Across Ontario, Nurse Practitioners (NPs) are already leading care teams every day, particularly in rural, remote, and underserved communities where access to healthcare remains limited. They are managing complex patient needs, improving access to care, and stepping into gaps across the healthcare system, often without the recognition or support their leadership deserves.
Yet conversations about healthcare leadership still tend to overlook nurses and NPs because of outdated views of care. The reality is, we should not still be asking whether NPs are capable of leading, because they already are. The more important question is why Ontario’s healthcare system has not fully recognized and supported that leadership through flexible funding models, fair compensation, and meaningful inclusion in healthcare decision-making.
NPAO regularly hears from NPs across the province about the realities they face on the frontlines. One story in particular stood out, because it reflects a broader pattern experienced by many NPs working throughout Ontario’s healthcare system.
Leadership is Already Happening on the Frontlines
One NP began practicing in 2017 and, within a year, was working in both primary care and addictions medicine in a rural Ontario community where healthcare demand far exceeded available providers.
When asked to help launch a Rapid Access Addictions Medicine clinic, they agreed immediately. The need in the community was urgent, and the opportunity to support vulnerable patients aligned closely with their clinical focus.
What began as a single clinic day each week quickly expanded beyond its original scope. Appointment slots filled almost immediately, crisis calls increased, referrals from other care teams continued to grow, all without additional staffing or operational support to match the rising demand.
Eventually, the clinic was designated as an official “spoke site,” meaning it would formally connect patients to a larger regional resource hub while allowing care to remain close to home.
But while the designation acknowledged the importance of the work being done, it did notcome with the staffing, infrastructure, or funding needed to sustain it. The program received approximately $12,000 annually, far from enough to support a growing addictions medicine clinic or build long-term capacity.
Like so many NPs across Ontario, this clinician and their team adapted the best they could. They absorbed additional responsibilities, expanded services where possible, and continued responding to growing patient needs despite limited support. But while demand continued to rise, system capacity did not.
Eventually, after years of sustained pressure, the NP left the role, not because the community no longer needed care, but because the model itself was unsustainable.
Unfortunately, this is not an isolated story. It reflects a larger reality unfolding across Ontario’s healthcare system.
Workforce Shortages Persist and NPs Continue to Step Up
Ontario’s healthcare system continues to face immense strain. Workforce shortages remain across primary care, hospitals, mental health and addictions services, and rural and underserved communities. At the same time, patient needs are becoming increasingly complex due to an aging population, rising chronic illness, growing mental health challenges, and continued pressure on emergency departments.
Across the system, healthcare providers are being asked to do more with less while burnout and retention challenges continue to rise. And in the middle of these pressures are NPs who continue stepping up to bridge gaps in care and improve access for patients and communities that might otherwise go without support.
Redefining What Healthcare Leadership Looks Like
Leadership in healthcare takes many forms, and NPs continue to demonstrate their leadership through the care they provide and the communities they serve. NPs are expanding access to care, responding directly to community needs, coordinating care, and supporting patients through an increasingly strained healthcare system.
The story shared above reflects this clearly. Faced with growing demand and limited resources, one Ontario NP expanded their scope of practice, pursued additional psychotherapy training, and continued responding to patient needs despite limited investments and supports in the program. Like many NPs across the province, they stepped up because their community needed them to.
But this story also highlights that leadership without support is not sustainable.
What Supporting NP Leadership Can Unlock
With flexible funding models, expedited compensation, and recognition of NPs as healthcare leaders, NPs will play an even greater role in strengthening Ontario’s healthcare system.
By better supporting NP leadership, Ontario can:
• Expand access to primary care, particularly in rural and underserved communities
• Strengthen recruitment and retention by ensuring NPs feel valued and supported
• Increase access to addictions and mental health services through NP-led models of care
• Reduce avoidable emergency room visits and relieve pressure across the broader healthcare system
The Time to Empower is Now
Supporting NPs as leaders does not diminish the role of other healthcare professionals. It strengthens the healthcare system as a whole. Ontario needs a healthcare system that empowers NPs to lead, innovate, and deliver care where patients need it most.
We encourage Ontarians to support NPs across the province by:
• Signing our petition: https://www.change.org/fundingforNPs
• Send a letter to your local MPP and Minister of Health Sylvia Jones: Publicly fund Nurse Practitioner Services – NPAO
• Share your story as a NP or as a patient of an NP:
