A new report has recommended expanding the range of procedures and referral services that nurse practitioners can offer to their patients under the Medicare Benefits Schedule.

The report, prepared by the Nurse Practitioners Reference Group (NPRG) for the Medicare Benefits Schedule (MBS) Review Taskforce, says increasing the scope of practice for Australia’s 1745 endorsed nurse practitioners (NPs) will not only deliver better health outcomes across the community, it will create a more cost-effective and effective health care system.

Lorna Scott, an NP in the Hunter region and the Vice President of the NSWNMA, welcomes the report’s recommendations.

She says, currently, if an NP in private practice wants their clients to have a mammogram, they need to refer them to a GP to be covered by the MBS scheme.

As an NP in the public system at the East Maitland community health centre, Lorna says she is fortunate to be able to refer patients for services and tests within the public system without patients being out of pocket. But the situation is more complicated when she sees patients in rural areas where radiology services are available privately but not in public hospitals.

“Because I don’t have access to the MBS, I have to either refer a client in Singleton back to the GP for an MBS referral to have a mammogram, or I have to send them down to the Mater Newcastle,” Lorna says.

“Because I don’t currently have access to the MBS a client who may have a breast mass has the option of a 180km round trip for a mammogram, or referring them to a GP to get one done locally. That means waiting for a GP appointment and the cost that involves if it cannot be bulk billed.”

Lorna also welcomes proposals in the report to open up more items in the MBS to NPs so that a lot of procedures that private nurse practitioners now already routinely do, such as biopsies and inserting contraceptive implants, are covered.

The NP is “a wonderful holistic position” that plays a unique role in the health system, Lorna says.

“I never know what people are coming in for. Usually appointments with us are for an hour, so we have the opportunity to discuss health concerns. Someone might come in for cervical screening, but you may actually end up talking about domestic violence, endometriosis, past sexual abuse, diabetes or whatever else is important for them at that time.”

Lorna believes NPs could make the health care system even more efficient and effective, while saving clients’ time and money, if they could refer clients to specialist dieticians or psychologists under a mental health plan without referring them first to GPs to get an MBS-rebated referral.