Feedback deadline is: October 26, 2019
The Minister of Health has asked the College to submit regulations to enable an expanded scope of practice for pharmacists to ensure that patients have streamlined care pathways that make connections easier in the health care system, and that there is access to minor and routine care in the community.
As a result of this request, the College is seeking feedback on proposed amendments to the General Regulation 202/94 of the Pharmacy Act, Part VII.3 (Controlled Acts) that, if approved, would authorize pharmacy professionals the expanded scope 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.
In addition to these amendments, the Minister asked the College to work with the Ministry to enable pharmacists to perform certain point of care tests (POCT) to support their role in medication management and treatment of patients. Point of care testing will require the Ministry to make amendments to the Laboratory and Specimen Collection Centre Licensing Act regulations. It will also require the College to enable pharmacy professionals to perform the act of piercing the dermis to obtain blood for purposes beyond that of patient education and demonstration. These enabling changes have been included in the proposed regulatory amendments.
The Minister has asked for these regulatory changes to be submitted by November 30, 2019. Additionally, the Minister requested that the College submit amendments to the regulations by June 30, 2020 to enable pharmacists to prescribe for minor ailments. Consultation on draft regulatory amendments related to prescribing for minor ailments will occur separately.
Currently, pharmacists are authorized to administer by injection and/or inhalation for the purpose of education and demonstration, according to a list of substances as identified in Schedule I and Schedule II of General Regulation 202/94 of the Pharmacy Act. However, the College is working with the Ministry to consider shifting this approach to a new classification model based on drug categories referenced in the American Hospital Formulary Service (AFHS). Therefore the College is consulting on both the substance list and drug category classification approach, given the potential that either of these models may be accepted for the proposed amendments.
Before providing your feedback, you are encouraged to review the proposed regulatory amendments to the General Regulation 202/94 of the Pharmacy Act.
When reviewing and commenting on the draft regulations, please consider:
- the intent of these regulation changes to protect the public and support quality pharmacy care;
- the expectations of the public in making sure the expanded scope for pharmacists (including interns and students and pharmacy technicians where applicable) is both accessible and safe;
- the expectations of pharmacy professionals that the regulation changes appropriately enable them to apply their current knowledge, skill and ability to perform the expanded scope activities safely.
The expanded scope of practice will enable pharmacists – the health care professionals with the most extensive pharmacotherapy education – to utilize their knowledge and experience and take on a greater role to improve health outcomes for patients.
Over the past seven years, pharmacists have demonstrated their ability to safely and appropriately administer substances by injection and inhalation for the purpose of patient education and demonstration, and to extend patients’ prescription renewals for up to six months. The competencies required and practice standards expected for the safe expansion of these activities remain the same.
Pharmacists, interns and pharmacy students who have injection training are currently permitted to administer certain vaccines to eligible patients who are five years of age or older and have shown their ability to do so competently. Initial consultations with public health experts, physicians, pharmacists and experts in pediatric pain management suggest that pharmacists could benefit from education to equip them with techniques and strategies to manage administration of flu shots to this younger age group. If required, this would become a requirement under the Universal Influenza Immunization Program (UIIP) and would apply to all pharmacists registered to provide flu vaccinations.