College of GPs’ position paper pulled after NP feedback

It’s just without consultation it doesn’t accurately reflect the nurse practitioner scope of practice or the training preparation

Concerns raised over the accuracy of an RNZCGP position statement on nurse practitioners have led to the paper being withdrawn today less than 24 hours after its release.

The four-page position statement on nurse practitioners’ contribution to general practice teams, aimed at clarifying the difference between specialist GPs and NPs, was released to RNZCGP members last night.

The College of Nurses Aotearoa and Nurse Practitioners New Zealand (NPNZ) raised concerns over inaccuracies in the statement and this afternoon formally asked RNZCGP to withdraw it so the three organsiations could work collaboratively to address the concerns.

RNZCGP president Samantha Murton confirmed to New Zealand Doctor Rata Aotearoa the College of Nurses had asked for the statement to be removed from its website.

“I have spoken with [College of Nurses executive director] Kate Weston and the [RNZCGP] will work collaboratively with the College of Nurses and NPNZ to make sure any minor errors are corrected,” Dr Murton says via email.

“During this time, the position statement will be unavailable.”

NPNZ chair and NP Sandra Oster says the intention of the document is not bad and NPNZ appreciated it showed a desire for collaboration between GPs and NPs..

“It’s just without consultation it doesn’t accurately reflect the nurse practitioner scope of practice or the training preparation. And that is all we wanted.”

Ms Weston, speaking to New Zealand Doctor prior to the RNZCGP withdrawing the statement, said her college would welcome the opportunity to work collaboratively with the college of GPs and she was disappointed this had not occurred before release of the initial statement.

“Because then we could have avoided inaccuracies being in their statement which has now gone out.”

Factual inaccuracies included stating the initial undergraduate nursing degree was four years rather than three years.

Ms Oster says while descriptions of the scope of practice and training were taken from official documents, they had been edited so they didn’t reflect the training preparation or scope accurately.

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Dr Murton, in a interview with New Zealand Doctor prior to the statement’s withdrawal, says work on it was done over a year and had some initial NP involvement.

She says it was prompted by concerns from GPs that there was uncertainty in the sector sometimes about the difference between general practitioners and nurse practitioners.

“Absolutely the college is keen on working together and having broader teams with nurse practitioners in their teams and that is what the statement is about.

“If there are inaccuracies about the training then, yes, we are happy to correct those.”

The initial position statement says it takes 11 years of training from starting an undergraduate degree to becoming a GP fellow, compared with six years of training to become a nurse practitioner.

Nursing Council chief executive Catherine Byrne says, by email, the minimum time it technically takes to meet the requirements to become a nurse practitioner, which includes a clinical master’s degree and submitting a portfolio to the Nursing Council for assessment, is nine years.

Most NPs have worked as a nurse much longer before they gain NP status, with only two of the current 612 nurse practitioners having gained NP status within nine years of starting their undergraduate nursing degree. Six have done it in 10 years.

“The 612 nurse practitioners on the register at 31 March 2022 had spent an average of 27 years’ practising since [registered nurse] graduation,” says Ms Byrne.