With funding, nurse practitioners say they could ease strain on health-care system

Nurses from the Sudbury area called on the province to ensure the 2023 budget prioritizes investments to address staff shortages and inflated operational costs plaguing nurse practitioner-led clinics in the region.

On Monday, the Standing Committee on Finance and Economic Affairs was in Sudbury as part of its travelling pre-budget consultations tour. Since early January, the committee has visited cities across the province to hear input from community leaders, as they prepare to draft their annual budget.

The province said it plans to table the budget by March 31.

In Sudbury, health-care funding was a top-of-mind issue.

Nickel Belt MPP France Gelinas, who is also the NDP Health critic, said local providers were eager to make their case, as funding issues have worsened their ability to provide care.

“Today you will hear their plea to help the people of Sudbury who have no choice but to go to the overcrowded emergency room at Health Sciences North," said Gelinas. “We have nurse practitioners under-employed, right here right now, in our city. They want to take on patients that don’t have family physicians. They want to provide primary care, but they can’t because they don’t have the money to do so.”

In the next provincial budget, Jennifer Clement, executive director of Sudbury District Nurse Practitioners Clinics, would like to see more funding to address the crisis of human health resources.

"(We) have an exceptional team, but they, like many who work in primary care today, are feeling overwhelmed, underappreciated, undervalued, and tired of being asked to do more despite going above and beyond for patients throughout the pandemic," said Clement in her remarks.

According to Clement, nurse practitioner-led clinics like theirs are struggling to attract and retain staff, especially in rural areas. She said turnover rates are high, with staff level for other positions because organizations like theirs can't offer salary increases under the wage-capping Bill 124.

Funding for staff, she said, increases the ability of clinics to provide primary care and take on new patients. A single nurse practitioner can have a roster of 800 to 900 patients.

"That’s patients that haven’t had access to primary care, that are going to the walk-in, using the emergency departments," she said. "They get that in nurse practitioner clinics. They get that primary care team.

"They have access to social workers, dietitians, pharmacists, registered nurses, registered practical nurses. We’re able to diagnose and treat early. And by doing education as well, prevent bad outcomes.”

Clement also said base funding increases are needed for health-care providers.

With Canadians experiencing record-high inflation rates, she said providers have not been receiving enough financial support to keep up with operational costs.

Since the Sudbury District Nurse Practitioners Clinics opened 15 years ago, Clement said it has not seen an increase in overhead funding, despite rising costs year-to-year. In fact, funding has been clawed back.

“We have become very adept at managing our budgets to ensure we don’t run a deficit," she said. "However, at times, this has come at the cost of patient care when positions go unfilled. In order to move money to overhead lines, to pay rent or utilities, to ensure capacity and continuity, base funding needs to be increased to keep up with inflation.”

In rural areas, the challenges are even more significant.

Nurse practitioner Amanda Rainville, executive director of Capreol Nurse Practitioner Led Clinic, said the services provided at their facility are in high demand. But without extra financial support, waitlists will continue to grow.

"There are many people who use our emergency room as a walk-in clinic or can present for non-urgent needs if they don’t have a primary care provider," she said. "This is very taxing on our health-care resources and our hospital is not in a position to see non-urgent patients as they’re often operating above 100 per cent occupancy. We strive to provide safe access for our patients and reduce the number of visits to emergency rooms for crisis interventions.”

The clinic, said Rainville, is the only health-care provider in the area, which is 35 km north of downtown Sudbury.

Because residents tend to be vulnerable, accessing care in the city isn't always an option. Household income is lower than the provincial average, as are employment rates. And there are no primary care providers, walk-ins, or mental health practitioners nearby.

Many residents also lack the resources to make the hour-long drive to Sudbury when they need care.

Currently, the clinic has enough staff and finances for 3,020 patients, but its intake waitlist is long. Its on-site social worker has 75 patients waiting to be seen and some may need to wait over a year before they can see a psychiatrist.

Rainville said the clinic was requesting a nearly $300,000 investment as a way to the clinic's capacity. The funding would allow them to hire another nurse practitioner, social worker, and administrative staff so it could take in an additional 800 patients.

The Local Journalism Initiative is made possible through funding from the federal government.


Twitter: @mia_rjensen

Mia Jensen, Local Journalism Initiative Reporter, The Sudbury Star