Supporting practice nurses

The Government will invest in supporting a broader and more flexible role for practice nurses under the Practice Nurse Incentive Program (PNIP).

Supporting practice nurses fact sheet (PDF 95 KB)

How does the Practice Nurse Incentive Program work?
Is my practice eligible?
What if my practice is financially disadvantaged?
How does my practice apply for the PNIP?
What are the MBS practice nurse items that are being removed?
Where can I get more information on the PNIP?
What has the Government done so far to support practice nurses?

The Australian Government is implementing a number of measures to support a broader, more flexible role for practice nurses through national health reform.

More support for practice nurses is part of the Australian Government’s national health reform efforts to deliver the right health care, at the right time, in the right location, and by the right provider.

Current usage of nurses in primary health care in Australia remains lower than in other comparable health systems such as the United Kingdom and New Zealand. Practice nurses including Registered Nurses, Enrolled Nurses and Aboriginal Health Workers can contribute significantly to the delivery of primary health care services, improving patients’ access to clinically appropriate primary health care services and helping to ease the pressure on GPs.

The Australian Government is taking action by investing an additional $390.3 million over four years to provide expanded, simplified support for practice nurses through the Practice Nurse Incentive Program (PNIP).

Practice nurses can play a key role in pro-actively supporting patients in the optimal management of their health conditions. The new arrangements will support practice nurses to continue to undertake activities such as immunisation, wound care and cervical screening as well as a broad range of activities that are not well-supported under the current financing arrangements including:

• Providing preventative health programs;
• Providing patient/carer education programs;
• Care coordination and monitoring of acute and chronic disease;
• Supported self care and self management; and
• Providing recall and reminder systems.

How does the Practice Nurse Incentive Program work?

The PNIP supports an expanded and enhanced role for practice nurses by providing funding through a single, consolidated and streamlined financing arrangement.

The PNIP replaces previous funding for practice nurses, provided through the Practice Incentives Program (PIP) Practice Nurse Incentive and six of the Medicare Benefits Schedule (MBS) practice nurse items. This funding has been redirected to the PNIP, along with an additional $390.3 million over the first four years of the program. The PNIP consolidates practice nurse funding arrangements into a simplified, single funding stream. This funding stream is administered by the Department of Human Services - Medicare (Medicare) .

Incentives under the PNIP are paid based on a practice’s Standardised Whole Patient Equivalent (SWPE) value:

• $25,000 per annum, per 1,000 SWPE where a Registered Nurse works at least 12 hours 40 minutes per week; and
• $12,500 per annum, per 1,000 SWPE where an Enrolled Nurse works at least 12 hours and 40 minutes per week.

Incentives are capped at five per practice, meaning that practices will be eligible to receive up to $125,000 to support their practice nursing workforce.

The new arrangements also include:

• support for all accredited practices to employ an Aboriginal Health Worker instead of, or in addition to, a practice nurse (Registered Nurse or Enrolled Nurse).
• support for practices in urban areas where there are workforce shortages, Aboriginal Medical Services and Aboriginal Community Controlled Health Services to employ an allied health professional such as a physiotherapist, dietitian and occupational therapists, instead of, or in addition to, a practice nurse and/or Aboriginal Health Worker.
• a rural loading of up to 50% based on the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA).
• a loading for Aboriginal Medical Services and Aboriginal Community Controlled Health Services.
• a one-off $5,000 incentive to support eligible non-accredited practices to become accredited.

Is my practice eligible?

General practices across Australia, including those in urban areas as well as Aboriginal Medical Services and Aboriginal Community Controlled Health Services may be eligible for an incentive to offset the costs of employing a practice nurse. Part of the eligibility requirement is that your practice is accredited under the current general practice standards of the Royal Australian College of General Practitioners.

What if my practice is financially disadvantaged?

Practices may be eligible for grandparenting or top-up payments if they are financially disadvantaged by the new arrangements.

Top-up arrangements will be available for the first three years of the program to ensure that accredited practices that join the PNIP are not financially disadvantaged by the cessation of the PIP Practice Nurse Incentive and/or the removal of the six MBS practice nurse items. Top-up payments will be available until 31 December 2014.

Grandparenting arrangements will be available for the first three years of the program to ensure that non-accredited practices are not financially disadvantaged by the removal of the six MBS practice nurse items. Grandparenting payments will be available until 31 December 2014.

How does my practice apply for the PNIP?

Practices can now apply for the PNIP and supply supporting documentation though PNIP Online system available through Health Professional Online Services. Practices can also still apply using the application form available on Medicare’s website at www.medicareaustralia.gov.au/pnip

What MBS practice nurse items were removed?

On 31 December 2011, the following MBS practice nurse items covering immunisation, cervical smears, and treatment of a person’s wound were removed:

• 10993
• 10994
• 10995
• 10996
• 10998
• 10999

The funding for these items has been redirected to the PNIP.

All other MBS GP services, where a practice nurse assists a GP in the delivery of a service and which are claimed by the GP – such as assisting with health assessments or care planning – are not affected by the new PNIP. In these circumstances, a GP can continue to use a practice nurse to assist in the delivery of care, within the relevant MBS guidelines, and can claim the relevant MBS item.

The bulk billing items 10990 - 10992 continue to be available for those remaining items to which they relate.

Where can I get more information on the PNIP?

Further information on the PNIP including details on practice eligibility, how to apply and the Program Guidelines are available on the Department of Human Services - Medicare's (Medicare) website: http://www.medicareaustralia.gov.au/pnip

The Department of Heath and Ageing and Medicare have developed the PNIP Incentive Payment Calculator – Ready Reckoner to assist in estimating the incentive amount a practice may be entitled to. The Ready Reckoner is available on Medicare's website: http://www.medicareaustralia.gov.au/provider/incentives/pnip/calculator.jsp

What has the Government done so far to support practice nurses?

Since 2007, the Government has:

• Supported around 200 additional practices in rural and remote areas and urban areas of workforce shortage to employ a practice nurse through the PIP practice nurse incentive.
• Provided:
  • $524.5 million to Health Workforce Australia for clinical training of undergraduate health professionals, including registered nurses, and training of clinical supervisors.
  • $59.7 million to enhance the role of nurse practitioners by enabling access to certain MBS and PBS items from November 2010.

Further information on national health reform is at www.yourhealth.gov.au

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