Expanded Scope of Practice: Engaging and Collaborating with Health System Partners and the Public for Patient Safety

The Ontario College of Pharmacists takes its role and public-protection mandate very seriously, and is committed to protecting patient safety and promoting quality care as the role of pharmacy professionals expands, enabled through regulatory changes and supported through effective policies, guidelines and standards.

The provincial government has asked the College to draft regulatory amendments that would enable expanded scope of practice of pharmacists. Working with the public, registrants, other healthcare 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 is why the College has taken a system-wide approach to developing regulatory amendments that put patient safety first. By engaging and collaborating with different parts of the health care system – patients, physicians, nurse practitioners and other health care providers, public health experts, professional associations, health-care regulators and others – the College is gaining valuable insight that is being applied to the drafting of the regulations and the identification of necessary resources and guidance to support implementation of expanded scope and ultimately improve health outcomes and access to care across the province.

The College has consulted broadly on an initial set of draft regulations to expand scope in certain areas, including the 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 renewing prescriptions (with the exception of narcotics and other controlled substances and monitored drugs) for up to a year’s supply – rather than six months – for the purposes of continuity of care. These consultations included early engagement with pharmacy professionals, health care providers and key health system 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.

The College is now applying this patient safety and systems-focused approach to its regulatory responsibility as it consults broadly with pharmacy professionals, the public and other healthcare professions as it moves forward with the drafting of regulations to enable pharmacists to prescribe for minor ailments. An important part of this work involves the establishment of a Minor Ailments Advisory Group (MAAG) comprising patient advisors and experts in pharmacy, medicine, public health, health systems research, and anti-microbial stewardship 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.

The College has developed a preliminary list of minor ailments based on the recommendations of the MAAG and Council, which serves as a starting point for further discussion with registrants and other stakeholders. Pharmacy professionals can provide their initial feedback on this list and prescribing for minor ailments through a survey, which will close at the end of January 2020. There will also 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 which will be posted on our website following the March 2020 Council meeting.

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. It also remains committed to listening to and learning from the perspectives of those who receive and those who provide patient care. Our responsibility and commitment as a regulator whose mandate is to protect the public is one that we take very seriously.

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 manner that keeps patient safety as the number-one priority.

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