Consultations on nurse practitioner scope of practice 2014-2016

Following extensive consultation the Nursing Council has made changes to the nurse practitioner scope of practice and education programmes that prepare nurse practitioners to meet future health needs of New Zealanders.  These changes come into effect in April 2017.

The new scope of practice has been broadened and the requirement to restrict nurse practitioners to a specific area of practice has been removed.   Nurse practitioners as advanced clinicians will be expected to self-regulate and practice within their area of competence and experience. 

The Council believes that these changes will allow greater flexibility and utility for nurse practitioners to meet future health needs of New Zealanders, including rural and other underserved and diverse and aging populations.  The revised scope of practice also makes the role and contribution of nurse practitioners clearer to employers and the public, and differentiates the nurse practitioner from advanced registered nurse roles.

The Council has also decided to refocus the education programmes to prepare nurse practitioners.  These programmes will have more specific programme outcomes and include 300 hours of protected clinical learning time.  These changes will lead to greater consistency and breadth in nurse practitioner preparation and improve readiness for registration on completion of the programme.

The Council has developed new education programme standards for the broader scope of practice which will require students to develop advanced skills in more than one setting. They will provide more structure to nurse practitioner preparation, improve the alignment between education and practice and increase consistency between education programmes.

The Council has decided to retain a refined portfolio and panel assessment system as the assessment process for nurse practitioner registration. In the second consultation the Council proposed two options for changes to the registration process. The first option of delegating assessment of clinical competence to education providers was not supported. The second option proposing that Council maintain a role in assessment in addition to assessment of clinical competence undertaken by education providers received support. Concerns were raised about the ability of multiple education providers to assess clinical competence in a consistent manner and potential conflict of interest for education providers to ensure student achievement of qualifications and professional standards. The Council plans to review this again when the new programmes have been implemented. It is expected that over time there will be increased confidence that a consistent standard of education and clinical training is being achieved.   

Consultation on the scope of practice and education programme 2014-2015

The Council consulted on the educational preparation for nurse practitioner to explore:

  • Any changes it should make as a result of the proposed changes to the scope of practice including specifying programme outcomes
  • The impact of the proposed introduction of the postgraduate diploma in registered nurse prescribing for patients with long-term and common conditions and
  • Whether it should specify clinical learning time within the education programme

The Council received 63 submissions following the release of the Consultation document on the nurse practitioner scope of practice in December 2014.  These have been collated into an Analysis of submissions and individual submissions can be accessed below.  Not all submitters have given permission for their submission to be made public.

Submissions from the Consultation on the scope of practice and education programme, December 2014

Many of the 63 submissions received can be viewed below (not all submitters have given permission for their submission to be made public).

2) New Zealand Institute of Rural Health (PDF, 46 KB)

3) Individual Nurse Practitioner (PDF, 41 KB)

4) Annoymous submitter (PDF, 38 KB)

5) Waitakere Union Health Centre (PDF, 41 KB)

7) Individual Nurse (PDF, 37 KB)

9) Pharmacy Council of New Zealand (PDF, 50 KB)

11) Individual Doctor (PDF, 39 KB)

12) Individual Nurse (PDF, 41 KB)

13) Maori Health Provider (PDF, 40 KB)

14) Intern and Nurse Practitioner peer review group (PDF, 47 KB)

15) Canterbury Directors of Nursing and the Nursing Directorate of Christchurch (PDF, 45 KB)

16) University of Auckland school of nursing (PDF, 79 KB)

17) Group of nurses (PDF, 125 KB)

19) General Practice New Zealand Nursing Leadership Executive (PDF, 50 KB)

20) Individual Nurse (PDF, 46 KB)

21) Taranaki District Health Board (PDF, 41 KB)

24) Individual Nurse (PDF, 42 KB)

25) Individual Nurse (PDF, 45 KB)

26) Family Planning (PDF, 49 KB)

28) Neonatal Nurses College of Aotearoa- NZNO (PDF, 41 KB)

29) University of Otago, Christchurch (PDF, 54 KB)

30) Starship Children's Hospital Nurse Practitioners (PDF, 55 KB)

31) Individual Nurse (PDF, 40 KB)

32) New Zealand Society of Anaesthetists (PDF, 48 KB)

33) Hawkes Bay District Health Board (PDF, 44 KB)

34) Grace Hospital (PDF, 44 KB)

35) Wairarapa District Health Board (PDF, 38 KB)

36) Primary Health Care Nurse Reference Group- Hutt Valley (PDF, 39 KB)

37) Hutt Valley District Health Board including primary health care (PDF, 38 KB)

38) Otago Polytechnic (PDF, 37 KB)

39) Nurse Practitioner Group- Hawkes Bay District Health Board (PDF, 47 KB)

40) Te tai Tokerau Nurse Practitioners (PDF, 60 KB)

41) Auckland University of Technology (PDF, 46 KB)

42) College of Emergency Nurses New Zealand- NZNO (PDF, 44 KB)

43) National Council of Women of New Zealand (PDF, 50 KB)

44) Nurse Executives of New Zealand (PDF, 51 KB)

45) New Zealand Rural General Practice Network (PDF, 404 KB)

46) Nurse Practitioner New Zealand (PDF, 53 KB)

47) Capital and Coast District Health Board (PDF, 45 KB)

48) Australian and New Zealand College of Anaesthetists (PDF, 608 KB)

49) MidCentral Health Nurse Practitioners (PDF, 53 KB)

50) Royal Australasian College of Surgeons (PDF, 658 KB)

51) MidCentral Health District Health Board (PDF, 294 KB)

52) Eastern Institute of Technology (PDF, 443 KB)

53) Victoria University of Wellington (PDF, 192 KB)

55) College of Nurses Aotearoa New Zealand (PDF, 256 KB)

56) Nurse Education in the Tertiary Sector (Aotearoa NZ) (NETS) (PDF, 472 KB)

57) Critical Care Complex- Counties Manukau District Health Board (PDF, 1 MB)

58) New Zealand Nurses Organisation (PDF, 263 KB)

59) Pharmacy Guild of New Zealand (PDF, 72 KB)

60) Health and Disability Commissioner (PDF, 382 KB)

62) Rural Women New Zealand (PDF, 436 KB)

63) Royal New Zealand College of General Practitioners (PDF, 302 KB)

Consultation on education programme standards and competencies for the nurse practitioner scope of practice – 2015-2016

The Council consulted on:

  • Draft education programme standards that would allow greater consistency between programmes preparing nurse practitioners and give the Council confidence to register nurse practitioner candidates based on assessments of clinical competence within the programmes. 
  • Ways of ensuring a consistent standard of candidate assessment between programmes e.g. external moderation, involvement of clinical experts.
  • Whether nurse practitioner candidates should continue to submit a portfolio to Council to demonstrate clinical competence when applying for registration.
  • New competencies for nurse practitioners that are more integrated and concise and reflect the new scope statement.  The draft competencies have been refocused on advanced clinical skills and leadership and prescribing has been integrated within the competencies.  
  • Requiring a year of supervision to support the development of newly registered nurse practitioners.

The Council received 54 submissions following the release of the consultation document:

Consultation document - Nurse Practitioner education programme standards and competencies November 2015 (PDF, 716 KB)

These have been collated into an analysis of submissions

Analysis of Submissions- Consutlation on education programme standards and competencies for nurse practitioner (PDF, 407 KB)

 Individual submissions can be accessed below (please note not all submitters have given permission for their submission to be made public).

Submission from the Consultation on education programme standards and competencies for nurse practitioner – November 2015

1) Individual nurse practitioner (PDF, 39 KB)

2) Individual nurse (PDF, 46 KB)

3) Individual nurse practitioner (PDF, 48 KB)

4) Individual nurse practitioner (PDF, 43 KB)

5) Individual nurse (PDF, 39 KB)

6) Individual nurse practitioner (PDF, 42 KB)

8) Group of advanced nurses (PDF, 38 KB)

10) Individual nurse practitioner (PDF, 43 KB)

11) Individual nurse (PDF, 42 KB)

12) Bay of Plenty District Health Board (PDF, 37 KB)

13) Individual nurse practitioner (PDF, 42 KB)

14) University of Auckland (PDF, 54 KB)

15) East Health Trust Primary Health Organisation (PDF, 45 KB)

16) Individual nurse practitioner (PDF, 42 KB)

17) Individual nurse (PDF, 40 KB)

18) Individual nurse (PDF, 46 KB)

19) Hawkes Bay District Health Board (PDF, 41 KB)

20) Te Pou o Te Whakaaro Nui (PDF, 43 KB)

21) Individual nurse (PDF, 42 KB)

22) Royal Australasian College of Surgeons (RACS) (PDF, 46 KB)

23) Hawkes Bay DHB Acute Care Nurse Practitioners (PDF, 40 KB)

24) New Zealand Society of Anaesthetists (PDF, 45 KB)

25) Southern Institute of Technology (PDF, 41 KB)

26) Eastern Institute of Technology (PDF, 52 KB)

27) Individual nurse (PDF, 44 KB)

28) Massey University (PDF, 56 KB)

29) Auckland University of Technology (PDF, 49 KB)

30) Family Planning (PDF, 58 KB)

31) Nurse Executives New Zealand (NENZ) (PDF, 49 KB)

32) Nurse Practitioners at MidCentral DHB (PDF, 43 KB)

33) Senior nurses at Wairarapa DHB (PDF, 43 KB)

34) Starship nurse practitioner group (PDF, 56 KB)

35) College of Emergency Nurses NZ (NZNO) (PDF, 50 KB)

36) Group of Hutt Valley DHB and primary care nurses (PDF, 42 KB)

37) Group of senior ED nurses- Christchurch hospital (PDF, 70 KB)

39) Royal New Zealand Plunket Society (Inc) (PDF, 1 MB)

40) New Zealand Rural General Practice Network (PDF, 656 KB)

41) College of Nurses Aotearoa (New Zealand) Inc (PDF, 738 KB)

42) University of Otago (PDF, 69 KB)

43) Kidz First Neonatal Care CNS Team (PDF, 514 KB)

44) Waikato Institute of Technology (PDF, 700 KB)

45) Capital and Coast District Health Board (PDF, 46 KB)

46) Matua Raki - Addiction Workforce Development (PDF, 545 KB)

47) Nurse Practitioners New Zealand (PDF, 1 MB)

48) New Zealand College of Midwives Inc (PDF, 780 KB)

49) New Zealand Nurses Organisation (PDF, 1 MB)

50) New Zealand Medical Association (PDF, 476 KB)

51) Australian and New Zealand College of Anaesthetists (PDF, 334 KB)

52) Victoria University of Wellington (PDF, 1 MB)

54) Pan Pacific Nurses Association New Zealand (PDF, 1 MB)

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