduces costs, reduces burdens on ERS and acute care services,” she says.
Rust says we currently have populations that are living longer with lots of chronic conditions, and it has become much more complex to manage a patient. “At the same time we’ve got a system that is poorly staffed so we’re trying to do more with less people.
“If you look at cardiac arrest rates, 20 or 30 years ago we would lose people with the first heart attack. And now they’re living 20 and 30 years after a heart attack because the care is improved. This population is living for many more years with conditions that can be managed. What used to be life-limiting has now become a chronic illness. And it can last for 20 and 30 years.”
Rust has worked in the nursing profession for 30 years, 20 of those as a nurse practitioner. She found a deep satisfaction from the long-lasting connections she formed in her community. “I’ve been fortunate to work in clinics where I’ve had the same patients for the 20 years that I’ve been a NP. The kids that I did prenatal care on are now university students. I’ve known their parents, grandparents and cousins. That care over a lifespan for me has been very fulfilling.” She says this is what primary care should be, providing stability and continuity.
The goal is to have more nurse practitioners in position as soon as possible. A new clinic in Warman recently became operational and another in Martensville is expected to open in April. The Saskatchewan Health Authority directs services at those clinics. By contrast, “a nurse practitioner-led clinic has a board of directors made up of NPS,” Rust says.
“What we’re exploring with this small pilot is, is there another way to put people on the ground, to put, as we say, pens to prescription pads,” Rust says. They are also exploring different ways of utilizing NPS.
A 2022 study revealed that NPS are under-utilized in the province and that the equivalent of 30 NPS could be immediately available to provide health-care services. The SANP has been in talks with the government over the past several years and always presents a list of places where the province could consider adding NPS in both urban and rural locations. Putting these people to work would improve access to care significantly.