Evolution of Pharmacy Scope of Practice

On December 11, 2020, the provincial government approved new regulations authorizing Ontario pharmacists to expand the healthcare services they provide to patients. Ontario pharmacists now have the authority to administer the flu vaccine to children as young as two years old and to renew prescriptions in quantities of up to one year’s supply. The new regulations take effect immediately.

The College took a system-based, collaborative approach to develop these regulations, involving input from a broad range of stakeholders representing registrants, regulators, associations, health providers and patients—a process that helped the College draft regulations that continue to protect the public with safe, quality pharmacy care and improved patient outcomes.

These new expanded scope activities build upon a growing list of healthcare services that pharmacists have been authorized to provide to patients in recent years.

Timeline

2012

In October of 2012, the provincial government first announced new regulations that expanded the role of pharmacy professionals in Ontario, giving them the authority to use their professional judgment to:

  • Initiate therapy for smoking cessation
  • Renew and adapt prescriptions for up to six months
  • Administer injections or inhalation (for the purpose of education or demonstration)
  • Administer the flu vaccine to patients as young as five years old

2016

Building on the success of the pharmacists’ participation in the administration of flu shots through the province’s Universal Influenza Immunization Program (UIIP), the provincial government in December 2016 authorized pharmacists to administer additional vaccines, particularly related to routine childhood vaccinations and travel.

2019

In a May 2019 letter from the Minister of Health, the College was directed to submit draft regulations that would expand the scope of practice for pharmacists, enabling them to:

  1. Administer the flu vaccine to patients as young as two years old;
  2. Renew prescriptions in quantities of up to a 12-month supply;
  3. Administer certain substances by injection and/ or inhalation for purposes that are in addition to patient education and demonstration;
  4. Prescribe drugs for certain minor ailments.

Draft regulations to enable the first three items of scope underwent a 60-day open public consultation, and were then submitted to the Minister and Ministry of Health in November 2019. These proposed regulations were subsequently posted on Ontario’s Regulatory Registry for a further 45-day public consultation. The first two were approved and announced by the government on December 11, 2020. The remaining two have not yet been approved.

2020

In the May 2019 letter from the Minister of Health, the College was also directed to recommend additional regulation changes by June 30, 2020 that would allow pharmacists to prescribe for certain minor ailments. A Minor Ailments Advisory Group (MAAG) of key stakeholders including experts in medicine, public health, health systems research, community pharmacy and patient advisors was established to define minor ailments and to inform and guide these changes.

Under MAAG’s guidance, the College developed regulatory amendments to enable pharmacist prescribing for the following minor ailments:

  • Urinary tract infections
  • Dermatitis
  • Insect bites, including tick bites, as well as hives
  • Conjunctivitis
  • Allergic rhinitis
  • Candidal stomatitis
  • Herpes labialis
  • Hemorrhoids
  • Gastroesophageal Reflux Disease
  • Dysmenorrhea
  • Musculoskeletal sprains and strains
  • Impetigo

MAAG’s Summary of Recommendations for Pharmacists Prescribing for Minor Ailments report provides additional information about MAAG and the process used to define minor ailments and inform the regulatory changes.

The minor ailments draft regulations were submitted to the Minister and Ministry of Health in June 2020, following several months of engagement with registrants, health system partners, other health professions and patients, as well as 60-day open public consultation. The draft regulations are pending government approval before coming into effect.

Please review the June 15, 2020 Board meeting briefing note for the complete details of the final regulatory amendments including a summary of the feedback received during the development of the regulations.

Learn more about minor ailments