Sustainable workforce reform: case study of Victorian nurse practitioner roles

Abstract

Nurse practitioner (NP) roles have been identified as a key strategy in the development of a sustainable and responsive health workforce. To date, the focus of research related to NP roles has been on implementation and short-term evaluation of aspects of NP care; however, little is known about the sustainability of NP roles. A major challenge for the healthcare sector is to demonstrate long-term outcomes of NP care and shift the research focus from individual NPs to the effectiveness of healthcare teams that incorporate NPs. This paper draws on a framework of the following domains of sustainability in primary care: political, institutional, financial–economic, workforce and client (or patient) and applies these domains to NP planning in the Victorian context. What is known about the topic?Studies have shown several positive outcomes of NP care including cost, quality of care, patient satisfaction and access to care. What does this paper add?Sustainability of NP roles is poorly understood; however, there are theoretical factors that may be useful in planning for sustainable NP roles. What are the implications for practitioners?There are opportunities to examine traditional roles, governance and funding structures in healthcare to optimise a sustainable contribution to healthcare by NPs and integration of sustainable NP models by health services.