Ontario considers expanding scope of practice for nurses, pharmacists, and more

Ontario is considering expanding the scope of what certain health professionals such as nurses can do in periods of "high patient volumes." Ontario Health Minister Sylvia Jones makes an announcement on healthcare with Premier Doug Ford in the province in Toronto, Monday, Jan. 16, 2023. THE CANADIAN PRESS/Frank Gunn. ROY

Ontario is considering expanding the scope of what certain health professionals, such as nurses, can do in periods of “high patient volumes.”

A spokesperson for Health Minister Sylvia Jones said in a statement that the government has already recently expanded the scope of practice for pharmacists, allowing them to prescribe for certain conditions, and allowing nurse practitioners to order MRI and CT scans, and now the government is looking to give more professionals more powers.

“Our government’s Your Health act, if passed, will increase staffing levels on a short term basis to manage periods of high patient volume by allowing health care professionals to work outside of their regular responsibilities,” Hannah Jensen wrote.

She did not offer information on how “short term basis” or periods of “high patient volume” will be defined.

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The ministry is looking at giving registered nurses prescribing powers, allowing nurse practitioners to order and apply defibrillation and apply ECGs, allowing pharmacists to administer “certain substances” by injection or inhalation, and allowing chiropodists, midwives, naturopaths and optometrists to prescribe more drugs, among other expansions, Jensen said.

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“Maximizing professional scopes to increase flexibility is a lesson learned from the COVID-19 pandemic and a key part in building a healthcare system that is easier to navigate and provides Ontarians with access to faster, more convenient care, when and where they need it,” she said in the statement.

Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said prescribing powers for registered nurses would be great news, as her association has been pushing for it for more than 10 years.

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“It will transform primary care overnight” by taking pressures off the rest of the system, she said.

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“We welcome the change.”

A key aim of the legislation is to allow more private clinics to offer certain publicly funded surgeries and procedures, in a bid to lower wait times, though critics are concerned about the expansion of private delivery of public health care.

The NDP and the Ontario Health Coalition advocacy group raised concerns Thursday about language in the health bill they say could deregulate certain health professions and allow people to call themselves doctors and nurses, even if not necessarily qualified.

Jones said at an unrelated announcement in Hamilton that section of the bill is intended to allow for new “as of right” rules, which would let health professionals work in Ontario without having to immediately register with the regulatory colleges in this province.

Liberal health critic Adil Shamji said he suspects that is indeed what that schedule of the bill is intended to do, but he criticized the Progressive Conservatives for leaving that and too much else in the bill up to regulations that get decided by government and not debated in the legislature as part of the legislation itself.

“The devil is in the details,” he said.

“It is unfortunate that we are facing very significant changes to things like the definition of regulated health professionals, without having the opportunity for input by the legislators, by all of us, and by the public in order to give the best input and share good insight.”


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