Umbrella Review of Primary Health Care Nurse Practitioner Transition Pathways in Australia

Background Australia's primary health care system is under growing pressure from an ageing population, increasing numbers of people living with multiple chronic conditions, and persistent workforce shortages that particularly affect rural and regional areas. Nurse Practitioners are well positioned to help build primary health care capacity, yet the transition pathway from registered nurse to Nurse Practitioner within primary health care happens without structured, consistent, system-level support. Aim This review synthesises Australian evidence relating to Nurse Practitioner roles, RN-to-NP transition experiences, organisational readiness, and workforce integration within primary health care, identifying implications for national workforce policy and system design. Methods An umbrella review with narrative synthesis was undertaken, drawing exclusively on Australian literature. Evidence was identified through searches of key academic databases and platforms commonly used in Australian health workforce research, including Google Scholar, MEDLINE, CINAHL, and Scopus, supplemented by policy and professional body publications. Results Australian evidence consistently supports the safety, effectiveness, and acceptability of care delivered by Nurse Practitioners in primary health care (Desborough et al., 2016; Schadewaldt et al., 2016; Rossiter et al., 2023). However, the RN-to-NP transition within primary health care is characterised by reliance on individually sourced supervision, mentorship, and organisational support, resulting in variable transition experiences across settings (MacLellan et al., 2017; Rossiter et al., 2024). Organisational readiness, funding structures, and access to mentorship emerged as key factors influencing Nurse Practitioner integration and workforce sustainability. Conclusion Challenges in RN-to-NP transition within primary health care reflect system design gaps rather than limitations in Nurse Practitioner capability (Currie et al., 2018). Establishing a structured, primary health care-specific transition framework represents a critical policy opportunity to strengthen primary health care sustainability in Australia.