Feedback deadline was: August 12, 2023
Summary
The Ontario health care system continues to see additional pressure, impacting patient access to care. By expanding the scope of pharmacists and pharmacy technicians to administer additional vaccines and offer appropriate treatment options for COVID-19 and influenza, patients will have improved access to care when COVID-19, influenza and Respiratory Syncytial Virus (RSV) may have significant impacts on the health system during the 2023-24 respiratory illness season.
The College has prepared regulatory amendments that would, if approved by government:
- Give pharmacists and pharmacy technicians authority to administer the RSV vaccine
- Give pharmacy technicians authority to administer vaccines from Schedule 3 of O.Reg. 202/94
- Give pharmacists authority to prescribe oseltamivir (Tamiflu)
- Remove age restrictions for the administration of influenza and other Schedule 3 vaccines by pharmacists and pharmacy technicians
- Transition authority for pharmacists and pharmacy technicians to administer the COVID-19 vaccine and for pharmacists to prescribe Nirmatrelvir/ritonavir (Paxlovid), from the Regulated Health Professions Act (RHPA), Controlled Acts Regulation (107/96) to the Pharmacy Act, General Regulation (202/94).
Recognizing the respiratory illness season is fast approaching, there is some urgency to enable these scope changes. While the College has initiated consultation with clinical experts and received feedback that supports the proposed expansion of scope, further input is being sought.
How You Can Participate:
The College is inviting all pharmacy professionals, system partners, and members of the public to comment below by August 12, 2023. Your feedback will help inform any potential changes to the proposed regulatory amendments prior to submission to the Ministry of Health for approval.
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, and;
- Whether the regulation changes enable pharmacy professionals to appropriately apply their current knowledge, skills and ability to perform the expanded scope activities safely.
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Seeing as I’m already injection trained and have given over 2000 Flu and Covid vaccines in the last 365 days and freed up the pharmacist’s time to be a pharmacist, I’m ok with the new expanded scope being approved
Pharmacists have become leading vaccinators/injectors in Ontario, pharmacy programs have removed barriers for patients and protected our communities. Pharmacists and technicians have the training to administer all vaccines, as opposed to just a selected list. I support the removal of age restrictions as well, as the act of providing a vaccine through similar routes (e.g., COVID, flu, HPV, shingles, pneumonia, etc..) is largely the same and age limitations for different types of vaccines can make it more confusing for pharmacy teams and patients. As evidenced throughout the pandemic (with paxlovid) and recently with minor ailments, pharmacists are able to manage clinical assessments to allow patients to access timely therapy. Tamiflu access would be best positioned in pharmacies provided there is adequate training and guidance for pharmacists (like what we saw with paxlovid). All of these proposed amendments would improve access to patients, simplifying the patient journey and thereby reducing healthcare costs. Future growth in access to publicly funded vaccines and allowing pharmacists to “prescribe” schedule II items or all vaccines (for insurance coverage) can further support timely patient care.
I think your continued foray into conflict of interest does not serve the public well. COI should be eliminated wherever it appears…you are actually spreading it.
Shifting the pressures from the health care systems onto pharmacists is not the solution. Adding more to the workload along with quotas, insufficient staffing, patient expectation of instantaneous services will further add to the burnout felt by many pharmacists. Just too much too fast. This is a hard NO.
Expanded scope of pharmacist is a good approach to help patients to get care more efficiently and it also promote owners to give more supports to pharmacists in busy workload
The continued expanded scope is welcome if pharmacists are able to receive proper compensation for their services in addition to having the support staff. Most pharmacists are expected to do the technical and clinical work without proper remuneration and staff. If this can be achieved only then would it prove a benefit for the public and the pharmacists.
There needs to be permanent changes for RPhT’s when it comes to vaccinating and expanding the scope so they can inject other IM injections. The pharmacists have so much on their plate… this will help eleviate some of that daily stress that they are facing with day to day workflow. Technicians are knowledgeable and capable of taking on this task fully. Stop amending and make this permanent for them.
To whom it may concern, I am a pharmacist writing to provide feedback on the proposed regulatory amendments. While I do welcome expanding pharmacist scope of practice to improve patient access to care; I have concerns about the proposed amendments and the current state of community pharmacy practice as a whole. Firstly, I have concerns about the following regulatory amendments: • Give pharmacists authority to prescribe oseltamivir (Tamiflu) • Remove age restrictions for the administration of influenza and other Schedule 3 vaccines by pharmacists and pharmacy technicians Regarding oseltamivir, the IDSA guidelines recommend therapy only in outpatients who meet certain criteria. Eligibility and exclusion criteria (for patient referral in cases of severe illness) would need to be explicitly defined before pharmacists receive authority to prescribe oseltamivir. Patients presenting with severe illness may also require further assessments to rule out secondary infections that pharmacists would not be able to provide in community pharmacy. This authority also raises the question regarding influenza testing. Community pharmacies do not have the resources and staffing to carry out the additional testing required for this authority and this would put both our patients and staff at increased risk of influenza infection during the already busy respiratory illness season. I am also against removing age restrictions for the administration of vaccines. The approved injection training I received, like many of my peers, did not sufficiently cover IM injections to the anterolateral thigh, the preferred injection site for infants. Therefore I do not feel like I have the required skills to provide this service and I would not be comfortable providing vaccinations to this population. I believe the current age restrictions in place are sufficient. Secondly, I feel that the current state of community pharmacy practice and the additional responsibilities is impacting patient safety. In 2022, the CPhA surveyed pharmacy professionals and reported that 43% of pharmacy professionals think their mental health is not good or poor and 92% are at risk of burnout. Increased workload was also reported as being the largest contributor to poor mental health. This report revealed that our profession was already overburdened. How can we provide patient care and alleviate pressure on the healthcare system when we are not able to take care of ourselves? Chain pharmacies are also hoping to use expanded pharmacy professional services to further increase their bottom line. There has been increased pressure from corporate to push professional services with regular communication of profit based targets. I feel increased stress from pressure to reach these targets through delivery of minor ailment prescribing, injections, and other professional services while also trying to manage the day to day dispensing at the same time without additional staffing and support. These changes, while expanding access to care will result in reduced quality of pharmacy care during dispensing and potentially an increase in near misses and medication errors. Therefore, I do not feel that the current environment in community pharmacy is ready for these proposed amendments. Ontario’s current approach to reducing pressure on the healthcare system has been to shift responsibilities onto an already overburdened and burnt out profession. This is not sustainable and will have a negative effect on patient safety and our ability to deliver quality patient care. So, at this time I do not support the proposed expanded scope proposal. Sincerely, Vivian Ho
The OCP should expand pharmacists to treat many more ailments like Diabetes, Hypertension, Hypercholesterolemia, Contraception, Strep Throat, Sinusitis, etc. They be allowed to provide Rx refills for more than 1 year. (Right now, many pharmacists are reluctant to give even 1 month more and they want to charge high dispensing fees every time.) Pharmacists should be covered to provide needles. They charge $20 privately whereas a doctor might only get a few dollars for this. This seems very unfair. Pharmacies are everywhere and they operate long hours. Pharmacies should be able to deal with all ailments like in a walk-in clinic. That will significantly help solve the primary care issue. In Alberta, pharmacists can do everything if desired. They can also order blood work, order urine cultures, and make referrals. They can substitute medications that are on back order. There are so many differences between provinces of what pharmacists can do. Pharmacists are now becoming similar to family doctors and nurse practitioners, and they can do a lot for the public. Stop the barriers and expand their scope as much as possible and do it soon.
I believe Pharmacists and Pharmacy technicians are already having enough in their plate and day by day it is becoming burdensome for them to cope with it. Unfortunately in Canadain community pharmacy workplace there is one professional called Pharmacy Assistant ( 80% of all community pharmacies are using help of a pharmacy Assistant), who inspite of doing all of the job (which pharmacy technician does) under the name of “deligated task”, is not recognised nor their efforts are being acknowledged. It will be a great effort if you would accept pharmacy Assistant as valuable pharmacy member and expand their role instead because it is not the technicians you see working in community pharmacies rather pharmacy assistants are their to help Pharmacist. They can effectively further reduce the burden of Pharmacists and provide them opportunity to have undivided attention to take care of clinical aspects of the prescription.
The implementation of the expanded scope of practice would only be feasible and beneficial to the public as long as the following are met: – sufficient staff support at the pharmacy that provides this service i.e. designated pharmacist for prescribing minor ailments, performing MedscChecks, immunizations etc. and a designated pharmacist for dispensing, otherwise it would be too chaotic for one pharmacist to perform all these tasks safely – fair remuneration and compensation for the pharmacist – there should be a rate increase considering that physicians get high reimbursement for performing the same prescribing and patient assessment for minor ailments – ensure to invest in proper training of pharmacists and staff when performing these tasks So basically, make it mandatory for pharmacies to have good staff support and training for performing all these tasks. Increase remuneration of pharmacists, considering they have more responsibilities now and they have not had a pay increase for the past decade. If these are not met, it would neither benefit the patients or the pharmacy profession.
I am FOR these amendments as it would result in quicker and better patient care to have easier access to such services. And pharmacist and pharmacy technicians based on their knowledge, skills and abilities are fully equipped for these changes.
Hello, I am Samuel Leung a registered pharmacist in Ontario. I am strongly against any further expanded scope for the time being, so that we can monitor the response from the current expanded scope (minor ailments, prescribing). There already seems to be a lot of confusion from the public regarding the current expanded scope. Minor ailments will again be expanded in October. I feel that there is not enough time to assess the impact, and that given pharmacy staffing it will be very difficult to provide adequate care for patients if the scope expansion is done so frequently. I am especially against removing age restrictions for administration of vaccines, as the pharmacy is not adequately staffed to deal with emergencies or difficult situations compared to a doctor’s office or clinic. If the situation is handled poorly this will negatively affect the perception of pharmacists by the public. Thank you, Samuel Leung
I’m currently completing my path to becoming a Registered Pharmacy Technician, and I think that expanding our scope to allow us to administer more vaccines (schedule 3 & RSV) is a move in the right direction. Since we’re already allowed to administer flu & Covid vaccines, and it has shown to be a positive change, I think it only makes sense to continue to expand our scope. WIth the addition to Pharmacists being able to prescribe for minor ailments it would be a great help to unburden the work load a bit with RPhT’s doing more vaccines. I’m not sure about removing age restrictions on these vaccines which will allow us to administer for all age groups, I do think that in very young children, vaccines are already scary, and can be quite upsetting so having someone they aren’t familiar with (unlike their family doctor) could add to the additional stress of the process and it may be very disruptive in a busy pharmacy.
While these additions are great, pharmacy professionals are already struggling to keep up with the current workload. It is unfair to them that they do not get reimbursed for any of these services but the pharmacy does. The pharmacist should be able to bill for these services under their name and get paid accordingly. Adding more workload to their already overworked schedules will cause more burnout and pharmacists will leave the workforce which will exacerbate the issue.
I think that this would be advantageous to the Ontario public. I’m all for the changes!
Expanding scope of practice is making a career in community pharmacy irrelevant for me. I’m still not comfortable giving injections and I don’t want to prescribe. I’m now looking for an alternative career options outside of pharmacy.
I am all for further expanded scope of practice. However, I am hesitant at this time. This provincial government likes to do lip service to us to say how valuable we are, but refuses to pay us appropriately for our services. They just seem to want to continue to load us up with additional responsibilities so that they don’t have to pay physicians and nurses. Funding for minor ailments isn’t sufficient and they aren’t paying us at all for injections. Expanding our scope without proper compensation for our time and skills isn’t sustainable. I feel the scope shouldn’t be expanded until the government agrees to pay us a fair amount for what we are already doing.
I know alot of people don’t have family doctors and having vaccinations are very important. Pharmacists do have the ability and so do technicians . My concern is having the time and not being distracted. These are tremendous causes for mistakes to happen. We are getting more distracted than ever with questions about minor ailments , vaccines, and medications. Faxes of prescriptions are coming in constantly . We cannot say we can’t see any more patients like physicians can. We are getting emotionally abused by public when we cannot fill their demands which leads to more stress and higher chance of errors again. It is really getting too much. I think mass immunization clinics run by public health during flu season would be a solution to the vaccines. As far as Tamiflu, I don’t see much benefit at all.
With your mandate to protect the public you need to consider how employers will provide new services. If you don’t mandate minimum staff requirements or services by appointment only, the public will be served by pharmacists that are working alone or with minimal staff while they also fill prescriptions, answer the phone,work the cash register and counsel on OTCs.
I strongly disagree with expansion of scope because pharmacists are already overworked to the point of burnout. How many of our colleagues have we already seen leave the profession for greener pastures, and it will only get worse. Certain companies are forcing staff who do not have much choice to do more and more work without adequate support, or a physical break which is downright unsafe and unsustainable. I also do not think most are adequately trained to administer vaccines to the infant age group and would not like to be forced to do so. Let’s maintain the higher age limit please. – I also feel that it’s a very bad idea to have sick people walking into the pharmacy where there are immunocompromised patients, to ask for rxs for flu and covid. We have experienced many times people walking in positive for covid looking for Paxlovid – many do not think about others and I don’t think that is going to change. BEFORE WE ADD TO OUR WORKLOAD, how about: 1. Changing the outdated employment standards act so community pharmacists get their deserved breaks like every other human being and profession? 2. Changing reimbursement model so businesses cannot force staff to churn out vaccinations and services
I look forward to an expanded scope as a Pharmacy Technician so I can better help my Pharmacists in our busy store.
This is unacceptable. Pharmacists did not sign up to be doctors. If I wanted to be a doctor I would have gone to med school. You are increasing our workload without proper training, compensation or consideration to our mental well-being. Doctors will support this initiative because it will lessen their load. Pharmacy owners who do not partake in the expanded scope will also support the expansion because they get to take advantage of staff pharmacists to do all this extra work on top of the usual workload and make more money. What about staff pharmacists? I do not want to have to worry about vaccinating a crying infant whose parents will walk in expecting timely service while I’m balancing five other tasks without a technician. Doctors have the ability to control who walks in but pharmacies doors are always open to the public. It is not fair to inflict that kind of pressure especially on stores operating with one pharmacist / without a technician or busier stores that are understaffed. If you ask a doctor if they would find it acceptable for patients to walk in to their office without an appointment to prescribe for minor ailments they would refuse, and that is their main/only job: assess, diagnose, prescribe treatment; but you are expecting us to do our job as pharmacists with all that would entail PLUS accommodate people without appointments to be assessed, diagnosed and prescribed treatment. Let’s be honest here: pharmacy tasks are unpredictable because patients don’t make appointments to go to a pharmacy, so it’s not very likely that a patient will walk in for a minor ailment and you would turn them away or ask them to come back 5 hours later or tomorrow (you cannot predict who will walk in and when and if the time you proposed will in fact be appropriate) so you will feel pressure to do that while juggling other tasks. This will increase the likelihood of making fatal mistakes and burnout would be an understatement because we are there already. Unless there will be laws in place to ensure a pharmacist doing minor ailments or vaccinations is not doing so at the same time as working dispensary, or that there be more than one pharmacist on staff to assist, then I am completely opposed to this change.
I support allowing RPhT to inject more vaccines. That being said, we need to be paid accordingly. On another note, this may alleviate some of the workload from our pharmacists.
The scope of practice for Part B pharmacists should be expanded eg injection administration.
We are seeing an increasing number of patients relying on the expertise of their local pharmacists to get their RX for minor alignment in which you can see how that what be a crucial successful role of pharmacy community in fixing the healthcare system
The COVID experience that we all have been through proves the pharmacists abilities and capabilities to do way more for the patients and yet it’s not authorized . We re ready and happily accepting doing more as long as there is enough reimbursement, we can do more without enough funding , everything is going up with the inflation rate except pharmacy reimbursement.
I support these changes. I’m very excited to see the changes that have come and are coming to pharmacy practice. The only amendment I have reserved thoughts about is giving pharmacy technicians authority to administer any schedule 3 vaccine. Thank you OCP for advocating for expanded scope and giving Ontarians more choices when it comes to who they receive their healthcare from – pharmacy is an excellent one I’d say.
I am happy to assist with administration of these vaccines as long as we are receiving proper compensation. I want to help people to the best of my ability and of course providing vaccinations is a large part of this. I hired a registered technician last year in time for the flu vaccination season. It was wonderful. However, I am not making enough to cover her wage, the scheduler, supplies, disposal of supplies. I know you have heard these complaints before, but I am hoping that if enough of us come forward, that organizations will continue to advocate for better compensation so that we can at least break even from providing new scopes. With respect to prescribing Tamiflu, I would only be comfortable if there is Point of Care testing to confirm influenza diagnosis that is covered by the Ministry with no capital costs to pharmacy businesses.
I do not support this initiative to load more responsibilities onto our already over-worked and underpaid pharmacists. We are being forced to churn out Meds Checks by greedy head office bureaucrats who are cutting staff and resources.We need to be treated like the professionals we are by FAIR REIMBURSEMENT and appreciation for our compassion and service to the often rude and impatient people we serve. And really, $40/hr? We are not H-Vac installers.
As a smaller pharmacy I believe adding more ailments to the already authorized list is just adding an increased work load on an already burnt out sector of the health care system. It is not feesible to provide appropriate pharmacy care and to be a doctor at the same time especially when many smaller pharmacies only have 1 pharmacist staffed for each shift.
I do not suppport this plan. Adding more responsibility to the pharmacists without increasing the number of pharmacists in each facility, without providing training and increasing the capacity of facilities, will only lead to further burn out of pharmacists and consequent shortage in the workforce. This will not resolve any current healthcare issues and will be detrimental to the public.
I’m absolutely against these changes. It’s reckless and irresponsible to invite patients with active contagious respiratory infections to walk into pharmacies seeking prescriptions for Tamiflu and Paxlovid and spread the infection to other vulnerable patients waiting their for vaccinations, prescriptions and advice. It’s impossible to control the spread of infections in a retail setting- no proper ventilation, PPE etc. It’s simply criminal to push everyone into the pharmacy setting- kids looking for flu vaccines, seniors and immunocompromised. I’m addition, pharmacists burnout rate is at peak levels already according to the national surveys. Pharmacists are not allocated additional time for training and are not compensated for taking the training. Increased workload leads to more stress , burnout, and increase in medication errors.
Increasing the scope of pharmacy professionals is always in the best interest of patients because it increases access to care. In terms of removing age restrictions for vaccines, this means that both pharmacist and pharmacy technicians may be able to give vaccines to infants. This is reasonable but would necessitate training on how to administer vaccines to this population. In terms of solidifying the pharmacist’s scope to prescribe antivirals, access to full patient lab data must be mandated for safe prescribing to occur. Also, to ensure that all or most pharmacists can offer this service, practical training should be mandated. In terms of vaccines that have public coverage, such as some meningitis vaccines, pharmacists need to understand how and if they can access public supply and their role in providing these vaccines relative to other providers who would typically do so (e.g., physicians, nurses).
I think all of this is a good idea except expanding pharmacy tech injection authority. Also, reimbursement must be considered, pharmacies are already overwhelmed and deserve to be compensated for an increased workload
Although expanding access to health care is important, i feel that removing the age restriction for vaccines will encourage parents to take their infants to the pharmacy for various vaccines, and pharmacists will not able to give a frightened infant the time and care to administer a vaccine in a more gentle/ patient way, and therefore this may contribute to future needle phobia and difficulty for the parents. At the height of the covid pandemic, pharmacists have encountered many patients with various needle and vaccine phobias who were forced to become vaccinated for work purposes. Also how would pharmacists examine patients for the purpose of prescribing Tamiflu? Pharmacists prescribe Paxlovid pursuant to a positive Covid test, but pharmacists are not able to examine patients, listen to their chests etc. Why are you considering Tamifu and not Strep throat therapy which is diagnosed with a swab? Please consider patient well being before adding further services obtained at the pharmacy, which can actually harm a patient.
I don’t believe most Pharmacists to be sufficiently trained to give vaccinations to infants, nor would they be comfortable doing so. That along with with increasing scope without addressing the current burn out makes these new amendments unfavourable.
I don’t support expansion in pharmacist duties. Most pharmacists are overwhelmed and drained. I feel that there is no consideration to pharmacist well being, mental or physical health. Not to mention that there is no appropriate compensation.
I believe this amendment would be a good idea.
If pharmacy owners are not regulated then they will continue to force staff pharmacists to perform more without compensation. The quota systems in place and the stresses they cause need to be addressed by the College. I don’t think the college should lower the age for injections at this time, simply due to inadequate staffing to perform all of their increasing duties simultaneously. As a retired pharmacist, I am very concerned about the increasing workload on the community pharmacist. This is dangerous. It worries me that the pharmacy owners are not providing more pharmacist staff at each shift.
Pharmacists are qualified to administer injections. It relieves physicians and clinics of unnecessary work. We should be paid by government for this service and not have to put the charge onto the patient.
How can pharmacists (and physicians) prescribe Paxlovid when RATs are no longer available? This makes little to no sense. And why can we give injections where there is zero reimbursement model in place from the government for us to do so, nor can we prescribe said injections?
Fully endorse the new expanded scope of practice for resp illnesses. This will improve the patients trust on healthcare system. Timely issuance of prescription for time sensitive disease management like flu.
As a pharmacy tech I have been administering the flu & Covid vaccines for the last few years. I have no interest in giving other shots and most certainly not to infants. I understand the pressures on our health care system but adding additional pressures to pharmacy is not of benefit to patients mainly in smaller pharmacies where there may only be one staff pharmacist on duty and one technician. Now with expanded scope of minor aliments which takes time for proper diagnosis and prescribing, technicians are stepping up with checking blisters, taking RX’s over the phone and doing the vaccines and finally starting to work to our scope as it is now. Pharmacists have many duties during the day and adding more only makes it more difficult to give good quality patient care.
Once again, more responsibilities added, with no consideration to the workload pharmacists are already struggling to handle! All while cutbacks continue to be made and pharmacists mental health and moral continue to decline.
I agree with opening up technicians to administer more vaccines but very hesitant and concerned about removing the age cut off for vaccinations. Communities pharmacies do not have the space or time it takes to administer to an infant, nor do we have proper training and expertise in that age group. I was interested to read the studying regarding Tamiflu use in outpatients, which makes me even more hesitant to want to be responsible for prescribing if it isn’t likely to be of benefit to the healthcare system anyway. I just hope we get appropriately compensated for this added work.
The June 25th posting by “Other” is very important to consider, given we are supposed to be healthcare professionals that weigh the evidence in making decisions. To me, we should not be wasting $$ on prescribing Oseltamivir (or other “amivir” congeners) at all. In addition to the above article, we should remind ourselves of the events of the past decade or so: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375804/ https://www.independent.co.uk/news/world/americas/donald-rumsfeld-makes-5m-killing-on-bird-flu-drug-6106843.html The first article, while pre-dating the reference made by “Other’s” comments, is supported by that current reference. Hopefully, the PHARMACISTS at the OCP that review these comments don’t just add up “yay/nay” and present a summary to the Board of “a majority favoured allowing it” (or minority, as the final case may be), but does a critical evaluation of the individual concerns and ensures that the Board sees those comments “as submitted” rather than as summarized by staff personnel who can inadvertently effect the goal of big pharma, etc. to increase bottom lines through what others have referenced as increasing quotas to gain payments. The ONLY goal should be patient safety, and these studies severely call that into question given the psychiatric adverse events described in the data.
Retired pharmacist, SDM associate for 30 plus years I have watched since retiring a steady increase in pharmacists scope of practice. I find it exciting and frightening at the same time . Having spent years in corporate pharmacy I can attest to the quota systems in place and the stresses they cause. I would accept the concept of increasing the scope of practice only under the following The college bans all forms of quotas in pharmacy , with fines large enough to deter any sneaky ways of circumventing the ban. The college institutes a rule of the number of prescriptions filled and the manpower minimums. The college does not lower the age for injections, All the above ARE in the colleges mandate of protecting the public. I feel OCP is afraid of corporate pharmacy and their legal teams.
This is too soon and too rushed.
It’s a welcome development but as several of my colleagues have pointed out , vaccinating babies should be reserved for hospitals and nurses as this often takes lots of time which we don’t have at the pharmacy level . All of extra work will come at a cost as pharmacists are already overworked at the pace and this is just a lot more work with no additional compensation . Please let’s slow down with the additional responsibilities
I Think expanding the scope for the above vaccine and oral medication would be great for the pharmacy technicians and Pharmacist.
Expanding the parmacist/techincian authority to administer more vaccines and be able to prescribe medications for other minor aliments, will greatly improve pt access to emergency care, and reduce the burden on physcians to address more critical issues with their patients. But we also need to keep in mind the the pharmacist these days is overwhelmed with lots of paper work and documentations he has to do, so we need to develop a way to reduce this burden and facilitate the work to have more effecient and productive patient care
With the the most efficacious patient treatment in mind, I agree 100% with the proposed Expanded Scope Regulatory Amendments.
I wanted to highlight a recent publication in JAMA Internal Medicine, entitled “Evaluation of Oseltamivir Used to Prevent Hospitalization in Outpatients With Influenza” – the article can be accessed here: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2805976 This was a meta-analysis of 15 RCTs examining the impact of oseltamivir in reducing hospitalisations. The conclusion from this study was that in influenza-infected outpatients, oseltamivir was not associated with a reduced risk of hospitalization but was associated with increased gastrointestinal side effects. In a subgroup analysis focusing only on outpatients at greater risk of hospitalisation, oseltamivir was still not associated with a reduction in hospitalisations. Although allowing pharmacists to prescribe oseltamivir would increase access to this medication, this meta-analysis suggests that doing may not result in substantial off-loading of the healthcare system, as oseltamivir does not appear to reduce the risk of hospitalisation, and in fact, may increase the chances of patients develop GI side effects from therapy.
I am disappointed that the OCP is fast-tracking a set of regulations without the input from all its members such as myself. If pharmacy owners are not regulated then they will continue to force staff pharmacists to perform more without compensation. We are overworked, underpaid and our own college doesn’t advocate for us.
I am in agreement to expand the scope of practice for Pharmacists, Pharmacy interns and Pharmacy Technicians. As a pharmacy technician, I have been giving the flu and covid injections already for the last few years. I believe it takes the pressure off the pharmacist so they can focus on patient care. The health care system in Ontario is spread quite thin so if we can make it easier for the patient to obtain these injections without a long wait involved, either at their doctor’s office or pharmacy, its a win win situation.
While the expanded scope may sound and be terrific news for the public , the extra workload is not welcomed by me especially when the employer has cut so many pharmacy hours and the work environment has deteriorated considerably .. more work with less people ? I would rather not !
I am so happy that finally we can help to prescribe medications for people who desperately looking for doctors help. I wish the authorities expand tge scope of practice for pharmacists in Ontario according the Alberta model. Thanks
This is a no-brainer, it’s just lore of what we’re already doing.
I would not only feel uncomfortable injecting babies/toddlers, but my workplace does not have an ideal layout or setup for accommodating the immunization of this patient population. During my OCP-approved injection training I never had the opportunity to practice on such a young patient, and to give the general public the expectation that they could safely bring their very young children to be immunized at a community pharmacy is wrong. Also, the autumn is cold and flu season, and community pharmacies like mine are extremely busy. I feel we would not have adequate staff to cope with demand of patients coming in and insisting on receiving Tamiflu and/or Paxlovid on the spot.
I do not support removing age restrictions for administration of vaccines. Vaccination of infants and younger children requires greater time, more private vaccination areas, and increased resources that are not available in most community pharmacy settings.
These regulation changes are important for the public and enhances the role of pharmacists in providing best health care system by applying their knowledge and skills to perform safely the expanded scope of activities.
As a retired pharmacist I can tell you that we are in theory able to expand our scope of practice. However on a practical basis, pharmacists are overworked. Pharmacists workloads have been ever increasing with no added help being given by our employers. Errors are on the rise and we are leaving the profession on mass.
I believe this is a great step forward in making all aspects of healthcare more accesible to the public
You are piling on too much change too fast. Adding another vaccine is reasonable. Expecting us to vaccinate babies is not.
These proposed amendments are not appropriate. Pharmacists cannot safely evaluate the risks to patients for prescribing medications as they do not have appropriate medical histories. ODB viewer is not an appropriate substitute to a medication history that a physician would have. The real issue is that the healthcare system is not being properly funded, providing physicians and nurses. Pharmacists have a crucial role to ensure that medications prescribed are safe; by continually offloading problems on to pharmacists you are increasing burdens on pharmacists and thereby increasing risks. Pharmacist burnout has drastically increased in the last few years due to your decisions to allow minor ailment prescribing and placing all liability on pharmacists (with no additional benefits to pharmacists rather just corporations), as such I have decided to practice significantly less in pharmacy. Your allowing minor ailment prescribing without restrictions on quotas or safeguard pharmacists right to opt out is destroying the profession. Corporate pharmacy are demanding quotas to be filled, and pressuring pharmacists to write prescriptions. This is highly dangerous. Due to these practices I choose to not work for corporate chains as such greater pressures are placed on the pharmacist on those locations. If you chose to allow pharmacist prescribing you need to create rules that protect pharmacist that wish to opt out and protect them from retaliatory consequences from corporations and managers.
Fully agree with the proposal, however it has to be very clear that there MUST be a fee per service approved by ODB and all insurance companies. Pharmacists are also stretched for time and very busy. In many situations, some stores will have to increase number of staff pharmacists in order to handle the additional/expansion of the scope of practice. Professional fees may not be sufficient for this purpose. Thank you.
How community pharmacist knows that patient is influence positive and be able to prescribe tamiflu or that should be empirical treatment based on the symptoms? I think it is an important question to be discussed Expanding scope of practise for pharmacist it is great initiative for Ontario health care system. however it is just adding more liability and more tasks on the pharmacist and more $ to pharmacy owner which will affect the quality and standards of the main services that pharmacist provide and chance of more error will happen because the pharmacy owners especially big players in the market need to squeeze their pharmacists till the end and unfortunately there is no strong body to advocate on behalf of pharmacist in that issue My suggestion here any expanding scope of practise the pharmacist ( who takes the full responsibility for prescribing ) should get directly reimbursed from the government similar to any other prescribers along with the pharmacy no sense to increase someone’s liability without benefit Thanks for the initiatives and asking for the feedback
I am only against the RSV vaccine as it is indicated for very young infants and I don’t feel comfortable vaccinating that age group.
Just no. The increasing workload is jeopardizing the safety of other patients, especially with the unrealistic quotas being forced onto staff pharmacists by corporate. Not all stores are staffed adequately to account for this increased workload, nor are employers compensating staff appropriately for the work. Further responsibilities for the community pharmacist should NOT be discussed until we have a proper compensatory system in place for the prescribing pharmacist. Personally, I am absolutely against the prescribing of Tamiflu. During COVID, there was a lot of drug seeking for Paxlovid from people who did not need or were not even in the country, and having to filter through and deal with these people accordingly was too much. I feel that there is already over prescribing of antibiotics in general, and not much is done to address the issue because ultimately, it ends up being money for the pharmacy. I predict that the aforementioned issues will happen with Tamiflu and we really don’t need more of that.
I don’t support these changes because there are no accompanying plans in place to provide compensation to individual pharmacists for their time, effort and increased workload for any of these new services including the recently rolled out minor ailments prescribing. A dedicated practice space for providing these services is also required. A counselling room is not supposed to be used for providing injections and some do not have adequate levels of privacy. What the OCP are doing is working with big corporations and pharmacy owners to lobby the Ministry to be able to provide more services that they can bill for, but without actually reimbursing the staff pharmacist providing the service. This makes for a great PR campaign to the public but will only benefit corporate stakeholders and pharmacy owners while taking advantage of pharmacists and putting patient safety at risk due to increased workload, poor morale and chronic burnout. Community pharmacists are leaving the store in droves because of this. The services are framed in a way that makes it look great for patients to improve accessibility and quicker treatment while freeing up the healthcare system, but in reality, you cannot simply walk into a busy community pharmacy and ask for a vaccination or minor ailment consult on the spot. There is not adequate support staff in the pharmacy to allow the pharmacist to drop everything for a walk-in patient. As such, patients will be asked to come back or make an appointment, which defeats the purpose of the increase in scope and causes confusion/frustration for the patient. Constant interruptions like these are conducive to errors too. The increases in pharmacist scope lobbied by the OCP in conjunction with corporate stakeholders are trying to obtain something from nothing and are tone deaf to the actual problems that staff pharmacists are experiencing in-store right now. I urge everyone in the profession to only support an increase in scope if it is accompanied by increased support staff, adequate in-store space, dedicated uninterrupted time to provide these services and FAIR COMPENSATION. Enough is enough.
I love the minor ailment. Having practiced in Alberta, I felt we are behind in Ontario. But now we are catching up, pharmacists are capable of practicing to more potential. Looking forward to more updates in this area.
The justification for continually expanding the scope of practice for Ontario pharmacists seems to always be that there are increased pressures on the Ontario health care system. No one ever seems to acknowledge that we are part of the Ontario health care system and we are also facing this increased pressure. Every time our scope is expanded, we see no increase is support staff to facilitate us offering these additional services. Continuing to add to our scope of practice without having a plan in place for how we are supposed to accommodate it could lead to some very real safety issues for patients and pharmacists. It’s not that we’re not capable of these additional responsibilities, but someone needs to think about the fact that the majority of pharmacies are now corporate chains. If we don’t require these chains to give us the support we need to provide proper patient care, then they will continue to increase the pressure on pharmacists and pharmacy technicians (without increasing support) for as long as they can get away with it. In addition to all this, if our scope is being expanded to fill a hole in the Ontario health care system, then why is our OHIP reimbursement less than physicians for the same services.
The challenges I’m having with making a clinical decision relates to patient continuity of care and the disruption cause by certain prescriptions going to selective pharmacies’ dues to insurance companies . Today, I had a patient who I could have had a dispensing error if I had recommended under the minor Ailments guidelines. I almost released the drug when I found out the patient was on a different specialty drug (XELJANZ) at another pharmacy that did not evaluate if the patient had Shingrix or not, which they didn’t. Since the patient was on XELJANZ and over 50 they should have been administered the Vaccine and other clinical information attained. Due to us not knowing about the drug, this put my license on the line. I’m hoping one day OCP follows what OPQ have done in Quebec, where they see PPNs a major issue when it comes to patient choice and continuity of care.
As pharmacists we are already feeling burned out with no extra support and required compensation. Any vaccinations for toddlers should stay with family physicians and paediatricians. I don’t think pharmacists are equipped to handle any medical emergencies, given to watch just some online videos in name of training for the expanded scope.
The corporate run pharmacies have not made adequate arrangements to free up pharmacist time to be able to safely incorporate the expanded scopes. Rather, they are cutting assistant hours, not allowing overlaps etc which is eventually increasing dispensing errors in pharmacies as pharmacist are over stressed. Additionally, pharmacists compensation package in view of these changes needs to be addressed accordingly.
I’d like and appreciate all the effort was done to release this law , but please keep in mind it will affect the work flow As a pharmacist in community setting that can already barely keep up with everything, I am against these additional responsibilities. There is increasing concern with risk to public safety as our duties increase, but our support does not. Pharmacists are already in a burnout phase. Minor ailments add more to the workflow for the average pharmacist with no increase in compensation. It’s too much and gonna affect the pt health and great more incidences .
It’s great to see expansion in pharmacist scope of practice as it showed better impact on patients qol and getting easier diagnosis and/or treatment. The only drawback is the compensation part is either goes to the pharmacy not the pharmacist or underpaid in comparison to other provinces.
While I am thankful for the proposed expansion in scope to allow for the administration of the upcoming RSV vaccine(s), I must express my disappointment that we are still using lists to define our scope of practice. The administration technique does not differ depending on what’s in the syringe, and we can expect additional vaccines to be marketed over time that the public may benefit from, so why are we maintaining a list of what can and cannot be administered by a pharmacist? It is arbitrary, not evidence-based, and ties up valuable resources whenever updates are required. I am strongly urging that any future efforts to expand scope do away with these lists and instead allow for the administration of ANY Health Canada approved vaccine.
While I welcome all expanded scope, I am increasingly frustrated with the lack of logic that is displayed in the process. I reviewed the “list” of meds we are allowed to inject. Many that I currently do will continue to require a direct order. If it can be injected IM or SC we should be allowed to inject it. There should be no list. Similar with Minor Ailments. Either we can or we can’t. We are trained to do this, so let us do it. Having it be so complicated is a barrier to patients especially if we need to get direct orders for so many.,
With increasing the number of HCPs that can give vaccines and more vaccines available, there needs to be a way to universally record this information and for patients to review this. Additionally does this include prescribing the RSV vaccines? Additionally for prescribing Oseltamivir, there is no rapid test well available for flu and otherwise diagnosing flu may be difficult based on symptoms (even physicians struggle with this). There needs to be clarity on this and documentation, especially as there is an LU code. Does the evidence support that wider spread use of Oseltamivir to actually prevent severe outcomes? Is there a better use of our time, and cost to prevent flu?
I believe expanding the pharmacist scope of practice in Ontario can only be executed safely if pharmacists are provided with proper training. Otherwise, we cannot provide these services without potentially causing harm. Integrating training for expanded scope services into current pharmacy school curriculums should also be a given. Main point is that this is not the pharmacist role that many of us signed up for when we graduated pharmacy school. I am in favour of expanding our scope as long as proper, FREE training is provided.
I agree with the new expanded scope of practice. Public is suffering so much from doctors. Family doctors refuse to accept new patients and they don’t have time for walk in patients. Walk in clinic do not allow more than 5 min for patient to talk and allow 1 complain at a time and refuse to refer to lab tests. Actually we need more tools in our hands. I do not understand why we are not allowed yet to administer Vit B12 injections and Prolia injection. it s a burden on health system for no reason.
I find this absolutely disgusting that the College has never once looked into safe workload volume with any of the big corporates – that we know of. Minor ailments add more to the workflow for the average pharmacist with no increase in work standards (not gleaming over zealous published texts , but actual practise ). Quotas are a reality in chain pharmacies – will the college ever have the moral spunk to ban this blatantly illegal practise???? . This will turn out to be another quota. There will be no or minimal increase to support staff. We are burned out. We will be more burned out after this passes. I understand the College’s purpose is to protect the public. Just so happens that when morale is bad in the workplace, the public is not safe. I see medscheck shifts advertised on relief apps from certain chain pharmacies. Is this is a safe and effective use of the medscheck service? I wonder how many medschecks are done during those relief shifts. I do not oppose minor ailments on principle. I have helped patients with minor ailments since Jan at personal cost to my time and with no additional compensation. However, I think the College should also try to help the average pharmacist who is drowning because patient safety matters!
I am all for expanded scope and helping the patients get the timely care that they deserve. I highly suggest that we allow pharmacists to prescribe ALL vaccines (for a fee that’s reasonable of course). That way we’re not only saving time from faxing doctors to prescribe vaccines but also help the patients get the protection through vaccines sooner rather than later. (eg. Pneumonia, HPV, Shingles and tetanus shots). Pharmacists should be able to prescribe Schedule II vaccines such as Gardasil for insurance purposes.
While well intended the college needs to recognize that community pharmacists/techs/assistants are beyond over worked and exhausted. Large organizations/chains are directly responsible for most of these issues. Until you can guarantee a safe environment, fair billing/compensation for these activities and basic human rights like lunch/bathroom breaks etc I am not supportive of this initiative.
I feel the added pressure to pharmacists has not been fully reviewed – Time, pressure, distraction from other duties, remuneration, public expectation, added professional obligations. The role of a pharmacist has changed dramatically over the past 10 year since adding flu vaccines to our scope. However, the hourly wages have not increased much since then and especially iver the past 5 years to even keep up with inflation. This included chain, banner, and independents – we are not getting paid anymore with the added responsibilities we have taken on. I do not believe this is where I am employed only, my colleagues in Ontario agree that our earnings have been raised accordingly and higher. (Ie, taking on many duties of a physician and getting remuneration $8 to $20, not personally but for the owner/operator)
I think that these proposed regulations are great to expand our practice, however, future changes should take into consideration the lack of time that most community pharmacists have in our day to day practice and that further expansions of scope may place additional strain on our mental health due to increasing workloads.
Not in best interest of patient Not in best interest at a retail level Not in best interest of continuity DO NO HARM
I understand that the government wants to loosen burden on our health care system, but this is just putting another burden on pharmacies. We are already burned out from covid vaccinations, testing, paxlovid prescribing and minor ailments on top of regular workloads.. patients don’t understand that they have to wait whenever they come to the pharmacy for their covid shots or minor ailments assessment. They simply saw advertising online from big chain and walked in pharmacy expecting pharmacists can help them in 5 mins. Also, it is really hard to give flu shot for young children. I can’t spend half an hour to calm them down! I’m not trained to give shots to infants and I don’t feel comfortable at all. That is why there’s family physicians and nurse practitioners who are fully trained.
not interested, i am already taking on minor ailments prescribing, ongoing covid vaccinations, flu shots, paxlovid prescribing in addition on top of regular job.
This should have been done many years ago. As healthcare practitioners we have to take more of a role in diagnostic and implementation.
My concerns are specific to the prescribing of Tamiflu. A diagnosis of influenza would be necessary for appropriate Tamiflu prescribing and we as yet don’t have a mechanism to do that. Assessment for influenza (scope) would need to come along with this, along with a full prior discussion as to whether that scope (and utilization of the drug) is helpful or safely appropriate.
PAY US FOR ALL THE EXTRAS YOU KEEP ADDING ON TO OUR WORKLOAD.
These proposals leave me with more questions than answers. 1. Paxlovid prescribing – if patients no longer have access to RATs, then how are we to know if a patient’s COVID positive? 2. Administering Schedule 3 vaccines – what’s the point of this if pharmacists don’t have the authority to prescribe said vaccines? And finally: 3. Why are we still pushing for baby steps regarding expanding pharmacists’ scope of practice when there’s still have HUGE hole in patient access to healthcare? The focus should be on reducing walk-in clinic visits e.g. letting us do strep tests and prescribe antibiotics for strep. Otherwise, you have what we have now – pharmacists able to see patients on a walk-in basis but patients having no idea when they can see pharmacists and them still going to walk-in clinics
I have to wait 2 days to get my prescriptions now and you want my pharmacist to do more. I’ll be waiting a week to get anything at the rate things are going.
In the interest of the public, I have to highlight the significant stress and workload that has been placed on the front line community pharmacists with the ever expanding scope of practice. On one hand, I’m proud to be able to contribute to the health system and use my skills and knowledge, on the other hand, I don’t believe the increasing workload is sustainable to front line staff. Can workload mitigation be included in the regulations be included to protect the public.
I think that pushing for all vaccines to be administered at community pharmacies makes sense (instead of only asking for RSV). I don’t know what the previous discussions have included but it seems that we are headed in this direction anyways. The main downside of expanding our scope, from what I can see, is the potential to overwork the staff at the pharmacy but from a health system standpoint it would be quite a bit more efficient. This is assuming a provincial vaccination platform (like COVAXON) can be implemented to ensure all necessary healthcare agents can enter and retrieve the immunization data.
Given the hard times that our community has been through over the past 2-3 years and given the vital role that most if not all community pharmacies played in administering COVID vaccines , either separate or mixed with flu vaccine . I believe we should have a full scope to administer whatever on the immunization schedule for the public instead of having only one or 2 kinds of vaccines approved every couple of years. Pharmacists and pharmacy professionals in Ontario can do it.
As a pharmacist in community setting that can already barely keep up with everything, I am against these additional responsibilities. There is increasing concern with risk to public safety as our duties increase, but our support does not. Pharmacists are already in a burnout phase.
Minor ailments add more to the workflow for the average pharmacist with no increase in compensation. Quotas are a reality in chain pharmacies. This will turn out to be another quota. There will be no or minimal increase to support staff. We are burned out. We will be more burned out after this passes. I understand the College’s purpose is to protect the public. Just so happens that when morale is bad in the workplace, the public is not safe. I see medscheck shifts advertised on relief apps from certain chain pharmacies. Is this is a safe and effective use of the medscheck service? I wonder how many medschecks are done during those relief shifts. I do not oppose minor ailments on principle. I have helped patients with minor ailments since Jan at personal cost to my time and with no additional compensation. However, I think the College should also try to help the average pharmacist who is drowning.
I fully support the suggested changes for the latest expanded scope. I see a great need for immunisation services in my community as it is a service that is well within our abilities and will help lessen the burden of the healthcare system.
I agree with all the proposed amendment requests. We need to act sooner than later. I also think sinus and throat infections should be added to minor infection prescribing.
I am in favour of the amendments but believe we need to stop this one by one addition of vaccines. Let’s just make one amendment that allows pharmacist to give any vaccine or injection. Any injection that can safely be given by a physician should be approved for pharmacist or registered technician. Patients are not getting their vaccinations because it is taking too long for them to get into see their physicians.
Authority to prescribe and administer all the vaccines available is very important. Pharmacist should be able to assess patient if applicable and decides to do so, be able to prescribe and administer vaccines at the same time.
I think that long acting antipsychotics should be included on the list of medications pharmacists can inject. They are an IM injection we are very capable of giving, and serve a particularly vulnerable population. These patients are often living in group homes, on disability, or already have difficulties with compliance – all of which make travelling to a doctors office a burden. Getting this injection at a pharmacy would save people the need to pay for a cab or arrange transportation often out of town. It would eliminate a delay in therapy if they would otherwise need to take time off work just to get to their doctors office while it’s open.
Pharmacist has to be paid for each administered vaccine and time spent on evaluation
I agree that as pharmacists we have the training and expertise required for these changes. And as a new grad, I consider myself more eager to advance the profession than many. But that being said… it is just not realistic to me at this point. We were NOT trained to administer vaccinations to infants (and I graduated from Waterloo, a top school for hands-on training as OCP is well aware) – and to be frank, I would not be comfortable doing so. I can agree that it’s extremely important, but doctors are compensated appropriately for that additional risk, and Ontario pharmacists are simply not. I’m speaking as a pharmacist who practices for a big chain – where I know 90% of my colleagues (or more) would NOT be willing to vaccinate an infant. We simply do not have the training, and our lack of compensation for all of these new professional services has really lowered morale. It makes it harder for us to feel motivated to learn new skills (like if we were offered training for infant vaccinations). This is not to say that we all care about money more than patient care because the opposite is true. But not being compensated for any of these services feels like we are not being respected or appreciated for the constant new services we are expected to provide, and that which add a TON more stress to our professional lives because of corporate expectations (who are gaining what we do not). And I know I speak for many community pharmacists. So all in all, I disagree with this new expansion of scope until something can be done about pharmacists’ compensation (and in mine and my coworkers/peers’ experience, appreciation) for the services we’re being asked to provide on top of our already full plates. We simply can’t keep up.
I am a family physician from Toronto, Ontario and would like to express my unanimous support for pharmacists’ expanded scope of care and most imminently, administration of the RSV vaccine when available. Having just emerged from 3 years of trying to vaccinate ourselves out of a pandemic, I am hopeful that a new medical system will embrace the notion of a team based approach to vaccination delivery, opening access and simplifying the process for patients . The end result is simple: improved patient care. As we fast approach influenza season and brace ourselves for the unwelcome trinity of RSV, COVID and influenza, it is clear that ensuring our patients CAN get their vaccines efficiently is essential. Change is not possible if we do not learn from the past. Let’s break barriers, embrace collegiality and understand that we have one common goal: optimal patient care.
It will be a great idea . Technician have capabilities to do lot more and can help pharmacists to free their time for other professional services.
Dear OCP – My name is Jia Hu, a public health and preventive medicine physician and family doctor and the CEO of 19 To Zero, a not-for-profit aimed at promoting important health behaviours like vaccination and cancer screening. I am writing to support the role pharmacists can play with immunization, something they clearly demonstrated during the COVID-19 pandemic. With new vaccines becoming available like the PCV-20 pneumococcal vaccine and the soon-to-be available RSV vaccine, it is more critical than ever that pharmacists have the ability to administer these vaccines. With the health system in crisis, we will simply not be able to immunize the population effectively without pharmacists supporting immunizations. Furthermore, I think having pharmacists prescribe critical medications for infectious diseases like Oseltamivir and Paxlovid will be critical for timely treatment. As these medications do need to be administered soon after infection, having pharmacists prescribe make a great deal of sense given their convenient hours and availbility compared to other healthcare providers. In summary, 19 To Zero fully supports these proposed changes. Ultimately, these changes will improve access and improve patient care. Best, Jia Hu MD MSc CCFP FRCPC CEO, 19 To Zero
The rollout of Minor Ailments has just happened this year. Teams are slowly getting used to performing Minor Ailments for the public. Now, we are rolling out even more responsibilities for pharmacists. The expansion is going too fast for pharmacy teams to cope. The additional pressure on pharmacy may lead to more dispensing errors, just like we had with the messaging on adapting adult Tylenol for children. The workload on pharmacy teams is consistently increasing without additional labor hours being given. This may lead to errors in vaccinations. 1. Removing the age restriction for vaccines may do a disservice to young infants and their families. A doctor’s office or a nurse practitioner’s office is more conducive in giving vaccines to very young infants. A busy Shoppers Drugmart is not an appropriate setting. 2. I do support prescribing for Tamiflu, however access to renal function is very difficult to obtain at the pharmacy level and may delay treatment. Depending on renal function, different doses of Tamiflu are warranted. I have noticed this when prescribing Paxlovid to patients. Our company does not have access to Clinical Viewers yet. So, we are faxing family doctors and waiting. 3. I support RSV vaccination as long as we have appropriate clinical guidelines.
We definitely need expanded scope of practice in these areas and more as pharmacists are very knowledgeable and can help alot during this health care access crisis.
It is more important than ever for pharmacists to be able to provide care to the public because it is almost impossible to get a doctors appointment in a timely manner. If pharmacists can help give vaccines to more people then it should be allowed. We need more flexibility in the system as long as it is safe and controlled. I believe it is the case for this change.
Adding more injections by pharmacist, put more pressure on pharmacist The reality of daily work is the workflow is already overwhelming because not enough technical support The RSV vaccine can be added to the others that we do now but not all the other list We have to do our primary job Medcheck Clinical review of each rx Counselling on rx and otc Minor ailments There should be a better ratio of technician/pharmacist
I don’t believe expanding the scope of practice for pharmacists is in the best interest of patients. As pharmacists were are not trained to diagnose and despite the verbiage of the law stating we are ‘not diagnosing’ patients are presenting to pharmacy not knowing and expecting us to confirm they have a certain ailment. This is leading to drug resistance issues and worsening conditions. They are coming to pharmacists as if these ailments are purchases for otc items—ask and you will receive. On more than 1 occasion they have red flags and when referred they explain they don’t have time to go to a doctor. This is an absolute ridiculous expansion with poor training and support in execution.
Fully supporting this but we enough and adequate reimbursement, with the current inflation rate , it’s almost impossible to keep expanding services which requires an increased/ higher cost for resources without increased the reimbursement module for pharmacists / pharmacies .
The ocp is expanding the scope of pharmacists and Pharmacy technicians without considering improving the working environment. In a approximately 5 square meters room, multitasks are expected to be done. Another issue, pharmacists are exempted from basic human rights including rest periods, overtime pay….etc. Giving an injection is a technical issue and this job should be within the scope of registered technicians and I encourage the ocp to authorize registered technicians to give all kinds of injections under the supervision of the pharmacists. Also doing A1c, lipid profile….etc is a technical issue and registered technicians should be authorized to perform this job under the supervision of the pharmacist. It is not logical and not cost effective to waste the time of pharmacists in technical issues. Pharmacists should utilize their knowledge and skills in Clinical issues not technical issues. Thanks
I support these updates to the scope of practice for Ontario pharmacists and pharmacy technicians. I hope that with all the changes underway to the pharmacist scope of practice there is also an expedited focus on updating the Public Hospitals Act to facilitate hospital pharmacists to work to their full scope of practice without the need for medical directives, etc.. Thank you for your efforts in improving health care access across the province!
Please expand scope as much as we are allowed in other provinces at least
I would like to begin by expressing my support for the proposed amendments to Regulation 202/94 of the Pharmacy Act, 1991, as outlined in your memo. The expansion of scope for pharmacy professionals to administer additional vaccines, remove age restrictions, and prescribe medications such as Tamiflu and Paxlovid represents a significant step towards enhancing patient access to care and addressing the pressing healthcare challenges faced during the upcoming respiratory illness season. While I appreciate these positive changes, I would also like to highlight our concerns regarding the continued reliance on lists within pharmacy regulations. While the proposed changes undoubtedly aim to improve patient access to care, relying on lists to determine the medications that pharmacists can prescribe or administer can be restrictive and hinder the profession’s ability to provide the best possible patient care. Lists, by their nature, are static and may not be able to keep pace with the rapid advancements in pharmaceutical therapies. New medications are continually being developed and approved, and pharmacists should have the autonomy to adapt their practice to include these innovative treatments as soon as they are available. However, a reliance on lists necessitates regulatory changes every time a new medication is introduced, causing delays in patient access and potentially limiting their treatment options. Moreover, lists can be overly prescriptive and may not encompass the full range of medications that pharmacists are competent and qualified to prescribe or administer. The professional training and expertise of pharmacists extend beyond the confines of a limited list, and they should be trusted to exercise their clinical judgment and make informed decisions based on their knowledge and assessment of individual patient needs. By relying solely on lists, we risk undermining the professional autonomy of pharmacists and impeding their ability to provide personalized and optimal care to patients. Instead of relying on rigid lists, an alternative approach that focuses on accountability, competency, and ongoing professional development would be more effective. By ensuring that pharmacists undergo comprehensive training, engage in continuing education, and demonstrate their competence through standardized assessments, we can trust that they are equipped to prescribe and administer medications safely and effectively within their scope of practice. This approach encourages professional growth, fosters innovation, and empowers pharmacists to provide patient-centered care. In conclusion, while the proposed expansion of scope for pharmacy professionals is commendable, I urge the College to reconsider the continued reliance on lists within pharmacy regulations. By shifting towards an approach that emphasizes accountability and competency, we can better meet the evolving needs of patients, promote professional autonomy, and ensure the highest standard of care. This will enable pharmacists to fully utilize their knowledge and skills, keeping pace with advancements in pharmaceutical therapies and delivering optimal patient outcomes.
It’s a horrible idea to allow pharmacists to prescribe Tamiflu and Paxlovid. Pharmacy must be a safe space for vulnerable patients who need care. When you allowed Paxlovid prescribing in pharmacies, it invited sick symptomatic patients to come in in person with zero PPE in place to seek care. In the same tiny counselling room where pharmacists prescribe other medications and administer Covid vaccines to kids and vulnerable seniors like myself. The front staff is not wearing PPE either and there is no proper ventilation in stores. It promotes the spread of the viruses to the most vulnerable. I’ve witnessed numerous times patients seeking Paxlovid arguing with the pharmacists who were refusing to prescribe it for various reasons. I’m also completely against administering vaccines to kids under 2 and even under 5 in pharmacies as it’s way more time consuming since kids don’t cooperate and often start crying. The noise interferes with pharmacists jobs and ability to do their first job- counseling patients and consulting with prescribers. I’ve been in situations when due to a child refusing the ca vibe and crying, I could not hear my pharmacist at all. Let’s not make pharmacies a dumping ground for our overburdened healthcare. Keep people with active infections such as flu and Covid out of the pharmacies where people get care for diabetes and blood pressure.
In my humble opinion the expertise of Pharmacists and pharmacy technicians can be utilized in order to help MOH budget so that can be utilized in some other venues to broaden the healthcare benefits.
Yes it would be great service to community and win win for all.
As much as this could be useful, pharmacists cannot replace the Public Health Agency. This government will look at this scope and simply cut public health budgets in kind. I don’t want to be blamed for the creep this government is taking towards privatization.
This a welcome change. Prescribing should be extended to routine vaccinations. Pharmacists are already capable and allowed to assess the appropriateness and administer vaccines such as Gardasil for HPV. However, insurance can not be directly billed without a prescription. This creates a cost barrier for the patient that requires contacting and waiting for the doctor for a prescription. This negates any benefit of accessibility and timeliness of care that these expanded scopes should be providing
This is all great for expansion. As a tech I will be able to better support patients and my team by being able to give more vaccines. As the pharmacists will be able to inject most substances as of July 1, I’d like to see techs have this full expansion as well.
I think this is a HUGE step for Pharmacy Technicians. There is a great need for these vaccines to be administered. This will expand the areas that Pharmacy Technicians can work (including public health units)
I fully support these changes and expansion in scope of practice for both Pharmacists and Regulated Pharmacy Technicians. I feel both professions have the necessary skills, training, and guidance (according to individual assessments of course) to perform these acts safely and appropriately. This will go a long way towards improving vaccination rates for all Ontarians for many many communicable diseases. I also agree with the ability of Pharmacists to prescribe oseltamivir after patient assessment and with appropriate notification to the patient’s primary care provider (when one exists). I feel this builds on the skills and capabilities pharmacists have demonstrated with Paxlovid as well as through minor ailment assessment and prescribing.
I fully support the expanded scope outlined. It is exciting to see that the knowledge and capabilities of RPhTs is slowly being recognized. I welcome even more scope expansion, perhaps even some clinical tasks (with advanced education). RPhT should be developed into a baccalaureate degree, to allow RPh more time and focus to complete complex clinical tasks.
I believe expanding the pharmacists authority to prescribe tamiflu and administer vaccination without age restriction is overdue and help to reduce the pressure on the health care system
This is a good first step. But as is the custom, is reactionary. We need to be more proactive. While opening up rules and regulations to allow for RSV vaccines we should also be adding the Pharmacist ability to inject ALL vaccines and ALL injectable medications that we can dispense, not from lists, but from schedules, thus no need to open regulations as new drugs are added. RSV is important during one season. Tetanus is important all of the time. Utilizing the time of your team and staff wisely, it would make sense to address this all at the same time. Further, Pharmacists should be able to initiate Rx for all of the above as well. Travel vaccine appointments take up valuable physician time. Emergency room visits for tetanus shots are exorbitant costs to the system. Pharmacist initiation and prescribing allows patients to use their private insurance for things like Shingles and Pneumococcal vaccines after a visit with the Pharmacist. Pneumococcal is a leading cause of morbidity and mortality in our senior population and we are not achieving population vaccine targets, likely, in great part, due to family physician shortage. As we work towards expanding the scope of Pharmacists to meet our training and ability, I implore OCP to go further in reducing barriers for patient access to care, by eliminating lists and requiring consultations for each vaccine. Open access will be of great benefit to the patients of Ontario.