Vision for Tomorrow: RNAO’s Nurse Practitioner Task Force report makes recommendations to enhance and expand the role of NPs to improve timely access to quality care

Feb. 25, 2021

COVID-19 has underlined the need for the Ontario government to ensure nurse practitioners (NP) are utilized to their full potential for the benefit of patients and overall population health.

Nowhere is this more evident than in the province’s long-term care (LTC) sector where a record number of residents died, victims of long-standing severe staffing shortages and systemic issues. LTC is just one sector where the education, competencies and skills of NPs are needed in much greater numbers.

In a groundbreaking report being released today during RNAO’s 21st annual Queen’s Park Day, the association is unveiling a comprehensive blueprint that calls for the NP role to be expanded and to fully utilize NPs to advance the health of Ontarians and strengthen the health system. The report also calls for the supply of NPs to increase by over 50 per cent by 2030 – just to address the needs of vulnerable and underserved populations.  

RNAO’s NP Task Force Vision for Tomorrow report examines how the NP role has evolved and the value NPs bring to the health system. It also explores issues compounded by the pandemic, and the health impacts of poverty and growing inequities in communities across the province. It highlights areas where NPs are already making a huge impact and other areas where they can affect positive change such as correctional facilities, shelters and Ontario Health Teams. The report chronicles real-life examples where NP care has been especially effective such as in Indigenous communities, in rural and remote communities where access to health services is limited, and with persons experiencing homelessness.

NPs have taken on important roles as attending NPs in LTC homes and running NP-led clinics. They also have the legislative authority to: admit, diagnose, treat, transfer and discharge patients in hospitals; order diagnostic tests; prescribe medications; and more. Yet, significant roadblocks still stand in their way preventing them from unleashing their full potential to benefit Ontarians and health-system effectiveness.     

When it comes to the sheer number of NPs, Canada and Ontario have a lot of catching up to do compared with the United States. The U.S. boasts 61.1 NPs per 100,000 people versus 15.3 NPs per 100,000 across Canada and 22.5 NPs per 100,000 in Ontario. Currently, there are 3,426 NPs practising in primary care, acute care and LTC in the province.  

“NPs are a resource for our health system and their role has evolved thanks to our advocacy. However, if we are serious about health-system transformation and integration, there is much more we must do so more Ontarians benefit from their expert care. NPs are key to delivering on the Quadruple Aim, which seeks to improve the patient care experience, improve health outcomes, improve the care provider’s experience, and reduce health costs. This is front-and-centre in our report and our recommendations,” says task force co-chair and RNAO CEO Dr. Doris Grinspun.

The task force, which includes NPs, nurse executives, scholars and health policy leaders from across Ontario, has eight recommendations with specific calls to action aimed at the government and other partners:

  1. Increase the supply of NPs across all sectors and settings.
  2. Optimize the utilization of NPs within current scope.
  3. Expand the scope of practice for NPs.
  4. Align NP curriculum with expanding scope of practice.
  5. Harmonize NP compensation across all sectors and settings.
  6. Invest in research to support NP practice and improved health outcomes.
  7. Optimize access and continuity of care by ensuring all insurance benefit carriers, and other such payers, accept NP services analogous to physician counterparts.
  8. Showcase impact of NPs through public education campaigns to advance full utilization of NPs across all sectors and settings.

“The significance of this report is that its impact extends beyond Ontario and Canada. With a framework grounded in the Quadruple Aim concept and the report’s attention to the United Nations’ Sustainable Development Goals, which strive to end poverty, protect the planet and ensure people’s well-being, I am confident that Vision for Tomorrow will have far-reaching impact,” says Dr. Elissa Ladd, co-chair of RNAO’s NP Task Force and director of Global Health Equity and Innovations at the MGH Institute of Health Professions in Boston. Dr. Ladd also serves as a deputy director of the International Council of Nurses’ Nurse Practitioner/Advance Practice Nurse Network Global Research Academy.

Following the release of today’s report, a group of NPs will take part in a panel discussion, sharing experiences from their day-to-day practice. Details can be found in RNAO’s Queen’s Park Day agenda.

Reporters are welcome to join the release of the report via our livestream Thursday, Feb. 25 at 6 p.m. ET and the panel discussion afterwards at 6:30 p.m. ET.  

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit our website at or follow us on Facebook and Twitter.

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Contact info

Marion Zych
Director of Communications
Registered Nurses' Association of Ontario (RNAO)