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A single classification of Nurse Practitioners (NPs): FAQS
CNO, along with the Canadian Council of Registered Nurse Regulators (CCRNR) and other system partners are collaborating towards the common goal of ensuring Nurse Practitioner (NP) regulation protects the public and improves health care outcomes for patient populations across the country. We are working together to make changes to NP regulation so there is only one classification of NP. Our vision will enable the appropriate national level of regulation in the public’s interest, facilitate collaboration among system partners and reduce unnecessary barriers to labour mobility in Canada.
Keep monitoring this page. We will update our FAQs as new information becomes available.
NPs (New and Current)
Why do we need a new way of regulating NPs across Canada?
CCRNR is overseeing the implementation of a new regulatory framework for NPs and CNO has been part of this national discussion since 2018. The initiative will change Ontario’s framework for registering NPs by removing the specialty certificates (NP-Primary Health Care, NP-Pediatrics, NP-Adult) and replacing them with one classification of NP registration.
This new vision for NP regulation will:
- enable the appropriate level of national regulation in the public’s interest, focusing on patient and cultural safety
- promote consistency in regulation across jurisdictions
- facilitate collaboration among regulators
- reduce unnecessary barriers and advance labour mobility activities across the country
Currently, CCRNR’s NP Regulation Framework Implementation Plan Project (NPR-FIPP) is dependent on a few factors such as unique jurisdictional implementation plans, Council and/or government approval of regulation changes, curriculum changes, program approval and a new national single-entry exam.
For more information about the project, check out A single classification of Nurse Practitioners (NPs).
Does this mean if an NP passes the new national entry-to-practice exam, they will be registered to practice in any Canadian jurisdiction?
The new national entry-to-practice exam will be one step toward registering with CNO as an NP. Ontario NP applicants will also need to complete their other entry-to-practice registration requirements with CNO to practice in Ontario. If that NP wants to move to another province, labour mobility will be easier as they will have successfully completed the national exam. They will still need to register with the nursing regulator in the province where they wish to practice.
How will this impact NPs in specialties? I understand that they will be able to keep their registration, but will this also translate into fewer opportunities and some work barriers?
No. In fact, a single classification of NPs will increase flexibility for different groups. NPs will have more flexibility to make career changes serving broader patient populations, employers will have more flexibility for deploying nurses and government will have more flexibility for health human resource planning.
Currently, each provincial or territorial regulator has its own set of regulations and by-laws, NP exams, registration requirements and standards of practice. A consistent NP regulatory approach across Canadian jurisdictions will advance labour mobility and minimize barriers to practice.
Once the new framework is implemented, how will I note my NP credential/specialty certificate?
Transition planning discussions are underway for current NPs, with consideration to title use. We will provide information and guidance on NPs’ title use and credentialing before we implement this model in Ontario.
With changes to the entry-level competencies (ELCs), will every NP coming out of an educational program be expected to practice as a Primary Health Care NP, or can they follow a study stream for an area of interest?
According to CCRNR’s 2015 practice analysis survey, evidence shows that NPs in Canada use similar competencies regardless of their specialty certificates. With the new model, all new NPs will complete a foundational education program that will prepare them to practice across patient populations and practice settings. This means NPs will have the option to work in the practice setting of their choice within their regulated scope of practice. There is no requirement for new NPs to practice in a primary health care setting. NPs entering practice will have the foundational knowledge, skills, and judgment to provide advanced nursing care in all practice settings. Then, similar to an RN, an NP can choose to pursue a specialization after entering practice, which may be obtained through formal courses, experience, continuing education and other opportunities.
In addition, CNO is working with our academic partners on a foundational NP education program. This will support an agile NP workforce and equip NPs to work in a rapidly changing health care environment.
In November 2022, the CCRNR board recommended the revised NP entry-level competencies (ELCs) for provincial/territorial regulators to review and approve. CNO endorsed the revised NP ELCs in December 2022. We are now working closely with universities and academic institutions to support their implementation into Ontario NP education programs in 2024. CNO is supporting this through our Program Approval process.
If you get rid of specialty designations, will there be any discussions about NPs who want to specialize in areas of practice and have these noted on their CNO profile?
NPs across Canada will receive education aligned with entry-level competencies (NP ELCs) take a common NP entry-level exam and be prepared to provide care across patient populations and practice settings. NPs can further enhance their knowledge and expertise over time and may pursue additional specialization, if they desire.
I’m an NP. How can I get involved in this national project?
We are asking NPs for your support and feedback along the way. For example, in March 2024, NPs across Canada received an email from CNO to participate in CCRNR’s NP practice analysis validation survey. Input from this survey will inform a new NP single entry-to-practice exam.
