Québec, 20 March 2026 — An agreement was reached on March 16, 2026 between the Fédération interprofessionnelle de la santé du Québec–FIQ and the Ministry of Health and Social Services (MSSS) to improve frontline patient management. This agreement clarifies and supports the role of specialized nurse practitioners (SNP) in family medicine groups (FMG), with a view to improving access to care and streamlining the organization of services for the public.

For several years, the FIQ has called for genuine professional autonomy for SNPs.  Despite the passing of An Act to amend the Nurses Act and other provisions in order to facilitate access to health services (Bill 6) in 2021, until recently, the ability of SNPs to register patients directly remained severely limited. Discussions with the MSSS have helped to develop the model for collaboration agreements between doctors and Santé Québec in order to remove these obstacles and encourage the registration and monitoring of patients by SNPs.

“The agreement clearly says that SNPs and doctors will work together in a professional collaborative relationship, without a hierarchal relationship. We also secured major commitments: SNPs who so wish can register their own patients, which will improve access to care”, emphasized Jérôme Rousseau, Vice‑President of the Organization of Work and Professional Practice Sector and the Negotiation Sector of the FIQ.

The discussions also provided an opportunity to explore in depth the issues surrounding the individual registration of patients in an FMG, particularly in situations where a SNP leaves or is on an extended absence. “The revised version of the collaboration agreement is now based on a consultative approach that respects each party’s roles and responsibilities”, added the vice-president.

In practical terms, the agreement confirms that SNPs are employed exclusively by Santé Québec, that the relationship with doctors remains strictly professional and collaborative, and that a transition procedure governs staff movements without restricting the rights of SNPs. It also stipulates that Santé Québec has the necessary means to take action if an FMG opposes the registration of patients by SNPs.

“We now have a clear framework which protects the SNPs’ rights, ensures the continuity of care and enables better integration of their expertise in frontline care. The aim is simple: a more effective, consistent frontline service that focuses on the needs of the public”, concluded Jérôme Rousseau.

About the FIQ

Created in 1987, the FIQ represents nearly 90,000 healthcare professionals (nurses, licensed practical nurses, respiratory therapists and clinical perfusionists) working in the healthcare institutions across Québec. The FIQ is a feminist organization composed of nearly 90% women, dedicated to defending its members, while ensuring the quality of care offered to the public and the sustainability of the public health network.