This guidance document outlines the College’s expectations for Designated Managers, registrants and community pharmacies opting to provide COVID-19 testing (including the specimen collection required to perform a test) to the public. It is intended to be used alongside, and not in place of, the guidance documents provided by the Ministry of Health (MOH) which oversees the province’s response to COVID-19.
Pharmacies provide essential healthcare services, and the choice to offer COVID-19 testing must not impede or limit the public’s accessibility to, or the safe delivery of, other pharmacy services. Therefore it is paramount that participating community pharmacies have processes in place to ensure the protection of their patients, personnel and visitors—especially those who may be part of a vulnerable population, such as the elderly or those with chronic illnesses.
Testing should only be offered when the pharmacy has the capacity and appropriate environment to do so in accordance with this Guidance.
As a result of sequential amendments enacted by the Ontario government to the regulations under the Laboratory and Specimen Collection Centre Licensing Act (LSCCLA):
Laboratory-based PCR Testing
- Pharmacies are exempt from requiring a licence to collect specimens for a COVID-19 test
- Pharmacists can order a polymerase chain reaction (PCR) laboratory COVID-19 test
- Pharmacists can collect specimens for any COVID-19 test
- Only pharmacists have the authority to collect specimens for PCR testing under the regulations; pharmacy technicians, registered pharmacy students and interns do not.
- Pharmacists cannot collect specimens using nasopharyngeal (NP) swabbing
- Refer to COVID-19 Provincial Testing Guidance (MOH)
Antigen Point-of-Care Testing (POCT)
- Any person can collect specimens for COVID-19 point-of-care testing (POCT)
- Although the LSCCLA refers to “any person”, pharmacy professionals collecting specimens for COVID-19 POCT must do so in accordance with the Standards of Practice and Code of Ethics, working within the limits of their competence and ensuring they have the appropriate knowledge and skill to do so safely
- Rapid antigen POCT are for screening purposes only
- Refer to COVID-19 Provincial Testing Guidance (MOH)
POCT for serology (antibody or Ig testing) is not permitted, nor can pharmacists perform specimen collection for, or requisition, lab-based serology tests.
For publicly-funded testing for patients who meet the eligibility criteria of the Provincial Testing Guidance, refer to the Ministry of Health Executive Officer Notices.
For non-publicly funded testing, refer to Considerations for Privately-Initiated Testing.
The practice environment must support quality patient-centered care and enable the safe provision of all pharmacy services at all times
- The College expects pharmacy professionals involved in COVID-19 testing to follow the relevant legislation, the Standards of Practice, and the Code of Ethics.
- Community pharmacies must comply with the requirements set out in the Ministry of Health (MOH) and Public Health Ontario (PHO) guidance relevant to the type of test performed.
- Pharmacy owners, directors and Designated Managers (DM) are accountable for continuing to meet the Standards of Operation for the pharmacy.
Before offering COVID-19 testing services, the DM and owner must assess whether the pharmacy is suitable for this purpose and develop written policies and procedures to ensure that the expectations mentioned above are met. Quality assurance mechanisms should be implemented to monitor the ongoing effectiveness of, and compliance with, policies and procedures.
The pharmacy’s physical space, facilities and premises as a whole (including the building and areas surrounding the pharmacy) must be adequate to safeguard the health and safety of patients, personnel and the public.
- Public health physical distancing guidelines to prevent the spread of COVID-19 are continuously maintained
- There is a suitable separate space designated for the purpose of specimen collection, segregated from the rest of the premises which protects the privacy and dignity of patients being tested
- There are separate, secure and temperature appropriate storage facilities for storing only specimens collected for testing
- Hand-washing facilities with soap and water, and/or an adequate supply of alcohol-based hand rub, are easily accessible and available for proper hand hygiene
Infection Prevention and Control
Pharmacies should consult Public Health Ontario’s Infection Prevention and Control Practice Considerations for Pharmacies Conducting Symptomatic Testing for detailed guidance.
Stringent infection prevention and control (IPAC) measures are implemented including:
- Passive and active screening of all patients; those who screen positive are triaged and managed appropriately
- Active screening of personnel
- Universal masking/face coverings for all persons on the premises
- Recommended routine environmental cleaning and disinfection is completed
- Patient contact surfaces are cleaned and disinfected in between patients
- Proper hand hygiene is performed in between testing patients as well as before putting on and taking off PPE
Pharmacies must also follow IPAC measures shared by Ontario’s Chief Medical Officer of Health (DDD Notice No.21158).
Providing patient care
The pharmacy must have an adequate number of staff available who are provided with the appropriate level of supervision and training to adhere to policies and procedures. It is strongly recommended that all pharmacy staff are vaccinated against COVID-19.
- Workflow should be optimized to minimize the number of patient-personnel interactions and movement to other areas of the pharmacy
- Appointments for testing on the premises are booked in advance whenever possible
- Appropriate use of Personal Protective Equipment (PPE) for pharmacy professionals performing specimen collection based on screening results
- The registrant explains what the test entails prior to inserting a swab into the nasal and/or throat passage to collect a specimen
- The registrant explains how the patient can obtain (or will be notified of) the test result and how follow-up will be communicated
Registrants are advised to access the additional references to support the implementation of policies and procedures that comply with Ministry requirements at the end of this document.
- O. Reg. 45/22 GENERAL (under the Laboratory and Specimen Collection Centre Licensing Act)
- Ministry of Health
- Ontario Health:
- Public Health Ontario
- Canadian Pharmacists Association
- Ontario Pharmacists Association
- Health Canada
- Ontario College of Pharmacists:
Published: September 2020 as COVID-19 Testing of Asymptomatic Persons in Community Pharmacies
Updated: November 2020; November 2021; January 2022; July 2022