Position

The Nurse Practitioners’ Association of Ontario (NPAO) supports workplace flexibility as an essential component of autonomous Nurse Practitioner (NP) practice and a key strategy for recruitment, retention, workforce sustainability, and patient access to care.

As regulated autonomous health professionals, NPs are accountable for determining how best to meet their professional obligations, regulatory requirements, and patient needs. This includes exercising clinical judgment regarding scheduling, continuity of care, follow-up processes, and the use of in-person, virtual, or hybrid models of care.

Principles

NPAO recognizes that many NPs practice within employee-employer relationships and interprofessional teams. Effective healthcare delivery requires a collaborative partnership between organizations and NPs that balances operational needs with professional autonomy. Employers have responsibilities related to staffing, access, and clinic operations. NPs have responsibilities related to clinical decision-making, continuity of care, and professional accountability. Both are essential to high-quality patient care. Workplace policies should support—not replace—the professional judgment of the NP. Decisions affecting how NPs meet their standards of practice, continuity of care obligations, and Most Responsible Provider (MRP) responsibilities should be informed by the NP’s clinical expertise and understanding of their patient population.

As autonomous practitioners, NPs should have significant influence over:

The organization of their clinical practice.
Their scheduling and workflow management.
The use of in-person, virtual, and hybrid care models.
Processes required to meet continuity of care and patient follow-up needs.

Workplace flexibility is not an employment perk. It is an operational approach that enables NPs to provide timely, patient-centred care while meeting professional standards and responding to changing patient needs.

Infrastructure Requirements

To support modern NP practice, organizations should provide:

Secure remote access to electronic medical records and clinical systems.
VPN or equivalent secure technologies.
Access to virtual care and communication platforms.
The technological infrastructure required to support seamless transitions between in-person and virtual care.

These capabilities are increasingly necessary to support continuity of care, patient access, organizational resilience, and effective healthcare delivery.

Recommendations

NPAO recommends that healthcare organizations:

1. Recognize workplace flexibility as a core component of autonomous NP practice.
2. Respect NP professional autonomy in determining how best to meet patient care needs and regulatory obligations.
3. Support collaborative decision-making regarding scheduling, service delivery, and models of care.
4. Provide the infrastructure necessary to support flexible and responsive NP practice.
5. Leverage workplace flexibility as a strategy to improve recruitment, retention, provider satisfaction, and workforce sustainability.

Conclusion

Nurse Practitioners are autonomous regulated professionals accountable for delivering safe, high-quality, patient-centred care. Organizations that support workplace flexibility, professional autonomy, and collaborative practice environments are better positioned to recruit and retain NPs, improve patient access, and strengthen Ontario’s healthcare system. NPAo provides educational materials to support NPs in navigating the implementation of workforce flexibility initiatives. More resources can be found on our website.

 

Download the position statement here.