What We Heard: Main Agreement Survey Results

October 2025

Why This Survey Was Conducted

In fall 2025, Nurses and Nurse Practitioners of British Columbia (NNPBC) invited nurse practitioners across the province to share their views on a bold and potentially transformative idea: the creation of a Main Agreement for NPs in BC.

Between September 3 and October 5, 339 NPs participated in the survey. Their input provides a clear snapshot of how respondents across the province currently feel about a Main Agreement and what more they want to understand.

Topline Results

More than 90% are familiar with the idea of a Main Agreement

A strong majority (80%) agree that NNPBC should pursue a Main Agreement on behalf of all NPs — and that now is the right time to do so.

NPs would like more information including a clear summary of what could be negotiated (such as pay, benefits, and supports), along with comparisons to current compensation models, explanations of possible risks or tradeoffs, and how a Main Agreement could affect existing options.

Who Participated

Career stage:

Early career (5 years or less) - 32%
Mid-career (5-20 years) - 55%
Long-serving NP (20+ years) - 9%
NP student – 2%
Other – 2%

Model of employment:

Health authority employee – 53%
Independent contractor – 33%
Other – 11%

Setting:

Longitudinal family practice – 61%
Episodic/urgent care – 20%
Specialized – 20%
Acute care – 17%
Urban – 15%
Rural – 12%
Private setting – 7%
Other – 9%

Region:

Greater Vancouver – 45%
Coastal Islands – 18%
Central Interior – 17%
Northern BC – 7%
Indigenous community – 3%
Other – 5%

Full Results

1. How would you rate your current understanding of what a Main Agreement is and what it could include for Nurse Practitioners (NPs)?

Familiar: 91%
- Very familiar: 9%
- Moderately familiar: 41%
- Slightly familiar: 40%
Not at all familiar: 9%

2. Nurses and Nurse Practitioners of BC (NNPBC) is the professional association for all nurses and NPs in the province. To what extent do you support or oppose NNPBC — guided by NPs — pursuing negotiations with the Government of BC to establish a Main Agreement on behalf of all NPs in the province?

Total Support: 80%
- Strongly support: 58%
- Somewhat support: 22%
Neutral / unsure: 11%
Total Oppose: 9%
- Somewhat oppose: 6%
- Strongly oppose: 3%

3. To what extent do you agree that now is the appropriate time to pursue a Main Agreement?

Total Agree: 80%
- Strongly agree: 51%
- Agree: 28%
Neutral: 12%
Total Disagree: 8%
- Disagree: 4%
- Strongly disagree: 4%

4. In your opinion, what should be the minimum level of support — among those who choose to vote — for NNPBC to move forward with this initiative?

50% + 1 (simple majority): 29%
At least 60%: 8%
At least 66% (two-thirds): 25%
At least 75%: 17%
At least 80%: 13%
Unsure / no opinion: 4%

5. What kind of information would help you better understand the benefits, risks, or implications of a Main Agreement?

A summary of what could be negotiated (e.g., pay, benefits, supports): 92%
A comparison between current NP compensation models and what a Main Agreement could include: 91%
Clear explanations of possible risks or tradeoffs: 88%
An explanation of how a Main Agreement could affect existing compensation options: 85%
Examples or case studies of Main Agreements from other professions: 68%
An overview of the path and timeline for pursuing a Main Agreement: 64%
More details on how NNPBC would fund and manage this work: 64%
Details on how NPs would lead and be involved in the process: 56%
Opportunities to ask questions (e.g., through webinars, town halls): 55%
A glossary of key terms and concepts: 38%
Other: 9%
None of the above: 1%

What We Learned

The survey results show strong support for moving forward with a Main Agreement. Four out of five respondents (80%) said they support NNPBC pursuing negotiations, and that majority support came from NPs working in a wide range of roles and employment models.

In their comments, many respondents shared a clear belief that a Main Agreement could help strengthen the NP profession. They said it could bring more consistency to employment terms, help fix pay gaps, and give NPs a stronger, united voice in the healthcare system, especially when it comes to having a formal seat at the table in negotiations. Some also said it could help improve working conditions and ultimately retention.

At the same time, some respondents expressed uncertainty. A key issue was whether existing benefits, including pensions, would be protected for those who already have them. Others weren’t sure if now is the right time to pursue a Main Agreement, given the fiscal environment, and wanted more clarity on how it would work.

Across all levels of support, one message came through clearly: NPs want to be represented fairly and included in the process. They also want open, transparent communication from NNPBC, both in deciding whether to move ahead and if negotiations begin.

It’s also important to note that about one-quarter of BC’s NP community responded to the survey. That means there are many voices we haven’t heard from yet. In the weeks ahead, NNPBC will focus on reaching more NPs and supporting those who are already engaged to connect with their colleagues and networks.

What Comes Next

NNPBC will use this feedback to:

Build out our Main Agreement FAQs, featured on the Your Voice, Your Future website

Create more opportunities to share information with NPs through webinars and other engagements

Ensure all NP voices are heard, across practice settings, regions and roles

Explore a date for a mandate vote, open to all BC NPs, on whether NNPBC should pursue a Main Agreement on their behalf

Sharing these survey findings is part of NNPBC’s commitment to keeping members informed and involved. As we consider next steps together, your ongoing input will help shape how we move forward in exploring the future of NP employment in BC.

We are grateful to all NPs who participated and shared their reflections.

Have questions? Please reach out to npagreement@nnpbc.com.