Written by: Angela Wignall, CEO, Nurses and Nurse Practitioners of BC
April 28, 2026
When Nurses and Nurse Practitioners of BC began exploring the idea of a comprehensive compensation framework, or Main Agreement, for nurse practitioners, we knew one thing from the outset: this could only move forward if it was led by nurse practitioners themselves.
This was never something that could be shaped by a small group behind closed doors. It needed to reflect the priorities and aspirations of nurse practitioners across British Columbia, in every region, every practice setting and every compensation model.
That principle guided our work from day one.
It started with listening
The earliest conversations began in late 2024 through NNPBC’s NP Leadership Committee, formerly known as NP Council. Interest in a Main Agreement was clear, but so was the need for broader engagement.
Over the many months that followed, we held townhalls, presentations and open discussions with nurse practitioners working in primary care, acute care, community settings, rural and remote communities, health authorities, independent and contracted models and specialized practice areas.
We met with NP departments and leadership teams across BC to explain what a Main Agreement was, how it could apply in different settings, and what it would take for NPs to pursue one. We joined existing forums and committees. We connected with NPs through conferences, webinars, grand rounds and direct outreach.
We heard from nurse practitioners who were enthusiastic, cautious, skeptical and undecided. Every one of those perspectives mattered.
In summer 2025, NNPBC launched a dedicated website and province-wide survey so nurse practitioners could learn more and share feedback in a structured way.
Some raised concerns about compensation gaps and uneven access to benefits and supports. Others questioned how a single agreement could impact existing benefits or arrangements already in place with their employers.
Some wanted to understand whether an agreement could help expand the ways and settings in which nurse practitioners are able to work. Workloads, recruitment and retention, rural practice realities, and many other issues were raised by NPs.
What we heard across nearly all conversations was that nurse practitioners wanted to be involved in shaping the future of their profession — to support its growth and to ensure NPs could provide the best possible care for patients.
Putting the decision in NPs’ hands
A Main Agreement would be the first comprehensive framework of its kind for nurse practitioners in Canada. A pursuit this significant, in our opinion, was a decision that needed to belong to the profession itself.
NNPBC therefore chose to seek a formal mandate through a secure, third-party vote open to all nurse practitioners registered to practice in BC, whether or not they were NNPBC members.
This meant that in addition to engagement with NPs about their needs, we had to make sure they had every reasonable opportunity to register and participate.
The vote was originally planned for early fall 2025. While engagement was strong, it became clear we still were not reaching enough NPs. The profession had grown from roughly 1,200 NPs when this began to more than 1,500 by early 2026, and we were committed to registering at least 75% of NPs so the vote would reflect the diverse roles, settings and perspectives within the profession.
And so the vote was delayed until the spring of 2026. For a decision this important, getting it right mattered more than moving fast.
A clear mandate
The vote was held from April 13 to 24, 2026.
In the lead-up, NNPBC hosted a province-wide town hall and published a detailed FAQ covering what a Main Agreement is, how it could affect different practice models and settings, and how NNPBC would proceed if it received a mandate from NPs.
For months beforehand, we also continued extensive outreach through email campaigns, direct communications and meetings with NP teams and professional forums across BC.
When voting opened, 1,019 nurse practitioners had registered. A total of 856 ballots were cast, representing 84% turnout. Of those who voted, 91.9% voted in favour of giving NNPBC a mandate to pursue a Main Agreement.
The result reflects a profession that is deeply committed to its own success and growth, and to helping shape a strong future for nurse practitioners in British Columbia. It also shows what is possible when a growing and diverse profession is meaningfully engaged through a process designed around its questions, perspectives and needs.
What comes next
This vote result is not the end of a process. It is the beginning of a new phase of work for NPs and for NNPBC.
Over time, nurse practitioners will elect an NP Caucus and NP Negotiating Committee to help guide strategy and lead negotiations with the province. Any tentative agreement will return to all NPs for a vote before it can take effect. In this model, nurse practitioners will set the priorities, shape the agenda and ultimately decide on any final agreement, keeping the profession firmly in the driver’s seat.
For NNPBC, we will begin the work to raise the funds and build out the team that will support this work operationally. We’ve got to continue to raise awareness of this effort amongst NPs, with government and with partners. And most importantly, we’ve got to keep listening.
To every nurse practitioner who attended a town hall, completed a survey, asked a hard question, challenged assumptions, encouraged a colleague to register or cast a ballot: thank you.
You helped ensure the process that got us to today was shaped not by theory, but by the lived realities, needs and hopes of the profession.
And that is exactly how it should be.