Fellows of College of Nursing Taskforce Meeting Notes - 24 April 2026

Attended:               

Jenny Carryer, Sue Adams, Andrew Jull, Sandy Bayliss, Jocelyn Peach, Helen Snell, Sandra McDonald, Catherine

Cook, Nicolette Sheridan, Josephine Davis, Mark Jones, Jill Wilkinson, Chelsea Willmott

Apologies:               

DNA:                        

Sue Gasgoine, Jill Clendon, Wendy Blair, Rachel Webster, Maree Sheard  

Discussion

A.     Cultural Safety and Scope of Practice

This is important work. Not scoped up as yet. Contact made with Allied Health and Medical groupings. A paper will be prepared by next meeting.

Action:

Jocelyn Peach, Kate Weston, Sandra McDonald

B.     Specialist Nurse Practitioner

Paper prepared by Helen with input from Rachel and Sue.  Data gathering has been challenging. Paper described: executive summary, current situation, the value of nurse practitioners as critical workforce across the primary, secondary and tertiary sector, transforming models of care and where Nurse Practitioners can add value. There is a problem statement.

Not clear whether there is a policy decision to reduce specialist roles and whether there is evidence of places reduced support for NP role establishment. Some examples of reduction in senior nurses through attrition and service cuts, one in one out. Where there are medical specialist vacancies – there have been letters from specialists supporting nurse specialists/nurse practitioners as essential to service continuity. Third section is around issues facing the health sector/challenges facing Aotearoa New Zealand. Section four is failed opportunities for NP development. Have gathered data on medical staff shortages from ASMS [reference on paper from 2024]. Importance of NP career planning as part of service planning and succession planning.  The fifth section is contribution of NPs in hospital and specialist services and section six is the key benefits of employing nurse practitioners. Someone reported that some NPs now not feeling role value and considering giving up being an NP and working as an RN with prescribing.

Action:

Helen asked to work with others to prepare a tight abstract that may be used next week at the NP event when key decision makers are present. Plan to complete the paper [Helen Snell, Rachel Webster, Jenny Carryer, Sue Adams]. Feedback information to Helen. Plan how the paper might be best presented/utilised for political influence.

C.     Labour policy funding GP’s and not specifying NP

Andrew has spoken to key people to discuss the issues that may influence policy. Kate and Chelsea had previously raised the issues with Hon Dr Ayesha Verrall.  Plan to follow-up more formally. Contact Dr Gary Payinda to discuss concerns. Discuss with Mark Jones when he is recovered.

Action:

Nil

D.     Funding – New Graduate funding

·       Paper circulated outlining information gathered regarding current situation relating to new graduate employment and HealthNZ workforce oversight. Liz Manning explained that the Minister of Health  receives monthly report in data for the sector: specialist services, aged care, primary care/community, private. See table below. Note: most new graduates are employed 0.8 although a number at 0.6. Graduates increasingly offered 0.6 FTE positions (below historic 0.8 average), creating financial hardship and insufficient clinical experience for first-year development.

·       Chief nurses report that graduates failing when employed at 0.6 FTE or below.

·       The data integrity is an issue. Someone reported some examples of new graduates being employed into very unsupported and risky environments, with very little oversight under SFYP. If the employer chooses to do their own thing. A number of Chief Nurses have commented that graduates are not succeeding when employed in 0.6 and under; many NG are having their support extended to help with this. There are reportedly increase in NCNZ notifications.

·       NZ Doctor has reported: Liz Manning and colleague advised that what was published had not been interpreted quite accurately in December.

o   General practices have filled 69 of the 147 places filled to date of the 400 new-graduate nurse places under the Government’s primary and community care incentive scheme. 

o   Rural employers, which receive the biggest dollar incentive under the scheme, have signed up 20 new graduate nurses for the 2025/26 intake. 

o   Overall, 917 of the 1658 new-graduate nurses applying for supported first-year-of-practice places at the end of 2025 were employed as of 19 January 2026 (including 36 by private surgical).

·       Josephine is interested in the new graduate employment profile of Māori nurses and Pacific. And in the medium to longer term, the impact of taking new grads into employment in an ad hoc way rather than a cohorted approach. It is quite a challenge to access the data outside TWO. She and Sandra are waiting for more information from the NETS collective which may give us more insight.

Action:

Request monthly data ongoing.

Need to work further on paper: 1. To gain increased FTE working on a casual basis in unsupported environments - this is not safe. 2. Data needs to separate out ARC and primary care. 3. What has happened to the funding for new grad PHC programmes.

Sandy is developing a new graduate survey – is happy for suggestions for questions for this.

E.     RN Prescribers

Jenny met with NCNZ staff regarding RN prescribing scope of practice. The points Jenny made was taken into consideration as a way forward. Nursing Council supports "RN (Extended Prescriber)" or "RN bracket EP" to avoid confusion with NP abbreviation; next meeting scheduled for May 29th.

Action:

Jenny to discuss thoughts/suggestions at the next meeting.

F.     RFP and Nurse Practitioner programme

·       The group identified critical gaps in nurse practitioner support systems, particularly around funding structures that favour primary care over hospital/specialist services, inconsistent implementation of the new NPTSS training contract, and emerging threats to RN roles in aged residential care. It is thought that Health NZ implemented one-in-one-out policy; refuses to convert medical vacancies to NP positions despite specialist shortages. Multiple regions disestablishing existing NP positions; replacement staff unclear. example: Hawke's Bay imposed blanket ban on specialist NP candidate positions in 2024. Charge nurse managers and directors of nursing blocking NP progression in NICU and other specialties, favoring CNS roles instead, despite medical team support.

·       Medical and nursing FTE budgets separated, preventing cross-budget appointments (psychiatry and palliative care positions held open rather than filled by NPs).

NPTSS Contract Implementation Problems

·       NPTSS funding restricted to 120 primary care positions with explicit directive preventing transfer to specialist services, even when primary positions unfilled.

·       Pipeline development unfunded: No support for nurses aspiring to become NPs prior to program entry; no workplace preparation or "soil tilling" for candidates.

·       Post-qualification support unclear: NPTSS promises 6 months post-graduation support but has no defined program content despite being 5 months into contract.

·       Role confusion: NP leads (employed by NPTSS) visiting workplaces and contacting students, creating overlap and confusion with academic mentor roles from tertiary providers.

·       Academic mentor role unfunded: TEPs receive teaching funding but not for academic mentoring; each provider handling differently.

·       Inappropriate assignments: Some NP leads requesting candidates complete assignments beyond academic requirements.

·       Pacific representation collapsed: Only 1 Pacific NP candidate out of 112 enrolled; no NPTSS funding for Pacific candidate support (historic support discontinued).

·       Contract holder inexperienced: ProCare administering contract but lacks delivery history; "learning as they go" across three-year contract.

Equity and Data Suppression

·       Ethnicity data becoming "invisible" across government, universities, research and ethics committees.

·       Pushback against including ethnicity as variable, labelled as "deficit approach" despite funding allocations requiring ethnic equity tracking.

·       Political environment making it challenging to argue for equity-based decisions or obtain ethnicity data for advocacy. The tertiary education providers for NP are accredited by the Nursing Council of New Zealand i.e. are providers of the NP training programme. The NPTECs are simply the funders.  They are the enablers, should be on supporting NP candidates in the employment setting, ideally warming up the employment setting and the managers to assist what a nurse practitioner require.  NPTECS are not funded to provide any work around pipeline development.

Sue reminded on the published evaluation of NP transition programme. She advised that current NPTSS upper leadership has a pretty clear plan and objective in their minds that has been established without consultation across nursing leadership. The question is how to deliver the actuality of what is happening.

https://www.nursingpraxis.org/article/144221-evaluation-of-the-aotearoa-new-zealand-transition-programme-for-nurse-practitioners-in-primary-healthcare  

Action:

·       Nikki suggested that a table be developed that outlines the policy directive source for NPTSS primary-only funding restriction (stated as "very clear direction from Health NZ/Health Workforce") and Components included/excluded in NPTSS contract award

·       Jos to ask Liz for advice about the contract oversight process - ? Claire Bosworth

G.    Concern about slashing of school nurse budget

Waiting for nurses from school nurse group to get back to us. Messages left. Message has been sent to https://www.schoolnurse.org.nz/

Action:

·       Gather information and make contact through the special interest group – Jocelyn Peach, Maree Sheard, Wendy Blair, Sandy Bayliss

H.     Aged Care

Jenny advised that she met Anna Blackwell who advised that Tracy Martin had made it clear that aged care could be made more affordable if more Enrolled Nurses were employed. Comment was that Tracy Martin was very supportive of Nurse Practitioner roles in Aged Care.  Further discussion is needed to reinforce the role of registered nurses caring for the vulnerable, complex and frail elderly.

Action:

·       Further work is needed to develop a paper outlining the safety and complexity issues

·       Connect with the nurse leaders on the Aged Care Advisory Group – Kate and Jocelyn