Māori NP training support at risk

You can’t just pluck Māori and Pacific nurses off a tree and turn them into nurse practitioners in a year

Underspending could be used to fix the problems snaring a contract aimed at supporting Māori nurses in primary healthcare set­tings to become nurse practitioners.

Nursing leaders say COVID-19 has meant many nurses won’t be ready to start their final year of NP training un­til 2025 – but the contract ends in December 2024.

Contract co-leaders Sue Adams and Josephine Davis, of the University of Auckland School of Nursing, say the contract governance group asked Te Whatu Ora – Health New Zealand to roll over or extend the four-year con­tract beyond 2024.

Dr Adams says that request was for­mally declined at a recent meeting with representatives from Te Whatu Ora and the Ministry of Health (formerly the contract-holder).

But a proposal is being considered to use the contract underspend to support Māori and Pacific nurses, including a graduate transition-to-practice pro­gramme for NPs, as well as Māori and Pacific scholarships.

Dr Adams says the pandemic con­tributed to the underspending of some of the $18.6 million, four-year contract for what is known as the Nurse Practi­tioner and Enrolled Nurse Workforce Programme for Primary Mental Health and Addiction.

Its aim is to support employment of more NPs and enrolled nurses in pri­mary health and community settings and to increase access to mental health and addiction care. The funding can also be used to expand the nurse prac­titioner training programme (NPTP) for final-year NP trainees.

“We said right at the start you can’t just pluck Māori and Pacific nurses off a tree and turn them into nurse practi­tioners in a year,” says Dr Adams.

She says it takes considerable engage­ment with the nurses themselves, in­cluding building their confidence to undertake postgraduate study, as well as helping their employers understand what is required to support a registered nurse to become an NP.

Ms Davis, who is an NP, says an issue faced by Māori and Pacific nurses is that they work full-time and also have sig­nificant commitments to their whānau, hapū and community.

These are extra pressures on Māori students trying to get through their studies, she says.

Dr Adams says the “huge burden of COVID-19 on Māori and Pacific health providers and nurses” has delayed that part of the contract.

Nurse leaders also want the NPTP expanded to fund all 90-plus NP trainees a year rather than just 50, as at present.

Nine Māori NP trainees in this year’s NPTP are also being supported by the contract’s pipeline funding targeted for building the Māori NP workforce.

But, Ms Davis says, as part of the contract’s pipeline training support, her team is also working with about 14 Māori and Pacific nurses who recently started postgraduate study towards a clinical master’s degree.

“Most of these students will not be academically ready to go onto the final [NPTP] practicum year until probably 2025, but the contract ceases in Decem­ber 2024,” she says.

“We are going to have this cohort of Māori and Pacific students ready to go, who we may not be able to support through that final part of their training and then into embedding their models within their clinical settings.”

It is now hoped that proposals for the contract underspend will be able to sup­port these students.

Ms Davis is also concerned the 2024 cut-off could affect another aspect of the contract: working with primary care providers to support kaimahi and other health workers to train as enrolled nurses.