Overview
Initiative type
Service Improvement
Status
Deliver
Published
June 2026
Summary
A nurse-led walk-in clinic delivers free, culturally safe, evidence-based primary healthcare through autonomous advanced nursing practice. The model strengthens workforce capability while expanding access to care.
Dates: Jul 2024 - Oct 2024
Implementation sites: Mt Gravatt Nurse-Led Walk-In Clinic
Partnerships: Office of the Chief Nursing Office (OCNO), System Performance Branch (SPB)
Aim
To design and implement a sustainable, legislatively robust nurse-led model that expands equitable access to safe, high-quality primary healthcare.
Outcomes
- Provided healthcare to 13,000+ patients since opening in October 2024.
- 68% of patients are women and children, aligning with the Queensland Women and Girls Health Strategy priorities.
- 2% of patients are Aboriginal and Torres Strait Islander people, delivering culturally safe, accessible care.
- > 250 consumer compliments received.
- Zero reported clinical incidents, demonstrating strong safety governance.
- 15 Registered Nurses (RNs) credentialed with extended scope under Part A of the Medicines and Poisons (Medicines) Regulation 2021.
- Three Nurse Practitioner (NP) Candidates achieved endorsement within the service.
- Development of a Health Service bespoke Health Management Protocol following gap analysis aligned to antimicrobial stewardship and therapeutic guidelines.
Background
Access to timely, affordable primary healthcare remains a persistent challenge in South Brisbane, particularly for women, children, and vulnerable populations. Increasing demand on emergency departments for low-acuity presentations, combined with primary care access constraints, highlighted the need for innovative, community-based solutions.
Simultaneously, Australia faces national Nurse Practitioner (NP) workforce limitations, restricting scalability of advanced nursing services. Traditional service models often rely on medical-led care or small NP cohorts, creating bottlenecks in service delivery
and limiting workforce sustainability. The central problem addressed by this project was: Can a nurse-led walk-in clinic be safely and effectively be established using an extended-scope RN workforce model, underpinned by structured governance and legislative
compliance, to improve equitable access to primary healthcare? In October 2024, the Mt Gravatt Nurse-Led Walk-In Clinic was implemented within ten weeks of securing a cold shell lease. Rapid establishment required structured governance and stringent project
delivery to ensure safety and risk reduction.
The service was intentionally aligned with the Queensland Women and Girls Health Strategy to prioritise accessible, culturally safe care. The project sought to demonstrate that autonomous, evidence-based nursing care, when intentionally designed within strong governance frameworks, can safely expand system capacity while maintaining clinical excellence. Enabling nurses to practice at top of scope is at the core of the service, ensuring the right patient receives the right care in the right place.
Methods
The Mt Gravatt Nurse Led Walk-In Clinic was established as a structured workforce and governance innovation, with strong foundations in clinical safety and accountability. Prior to opening, a comprehensive governance and clinical safety framework was developed, a Health Management Protocol aligned with the Primary Clinical Care Manual (PCCM) was drafted and formally endorsed, alongside the development and publication of local procedures and clinical guidelines. As a digital site ieMR PowerPlans were designed in collaboration with other sites to standardise documentation and support consistent clinical decision-making. Fifteen RNs were recruited and underwent a structured bespoke education program and were credentialed to practise with extended scope under Part A of the Medicines and Poisons (Medicines) Regulation 2021.
This supported the RNs to provide autonomous nursing care as per the PCCM HMPs. The workforce model was equally deliberate in its design and sustainability was embedded through the creation of formal Nurse Practitioner Candidate (NPC) roles, provision of supervised advanced practice hours, structured career progression pathways, and support for Nurse Practitioner Students from within the Health Service to undertake clinical placements in the clinic. Since opening, three NPCs have successfully achieved endorsement within the service, demonstrating the model’s effectiveness in building advanced nursing capability. Six months after opening, a revised PCCM was released.
Rather than immediate adoption, a multidisciplinary working group conducted a comprehensive gap analysis. This included benchmarking against antimicrobial stewardship standards and therapeutic guidelines. The outcome was development of an independent Health Service Health Management Protocol to ensure local legislative integrity. The service also advocated for amendment to the Queensland Medicines
and Poisons Regulation 2026 to authorise RNs to repackage medicines to provide treatment doses under extended practice authority. The clinic is participating in the QUT and Office of the Chief Nursing Officer Designated RN Prescribing Research Project, contributing
to the national evidence base for regulated RN prescribing reform. With five nurses currently enrolled in post graduate study to support achieving AHPRA endorsement.
Discussion
Several contextual factors were critical to the success of the model. Strong executive sponsorship and clear organisational alignment provided authority, visibility, and strategic direction from the outset. Governance structures were clearly defined prior to implementation, ensuring accountability and clinical safety were paramount. Workforce readiness was equally important, supported by an existing culture of advanced nursing practice and clinicians prepared to work to extended scope. The model was deliberately aligned with broader strategic priorities, including women’s health initiatives.
Careful attention to legislative compliance and proactive engagement with policy frameworks further enabled confident implementation. The rapid establishment of the service within 10 weeks demonstrated that innovation can occur without compromising safety when governance is prioritised from inception. Several key lessons emerged from implementation. Extended-scope registered nurse models require deliberate credentialing processes and highly standardised clinical protocols to ensure safety and consistency. Clear legislative interpretation and policy clarity are essential to enable practitioner confidence and reduce ambiguity in scope of practice. Embedding Nurse Practitioner (NP) Candidate roles from the beginning significantly accelerates workforce sustainability and succession planning. Multidisciplinary engagement enhances clinical integrity, particularly in areas such as antimicrobial stewardship. Finally, establishing research partnerships strengthens credibility, supports rigorous evaluation, and enhances scalability.
The findings to date reflect the initial operational period only and therefore represent early implementation outcomes. Long-term clinical outcomes and comprehensive cost-effectiveness analyses are still in progress. Additionally, while service utilisation data is encouraging,
cultural representation data indicates an opportunity to strengthen engagement with Aboriginal and Torres Strait Islander communities to ensure equitable access and culturally responsive care. The model demonstrates strong potential for scalability across Queensland. The success of the Mt Gravatt Nurse Led Walk in Clinic, has identified that similar projects could be successfully implemented in high-demand metropolitan growth corridors, communities experiencing limited access to general practitioners, and as part of emergency department diversion strategies to reduce avoidable presentations.
The model is also well suited to women’s and children’s community health hubs, where structured advanced nursing practice can enhance timely access to care. Future priorities include supporting RNs prescribing endorsement under AHPRA, undertaking formal evaluation of cost-effectiveness and broader system impact, and expanding partnerships with Aboriginal and Torres Strait Islander communities. Continued legislative advocacy will also be important to sustain and expand autonomous nursing practice. Overall, this project demonstrates that intentionally governed autonomous nursing practice can safely and effectively transform healthcare delivery across Queensland.
References
Australian Commission on Safety and Quality in Health Care. (2021). National Safety and Quality Health Service (NSQHS) Standards (2nd ed.). Accessed from https://www.safetyandquality.gov.au/standards/nsqhs-standards Australian Health Practitioner Regulation Agency. (n.d.). Nurse Practitioner Standards for Practice. Accessed: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-standards/nurse-practitioner-standards-of-practice.aspx
Queensland Government. (2021). Medicines and Poisons (Medicines) Regulation 2021 (Qld). Accessed: https://www.legislation.qld.gov.au/view/whole/html/inforce/2025-12-01/sl-2021-0140
Queensland Health. (2024). Queensland Women and Girls Health Strategy 2032. Accessed: https://www.health.qld.gov.au/women-girls-health-strategy
Queensland Health. (2025, April 7). Extended Practice Authority ‘Registered Nurses’ (Version 6). Queensland Government. https://www.health.qld.gov.au/__data/assets/pdf_file/0030/1108947/epa-registered-nurse.pdf
Queensland Health & Royal Flying Doctor Service (Queensland Section). (2025). Primary Clinical Care Manual (12th ed.). Office of Rural and Remote Health, Queensland Government. Accessed: https://www.health.qld.gov.au/orrh/clinical-manuals/primary-clinical-care-manual-pccm
Therapeutic Guidelines Ltd. (n.d.). Therapeutic Guidelines. Accessed: https://www.tg.org.au/products/therapeutic-guidelines/
Key contact
Emily Pickup
Nurse Unit Manager
Mt Gravatt Nurse-Led Walk-In Clinic
Metro South Hospital and Health Service