Introduction

The optimization of the roles and skills that all healthcare professionals play is imperative, not the least of which is in the foundational primary care sector. 

Data abound about how so many different healthcare professionals are constrained in their ability to apply in the provision of care the skills for which they have trained so diligently to master – and for which they and the Canadian public have supported financially through the funding of training institutions. We need to see a way around the manner that we train yet constrain health professionals, particularly during a workforce crisis.

When it studied the state of the optimization of health professional scopes of practice over 10 years ago, the Canadian Academy of Health Sciences (CAHS 2014) boldly stated that:

One of the key problems in the way health care is delivered in Canada today is that health professional scopes of practice and associated models of care tend to be organized on the basis of tradition and politics rather than in relation to the evidence of how best to meet contemporary population health needs (p. 19).

Confronting these structural barriers, particularly around funding and regulatory reform, was where it focused its key recommended actions.

The recent reinterpretation of the Canada Health Act (1985) by the federal minister of health (Health Canada 2025) is consistent with these calls. This in turn creates a timely and synergistic opportunity for nurses' and other health providers' integration into primary care. The key to optimizing their role in primary care is in defining in turn what are medically necessary primary care services that should be accessible to all Canadians; who has the training and regulated scope to provide these services; and as Spencer et al. (2025) describe herein, how do we ensure that funding, compensation and practice models support a complement of healthcare professionals who can collaboratively deliver these services.

Indeed, the goal ought not to simply be the optimization of health professional scopes of practice within professional practice silos – it should quite explicitly be the optimization to work in teams in team-based models of primary care.

This was one of the key principles of the Team Primary Care: Training for Transformation initiative that we co-led (Team Primary Care 2024). We specifically brought together over 20 primary care practitioner-focused training teams to develop curricula and programs to better learn about, from and with all of those who can contribute to higher quality team-based care across Canada's primary care systems. We started first by sharing what each provider group is trained and regulated to do as foundational knowledge for working better together.

Similar to the over 20 other partners, the registered nursing team co-led by Marie-Eve Poitras, Julia Lukewich, Treena Klassen and others developed some of the project's most innovative team-based primary care-focused training for nurses, showcased here in this special issue and in an earlier special issue of Team Primary Care (Poitras et al. 2024).

With nursing being the largest group of healthcare professionals, initiatives to integrate and optimize the role for registered nurses in team-based primary care have the greatest potential to significantly enhance the provision of primary care across Canada.

Primary care – what ought to be the front door to our health system – will benefit from greater and strategic involvement of nursing.

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