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Enhancing the Role of Nurse Practitioners


Enhancing the Role of Nurse Practitioners

Ministry of Health and Long-Term Care

Nurse practitioners provide a full range of health care services to individuals, families and communities in Ontario. As highly trained health professionals, they combine advanced nursing skills and a deep understanding of health management, health promotion and disease and injury prevention. 

Amendments to Enable Direct Referral

It is within the current scope of practice of a nurse practitioner to refer patients to specialist physicians.  As of May 1st, new amendments to the Health Insurance Act and the Schedule of Benefits for Physician Services remove barriers for a nurse practitioner to directly refer a patient to a specialist and receive the specialist's advice directly.

Before these amendments came into effect, specialists could only claim their full consultation fee for patient referrals made by a physician. The changes now allow specialists to claim their full consultation fee for nurse practitioner referrals, which enables nurse practitioners to provide a service that they are already qualified to perform.

Scope of Work: What Do Nurse Practitioners Do?

The nurse practitioner role expands on the practices that have traditionally been outside the scope of practice for registered nurses. Specifically, nurse practitioners have the skills and training to:

  • Order and interpret screening and diagnostic tests
  • Diagnose health and illness conditions
  • Discuss health care options with patients and make decisions about treatment
  • Prescribe medications
  • Treat and manage acute and chronic illness
  • Make referrals to specialist physicians as necessary.

In addition to providing a wide range of health care services to patients, nurse practitioners help patients access other health and social services and work collaboratively with other health professionals.

While more than half of the 2,209 nurse practitioners in Ontario practice primary care, nurse practitioners may also specialize in geriatrics, acute care, emergency care and cardiac care.

Setting: How and Where Do Nurse Practitioners Work?

Nurse practitioners provide high-quality, patient-centred, well-coordinated care in a variety of settings, including community clinics and health centres, hospitals, medical practices and long-term care homes.

Nurse practitioners can work independently or as part of a health care team.

Nurse Practitioner-Led Clinics

Nurse practitioner-led clinics offer important health services such as comprehensive primary care, illness prevention and health promotion, diagnosis and treatment of acute and chronic illness, health assessments and primary mental health care.

Ontario is a frontrunner in the use of nurse practitioner-led clinics. First introduced in 2007, there are currently 25 operational nurse practitioner-led clinics, which provide primary care to more than 49,000 people.

Training: What Schooling Do NursePractitioners Have?

Training programs for nurse practitioners vary in length, but most programs require one to two years of study, and all programs include opportunities for practical experience. The advanced education and experience that nurse practitioners gain from additional schooling enable them to provide services that are beyond the scope of practice for registered nurses.

Working: What Is Required for Nurse Practitioners to Enter the Field?

Nurse practitioners in Canada:

  • Are registered nurses
  • Hold either a nurse practitioner post-baccalaureate certificate, a nurse practitioner postgraduate certificate and/or a nurse practitioner graduate degree (master's degree)
  • Pass an entry-to-practice exam that varies depending on the area of specialty
  • Register with a provincial/territorial regulatory body.

Nurse practitioners play a crucial part in providing faster access to the right care. Supporting nurse practitioners in Ontario is part of the government's plan to build a better Ontario through its 'Patients First: Action Plan for Health Care', providing patients with faster access to the right care, better home and community care, the information they need to live healthy and a health care system that's sustainable for generations to come.Enabling nurse practitioners to work to their full scope of practice, particularly on collaborative, interdisciplinary teams, allows each health care provider to contribute their skills most efficiently and effectively.

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  • David Jensen

    Communications and Marketing Division-MOHLTC



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    Minister's Office


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