In the realm of healthcare, where every decision matters, the role of nurses is often underestimated. But, as the Australian College of Nursing (ACN) Chief Executive Officer, Adjunct Professor Kathryn Zeitz, argues, nurses are the unsung heroes of the fight against chronic diseases. The current healthcare system, with its focus on hospital care, is failing to address the growing burden of chronic conditions, and it's time to reevaluate the role of nurses in primary healthcare.
The Growing Burden of Chronic Diseases
Chronic diseases, such as diabetes, heart disease, and kidney disease, are on the rise in Australia. According to the Australian Institute of Health and Welfare, three in five Australians now live with at least one chronic condition, and two in five with two or more. This is a significant problem, as chronic conditions now cost the health system $98 billion a year, with almost two-thirds of that consumed by hospitals. The situation is further exacerbated by the fact that overweight and obesity have overtaken tobacco as the leading drivers of disease burden.
The Cost of Delayed or Skipped GP Visits
The cost of healthcare is a significant barrier for many Australians. The share of people needing a GP but delaying or skipping a visit due to cost has nearly doubled in a decade, from 4.1% to 7.7%. People with chronic conditions are more likely to forgo care due to cost than those without (9.2% compared with 5.5%). This is a critical issue, as the sickest Australians are the ones being priced out of primary care, which ends up shifting the cost onto the expensive hospital system.
The Role of Nurses in Primary Healthcare
Nurses are the largest, most trusted, and most widespread workforce in healthcare. They are well-equipped to deliver safe, high-quality chronic disease care, including monitoring, prescribing, wound care, health checks, and prevention. However, they are currently locked out of primary care funding, which means they cannot deliver the care that is needed. According to Adjunct Professor Zeitz, nurse practitioners and nurse-led clinics can deliver care at lower cost and closer to home, reducing the pressure on hospitals.
The Need for Funding Reform
The ACN is calling for funding reform that will unlock nurse-led care. This includes establishing the Baseline Practice Payment and extending the Workforce Incentive Payment (Practice Stream) to nurse-led services accredited under the ACSQHC National Safety and Quality Primary and Community Healthcare Standards. Removing MyMedicare barriers and extending the MBS 75% rebate rule to nurse practitioners will also help. Scaling designated registered nurse prescribing and providing a funding mechanism and pathology-testing access via a Nurse Payment Administrator will further support nurse-led care.
The Broader Implications
The implications of this funding reform are far-reaching. By unlocking nurse-led care, we can deliver high-quality care efficiently. This will not only reduce the burden on hospitals but also prevent many hospitalisations and re-hospitalisations. Around one-third of Australia's disease burden is preventable, and keeping a person with diabetes, heart disease, or kidney disease well-managed in the community can save many times what that care costs by preventing hospitalisation.
Personal Perspective
Personally, I think that the role of nurses in primary healthcare is often overlooked. But, as the evidence shows, nurses are the key to tackling chronic diseases. By unlocking nurse-led care, we can deliver high-quality care efficiently and effectively. This will not only benefit the individuals with chronic conditions but also the entire healthcare system. It's time to reevaluate the role of nurses and give them the funding and support they need to deliver the care that is needed.
