Nurse-led model a solution to rural GP shortages in Ōtorohanga

When the doors opened at Ōtorohanga Medical Centre in 2019, it was a new building that truly reflected the strength of the community behind it. Locals raised $3.4 million to make the architecturally designed facility debt-free from day one, through donations, a black-tie gala where staff became the event’s valets and servers, and major gifts from families including the Olivers and the Knutsons.

Today, the building is owned by the Ōtorohanga Charitable Trust, which reinvests over $100,000 of lease income back into local projects every year, even buying a horse for Riding for the Disabled.

That same determination is now shaping how healthcare is delivered at the practice, by putting nurses at the centre of care.

Like many rural areas, Ōtorohanga faces GP shortages and growing demand for care. Rather than accept the status quo, the practice took a “grow your own” approach, creating a pipeline for nurses that runs from student placements to prescribing roles.

“We’ve had to think differently,” says practice manager Michelle McKenzie. “The community is growing, and we need to respond to what people need. Nurses bring incredible expertise, and when we give them opportunities to upskill, patients get better access and faster care.”

At the heart of this change is Suz Cornelissen, clinical nurse lead and one of the practice’s newest nurse prescribers after gaining prescribing authority from the Nursing Council in May 2024.

“I love being hands-on with patients and leading a team that’s passionate about learning,” says Suz.

“The directors have been amazing – they trust us and encourage us to develop. That trust makes a difference. If a patient comes in and needs something outside our standing orders which are basically the set rules we follow to give certain medicines in specific situations, the GPs back our judgment 99 per cent of the time. It means patients get timely care.”

This support has allowed the team to introduce nurse-led clinics such as diabetes high needs, sexual health, ear suction, Best Start pregnancy, a dedicated cough and cold clinic over winter and advanced prescribing pathways.

Nine nurses now work at the practice, with two set to become community prescribers this year and one nurse who has completed her RN Designated Prescriber and has been signed off by the nursing council so is now running her own designated clinic.

There’s a strong emphasis on developing local talent.

New graduate nurse Katrina Hovind-Marx says, “I grew up here my whole life, so staying in the community was important. I did two placements here as a student and knew this was where I wanted to be. Everyone is so supportive. I’m learning something new every day. In hospital, you might specialise in one area, but here, the variety is amazing.”

Suz recalls a young woman who repeatedly missed appointments for her contraceptive injection. “When she came in, I was able to offer a long-term option on the spot – no waiting, no extra booking. That’s the difference this model makes.”

For the practice’s three GP directors, it’s about sustainability. “There’s a severe GP shortage, so if we don’t enhance and upskill nurses, rural healthcare will always struggle,” says Dr Jo Ann Francisco.

“Nurses are seeing more patients and doing more clinical work, which means people don’t have to wait three weeks to see a GP. We’re proud of what the team has achieved. It’s making a real difference.”