Further to the response provided to the Member for Yellowknife North on May 26, 2025, regarding Nurse Practitioner scope of practice, sole responsible provider and professional development, the following additional information is provided:
The Nursing Professions Act defines the scope of practice for Nurse Practitioners in the Northwest Territories. The College and Association of Nurses of the Northwest Territories and Nunavut, the body that regulates Nurse Practitioners, further defines scope of practice through documents such as the National Entry-Level Competencies for Nurse Practitioners 2023. Employers then determine the extent to which a Nurse Practitioners scope is applied based on the specific role for which they are hired and as outlined in the job description. The employer may also reinforce these roles and expectations of care through policies and procedures, guidelines and memos. Nurse Practitioners also must provide client care based on their individual competence, which they self-assess based on their education, training, and experience. This must also align with employer policies, procedures, and guidelines. If a client’s needs exceed or differ from the scope of practice the Nurse Practitioners can provide, they are expected to refer clients to the most appropriate resource which can meet their needs.
The Nurse Practitioner Privileging List from the Office of Medical Affairs and Credentialling within the Northwest Territories Health and Social Services Authority assists both the employer and the employee to determine to what scope a Nurse Practitioner has been granted privileges for providing clinical services in NWT health facilities. This application outlines the skills and competencies the Nurse Practitioner self-identifies as being competent to provide, and the associated documented evidence of training, experience and certification. These requests for privileging also require two references that may be a clinical supervisor or equivalent, or a program director who can attest to the applicant’s final evaluation and skills set, if they have recently completed training. The second reference is required from a colleague with whom they have worked and can speak to their clinical area experience and/or expertise. This request is reviewed by the Territorial Application Review Committee. Once a decision is made regarding their application, the associated letters of approval/credentials will be provided to hospitals and clinics enabling their practice scope.
Regarding Nurse Practitioners and being sole provider, our NWT model of primary care is not based on patient attachment to a single Nurse Practitioner or family physician. Territorially, our model of care emphasizes access to primary care but does not attempt to ensure access to a particular provider. The circle of care model that is in place includes a wide variety of healthcare professionals who together can meet the health needs of residents. Nurse Practitioners are a part of this care team. Our priority is to ensure that residents have access to primary care services, not a specific provider. There are some examples where the Nurse Practitioners are considered the Most Responsible Provider however, this reinforces what was stated earlier, that the scope of care that Nurse Practitioner’s provide is based on the role they are hired into.
