Evolving roles and workforce trends among nurse practitioners in Aotearoa New Zealand (2014-2022)

We aimed to describe nurse practitioner (NP) workforce characteristics, clinical practice and enablers and barriers in Aotearoa New Zealand.

Five cross-sectional, self-reported online surveys were distributed biannually in collaboration with Nurse Practitioners New Zealand. Eligible participants were registered Aotearoa New Zealand NPs. Quantitative items covered demographics, practice activities and work environment; qualitative items captured priorities for change. Data were cleaned and reclassified to ensure comparability across survey rounds, and descriptive statistics were used to report findings. Ethics approval: Te Herenga Waka-Victoria University of Wellington, Human Ethics Committee, 2024/HE000107.

Of the 1,004 valid responses (52-74% of the workforce per survey), most respondents were practicing clinically (>94%). By 2022, prescribing was near-universal (98%), with most ordering laboratory (92%) and radiology (70%) investigations. Employment was concentrated in district health boards/Health New Zealand - Te Whatu Ora, with increasing representation in primary health organisations, private practice, non-governmental organisations and self-employment. Respondents reported barriers to practicing at full-scope of practice, limited succession planning and challenges to workforce sustainability.

NPs are an established part of Aotearoa New Zealand's health workforce. However, persistent structural barriers, limited succession planning and variable support for full-scope practice continue to constrain their contribution. Strengthening integration and sustainable policy support are essential to realise the full potential of the NP role.