Updated Contract Guidance for New to Practice Family Physicians and PCN Nurse Practitioners
- Jul 31
- 2 min read
The Ministry of Health issued a revised memo on July 16, 2026, clarifying expectations for New to Practice (NTP) physician contract extensions and Primary Care Network (PCN) Nurse Practitioner (NP) contract renewals.
New to Practice Physician Contracts
The Ministry reaffirmed that NTP contracts are intended as two-year contracts, with physicians expected to transition to the Longitudinal Family Physician (LFP) or Fee For Service (FFS) payment model once the contract expires.
Health Authorities may grant a one-time extension of up to six months, but only in limited cases where physicians have achieved 60–84% attachment and are progressing toward contract goals.
Attachment expectations include:
85% or greater attachment: Physicians are expected to transition to LFP or FFS.
60–84% attachment: A one-time extension of up to six months may be considered if the physician is progressing toward contract goals.
Less than 60% attachment after two years: Extensions are generally not recommended.
PCN Nurse Practitioner Contract Renewals
For NP PCN contracts, renewals will generally continue to be supported to maintain continuity of care. Health Authorities are encouraged to monitor contract performance and begin renewal discussions at least six months before contract expiry.
Renewal decisions are tied to patient attachment levels:
85% or greater attachment: NPs are expected to receive contract renewals.
50–84% attachment: NPs may be renewed with additional monitoring, attachment improvement strategies, and support from PCNs and provincial NP programs.
Less than 50% attachment over three years: Health Authorities may consider a one-year renewal or reduced FTE arrangement in consultation with the Ministry.
The Ministry noted that requests outside these parameters will continue to require Ministry consultation and approval. The revised guidance is intended to promote consistency across the province and support effective management of primary care contracts.
For full details, review the Ministry of Health memo here.