Expanded Scope of Practice: Consulting and Engaging with Health System Partners and the Public


The College is committed to consulting broadly with pharmacy professionals, the public, other healthcare professionals and health system stakeholders in our work to enable pharmacists to prescribe for certain minor ailments. This engagement is key to drafting regulations that promote safe and quality care for patients.

Pharmacy professionals play an important role in a patient’s healthcare journey. Understanding that role within the continuum of care and working with healthcare partners is an important part of our collective efforts to enhance coordination and communication between different parts of the healthcare system, which will ultimately improve health outcomes.

With this in mind, the College has taken a collaborative approach to expanding scope of practice, engaging different parts of the healthcare system – patients, registrants, physicians, nurse practitioners and other healthcare providers, public health experts, professional associations, regulators and others – to gain valuable insights that have and will continue to inform our work to enable expanded scope of practice. It also enhances our ability to identify necessary resources and guidance to support the profession as these changes are implemented.


COLLABORATION IN THE EARLY STAGES

Last year, the College consulted broadly on the first set of draft regulatory amendments to expand pharmacists' scope of practice. These amendments include administration of the flu vaccine to patients as young as two years old, as well as patient services that pharmacists have been providing for a number of years, such as administering certain substances by injection and/or inhalation - which will be expanded for purposes beyond patient education and demonstration.

Consultations included early engagement with a broad range of stakeholders to help guide the work in developing the regulatory changes, as well as an open public consultation on the draft regulations before they were submitted to the government for consideration in late November.


COLLABORATION IN PRESCRIBING FOR MINOR AILMENTS

The College is applying a systems-focused approach to the next phase of draft regulations that would enable pharmacists to prescribe for minor ailments, consulting broadly with pharmacy professionals, the public and other healthcare professionals as it moves forward with this work.

The Minor Ailments Advisory Group (MAAG) was established to provide guidance and recommendations on regulatory, policy, implementation and evaluation considerations, with a view to improving health outcomes and health system quality while ensuring patient safety. It comprises patient advisors and experts in pharmacy, medicine, public health, health systems research, and anti-microbial stewardship.

The College has developed a preliminary list of minor ailments based on the recommendations of the MAAG, which serves as a starting point for further discussion with registrants and other stakeholders.

In developing this list, the MAAG took an evidence-informed approach, looking at conditions that have been approved in at least one other province, then considering which ones may have the highest potential to streamline care pathways for routine care in the community and reduce the burden on emergency departments.

PRELIMINARY LIST OF MINOR AILMENTS

    1. Urinary Tract Infection (uncomplicated)
    2. Dermatitis (Atopic-mild/moderate eczema, allergic contact and irritant contact)*
    3. Insect bites, urticaria (hives)
    4. Conjunctivitis (pink eye) – bacterial, viral and allergic
    5. Acne (mild to moderate)*
    6. Allergic rhinitis* (hay fever)
    7. Candidal stomatitis* (oral thrush)
    8. Oral aphthae* (canker sores)
    9. Herpes labialis (cold sores)
    10. Hemorrhoids*
    11. Diaper dermatitis
    12. Vulvovaginal candidiasis (yeast infection)
    13. Dysmenorrhea* (menstrual cramps)
    14. Musculoskeletal sprains and strains
    15. Impetigo
    16. Nausea and vomiting during pregnancy
    17. Gastroesophageal Reflux Disease (GERD)
    18. Pinworms and threadworms
    19. Lyme disease, post-exposure prophylaxis

* Common ailments that have been approved for pharmacist prescribing in 7 out of 7 provinces.

CONSULTATIONS ON MINOR AILMENTS

Pharmacy professionals were able to provide their initial feedback on this list and prescribing for minor ailments through a survey, which closed at the end of January. The College is also consulting with health system stakeholders, including professional associations, and will continue to collaborate with them as well as registrants as this work moves forward.

There will be opportunities for the public, pharmacy professionals and other stakeholders to share their views on draft regulations on prescribing for minor ailments, including a 60-day open public consultation that will be posted on our website subject to approval at the March Council meeting.


TAKING A SYSTEMS-WIDE APPROACH

Health system challenges require health system solutions that involve cross-sector collaboration, innovation and insight. The College is committed to supporting the profession in adapting to these practice changes safely and with confidence.

We also remain committed to listening to and learning from the perspectives of those who receive and those who provide patient care. As we move forward, the College will continue to engage and collaborate with patients, registrants, pharmacy stakeholders and other health system partners and professionals to plan for and implement expanded scope and to do so in a manner that keeps patient safety as the number-one priority.

Learn more about the College's work on expanded scope on the OCP website.