Empowering Nurse Practitioners: The Key to Canada’s Healthcare Transformation

The Underutilized Potential of Nurse Practitioners

As Canada’s healthcare system faces overwhelming demand, the strain on our healthcare services is growing while Nurse Practitioners (NPs) remain significantly underutilized, underemployed, and undervalued. Currently, more than six million people in Canada lack access to a primary care provider. The current models of care do not fully leverage NP talent and advanced competencies as clinicians and leaders in providing high-quality care within their communities.

If Canada aspires to lead the future of healthcare, we must invest in and respect Nurse Practitioners as a vital longitudinal solution to the primary and specialty care crisis across the healthcare system sectors.

The Role and Scope of Nurse Practitioners

Nurse Practitioners can meet the healthcare needs of most Canadians across diverse care settings, including hospitals, long-term care, correctional care, and home and community care. NPs are highly educated healthcare professionals with foundational training and education in nursing.

NPs play a unique and complementary role in the healthcare system, practicing autonomously while integrating advanced clinical knowledge, diagnostic skills, and specialized expertise. They are qualified to diagnose, prescribe, treat, and manage a wide range of health conditions, from minor ailments to complex illnesses. Rooted in whole-person and patient-centred care, NPs consider the social determinants of health to provide comprehensive and individualized patient care. Their practice reflects both their nursing background and advanced medical knowledge, allowing them to effectively meet diverse patient needs.

NPs can autonomously and independently provide care across the lifespan, including managing palliative care and Medical Assistance in Dying (MAID) services. They are well-equipped to function and partner with patients and teams as your most responsible provider to help navigate the health journey.

Proven Value and Impact of Nurse Practitioners

Research confirms NPs improve public access to high-quality care at a cost savings to the system. NPs improve healthcare access, deliver effective patient outcomes, and strengthen interprofessional collaboration. They decrease emergency visits, reduce hospital readmissions, and shorten wait times.

NPs are trusted, have high client satisfaction, are cost-effective, and alleviate pressures on the healthcare system.

Barriers and Inequities in Compensation

Despite NP abilities, qualifications, and evidence-informed outcome contributions, outdated, non-competitive compensation models coupled with structural barriers continue to limit the recruitment, retention, and respectful inclusion, integration, and utilization of NPs.

Ontario was the first in Canada to adopt the publicly funded Nurse Practitioner-Led Clinic (NPLC) model. Ontario’s Primary Care Action Team’s success will be measured by 100% of Ontarians being attached to a Nurse Practitioner or Physician and supported by teams within the next four years.

The recent 2.7% primary care compensation increase for NPs and teams barely matches inflation and the cost of living, resulting in no real pay gain after seven years of frozen wages since 2017. In contrast, physicians represented by the Ontario Medical Association experienced a deserved 9.95% increase in compensation from 2024 to 2025, highlighting significant professional inequity. The Family Health Organization Plus model (FHO+) embeds increases of up to 30%.

Nurse Practitioners’ salaries in primary care are at a maximum of $125,000, while physician colleagues receive over $400,000 in community health clinics for similar services delivered. This chronic NP underfunding directly impacts the accessibility of care for Ontarians, creating barriers that impede the delivery of timely and efficient healthcare services.

NPs are prepared and capable of providing effective solutions within the healthcare system, but they need to be properly compensated. Although this increase is a positive step forward in narrowing the pay gap, it is insufficient to close the long-standing compensation gap and reflect the true value that NPs bring to patient care. It also fails to advance pay equity, harmonize sectors, or deter from Pan-Canadian opportunities to keep NPs locally.

The Path Forward: Equity, Integration, and Modernization

The Nurse Practitioners’ Association of Ontario (NPAO), which represents over 5,400 NPs in Ontario—more than 50% of NPs across Canada—is calling for expedited, respectful action toward an integrated healthcare system in which every individual receives equitable, high-quality, comprehensive care from a well-trained, well-supported, and optimally utilized primary care provider (NP or MD) and team.

In Ontario, an urgent phased approach toward NP compensation to stabilize primary care should advance compensation by 30% to progress toward $180,000, to be competitive with provinces such as British Columbia or Alberta, which also enjoy direct reimbursement models of care with NP attachment incentives to bring NP compensation closer to parity.

By implementing flexible funding models (salaried, capitation, blended, and billing), NPs can flex their ways of working, whether as employees or independent contractors. Recognizing NPs as delivery physician equivalent and medically necessary NP services into public health plans, as indicated in the latest interpretation letter of the Canada Health Act, Canada by April 1, 2026, can position itself at the forefront of modern healthcare delivery.

This approach empowers NPs to provide immediate and ongoing care to communities in need. It is essential that NPs are included in all discussions and negotiations. Their voices, perspectives, and expertise are vital for helping decision-makers shape innovative models of care and inform policies that address gaps in care, improve access, and promote better health outcomes.

A Vision for the Future

Redesigning our primary care system and beyond is a challenging but necessary task. We are confident that, together, we can accomplish this and deliver the quality care that patients deserve.

Considering the current shortage of primary care providers, Nurse Practitioners offer a forward-thinking solution for governments to bridge the various gaps in our healthcare system.

The NPAO is committed to continuing its collaboration with the government to ensure patients across Ontario and Canada have access to convenient care as close to home as possible.