Nurse practitioners can diagnose, prescribe medicine and make referrals to specialist care. File photo. Photo: 123RF
The funding to train this year's intake of nurse practitioners - who can diagnose, prescribe medicine and make referrals to specialist care - is yet to be confirmed, even with the training for 121 people getting under way last week.
Many nurse practitioners are now helping to fill some of the gaps left by the shortages of GPs, particularly in rural areas.
The main training programme for nurse practitioners - referred to as Nurse Practitioner Training Programme (NPTP) - is overseen by Auckland University which co-ordinates training by six universities.
The NPTP is a part-time practical year of training, which people can do when applicants will have already completed a master's programme or will be able to meet all the requirements at the end of the practicum year.
For the past five years the government funding for the NPTP was comprehensive, covering tuition fees, workplace release time and mentoring for students.
That funding came to an end at the end of last year.
On Thursday about 50 trainee nurse practitioners started their training at the Auckland University, despite the lack of details about this year's funding.
Nurse Practitioners NZ chair Chelsea Willmott said in late December Health NZ indicated it would fund all 121 successful applicants, but it has still not confirmed the funding.
"The previous five year contract had a certain monetary value for each of the things," said Chelsea Willmott, "like how much money would an employee get, funding for a certain number of academics per number of candidates, certain number of travel paid, all of those major details of the contract have not been confirmed, and that is a real concern."
Willmott said all those aspects were essential for successful training.
She said the delays were putting students and their workplaces on edge.
"In the last three weeks at least 25 calls from different, small, particularly rural, health services, medical centres and other NGOs and other Maori based providers, all sorts of people ringing me, really concerned with how they are actually going to support their candidate from a financial perspective, without any confirmation of what the funding package will look like."
Josephine Davis is the associate head of school - Māori at the University of Auckland's School of Nursing, and was the co-lead of nurse practitioner training nationally until the funding for that role stopped at the end of last year.
She said the late confirmation had made people uneasy.
"Within the health sector rostering and planning takes place months in advance" said Josephine. "So I know at the end of last year we were feilding many calls and emails from the sector, students and employers, asking what was happening. So yeah there is a degree of unease in the sector."
Davis hoped that at a minimum the aspects funded previously are continued, and she would like to see it expanded.
University of Auckland head of the school of nursing Professor Julia Slark said she was expecting the contract confirming funding, and what it covered, to come through at any moment.
"I'm very confident the money will come through. I have the full support of the University of Auckland. We appreciate that it is really strategically important for New Zealand that we train nurse practitioners. The course will go ahead and I am confident we will get the funding to support it."
Bruce Arroll - a professor of General Practice and Primary Health Care at Auckland University, a GP at Auckland City mission, and a patron for Nurse Practitioner NZ - said nurse practitioners were playing an increasing role in filling the shortage of GPs.
He said there was a danger that the uncertainty about the course will put prospective nurse practitioners off from starting the long lead-in process to get the qualification.
"The risk of the uncertainty - this is very late in the day and the courses are starting - you just put instability into the system, and perhaps discourage potential applicants and that will just contribute to the shortage."
In a statement, Health NZ director workforce planning and development John Snook said it was committed to growing the nurse practitioner workforce, and is currently finalising contract arrangements with the previous contract holder for the delivery of the nurse practitioner education for the 2025 academic year.
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