Nurse practitioners employed by primary health organisations can enroll patients and receive capitation funding, says Health Minister Tony Ryall.
In response to Nursing Review questions about funding frustrations expressed by nurse practitioners, and specifically around the funding of NP-led youth health service Waves, he said it was “worth noting” that NPs could enroll patients and “some already do”.
"I am very supportive of the nurse practitioner role, and the Ministry is working with key nursing groups to ensure greater utilisation of the nurse practitioner role," Ryall said.
Professor Jenny Carryer, executive director of the College of Nurses and patron of Waves, said the Minister and Ministry of Health “technically agree” that an NP can enroll patients and claim capitation, but this was not widely known by primary health organisations (PHOs) across the sector. “In fact, it is widely believed it is not the case.”
“It’s technically possible but blocked by ignorance of that possibility and lack of willingness to make it work on the part of PHOs.
“You would have to say that the Ministry has made no effort whatsoever to make known that it is possible, and I wonder why,” said Carryer.
She said she knew of an inner city health centre that had struggled but eventually been successful in gaining PHO capitation funding for NP-enrolled patients. But NPs are still unable to claim the General Medical Subsidy under which GPs can claim funding for treating “under-six-year-olds” or “clawback” funding if they see a patient who is enrolled with another PHO or is not enrolled anywhere.
Ryall said he had been advised by the Taranaki District Health Board that the closure of Waves’ NP-led youth health service in New Plymouth (see other News Feed stories) was “not a funding-related issue”. He said youth one stop shops (YOSS) like Waves have “always been and will continue to be funded from a range of sources” including health, education, social welfare, local body, and philanthropic support.
Sandra Boardman, funding and planning general manager for the DHB, said it has never directly funded Waves as it had been funded through a PHO that “provided a scale and level of oversight/clinical safety that WAVES would not be able to achieve as a standalone entity.”
Waves chair Garth Clarricoats said Waves had “mutually agreed” to exit a contract with Midland PHO, and after gaining external accreditation as a health provider, had unsuccessfully sought transitional funding from the DHB while it negotiated an agreement with a new PHO (see other News Feed story).
Boardman said the DHB had facilitated discussions between Waves and a number of health providers “aimed at identifying a provider able to partner with Waves and provide oversight, unfortunately these attempts have not been successful”.
“The DHB is strongly supportive of health services being delivered on the WAVES site by other contracted providers and would be happy to continue discussions on this,” said Boardman.
