The ongoing struggle to achieve workforce flexibility in nursing. cont.
( ie awarded monies) when MOH recognise that a patient is seen by a provider other than their registered provider. The problem is that for the purposes of GMS, MOH IT system is not capable of recognising a nurse practitioner council number as the REGISTER PROVIDER as it recognises only a medical council number as a valid provider identifier.
Hence any service provided to a patient who is registered to an NP will not be recognised by MOH as a valid capitated service and will not be correctly received or paid at MOH level. This also includes services, which are not necessarily provided by the NP herself, eg immunisations, 1st trimester maternity services. I have tried to resolve this issue with MOH directly; I have met a dead end! The bottom line is that we do not receive full funding for patient registered to NPs, unless we resubmit the claim under a doctor’ s name and NZMC number. If the MOH IT system could be changed to accept an identifying number or code for a NP then the funding would flow. They are either unable, or unwilling to substitute a NP NZNC number for a doctor’ s general medical council number. Were they able, then the problem would be resolved”
The same Nurse Practitioner then explains the clinical impact as follows
“ The clinical knock-on effect of not being able to register patients to me is that I do not receive any discharge summaries and reports from specialists for patients I have referred to hospital services. This is because the hospital uses the registered provider of the patient to send information to. So I have to keep an electronic diary to remind me to keep looking out for the information coming back from secondary care. As you can imagine this is very time consuming and very difficult to run. It is also a clinical risk for me as the information does not arrive in my inbox automatically. I have to rely on my GP colleagues to pass the information on if they become aware of something urgent, which they recognize they have had nothing to do with arriving automatically in their inboxes. They do this after looking up the details and then seeing it is actually me that has been working with the patient. As you can see, this is totally unsatisfactory and potentially risky.“
In similar vein Ministry of Health staff continue with outdated custom and practice behaviours. For example Medsafe when commenting on potential drug problems, regularly advise the public to discuss any concerns about medications with their doctor, despite being requested by the College of Nurses on numerous occasions to instead refer to‘ doctor or nurse practitioner’. Such requests have never even been acknowledged. On one level this may seem to be a trivial issue but we believe change in the health sector requires bringing an informed public( and colleagues) with us. If the Ministry of Health acts as if medical practitioners are the only source of care, treatment, prescribing and advice, the public will never see it differently or understand the relevance of the multi-disciplinary team.
ACC payments continue to reduce the viability of nurse practitioners in primary health care since co-payments for nurse practitioners are not aligned with those of GPs despite nurse practitio-
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