WHEREAS the Government of Alberta is responsible for the delivery of medical services to Albertans; and
WHEREAS there is a shortage of physicians in the province, particularly in rural Alberta; and
WHEREAS the Government of Alberta established the Rural Physician Action Plan in 1991 to support practicing rural physicians; and
WHEREAS the Rural Physician Action Plan met with limited success, and rural Alberta municipalities continue to struggle with the attraction and retention of physicians; and
WHEREAS Alberta has more than 800 licensed nurse practitioners, with 30to 100 new graduates annually; and
WHEREAS nurse practitioners are health care professionals with training to provide essential health care services; and
WHEREAS nurse practitioners are completely independent health care professionals who could work in urgent care facilities, nursing homes, assisted living facilities, community clinics, primary care offices, and hospitals; and
WHEREAS most of Alberta’s nurse practitioners work in hospitals due to lack of a salary-based funding model which would compensate them fairly and equitably, and enable the establishment of independent practices throughout Alberta; and
WHEREAS adequate Government of Alberta funding for nurse practitioners will alleviate the shortage of physicians and expand the reach of health care to rural Albertans of all ages;
THEREFORE, BE IT RESOLVED that the Rural Municipalities of Alberta request the Government of Alberta to establish a salary-based funding model that will fairly and equitably compensate nurse practitioners for work in rural local care facilities and rural independent clinics.
Rural Albertans continue to experience significant challenges to health care accessibility. The number of family physicians has dropped 0.9% between April 2019/March 2020 and April 2020/March 2021 despite an increase in Alberta’s population. A 2022 survey conducted by the Alberta Medical Association indicates that 34% of Albertans do not currently have a family physician.
One solution to this issue is care provided by nurse practitioners.
Nurse practitioners are health care professionals educated at the Master’s or PhD level. They are qualified to provide essential health care services such as primary care, outpatient clinic-based care, or hospital care, very similar to the care that a family doctor provides.
Nurse practitioners offer a wide range of services which include ordering and reading x-rays, tests, and laboratory results, performing exams and diagnosing problems, providing or ordering treatments, prescribing medications, providing follow-up care and education, and referring to specialists. They are independent and require no outside supervision of their practice.
Across Canada, nurse practitioners work in hospitals (35%), community health facilities (36%), and nursing homes (4%). The other 24% are educators, researchers, have returned to registered nursing roles, or are employed in private practices. Three million Canadians receive primary care from nurse practitioners and based on a study conducted by the Canadian Nurses Association in 2012, nurse practitioners have contributed to a 20% reduction in emergency department admissions from long-term care, and a 55% reduction in the use of multiple medications.
In Alberta, provincial funding to nurse practitioners working outside the hospital system flows through primary care networks (PCNs). PCN positions are historically underpaid and have limits placed on the number of patients who can been seen. The Nurse Practitioner Association of Alberta submitted a proposal to the Government of Alberta in 2021, suggesting a salary-based model in which nurse practitioners are paid directly by the Government of Alberta. Compared to a per-patient funding model, a salary-based model would enable nurse practitioners to provide a thorough, holistic approach to a patient’s health-care needs.
Due to the frequent leadership changes in government, the proposal has not moved forward.
RMA has no active resolutions directly related to this issue.
This resolution urges the Government of Alberta to establish a salary-based funding model to fairly and equitably compensate nurse practitioners (NPs) for work in rural local care facilities and rural independent clinics.
Alberta’s government recognizes the importance of NPs in the health system and is committed to providing Albertans with greater choice in their health care providers by increasing the number of NPs in Alberta. Currently, the province funds/employs NPs to deliver services through AHS and the Primary Care Networks (the PCN NP Support Program).
The PCN NP Support Program was initiated in 2019 to increase the number of NPs working in primary care through targeted funding. The goal of the support programs is to:
As of November 2022 there are a total of 55.29 full-time equivalent NPs registered with the PCNs. Some of these NPs are working in rural Alberta, but we also recognize that more can be done.
Moving forward, we are continuing the work of the Modernizing Alberta’s Primary Care System initiative and assessing alternative compensation models for family physicians and NPs. I am pleased to let you know that the work on a NP funding model is underway.
RMA is pleased to hear that the Government of Alberta is working to create a funding model for NPs in Alberta. A funding model that allows NPs to practice in rural and still be compensated fairly for their work is key to the recruitment of practitioners and could ease the current stress placed on the health care system due to lack of access.
RMA staff have collaborated and discussed this issue with the Nurse Practitioner Association of Alberta (NPAA) and will continue to monitor progress. Current advocacy efforts include the push for NPAA to be involved in the development process.
As the province develops this model and more information becomes available on the status of developing the salary-based funding model, RMA will revisit the status of this resolution, however as it stands currently, the resolution has been assigned a status of Intent Not Met.