The Australian College of Nursing (ACN) says the budget funding boost to make Medicare Urgent Care Clinics (UCCs) permanent will only be effective if there are urgent reforms to enable efficient use of all health professionals to their full scope of practice.
Three years since the first Medicare UCC opened, ACN is calling on the Government to revise the UCC Operational Guidance and update Medicare Benefits Schedule provisions to unlock the full potential of nurse practitioners, registered nurses, and the broader nursing workforce in delivering high-quality urgent care.
Rather than the development of any new UCC standards, the current Operational Guidance should be strengthened to be a strong multidisciplinary framework to build trust and ensure consistency and continuity of care between UCCs and a consumer's primary health care providers.
The Guidance must genuinely reflect the strengths of the multidisciplinary team, allowing all health professionals in UCCs to work to their scope of practice.
A key operational barrier holding back UCCs is the requirement in the Operational Guidance mandating a general practitioner on-site at all times. This rule contributes to clinics reducing operating hours or closing temporarily.
ACN is calling on the Government to revise the UCC Operational Guidance to explicitly permit NP-led service delivery when a medical practitioner is not on-site, and to update Medicare Benefits Schedule provisions accordingly. This reform is consistent with the commitments of the Government's own Nurse Practitioner Workforce Plan 2024–2034.
"Genuine quality of care is achieved through robust clinical governance, not by restricting which qualified professionals can lead care," said ACN CEO, Adjunct Professor Kathryn Zeitz FACN.
"The Operational Guidance does not reflect the Government's own Nurse Practitioner Workforce Plan, which calls for efforts to unleash nurse practitioner leadership – especially amid GP shortages, and when nurses already lead ACT urgent care centres and remote Urgent Care Clinics."
Nurse practitioners hold a Masters-level qualification, complete a minimum of 5,000 hours of advanced clinical experience prior to endorsement, and are nationally regulated by the Nursing and Midwifery Board of Australia to practise autonomously. The proof of concept is they are already leading urgent care in the ACT's Walk-in Centres and in a number of remote UCCs. The Government's own interim UCC evaluation confirms these models are working.
"With the health system under immense strain from an increasing burden of chronic disease, an ageing population, and health care workforce shortages, every dollar spent on health care must be as efficiently and effectively used as possible.
"This includes the additional $1.8 billion over five years that the Federal Government has announced to make Urgent Care Clinics permanent," said Adjunct Professor Zeitz.
ACN also urges the Government to establish a clinical governance framework to enable designated registered nurse prescribers to prescribe within their scope of practice at UCCs, and to fund nurse-led vaccination programs at UCC sites. Together, these measures would expand the range of services UCCs can deliver, increase access for people, and make better use of a highly skilled workforce, already present in these clinics every day.
The latest evaluation of the Medicare UCC program found training programs and opportunities for nursing staff lagged behind those available to medical staff. ACN calls on the Government to invest in professional development and embedded career pathways for nurses working in UCCs, on par with those provided to their medical colleagues.
"The Urgent Care Clinic model has proved a valuable option for health care consumers seeking care for urgent, but not life-threatening, conditions," said Adjunct Professor Zeitz.
"Nurses are central to the UCC offering, and we must support and invest in them to work at the top of their scope of practice to improve safe, quality, accessible care to all Australians.
"Nurses are crying out for embedded training and career pathways. The Federal Government has an opportunity to deliver on this via its own urgent care model."
