Breaking Legislative Barriers to Nurse Practitioners, Canada

Good Health and Well Being
Case Study Submitted by: Carolyn Pullen, Director, Advocacy and Strategy, Canadian Nurses Association
Country: Canada
Despite progress, numerous pieces of federal legislation still require updating. Without these changes, barriers in access to care persist for many Canadians

Over 20 years ago, nurse practitioners (NPs) became a regulated class of healthcare providers in Canada with the aim of improving access to primary care for many citizens, especially indigenous peoples living in rural and remote communities. Today, there are almost five thousand NPs in Canada, many of whom are members of multidisciplinary care teams, and the primary care providers for over three million Canadians.

Since the introduction of NPs, many pieces of provincial, territorial and federal legislation have gradually been modernised to recognise and list NPs as professionals eligible to provide a range of health services, but many legal amendments still need to be implemented to increase the scope of practice of RNs and to extend access to care to all.

Updates have allowed NPs to officially sign off on a range of legal and administrative documents that verify they have examined or treated a patient and assessed a patient’s eligibility for a federal programme.

British Columbia has been the leader in removing provincial barriers where legislation required modernisation to include NPs. In 2014, the British Columbia College of Physicians and Surgeons and the College of Registered Nurses of British Columbia collaborated to successfully address this issue with the province passing Bill 17 to make 11 changes in nine Acts.

As progress is made at the provincial level, the Canadian Nurses Association (CNA) and their partners, including the Canada Association of Advanced Practice Nurses and the Canadian Indigenous Nurses Association, continue to work with the federal government to make similar legislative changes at the federal level. While the required legislative changes are minor, collectively they will greatly enhance access to care.

The CNA continues to advocate strongly at the federal level for changes to 34 pieces of federal legislation. They are presently working toward an omnibus solution that may be implementable in 2017 to comprehensively address the issue. The most current outcome is a high level of awareness of the issue among federal politicians and policy makers and strong support for change.

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