A survey of the NP workforce in primary healthcare settings in New Zealand.

Aim: The aim of the survey was to describe the demographics, distribution, clinical settings and employment arrangements of the New Zealand nurse practitioner workforce in primary healthcare settings; and organisational factors limiting their practice.

Method: An online survey was developed and sent to all NPs in mid-2019.

Results: The survey was completed by 160 nurse practitioners who worked in settings broadly defined as primary healthcare (response rate 71.4%). In addition to clinical work, nurse practitioners engaged in teaching and clinical supervision; leadership and management; policy development; locum work; and research; but 14% continued to do at least some work as a registered nurse. One hundred and fifty-one respondents were working clinically and 48% of these worked in more than one clinical setting. General practice-type settings (39%), of which over 40% were very low-cost access practices, and aged residential care (19%) were most commonly identified as the main clinical setting. Others included long-term conditions; mental health and addiction; sexual health/family planning; whānau ora; child/youth health; and various community nursing service roles. Seventy-three percent of nurse practitioners earned less than $120,000 per annum for full-time work; and 60% had $2,000 or less available for professional development. Three quarters had worked in the same setting for at least two years, and 60% intended to stay a further three years. Fourteen percent worked rurally. Employment models, models of care, and access to diagnostics, particularly radiology, were most limiting to their practice.

Conclusion: The nurse practitioner workforce offers stability and flexibility in working across multiple clinical settings in primary healthcare. They provide the potential solution to the general practitioner workforce shortage by improving access to primary healthcare and reducing health inequalities. As authorised prescribers able to enrol patients, receive capitation payments and claim general medical services, it is timely to facilitate the expansion of the nurse practitioner workforce in New Zealand.