Expanded Scope of Practice: Consultation on Draft Regulations Now Open


In May, the provincial government announced its intention to expand scope of practice for Ontario pharmacy professionals to help improve access to care and enhance the patient experience.

Specifically, the government asked the College to draft regulations that would enable pharmacists to:

  • administer the flu vaccine to children as young as two years old;
  • renew prescriptions in quantities of up to a 12-month supply;
  • administer certain substances by injection and/or inhalation for purposes that are in addition to patient education and demonstration; and
  • prescribe drugs for certain minor ailments.

The government also requested that the College work with Ministry staff to enable pharmacists to perform certain point of care tests to support their role in medication management and the treatment of patients.

The College is to submit draft regulations pertaining to the first three activities and point of care testing to the government by November 30, 2019. A second set of regulatory amendments that would facilitate the prescribing of drugs for certain minor ailments is to be submitted by June 30, 2020.

The College has worked closely with the Ministry of Health on policy development and has also completed stakeholder consultation. We are committed to meeting the Ministry’s deadlines while fulfilling our mandate to serve and protect the public.

Expanded Scope Flu Shot

DEVELOPMENT OF THE FIRST SET OF PROPOSED REGULATIONS

The College consulted with a broad group of stakeholders to develop the first set of proposed regulations. These stakeholders included pharmacy associations, provincial pharmacy regulators and subject matter experts in pharmacy, medicine and public health. The College has also drawn on lessons learned from other jurisdictions where pharmacists have acquired similar scopes of practice. Pharmacy professionals provided preliminary feedback on the first three scope-related activities during an eight-day online survey (linked from e-Connect).

These efforts have helped the College define the appropriate parameters to maximize the knowledge and skills of pharmacy professionals while also ensuring the delivery of safe, high quality patient care.


CONSULTATION ACTIVITIES

In our efforts to meet the timeline for the first three activities, the College held a special Council meeting on August 22 seeking approval to post the draft regulatory amendments for a 60-day open public consultation.

Council approval was granted and these proposed regulatory changes are now posted on the College website for comment through October 26. The Ministry will also post them concurrently on the government of Ontario's public registry for a 45-day consultation period.

Pharmacy professionals wishing to provide feedback on the draft regulations are invited to participate in the public consultation. There will also be the opportunity to provide input in the near future as the College moves forward to draft regulatory amendments to enable prescribing of drugs for certain minor ailments.


FINALIZING REGULATORY AMENDMENTS

A second special Council meeting will be held November 21 to request approval of the final regulatory amendments before they are submitted to the Ministry for consideration.

Our highest priority in finalizing these amendments will continue to be the best interest of patients. Further information will be provided to registrants as this work moves forward, including details about planned consultation and engagement activities. Watch for updates on the College’s website, in e-Connect and in future issues of Pharmacy Connection.

CURRENT SCOPE OF PRACTICE FOR ONTARIO PHARMACY PROFESSIONALS

Pharmacists, interns and pharmacy students who have injection training are currently permitted to administer certain vaccines to eligible patients five years of age or older. These include the flu shot and 13 other vaccines for preventable diseases (list of vaccines).

Pharmacists, interns and registered pharmacy students under the supervision of a pharmacist have the authority to renew prescriptions for the purpose of continuity of care (with the exception of narcotics and other controlled substances and monitored drugs). The prescribed quantity of a renewal cannot exceed the total quantity (including refills) that was authorized by the original prescriber, or a six-month supply – whichever is less. Additional information can be found on the OCP website.

Currently, pharmacists, interns and registered pharmacy students under the supervision of a pharmacist are able to administer a substance by injection or inhalation for the purposes of education and demonstration as outlined in the legislation. The expanded scope would enable these pharmacy professionals to administer substances beyond the purposes of education and demonstration, to therapeutic purposes as well.

Currently, pharmacists, interns, registered pharmacy students and pharmacy technicians under the supervision of a pharmacist are able to pierce the dermis to obtain blood for the purpose of patient education and demonstration. The expanded scope would enable them and pharmacy technicians to perform this act for purposes beyond that of patient education and demonstration. Point of care testing will also require the Ministry of Health to make amendments to the Laboratory and Specimen Collection Centre Licensing Act regulations.