Expanded Scope of Practice

The College is committed to protecting patient safety and promoting quality care as the role of pharmacy professionals expands. Working with the public, registrants, other health care professionals and health-system stakeholders is key to ensuring that patients receive appropriate and safe care at every point in their health care journey.

That’s why the College has taken a system-wide approach to developing regulations that will put patient safety first. It’s engaging and collaborating with registrants, patients, physicians, nurse practitioners and other health-care providers, public health experts, professional associations, other health profession regulators and others to provide insights and recommendations in the development of new regulations, as well as identifying necessary resources and guidance to support implementation and improve health outcomes and access to care in Ontario.

The provincial government has directed the College to submit draft regulations that would enable pharmacists to:

  1. Administer the flu vaccine to children as young as two years old;
  2. Renew prescriptions in quantities of up to a year’s supply;
  3. Administer certain substances by injection and/or inhalation for purposes that are in addition to patient education and demonstration;
  4. Perform point of care tests for certain chronic conditions; and
  5. Prescribe drugs for certain minor ailments.

Proposed regulatory amendments for the first four items of scope have been submitted to the government for consideration. The authority to perform point of care tests also requires regulatory changes to the Laboratory and Specimen Collection Centre Licensing Act, which will be managed by the Ministry of Health.

The government will determine when these proposed changes will take effect.

Minor Ailments

The College has been directed to submit draft regulations by June 30, 2020 to permit pharmacist prescribing for certain minor ailments. A preliminary list of 19 minor ailments has been proposed as a starting point for further discussion with pharmacy professionals, stakeholders and the public:

  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

Pharmacy professionals provided feedback on the preliminary list through a survey that closed on January 31, 2020. There will also be an opportunity to comment on the draft regulations which will be circulated through a 60-day open public consultation in spring 2020.

This preliminary list was developed through the work of the Minor Ailments Advisory Group (MAAG), comprising patient advisors as well as experts in pharmacy, medicine, public health, health systems research, and anti-microbial stewardship. The advisory group’s role is to provide guidance and recommendations to the College on regulatory, policy, implementation and evaluation considerations, with a view to improving health outcomes and health-system quality while ensuring patient safety. (See the MAAG’s Terms of Reference.)

The College has been and will continue to consult broadly with pharmacy professionals, the public and stakeholders as it moves forward with this work, and will provide further information on expanded scope of practice as it becomes available.

Check this webpage often and watch for updates in e-Connect and Pharmacy Connection for additional details on planned engagement opportunities, as well as the latest developments regarding expanding scope of practice.