Nurse Practitioner; Expanded Service

Our nursing team now includes a Nurse Practitioner (NP). In addition to the existing primary care that our Registered Nurses provide, this NP position can also write prescriptions, make referrals and order diagnostic lab tests. This expanded scope gives clients more comprehensive care and responds to the varied, changing and aging needs of our clients.


Toronto’s homeless population includes newcomers, older adults, aboriginals, sex workers and members of the LGBTQ community.  Often, low income predicts health outcomes. Individuals who are homeless are more likely to suffer from chronic illnesses, mental health issues and addictions. Barriers to accessing care sometimes lead to health conditions going undiagnosed, untreated and worsened. Poor access to safe shelter, a decent meal, TTC transportation costs and coping with chaotic lifestyles can often make it a challenge to comply with “doctor’s orders”, long hospital wait-times and with keeping appointments. Lost or stolen identification, stigma and past negative healthcare experiences are also large barriers to accessing and following-up with care.

Barriers to accessing care sometimes translate into difficulty following treatment plans. “Clean the affected area, apply this medication, and put on fresh clean socks”, may not be easy for someone with limited resources who is living on the street. Language barriers, mental health issues, problems with vision, mobility, literacy. Limited access to prescription medication coverage, privacy, bathrooms, safe places to rest and/or funds for healthy food make monitoring and follow-up essential to chronic illness management and to achieving wellness.

When compared to the general population those who are homeless are less likely to have a family doctor and more likely to seek care at an emergency department.

The introduction of a Nurse Practitioner to our nursing services with allow Street Health to accept referrals from community services including hospitals, shelters and detox centres and provide urgent access to nursing care and case management. Flexible care is offered in office and at weekly nursing drop-in clinics. Along with our RNs, our Nurse Practitioner promotes timely access to diagnoses and treatment of acute and chronic illnesses, health screening and referrals to specialty care…which improves the patient experience.

The types of clients who could benefit from this expanded scope may include

  • Service users who do not have a family doctor
  • Those who would benefit from case management and support on an ongoing basis
  • Service users who have a doctor but have trouble accessing them, have a poor relationship with them and/or have complex needs that exceed what one primary care provider can offer
  • Service users whose condition may require monitoring, follow-up and health education on an ongoing basis
  • Those who cannot access care through mainstream organizations (i.e. lost or stolen ID )
  • Any service users who need help linking to specialty services (psychiatry, physician care, etc.) with accompaniment

Within the next 10 years the population of older adults in downtown Toronto is expected to increase by 48.5% and the size of the homeless population continues to grow each year. This increases the need for accessible and specialized care.

With this new NP position, this expansion of our services, and with current renovations to create a wheelchair accessible space, Street Health continues to evolve and respond as client needs become more complex.