As the regulator for the profession of pharmacy in the province, the College is responsible for ensuring that Ontarians have access to relevant information about pharmacists, pharmacy technicians and pharmacies, and a clear understanding of regulatory processes and decision-making. Transparency is not just about making additional information public, it is also about making the information we do share clear, accessible and easy to understand.
The College strongly believes that transparency and accountability are pillars of good governance. In 2012, Council identified transparency, accountability and excellence as core values and integral parts of the 2012 to 2015 Strategic Plan.
In October 2014, the Minister of Health and Long-Term Care sent a letter to all health regulatory colleges asking for a report outlining the measures each college had taken and were planning in order to make transparency a priority. This College responded with a letter outlining both our independent transparency-related initiatives and our work with the Advisory Group of Regulatory Excellence (AGRE).
AGRE Transparency Project:
In 2012 the College joined AGRE — a working group of health regulators that is leading a province-wide project examining transparency. Representatives from medicine, nursing, dentistry, optometry, pharmacy and physiotherapy are working together on a multi-staged initiative designed to examine information-sharing practices and determine what additional information regulators should share publicly. The project recognizes that access to more information may assist the public in choosing a regulated health professional, enhance accountability, and better inform any evaluation of the performance of self-regulation.
One of the first steps in the transparency project was for AGRE to develop principles to guide the regulatory colleges’ ongoing decisions about publicly-available information. The various college councils representing AGRE approved and endorsed these principles:
- The mandate of regulators is public protection and safety. The public needs access to appropriate information in order to trust that this system of self-regulation works effectively.
- Providing more information to the public has benefits, including improved patient choice and increased accountability for regulators.
- Any information provided should enhance the public’s ability to make decisions or hold the regulator accountable. This information needs to be relevant, credible and accurate.
- In order for information to be helpful to the public, it must:
- be timely, easy to find and understand
- include context and explanation
- Certain regulatory processes intended to improve competence may lead to better outcomes for the public if they happen confidentially.
- Transparency discussions should balance the principles of public protection and accountability, with fairness and privacy.
- The greater the potential risk to the public, the more important transparency becomes.
- Information available from Colleges about members and processes should be similar.
Next, AGRE compared processes and data collection among Ontario’s health regulatory colleges and engaged a public consultation firm to conduct research to better understand the type of information the public would find useful when making decisions related to their healthcare.
This information was analyzed by AGRE and used to develop a recommended two-phased approach for the implementation of changes and the disclosure of specific information regarding decisions and processes to the public.
Phase One — Complete
Phase one focused primarily on enhancing the consistency and clarity of existing information found on the public register. Amendments to College By-Law No. 3 were required and following a 60-day public consultation period (ending November 19, 2014), Council considered the feedback received and approved the amended by-law at their December 2014 meeting.
Specifically the amendments included:
1. Posting summarized findings of guilt (if relevant)
The College will post a summary of any federal or provincial findings of guilt — made after April 1, 2015 — against a member if the College knows about them, and the Registrar believes that they are relevant to the member’s suitability to practise.
2. Posting of a notice of hearing
The College will post a notice of hearing for any discipline hearing regarding professional or proprietary misconduct where the matter is outstanding. If the hearing is awaiting scheduling, the College will post a statement of that fact. If the hearing is completed and awaiting a decision, the College will post a statement of that fact.
3. Posting of custody or release conditions
A change was made to the wording of the posted summaries of current custody or release conditions in provincial or federal offence processes that the College knows about them, and the Registrar believes that they are relevant to the member’s suitability (instead of right) to practise.
Phase Two Complete
Phase two proposed adding more information about pharmacists and pharmacy technicians to the College’s public register. This included additional information relating to the College’s complaints process and the outcomes from the College’s Inquiries, Complaints and Reports Committee (ICRC).
Additional amendments to College By-Law No. 3 were required and were circulated for public consultation with a feedback deadline of February 10, 2015. Following the 60-day consultation period, Council considered the comments received and approved the amendments at their March 2015 meeting.
Council noted that any information regarding federal and provincial charges is already publicly available and that criteria and processes for some of the other information (e.g. determining relevance to suitability to practice) is currently being developed.
Specifically the proposed amendments include:
1. Posting known criminal charges (if relevant)
The College will post a summary of any federal or provincial charges against a member if the College knows about them, and the Registrar believes that they are relevant to the member’s suitability to practise.
2. Disclosing members under investigation
The Registrar will confirm that the College is investigating a member if there is a compelling public interest reason to do so pursuant to 36(1)(g) of the Regulated Health Professions Act.
3. Posting of complaint outcomes: Cautions
The College will disclose when a panel of the Investigations, Complaints and Reports Committee (ICRC) cautions a member as a result of a complaint. A caution would be issued by the ICRC when there is a significant concern about a member’s conduct or practice that can have a direct impact on patient care, safety or the public interest if it is not addressed. Cautions require the member to meet with the ICRC in person for a face-to-face discussion concerning the member’s practice and the changes they have planned that will help avoid a similar incident from occurring in the future. The College would post a summary and date of the caution on the public register. This would apply to complaints filed after April 1, 2015.
4. Posting of complaint outcomes: SCERPs
The College will disclose when a panel of the ICRC requires a member to complete a specified continuing education or remediation program (SCERP) as a result of a complaint. A SCERP would be ordered when a serious care or conduct concern requiring a pharmacist or pharmacy technician to upgrade his or her skills has been identified. The ICRC orders SCERPs only when they believe that remediation is necessary. The College would post a summary of the required program and its date on the public register. This would apply to complaints filed after April 1, 2015.
5. Posting of applications for reinstatement
The College will disclose if the Registrar has referred an applicant for reinstatement to the Discipline Committee.
6. Posting of known licenses in other jurisdictions
The College will disclose whether a member is currently registered or licensed to practice the profession in another jurisdiction, if known.
7. Posting of complaint outcomes: Summary of variation
The College will disclose when a panel of the ICRC was required, after a review, to remove or vary an original outcome of a caution or SCERP. This would include posting the process leading up to the review.
In 2012 the College re-designed its website with the goal of providing visitors with access to simple, relevant, clear and transparent information about the College and its processes.
Although all content currently available on the website is accessible by anyone, the re-design — which launched in January 2014 — created a tailored experience for each of the identified user groups: the general public, applicants and members. Each group has their own homepage that provides the information our research results identified as the most important for them. The College acknowledges that ongoing evaluation, research and enhancement of both content and navigation are necessary to keep pace with the evolving needs of users.
Inspections of Pharmacies & DPPs
Effective July 1, 2013 following the necessary by-law changes, the College began posting the status and/or outcome of accredited pharmacy inspections on the public register. Similarly, when the College was granted the authority to inspect drug preparation premises (DPPs) the status and/or outcome of these inspections were also added to the public register. This same disclosure will be provided for hospital pharmacy inspections once authority has been granted.
To support clarity and understanding regarding the posting of inspection status and/or outcome, the College provides definitions for each of the potential outcomes and a description of the inspection process. Enhancements to the disclosure of information relating to inspection processes and outcomes are ongoing.
Public Register Re-design
Building on the principles that guided the website re-design the College engaged in an initiative to enhance the public register. At the core of the re-design was revisions to better assist members of the public with completing basic tasks such as improvements to how easily they access information about the pharmacies in their neighbourhood, or the practitioners that work there. The new public register was launched in Spring 2016.
Transparency is not something to be achieved but rather a foundational value that must be consciously considered and diligently applied to all of the work that the College does. At the strategic planning session in March 2015, Council once again solidified transparency as a core value and identified it as a key priority in the 2015 to 2018 Strategic Plan, and beyond.
The College is committed to continuously and collaboratively working to identify and implement measures to enhance transparency, and ensure the public has access to the information that they need to make informed choices about their healthcare.