The Nursing Policy Secretariat (NPS) was formally established in 2017 by the ministry as per a Memorandum of Understanding in the Nurses Bargaining Association Collective Agreement. This ministerial commitment was intended to support collaboration between the ministry, health authorities, professional colleges, the Nurses Bargaining Association, and other partners, to consider issues related to the scopes of practice for licensed practical nurses, registered nurses, nurse practitioners and registered psychiatric nurses across the province, as well as to develop priority policy for the nursing profession.
In January 2018, the report on the recommendation was released (refer to: Nursing Policy Secretariat: Priority Recommendations report available at: www.health.gov.bc.ca/library/publications/year/2018/nursing-policy-cons….
The report contains 50 priority recommendations focused in 13 thematic areas to provide strategic direction to the Ministry of Health and system partners to optimize nursing practice, better support patients, and achieve health system goals overall. The themes included: role of nurses in primary care; nurse practitioners; scope of practice; surgical model; nursing representation; quality practice environments; education; health human resources; collective agreement; documentation; nursing expert access and advice; leadership; and rural and remote practice.
In 2018, the NPS established the Provincial Nursing Network (PNN), comprised of representatives from all health authorities and key partner groups, to provide advice on nursing practice, education, regulation, policy, and research; and support the implementation of the priority recommendations (including priority sequencing). A parallel governance structure, the Nurse Practitioner Advisory Network was also established to advance the NPS recommendations pertaining to nurse practitioners (NPs) and to focus on cross-system integration of NPs. To date, 76 percent of the recommendations have been completed or are in progress. Two key initiatives undertaken by the NPS that relate to the advancement of universal access to primary care are described below:
Improving Access to Team-Based Primary Care
The ministry has developed strategic policy direction to support the implementation of team-based primary care in B.C. The policy affirms that effective health care delivery in the B.C. health system requires collaboration and coordination of care by multiple health care disciplines on behalf of the patient. It also outlines definitions and policy guidelines for the establishment of effective health care teams.
To support enhanced attachment and access to primary care, the ministry has funded additional educational seats for nurse practitioners. A new compensation model has been created for NPs in these settings to enable them to provide longitudinal primary care services and work to their optimal scope of practice under an independent contract. Additionally, an innovative model of team-based care, i.e., Nurse Practitioner Primary Care Clinics (comprised of an interdisciplinary team, e.g., NPs, registered nurses, mental health worker, midwife, and general practitioner) has been launched at three sites across the province. It is anticipated that these clinics will address a significant attachment gap over the next three years.