From Data to Insights
Exploring Access to Primary Care and Shifting Models
Who this is for: Those who work with data to support health workforce planning and decision making.
What this is: An example focused on shifting primary care models that illustrates how you can begin generating your own insights using data and information from Health Workforce Canada tools.
How this can help you: There is a significant amount of health workforce data and information across Canada, but answering meaningful questions often requires layering multiple sources and viewing them through different lenses.
This example shows how pieces of data can lead to new questions or highlight areas that need deeper exploration, local expertise, and contextual information. It showcases a process for getting to answers that are more robust and relevant to local needs.
Publication date: March 26, 2026
Accessibility note: Accessible table versions of all charts are available at the bottom of this report. For optimal performance, we recommend viewing this page on a web browser rather than on a mobile device.
The big picture
Aligning access measures and provider ratios to begin understanding primary care models
In 2024:
- Yukon, the Northwest Territories, and Newfoundland and Labrador exhibited the largest urban-rural disparities in access to primary care.
- British Columbia, Alberta, and Quebec had the highest family medicine physician (FMP) to nurse practitioner (NP) ratios. In British Columbia, it was 7.9 – meaning there were about 8 FMPs per 1 NP.
- On the other hand, Newfoundland and Labrador, Yukon, and Prince Edward Island had the lowest. In Newfoundland and Labrador, the ratio was 2.3 – signaling a closer balance between the number of FMPs and NPs practicing there.
- A higher or lower FMP:NP ratio is not an indicator of quality. Across the country, either result did not necessarily correspond with a higher percentage of residents with regular access to a primary care provider. The appropriate ratio is context-dependent, and factors such as geography, prevalence of team-based care, and scope of practice differences should be considered.
Consider the following:
- What other indicators could help you understand the relative impact of these factors across different settings and populations?
- Does the type of regular care provider individuals have access to (e.g., family medicine physician, nurse practitioner, specialist, or other provider) play a role in the observed trends?
- Based on primary drivers, what next steps could you recommend for targeted improvement?
A closer look at key indicators
Capacity of the NP workforce
- On average, about 3% of licensed NPs are not employed in the profession.
- Understanding the reasons why eligible NPs are not employed will be key for any targeted approaches to reducing barriers to employment.
- Additionally, an appropriate mix of NPs in non-direct care roles is essential to support other activities such as education and training.
Consider the following:
- What additional information is needed to help differentiate between untapped direct care capacity and the required balance of NPs in non-direct care roles?
- How would you determine if any barriers are preventing eligible NPs from working in direct care?
- If barriers exist, what strategies could you recommend to address them?
Changes in primary health care workforce over the decade
- The NP profession continues to expand across the country, growing by an average annual rate of 10% over the last decade.
- In many jurisdictions, pharmacist scope of practice has been expanded to include additional prescribing authority, including initiating treatment for certain minor ailments [1]. Growth in the supply of pharmacists has fluctuated in recent years, while at the same time growth in Canada’s population has accelerated.
- The group of health care providers contributing to primary health care goes far beyond those shown here. More comprehensive data for a broader range of professions will be essential for getting the full picture.
- When assessing growth rates and planning for sustainability of primary health care, pipelines into and within the workforce should be considered. For example, any policies that focus on expanding the NP workforce can have downstream effects on available RN capacity.
Consider the following:
- Beyond supply and population growth, what complementary indicators would help determine whether demand can be met?
- What conditions (e.g., funding models, legislation/regulation, team integration) will enable expanded scope of practice to translate into real impact?
Models of primary care and access vary by geography
- Hospitalizations for an ambulatory care sensitive condition (ACSC) can be a measure of access to primary health care [2].
- Rural residents often have lower rates of access to a regular primary care provider, and the rate of hospitalization for an ACSC per 100,000 population tends to be higher in these areas as well.
- Many jurisdictions are looking to leverage NPs to fill these gaps. Where data is available, between 8% (BC) and 34% (Saskatchewan) of NPs are working in a rural or remote area.
- Increased supply of these providers may not be enough to close gaps; other factors such as retention and scope of practice can play a major role.
- Tracking the distribution of primary care providers alongside measures of care access is key to monitoring success of new models and identifying other drivers of access gaps. To see the impact, comparable high-quality data on both the health workforce and the populations they serve is needed.
Consider the following:
- Who can you work with in communities to better understand the realities of day-to-day service delivery, and how can that inform improvement strategies?
- How are other jurisdictions with similar populations providing services and what kind of outcomes are they generating? How can you get an understanding of this if the data isn’t readily available?
Evolving landscape of primary care
Evolving scope of practice for professions like pharmacists and NPs may contribute to trends seen in the type of roles and level of integration in primary care. For example, in some jurisdictions NPs can diagnose, refer, and prescribe independently, while in others, they have more restrictive scopes, unclear roles, and limited autonomy [3]. Additionally, fee-for-service models and traditional primary care team structures may create barriers for shifting to team-based care [3,4]. Innovative models that leverage the knowledge and skills of a broader primary health care team, including physiotherapists, paramedics, dietitians, and other providers are being implemented across the country [5], but better data is needed to improve coordination and planning. Health Workforce Canada’s Health Workforce Data Strategy highlights some of the work already underway and provides recommended actions for better connectedness, timeliness, and comprehensiveness of primary health care data.
To explore these data in more detail and export them for your own work, visit the Primary Health Care and Recruitment and Retention dashboards.
Want to learn more about what is happening on the ground?
Try asking our Digital Front Door these questions to find resources:- What types of team-based care models are being leveraged across the country?
- What are the roles of different types of health care providers as part of primary health care teams?
- What are successful approaches to improving access to primary health care in rural areas?
Related resources
Notes
Notes, Sources and Accessible Table Versions
- Supply and workforce data are sourced from the Canadian Institute for Health Information (CIHI) Health Workforce Database (HWDB), and can be explored on the Primary Health Care dashboard. For detailed methodology and definitions, consult CIHI’s profession-specific methodology notes.
- Data on access to a regular care provider is from the Statistics Canada Canadian Community Health Survey — Annual component as reported in the following table: Canadian Institute for Health Information table Canadians With a Regular Health Provider, 2023 — Data Tables. Ottawa, ON: CIHI; 2024. Data can be explored on the Primary Health Care dashboard. For detailed information on methodology, refer to the source table.
- A regular health provider is defined as “one health professional that you regularly see or talk to when you need care or advice for your health.”
- Data on ambulatory care sensitive conditions hospitalizations is sourced from CIHI’s Ambulatory Care Sensitive Conditions Hospitalizations indicator, and can be explored on the Primary Health Care dashboard.
- Ambulatory care sensitive conditions hospitalizations are defined as “age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care prevents or reduces the need for admission to hospital for population younger than age 75.”
- Fluctuations in pan-Canadian totals may be due to changes in data coverage or availability across the provinces and territories over time. Visit Health Workforce Canada dashboards to explore data at the jurisdiction or health region level (where available).
- Family physicians (FMPs) include general practitioners, as well as family medicine specialists and emergency family medicine specialists who are certificates of the College of Family Physicians of Canada (CFPC).
- The FMP:NP ratio is calculated by dividing the supply of family medicine physicians (FMPs) by the supply of nurse practitioners (NPs).
- Higher or lower ratios are not a measure of quality. The appropriate ratio is context-dependent (e.g., urban vs. rural setting, prevalence of team-based care, scope of practice differences, etc.).
- Note the following limitations: there may be variation in FMP practice patterns; it is not clear from the available data how many NPs are working in primary care as a main area of practice; and not all FMPs or NPs in the supply are providing direct clinical care.
- Additional data such as the number of FMPs or NPs per 10,000 population by health region or FMP service delivery and full-time equivalent data may provide supporting context.
References
- Canadian Pharmacists Association. Scope of Practice. Accessed February 3, 2026.
- Canadian Institute for Health Information. Ambulatory Care Sensitive Conditions Hospitalizations. Accessed January 30, 2026.
- Black S, Fadaak R, Leslie M. Integrating nurse practitioners into primary care: policy considerations from a Canadian province. BMC Family Practice. 2020.
- Marceau R, O’Rouke T, Montesanti S, Hunter K. A Critical Analysis of Funding Models: Sustainability of the Nurse Practitioner Role in Canada. The Journal for Nurse Practitioners. 2021.
- Healthcare Excellence Canada. Promising Practices for Strengthening Primary Care in Northern, Rural and Remote Communities. Accessed January 7, 2026
Text version of charts
Access to a regular primary care provider vs. family medicine physician to nurse practitioner ratios (FMP:NP)
| Jurisdiction | Percent of Population with Access to Primary Care (%) - Rural / Remote | Percent of Population with Access to Primary Care (%) - Urban | FP:NP Ratio |
|---|---|---|---|
| Newfoundland and Labrador | 66.6 | 83.0 | 2.3 |
| Prince Edward Island | 67.1 | 57.5 | 2.7 |
| Nova Scotia | 80.9 | 76.9 | 3.6 |
| Manitoba | 80.3 | 86.3 | 4.9 |
| New Brunswick | 82.2 | 81.2 | 5.2 |
| Saskatchewan | 78.8 | 84.0 | 5.1 |
| Quebec | 78.7 | 73.1 | 7.0 |
| Ontario | 88.6 | 88.5 | 3.7 |
| Alberta | 77.3 | 85.0 | 7.3 |
| British Columbia | 84.8 | 79.4 | 7.9 |
| Northwest Territories* | 51.1 | 66.6 | — |
| Nunavut* | 41.5 | — | — |
| Yukon* | 57.7 | 84.9 | 2.8 |
– Data is unavailable
NP supply data reported collectively for Northwest Territories and Nunavut; therefore, the FMP:NP ratio calculation for each is not possible.
Source: CIHI Health Workforce Database; Statistics Canada Canadian Community Health Survey.
Eligible nurse practitioners not working in direct care roles – detailed breakdown (2024)
| Jurisdiction | Percent of Total NP Supply (%) | |||||
|---|---|---|---|---|---|---|
| Not Employed in the Profession | Administration | Education | Research | Unknown | Total | |
| New Brunswick | 3.5 | 0 | 0.9 | 0 | 2.6 | 7 |
| Ontario | 4.6 | 0.8 | 1.7 | 0 | 0 | 7.1 |
| Quebec | 0.7 | 3.1 | 1.6 | 0.1 | 2.2 | 7.6 |
| Newfoundland and Labrador | 0 | 0.7 | 2.8 | 0.3 | 5.2 | 9 |
| Prince Edward Island* | 0 | 5.6 | 1.4 | 0 | 2.8 | 9.9 |
| Nova Scotia* | 4.8 | 0.9 | 4.2 | 0.6 | 0 | 10.6 |
| Alberta* | 5.8 | 2.1 | 3.2 | 0.3 | 0 | 11.3 |
| British Columbia | 3 | 1.6 | 0.9 | 0.1 | 7.5 | 13.1 |
| Yukon* | 5.3 | 5.3 | 0 | 0 | 5.3 | 15.8 |
| Saskatchewan | 5.7 | 0.4 | 1.8 | 0 | 12.4 | 20.2 |
Percent change in supply of selected primary health care providers and Canada’s population (2024) (Provinces/territories with available data)
| Year | Percent change from the previous year (%) | ||||||
|---|---|---|---|---|---|---|---|
| Nurse Practitioners | Family Medicine Physicians | Registered Nurses | Occupational Therapists | Physiotherapists | Pharmacists | Canada's Population | |
| 2016 | 11.0 | 2.3 | 0.5 | 2.9 | 2.8 | 4.1 | 1.1 |
| 2017 | 9.1 | 3.9 | 0.6 | 3.8 | 2.7 | 2.3 | 1.2 |
| 2018 | 8.0 | 2.9 | 0.6 | 3.3 | 7.3 | 2.5 | 1.4 |
| 2019 | 8.1 | 1.5 | 1.1 | 3.6 | 2.6 | 2.0 | 1.5 |
| 2020 | 8.5 | 1.4 | 1.4 | 2.2 | 2.9 | 0.8 | 1.1 |
| 2021 | 10.7 | 1.4 | 2.5 | 3.9 | 3.8 | 3.5 | 0.6 |
| 2022 | 10.9 | 1.8 | 1.1 | 3.1 | 3.8 | 2.2 | 1.8 |
| 2023 | 9.7 | -0.1 | 2.0 | 3.1 | 3.9 | 3.5 | 3.0 |
| 2024 | 9.9 | 1.9 | 5.3 | 3.0 | 5.6 | 0.3 | 3.0 |
Hospitalizations for ambulatory care sensitive conditions (ACSCs) vs. percentage of NPs practicing in rural/remote settings (2024)
| Jurisdiction | ACSC Hospitalizations per 100K - Urban | ACSC Hospitalizations per 100K - Rural | NPs in Rural/Remote Settings (%) |
|---|---|---|---|
| Alberta | 299 | 431 | — |
| British Columbia | 262 | 355 | 7.8 |
| Manitoba | 227 | 411 | — |
| New Brunswick | 364 | 352 | 26.9 |
| Newfoundland and Labrador | 391 | 467 | 26.2 |
| Northwest Territories | 388 | 728 | — |
| Nova Scotia | 346 | 405 | — |
| Nunavut | — | 1212 | — |
| Ontario | 327 | 396 | 10.2 |
| Prince Edward Island | 347 | 366 | — |
| Saskatchewan | 401 | 513 | 42.5 |
| Yukon | 453 | 494 | — |
Source: CIHI Ambulatory Care Sensitive Conditions Hospitalizations Indicator; CIHI Health Workforce Database.