Feedback deadline was: November 24, 2025
This consultation has closed. A summary of the feedback received, and how it will inform decision making, will be made available in the coming weeks.
Summary
The Ministry of Health has announced a series of proposed changes that would expand the scope of practice for pharmacy professionals. As part of this proposal, the Minister of Health has requested that the College draft regulatory amendments to Ontario Regulation 256/24 under the Pharmacy Act, 1991, to enable the proposed expansion of scope of practice for pharmacists and pharmacy technicians in Ontario.
Following approval by the Board of Directors, the College is hosting a 60-day open consultation on the draft amendments to the regulation and associated schedules.
Proposed changes
If approved by government, these amendments would:
- authorize pharmacists to assess and prescribe for 14 additional minor ailments including:
- sore throat (acute pharyngitis)
- calluses and corns
- headache (mild)
- shingles (herpes zoster)
- acute insomnia
- fungal nail infections (onychomycosis)
- swimmers’ ear (otitis externa)
- head lice (pediculosis)
- nasal congestion (viral rhinitis, rhinosinusitis)
- dandruff (seborrheic dermatitis)
- ringworm (tinea corporis)
- jock itch (tinea cruris)
- warts (Verrucae – vulgaris, plantar; excluding face and genitals)
- dry eye (xeropthalmia, dry eye disease)
- authorize pharmacists to administer injectable partial opioid agonists and antagonists (specifically, buprenorphine)
- enable pharmacists to provide additional routinely administered vaccines not currently listed in Schedule 3 of Ontario Regulation 256/24 under the Pharmacy Act, 1991
- enable pharmacy technicians to administer all vaccines listed in Schedule 3 of Ontario Regulation 256/24 under the Pharmacy Act, 1991.
The Ministry of Health has also asked the College to collect feedback and provide recommendations on potential laboratory tests and point-of-care tests (POCTs) to support minor ailments assessments. The consultation is limited to tests relevant to the 14 proposed minor ailments included in the proposed regulations. These recommendations will be provided to the MOH as they consider future changes to regulations under the Laboratory and Specimen Collection Centre Licensing Act (LSCCLA) to authorize pharmacy professionals to conduct these activities to support the minor ailments program.
List of potential laboratory tests and point-of-care tests (POCTs) to support minor ailments assessments
| Minor Ailment/Health Condition | Laboratory Test | POCT |
|---|---|---|
| Acute pharyngitis (sore throat) | Throat swab culture | Rapid strep test |
| Onychomycosis (fungal nail infection) | Nail clipping/scraping for culture and microscopy |
Additional Regulatory Changes Recommended by the College
In addition to housekeeping amendments to ensure consistent and effective regulation of pharmacy practice, another regulation change includes authorizing intern technicians to administer Schedule 3 vaccines.
How You Can Provide Your Input
You are invited to provide feedback by November 24, 2025, at 4 p.m. Before providing feedback, you are encouraged to review the proposed regulatory amendments to Ontario Regulation 256/24 of the Pharmacy Act. A clause-by-clause comparison of the draft regulations is available here.
When reviewing and commenting on the proposed regulation changes and list of tests as outlined above, please also consider and provide feedback on how these changes can be implemented effectively and in accordance with the practice, operational and ethical standards of the profession that promote the delivery of safe, quality and ethical care to patients.
The feedback we receive is published publicly in accordance with our Posting Guidelines.
Next Steps
The input from this consultation will help inform any potential changes to the proposed regulatory amendments prior to submission to the Board for approval in December 2025, and subsequently to the Minister of Health.
Final government approval and confirmation of an implementation date is needed prior to these changes coming into effect.
Helpful Links
- Draft regulations
- Clause-by-clause comparison of the draft regulations
- Ministry of Health September 2024 Consultation: Consultation on proposed changes to advance the pharmacy sector in Ontario
- Posting guidelines and consultation process
- Expanding scope of practice webpage, including FAQs
Ressources Françaises
- Consultation publique sur l’élargissement du champ d’activité
- Modifications proposées au Règlement de l’Ontario 256/24, pris en vertu de la Loi de 1991 sur les pharmaciens
- Comparaison de chaque disposition dans les modifications proposées
Read The Feedback
Thank you for the opportunity to provide feedback regarding the expansion of pharmacy scope of practice. Lambton Public Health’s feedback includes the need for OCP Regulatory oversight for minimum IPAC standards for Pharmacy setting administration of these vaccines and privacy considerations (i.e., private rooms). Thank you for your consideration.
This response was submitted by Adult Vaccine Alliance. Read the full submission here.
This response was submitted by Health Canada. Read the full submission here.
This response was submitted by McKesson. Read the full submission here.
This response was submitted by GSK. Read the full submission here.
This response was submitted by OCFP. Read the full submission here.
This response was submitted by CPhA. Read the full submission here.
This response was submitted by National Institute on Ageing. Read the full submission here.
This response was submitted by CareRx. Read the full submission here.
Public Consultation on Expanded Scope of Practice November 24, 2025 Executive Summary Merck Canada is pleased to provide input regarding the proposed regulatory amendments to expand the scope of practice for pharmacy professionals in Ontario. This support stems from Merck’s more than 130-year history of developing important medicines, our dedication to advancing public health through innovative vaccines and our commitment to helping ensure equitable access to evidence-based preventive care for all Ontarians. Merck Canada strongly supports enabling pharmacy technicians to administer all Schedule 3 vaccines. This change could help enhance patient access to immunizations, particularly for rural and remote communities where healthcare access can be limited. Expanding pharmacy technician vaccine administration could help improve convenience, increase vaccination rates by removing barriers, and optimize health care resources by enabling pharmacists to focus on more complex patient care activities. This expansion can be particularly important for improving pneumococcal vaccination rates among Ontarians aged 65 and older. Canadian adults aged 65 and older currently exhibit low vaccination coverage (54.7%) and have not achieved the Public Health Agency of Canada’s 80% vaccination target.1 Greater accessibility through pharmacy technicians may help close this important gap. We recommend implementing robust safeguards, including standardized training and certification, comprehensive documentation systems, cold chain compliance monitoring, and regular regulatory audits. Merck Canada also supports enabling pharmacists to provide additional routinely recommended vaccines beyond those currently listed in Schedule 3. Removing regulatory barriers to vaccine prescribing and administration can contribute to improving patient access and support Ontario’s mandate to enhance publicly funded vaccine uptake. We encourage consideration of a future state where pharmacy professionals can prescribe vaccines. The proposed scope expansions represent important steps toward optimizing pharmacy professionals’ expertise and improving patient access to preventive care services. Merck Canada has intentionally focused our comments on vaccine-related scope expansions that align with our areas of specialization. We commend the Ontario College of Pharmacists (OCP) and Ministry of Health for these forward-thinking regulatory changes. Overview As a leading biopharmaceutical company with over 130 years of commitment to the development of important medicines and to advancing public health through vaccine innovation, Merck Canada strongly supports the Ontario College of Pharmacists’ proposed regulatory amendments to expand scope of practice for pharmacy professionals. Our vaccine portfolio includes key products for the prevention of pneumococcal disease; human papillomavirus (HPV) infection; measles, mumps, rubella (MMR); varicella hepatitis A and B; and rotavirus infection—representing significant public health priorities in Ontario. This expertise positions us to understand both the clinical imperatives and practical implementation challenges of expanded immunization access. With over 4,900 community pharmacies serving as accessible healthcare touchpoints across Ontario, expanding both pharmacists’ prescribing and administration authority for vaccines would help significantly strengthen the province’s immunization capacity.2 Prescribing authority enables pharmacists to assess patient eligibility and issue the vaccine directly, eliminating the need for a separate prescriber visit. Administration authority allows them to then deliver the vaccine in the pharmacy setting, improving access and continuity of care. Together, these capabilities can contribute to a seamless, end-to-end vaccination experience that increases access and uptake. Expanding pharmacy technicians’ authority to administer vaccines can further enhance system efficiency—freeing up pharmacists to focus on patient assessment, education, and other clinical services—helping create a true force multiplier effect for public health interventions across Ontario.3 All of these measures together are critical as Ontario faces persistent challenges in achieving national immunization targets and addressing health equity gaps in underserved communities. Ontario’s Persistent Immunization Coverage Gaps Despite Ontario’s robust public health infrastructure, significant immunization coverage gaps persist. In Canada, pneumococcal vaccination coverage among adults aged 65 and older remains below the Public Health Agency of Canada’s (PHAC) 80% target1, despite approximately 3,000 cases of invasive pneumococcal disease reported annually in Canada.4 Herpes zoster vaccination uptake among adults aged 50 years and older could be improved, considering that nearly one in three Canadians are developing shingles in their lifetime.1,5 These coverage gaps disproportionately affect vulnerable populations. Rural and northern communities face geographic barriers, with approximately 13% of Ontario’s population residing in rural areas in 2021, where community pharmacies may serve as the most accessible6—or only—local healthcare touchpoint. Ontario’s 2.6 million residents aged 65 and older (2021)7 may face mobility limitations and transportation challenges, and the 2.6 million Ontarians living with disabilities8 may encounter some access barriers. For these populations, pharmacy-based vaccination can help remove certain access barriers that traditional healthcare settings cannot address. Strategic Value of Pharmacy Technician Vaccine Administration Authorizing pharmacy technicians to administer all Schedule 3 vaccines represents a form of workforce optimization that could yield immediate access benefits without requiring any new infrastructure investment. Ontario pharmacy technicians are regulated healthcare professionals with standardized education, trained to maintain patient safety at levels comparable to other healthcare providers. Pharmacy technicians are well-versed in technical procedures that demand precision, patient interaction, and strict protocol adherence. The practical impact of this scope of practice change would likely be significant. During peak vaccination periods when there is significant demand for vaccines such as influenza, Respiratory Syncytial Virus (RSV), and pneumococcal vaccines, pharmacy technician capacity can be critical for managing patient flow. This expansion can allow pharmacists to focus on other assessments and medication management requiring their specific expertise, while pharmacy technicians handle vaccine administration, representing a best practice in healthcare human resource management. Expanding Pharmacist Vaccine Authority: A Strategic Approach While pharmacy technician authorization can address immediate capacity needs, Merck Canada also encourages the adoption of a more strategic, forward-looking approach to increase vaccination uptake, reduce pressures on the primary care system, and remove certain barriers that may prevent individuals from accessing vaccinations within their communities. While pharmacists are authorized to administer Schedule 3 vaccines, they are not permitted to prescribe them. As a result, patients can often begin the process at a pharmacy but are redirected elsewhere for a prescription. This creates unnecessary delays and barriers to timely vaccination. This restriction can impact uptake and causes patients inconvenience, especially when products are covered by workplace or private insurance, but only when accompanied by a prescription. Patients beginning at the pharmacy to get vaccinated and then being redirected elsewhere for a prescription prolong the process and delay access. By contrast, provinces such as Alberta and Quebec enable pharmacists to prescribe vaccines directly9, allowing immediate access for patients with private coverage without requiring a physician visit, which can significantly reduce red tape. Granting pharmacists prescriptive authority – the ability to assess and issue prescriptions – would enable more patients to access vaccines directly through pharmacies. This approach leverages existing private insurance coverage for vaccines and pharmacy services, potentially expanding access with minimal budget implications for the provincial government. The current framework, which lists specific vaccines, can also lead to delays. This means that even when new vaccines are approved by Health Canada, they cannot be administered immediately to eligible patients, despite the availability of similar products. Principle-Based Framework for Prescribing and Administering Vaccines Several Canadian provinces have adopted principles-based frameworks that authorize pharmacists to prescribe and administer vaccines based on clinical appropriateness rather than specific product lists. For instance, Alberta’s Additional Prescribing Authorization (APA) permits broad prescribing authority, allowing qualified pharmacists to independently prescribe for many conditions based on their expertise.10 More recently, British Columbia has successfully implemented its Minor Ailments and Contraception Service (MACS),11 which authorizes pharmacists to prescribe for a specific list of conditions and associated medications. Merck Canada recommends that Ontario adopt a principles-based approach whereby pharmacists may prescribe and administer any Health Canada-approved vaccine for which they possess appropriate training and clinical competence. This applies to both publicly funded vaccines and those covered by private insurance. We believe that granting prescriptive authority is an excellent example of red tape reduction that should be tackled as soon as possible. This could maintain patient safety through professional accountability while removing regulatory barriers that might impede timely access and unnecessarily burden primary care providers. Implementation and Quality Considerations Scope expansion requires robust quality and safety safeguards. Standardized training for pharmacy technicians should address vaccine-specific knowledge, injection technique, adverse event recognition and management, patient counselling, and documentation requirements. The College should collaborate with pharmacy associations, educational institutions, and industry partners to develop comprehensive training programs to ensure provincial consistency. Economic and System Benefits Beyond direct health benefits, scope expansion may offer significant economic advantages. Vaccine-preventable diseases can impose substantial healthcare costs through hospitalizations, emergency visits, and lost productivity.12 Community pharmacies can help absorb demand that would otherwise fall to physician offices and hospitals, and the accessibility of pharmacy-based access can lead to higher vaccination rates and reduced disease burden. This may reduce acute care costs and help support long-term complication management. The COVID-19 pandemic illustrated the value of distributed vaccination capacity. This capacity—expanded through pharmacy technician authorization and enhanced pharmacist authority— is a necessity for future public health emergencies or seasonal campaigns. Conclusion and Recommendations The proposed regulatory amendments represent a strategic opportunity to help optimize pharmacy scope, improve preventive care access, address immunization gaps, and strengthen public health infrastructure. The case for pharmacist prescriptive authority is particularly compelling. Consider a patient who needs a vaccine for the prevention of a specific type of infection: this patient should not have to seek a prescription from a primary care provider to have the cost of the vaccine covered by their workplace or private insurance benefit plan. Currently, to access private insurance coverage, a patient must first seek out a prescription before returning to the pharmacy for vaccine dispensing and administration services. By eliminating barriers to vaccine administration, such as the need to obtain a separate prescription or seek administration services elsewhere, Ontario could avoid missed vaccination opportunities and help improve the overall patient journey. This can be particularly crucial in rural and remote areas where access to primary care providers may be more limited. Requiring a prescription from a physician can also be burdensome due to appointment delays and the shortage of family physicians. By empowering pharmacists with prescribing authority for vaccines, the province can eliminate this barrier and ensure that Ontarians have access to essential vaccinations by expanding options to obtain vaccines from community pharmacies. Allowing pharmacists to write prescriptions for vaccines would align Ontario with leading provinces, help reduce delays, and contribute to closing some of the coverage gaps. Ontario’s current restrictions leave it a laggard relative to peers which can impact timely, convenient vaccine access. Merck Canada recommends: ● Proceed expeditiously with pharmacy technician authorization for all Schedule 3 vaccines with robust training and quality safeguards. ● Immediately tackle prescriptive authority as a red tape reduction priority by adopting a principles-based framework for pharmacist vaccine prescribing and administration authority that covers both publicly funded vaccines and those accessed through workplace and private insurance, allowing for clinical judgment and response to emerging needs. ● Implement comprehensive training through collaboration between the College, associations, educational institutions, and industry. Merck Canada offers our expertise in vaccine research, clinical evidence, safety monitoring, and program implementation to support a successful rollout. Our commitment to Ontario’s public health extends beyond commercial interests. Merck is committed to equitable access to evidence-based preventive care as fundamental to a resilient healthcare system. These amendments align with best practices in healthcare workforce optimization and patient-centered care delivery, positioning Ontario as a leader in pharmacy scope of practice. We thank the College for this consultation opportunity and remain committed to supporting the successful implementation of these regulations. References 1. Government of Canada. Adult National Immunization Coverage Survey (aNICS): 2023 results. Available here 2. NAPRA: Statistics of Pharmacists, Pharmacy Technicians and Pharmacies in Canada. 2025. Available here. 3. Pharmacy Technicians in Immunization Services: Mapping Roles and Responsibilities Through a Scoping Review. 2025. Available here. 4. Government of Canada. Invasive Pneumococcal Disease. Public Health Agency of Canada. Available here 5. Government of Canada. Herpes zoster (shingles) vaccine: Canadian Immunization Guide. Public Health Agency of Canada. Available here 6. Statistics Canada. Canada’s rural population 2016 – 2021. Available here 7. Statistics Canada. Ontario population by age group. 2021 Census. Available here 8. Government of Ontario. Accessibility for Ontarians with Disabilities Act Annual Report 2019. Available here 9. Canadian Pharmacists Association. Pharmacists’ Scope of Practice in Canada. Last Updated February, 2025. Available here 10. Alberta College of Pharmacy. Additional Prescribing Authorization. Available here 11. BC College of Pharmacists. Minor Ailments and Contraception Service. Available here 12. Realizing the Future of Vaccination for Public Health. Chief Public Health Office of Canada’s Report on the State of Public Health in Canada 2024. Available here
Expanding scopes is so WRONG for so many reasons. Do the right thing. Reject the proposal. Those who claim so, need to stop saying that ACCESS will be improved. It is foolish thinking. If it really were the case, then government should just allow all medical products to be available over the counter, for use at the discretion of each human being. That would not be any more dangerous than accepting the proposal. Do you realize how many pharmacies require appointments? Do you realize how many patients are waiting too long to pick up medication? There are plenty of doctors who wish they can work, but the faulty system is making them drop out. Have you asked any Doctor who gave up their licence or considering to, since 2023 if any part of their decision or contemplation derived from increased messages from pharmacists, into their computer inbox? You are worsening a specific problem that has been presented to government in recent years as a major reason for making the jobs of the ‘Family Doctor’ unsustainable. What a shame to lose such valuable brains and hands needed to save our loved ones. What a shame that each health profession is not being recognized and respected for what it traditionally has represented. It is my firmly held belief that if Canada does not stop letting people move to Canada and Ontario, then the ratio of residents to services and resources will remain overwhelmed. I would think that it will be impossible to pay practitioners properly, but yet how come so much money is being dumped into pharmacy? I urge you to remove the MedsCheck billing by pharmacies promptly. What a waste of money spent by government, in my opinion. When you couple that with the provincial health plan not decently paying most primary/front-line/’Family Doctors’ for so many services or procedures, such as the ones which having approximate $2, $3, $4, $5 or not paying for encounters at all, sometimes, with no secure way for the practitioner to tell at the moment of check-in, then of course one would lose motivation, feel undervalued, cheated, and consumed, leading them to seek work in other areas. What a waste of trained Family Doctors. The specialty trained ‘Family Doctor’ is the person you would find working in traditional settings, walk-in, focused primary care practice, sports medicine, Emergency Room doctor and any other field of medicine not requiring a referral. They are too valuable for the government to seemingly ignore. Collaborate with them; They will help to improve our system. You can’t force them to work for free or almost free. They are not existent being who should be battered mentally and emotionally. Public members need to be made aware and Doctors need to do a better job convincing. I think that the same situation of lost pleasure in work and incapacity to perform coupled with outright refusal to work in a rushed unjust environment with undesired service to the patient, shall too occur to pharmacists. The government officials must not get pressured by organizations, people, companies/stakeholders, however is mot appropriate to refer to them. What a conflict of interest for some of these to be submitting recommendations if or whenever they may do so, when/if what they stand to gain is money. ‘Minor Ailments’ are not as minor as you may think. Even the most highly educated, trained, skilled, experienced expert specialist doctors can find making the diagnosis difficult at times. That is why tests exist and even then the result must be interpreted by a higher level critically thinking mind, to make sense out of the clinical presentation. If what one needs is chemotherapy, you should not give bubble gum as the treatment. If patients are needing Doctors, they should not go to pharmacists. Urine, fungus, lice, yeast, bacteria, streptococcus – in pharmacies ? How awfully wrong this is. Who is advocating for what is the right thing to do for the sick people of Ontario? Ontario- what a tremendously scary place to become sick, it has become.
This response was submitted by Roche Diagnostics. Read the full submission here.
This response was submitted by Ottawa Public Health. Read the full submission here.
This response was submitted by OPA. Read the full submission here.
This response was submitted by Neighbourhood Pharmacy Association of Canada. Read the full submission here.
This response was submitted by CSHP. Read the full submission here.
To: Ontario College of Pharmacists 483 Huron Street Toronto, ON M5R 2R4 From: Adult Vaccine Alliance Date: November 24, 2025 SUBJECT: Letter of Support for Proposed Regulatory Amendments to Ontario Regulation 256/24 of the Pharmacy Act Dear Ontario College of Pharmacists, On behalf of the Adult Vaccine Alliance (AVA), a national coalition of leading public health and vaccine experts, health care providers, patient groups, researchers and industry partners, I am writing to express our full support for the Ontario College of Pharmacists’ proposed regulatory amendments to expand the scope of practice for pharmacists and pharmacy technicians related to vaccination. AVA is committed to improving adult immunization rates and strengthening equitable access to vaccines across Canada, and we recognize the significant role that Ontario pharmacy professionals play in advancing public health. The proposed scope expansions related to authorizing pharmacists to administer additional vaccines and authorizing pharmacy technicians to administer all Schedule 3 vaccines under Ontario Regulation 256/24 – represent an important and evidence-based step toward improving healthcare access in Ontario. These changes do not introduce new or untested responsibilities; rather, they build on the demonstrated expertise, accessibility, and success of pharmacy professionals who already deliver a substantial proportion of vaccinations in the province. The COVID-19 pandemic demonstrated how essential pharmacists are in ensuring timely, convenient access to immunization. Pharmacies offer extended hours, walk-in options, and culturally responsive care that has reduced barriers for millions of Ontarians. Expanding pharmacists’ ability to deliver a broader range of vaccines will meaningfully improve uptake, particularly for those who lack a regular primary-care provider or face challenges securing timely appointments in other settings. This is especially crucial in rural, remote, and underserved communities in Ontario, where pharmacists are often the most accessible health-care professionals. Enabling pharmacy technicians to administer all Schedule 3 vaccines will increase workforce capacity, reduce bottlenecks in clinic operations, allow pharmacists to dedicate more time to complex consultations and priorities, and create more patient-centred pathways that ultimately support immunization efforts by minimizing missed opportunities for patients who are ready and willing to be vaccinated at a pharmacy. These amendments to expand pharmacy scope will improve population health outcomes, strengthen system resilience, and enhance Ontario’s capacity to deliver routine, seasonal, and outbreak-related vaccination programs. Findings from AVA’s recent return-on-investment (ROI) analysis further illustrate this value. Improved access to adult vaccines: yields substantial economic benefits through reduced hospitalizations, decreased productivity losses, and avoided strain on an already overburdened health system. Empowering pharmacists and pharmacy technicians is one of the most effective mechanisms to achieve these gains. AVA fully supports the development and implementation of a comprehensive immunization registry as a valuable tool for Ontario’s healthcare system. However, progress on scope of practice expansion must not be contingent upon this. Vaccination providers across all professions and settings currently practice without access to a comprehensive registry. Delaying improvements to vaccine access because of an infrastructure gap that affects the entire health care system would undermine public health protection. Importantly, the risk of vaccinating an individual without a full documented history is low and is far outweighed by the population-level benefits of improving immunization coverage. We recommend that the College proceed with the amendment while supporting continued action to accelerate registry implementation, ensuring pharmacy professionals are included in the planning of registry integration. We also note that successful implementation of expanded vaccine access through pharmacies will depend on appropriate training, infrastructure, staffing, data capture and communication strategies. AVA stands ready to support the College in outreach, education and public-awareness initiatives to ensure that expanded scope translates into improved access, equity and outcomes. The Adult Vaccine Alliance fully supports the proposed regulatory changes and urges their timely adoption. We appreciate the College’s leadership in advancing this important work and stand ready to support high-quality, safe and equitable implementation for the benefit of all Ontarians through education, advocacy and collaborative partnerships. Thank you for the opportunity to provide input. Should you require any further information or wish to discuss these recommendations in more detail, we would be pleased to contribute. Sincerely, Shelita Dattani, PharmD, RPh Executive Member, AVA
Stop the scope of practice expansion proposal now ! This most recent additional list of ‘minor ailments’ passed in Oct 2013, in addition to the currently proposed, has turned our health system crisis into a CATASTROPHE. I highly disagree with these outrageous suggestions that ‘minor medical conditions’ be billable to OHIP by pharmacies/ pharmacists. It seems that our government will be unnecessarily OVER SPENDING and taking us further away from the proper solution. I wonder- would it subsequently force raised taxes? Patients already are seeing both a Doctor and a pharmacist on the same day, thus, double the payout by the Ministry !? Pharmacists already get to bill for services that doctors do but doctors don’t get OHIP billing codes for ( in other words they don’t get paid for). How much more money is this going to cost Ontarians? Contrary to what was suggested as decisions for selection for ‘minor ailments’, I believe one could argue that the majority are: • NOT a short-term condition • needing ordered tests & Lab results • high risk of treatment masking underlying conditions • conditions that NO algorithm and no pharmacist can be expected to recognize as red flags that could suggest a more serious condition • recurrent, or just one manifestation of a chronic disease and for which follow-up is required Letting patients be served for anything other than a DISPENSED drug is making matters worse by patient records being scattered in too many locations. Don’t you think for a minute that pharmacists will be protected by faxing off the encounter note to the patient’s Family doctor. For all those patients who get taken care of at a walk-in clinic, you must not bombard their inbox either, firstly because that patient is not attached to any particular doctor and secondly that patient could have seen many different doctors from the same clinic. Patients should be encouraged to request their visit notes/ record from pharmacies, for services allowed to date and ongoing. I further advise that the government audit pharmacy practices to date collaborating with doctors to see where there has been benefit vs harm. Don’t you think that would be a caring, curious, responsible thing to do- to be held accountable to what I am sad to say i believe to be sloppy decision making ( although the intention may not have been so )? What entered my mind has been wonders about whether decisions were made carelessly, without proper thought, planning, or attention to detail OR was money into bank accounts for some the main driver? Nowhere in this proposal does my brain process the benefit to the patient!!! This is based on my knowledge and experience, contributing to my perspective as a patient. Government, if you don’t put an abrupt end to pharmacists trying to prescribe, you might likely be recalled as having contributed to destruction of our once upon a time descent system, in my conviction. Already with the growing adoption of prescribing by pharmacists, we will never again see calm pleasant helpful pharmacists. With the current proposal, if passed, I think we would see chatic and congested pharmacies, consumed pharmacists plus improperly managed patients, suffering, at the mercy of whoever shall be the Ministry’s decision maker/s. This is a game being played by perhaps one too many. By that, i mean it does not seem to be taken as seriously as it should be. This is what I recall witnessing at the pharmacy: A pharmacist reading from an algorithm of bladder synptoms complaint, a series of questions. When the patient answered “YES” to ” Discomfort?” and “YES” to increased frequency?”, the pharmacist attempted to scroll down the series of questions, but the patient volunteered ” I am running to the toilet ( urgency ) and it is very itchy”. Then, the pharmacist said ” I can’t check off more than two because then I would have to tell you to see a doctor”. He proceeded down the computer list of questions and comments, only to arrive at ” Is there any particular ANTIBIOTIC you prefer?” This highlights firstly that conflict of interest exists- pharmacist was eager to prescribe. Secondly, with $ income being at stake, much more unethical behaviour can be anticipated to recur, whether that be by the same pharmacist or by numerous others. Lastly, it reminds me of the adage “When all you have is a hammer, everything looks like a nail”. Meaning, in this case, that the pharmacist, not being a doctor, probably was not knowledgeable enough to formulate a differential diagnosis to consider a yeast infection! That patient had finished a round of antibiotic the week prior ( another clue ). To the college of pharmacists, Why would you want to be faced with college complaints which will without a doubt in my mind increase as time progresses due to all the medical-legal risks accumulated from all the tasks you want to see be added to the pharmacist’s allowances/ Act? To the Ministry, For the greater good of people in Ontario and pharmacists begging to stop complicating their jobs, REJECT this proposal in it’s entirety.
Ontario’s healthcare system is evolving, and the expanded scope of practice review provides an opportunity to ensure our regulations keep pace. Schedule 1 has not been updated for some time, leaving out critical therapies such as inclisiran and other injectables approved by Health Canada. This update is not just about convenience—it is about aligning policy with evidence-based care and optimizing the healthcare workforce by supporting integrated care delivery by pharmacists and reducing strain on physician services. I urge the Ministry to prioritize this change.
It is extra duty, risk @ less than what they pay for MD and zero benefits for pharmacist.
Many postings make the statement that pharmacists are alleviating the burden on the health care system. Reminder: We ARE part of the health care system. And who alleviates the burden on us? Let’s just keep piling it on – more responsibility, more stress from demanding ‘patients’ in unsupported work environments. After all, we are perceived as accessible and quick. Why is that? Could it be corporate ads ‘promoting’ pharmacists and flu shots, minor ailment prescriptions ‘on the spot’, or could it be the TV news stories featuring a non-pharmacist CEO of a voluntary association ‘promoting’ the virtues of the expanded scope of practice of a pharmacist? Throat swabbing and toe-nail clipping collection are, for one, disgusting and two, not appropriate in a retail pharmacy setting. Stop trying to make us into cheap health care providers. And need we also be reminded that pharmacists worked throughout the COVID-19 pandemic, while many primary care physicians and nurse practitioners scattered. Who supported us then? Who is supporting us now?
It’s fine to expand scope of practice for pharmacists : if there will be peoper and paid training ( we are not doctors and we have limited experience to diagnose), if we get direct reimbursement for each minor ailment assessment or special service, if we get more than one staff pharmacist per shift to be able to perform all these tasks(dispensing, checking interactions, counselling, injections, medchecks, minor ailments, otc counselling, doing tests). If those conditions are met, then it’s great we are more than happy to help the public, but if not, then I disagree with adding more stress to the pharmacist. Pharmacists are burnout already since covid without recognition and the stress is increasing now. That would lead to mental breakdown and making mistakes that put patients life at risk.
It’s a great idea and I’ve helped so many patients that don’t have to physicians in timely manner – when I don’t feel confident I ref flag and refer out, great system and I trust myself and pharmacists a lot.
Acupuncturists treating infertility and pregnancy issues; Chiropractors claiming that back manipulation will prevent or mitigate COVID (in the early days of the pandemic); homeopaths using the title ‘Dr.’; physiotherapist treating rosacea ( a skin disease) with a device ‘…blessed by the Pope’. These are true blatant abuses of Scope of Practice that I have seen. Scope of practice is vital to proper patient care and granting an expanded scope is wrong headed if the RHP practitioners are not properly trained, and a module isn’t going to suffice. If I am a dermatologist, I suppose by law I could deliver a baby, but doing so is not in my scope of practice. RHP colleges have a duty to protect the public from their members taking on issues for which they are not trained. Once, the head of the nurses association wrote a letter, published in the Star, that they could help with simple things like ‘skin rashes’. Ya, right. Let me offer some points proving that pharmacists cannot and should not be treating the following: Do they know how to differentiate nits from pseudo-nits? Do they know that the recommendations on the product monographs are widely viewed as incorrect in that a contact time of 15 minutes is inadequate to cure pediculosis? ‘Corns and calluses’-do they know that the terms are synonymous and not two different issues? The most effective treatment of these is paring which I do with a razor blade in the office. Wearing appropriate footwear is next important. Softening with Vaseline is third. Salicylic acid topicals are way down the list of best treatments. Tinea corporis-I recently had a case of a young woman whose rheumatologist diagnosed her body rash as tinea corporis and it was in fact cutaneous T cell lymphoma. Other mimickers are psoriasis, eczema, drug eruption. Verrucae-until March 31, 1998, OHIP considered the treatment of warts a medical condition, and it was covered. On April 1, 1998, as the clock struck 12, warts became ‘Cosmetic: not medically necessary’. Then OHIP declared that plantar warts; genital warts; head and neck warts of children under 16 and warts in immunocompromised patients were covered. All other warts are NOT covered! Will pharmacists be paid to offer treatment of non covered warts and still bill OHIP? If so, they will be paid to treat something that doctors treat and not paid by OHIP. Liquid nitrogen is the treatment of choice followed by cantharone. Salicylic acid solutions are way down the list in efficiency. The topical sprays available in pharmacies are useless. Onychomychosis-the biggest complaint that dermatologists have with family doctors is their inappropriate treatment of toenail issues. Best practice dictates that a culture be taken and treatment NOT commenced until a fungus is confirmed by CULTURE and NOT by the presence of ‘filaments’. If pharmacists are allowed to take cultures, patients will have to return in 4-5 weeks to learn the results and start treatment. What if the cultures grow fusarium of other saprophytes-what is the pharmacist going to do then? If they don’t wait for culture results, or don’t take one, they will join the parade of family doctors who prescribe Jublia inappropriately. Most toenail issues are NOT fungal but traumatic or ageing in nature. Patients should NOT take their own culture; this should be done by the physician. We have countless patients who have used Jublia for months with no response, because the diagnosis is WRONG. Culture then cannot be taken until the patient has been off the Jublia for 3-6 months. The sales of Jublia, a relatively ineffective topical with about 10-20% fungal cure rate, is expensive, time consuming and requires 42 weeks of treatment. Tinea cruris-does the pharmacist know how to differentiate this from psoriasis. I certainly don’t in all cases and must take samples for culture. Differential is large and includes extramammary Paget’s disease (a form of cancer); inverse psoriasis; even a form of cutaneous Crohn disease. Do they know that a diagnosis of T cruris should be followed by foot exam to see if T pedis is present? It’s WRONG, WRONG WRONG to expand their scope to include these ‘simple rashes’.
I am writing to provide feedback during the expanded scope of practice review. Ontario’s Schedule 1 list of injectable drugs has not been updated since October 2024, and it is critical that it reflects current clinical practice. I strongly recommend adding inclisiran and other injectable therapies approved by Health Canada since the last update. Their absence from Schedule 1 prevents us from administering it, creating unnecessary barriers to care. Updating the Schedule 1 will align regulations with Health Canada approvals, empower us pharmacists to deliver safe, effective care and improve patient access and adherence. Thank you for considering this important update.
I agree with expanding the scope to the 49 minor ailments across Canada, but before lifting the stree from healthcare system due to shortage OCP should lift the pressure and roadblocks against licensing the international graduated pharmacists finished the bridging program with jurisprudence and pace exams and sticker with the unsolvable federal pebc mcq exams to override this roadblock and licensing then based on the successful completion of the bridging program of university of Toronto
Yes, IF you could justify why owner pharmacists could bill OHIP directly and retail pharmacist does it for free for the same service provided . ABSOLUTELY NO! Whom ever comes up with these brilliant ideas definitely profits from them, likely owner pharmacists, or big corporates to take advantage of their employees and pressure them even more for easy free profit. Aren’t retail pharmacists burned out as is? Between dealing with the dispensary, vaccinations, minor ailments, and MedChecks…. let’s add even more. … why not … there is no OBJECTION. What about the impact of increased corporate pressure by do more…. do more … reach target …..on quality of pt care considering the time restraint? Just compare the income that has been brought to businesses by these professional services and the pharmacist salary this feels like slavery. More professional services , added responsibilities, huge liability, and no reimbursement. … UNBELIEVABLE Aren’t our human rights being violated here?
Even with “proper” training, an online module does not replace medical school. The minor ailment module education for the last set of conditions was a joke and not sufficient. STop trying to make pharmacists into cheaper doctors.
Pfizer Canada Statement of Support: Proposed Expansion of Pharmacy Scope for Vaccine Administration in Ontario Pfizer strongly supports the Ontario College of Pharmacists’ (OCP) proposed regulatory changes to: • Enable pharmacists to provide additional routinely administered vaccines not currently listed in Schedule 3, • Enable pharmacy technicians to administer all Schedule 3 vaccines, • Authorize intern technicians to administer Schedule 3 vaccines. • In order to improve patient access to vaccines Pfizer encourages the OCP to look beyond the current suggested expansion and amplify support for Ontario pharmacists authorization to prescribe all vaccines Rationale for Support 1. Improved Vaccination Rates and Public Health Outcomes Streamlining vaccine access through pharmacies will likely increase vaccination rates by reducing missed opportunities. Pharmacies are highly accessible, and allowing direct administration of all recommended vaccines will help protect more Ontarians from vaccine-preventable diseases. This aligns with public health goals and supports Ontario Health’s mandate to improve vaccine uptake. 2. Enhanced Convenience and Timeliness Pharmacies offer extended hours and are often located in communities underserved by other healthcare providers. Allowing pharmacists and technicians to administer a broader range of vaccines means patients can receive timely immunizations, including during outbreaks or for last-minute travel needs, without unnecessary delays or multiple appointments. 3. Efficient Use of Healthcare Resources Expanding pharmacy scope optimizes healthcare delivery by leveraging pharmacists’ expertise and accessibility. This reduces the burden on primary care providers, allowing them to focus on complex cases, and supports a more efficient allocation of healthcare resources. 4. Strengthening Preventive Care and Patient Experience Pharmacists are trusted healthcare professionals who can provide education, counseling, and preventive care. Expanding their role fosters integrated care, improves patient experience, and encourages holistic health discussions. This is particularly impactful for adult immunizations, where coverage rates remain far below national targets. 5. Safety and Quality Assurance Pharmacists and pharmacy technicians in Ontario receive rigorous training in vaccine administration, including injection technique, adverse event recognition, and reporting. With appropriate oversight and ongoing education, the proposed changes can be implemented safely, maintaining high standards of public protection. 6. Eliminating Barriers to Vaccine Access Pfizer also supports expanding pharmacists’ scope of practice to administer any vaccine, both publicly funded and private payer, and to grant Ontario pharmacists prescriptive authority for all vaccines. A patient needing a recommended but non-publicly funded vaccine should not have to seek a prescription from a primary care provider to have the cost covered by their private insurance. Removing barriers such as separate prescriptions or seeking administration services elsewhere can prevent missed vaccination opportunities and enhance the patient journey, especially in rural and remote areas with limited access to primary care providers. Empowering pharmacists with prescribing authority can reduce appointment delays and alleviate the burden caused by the shortage of family physicians. Addressing private insurance coverage issues and expanding pharmacy services to include additional vaccines could positively impact immunization rates for Ontarians. Pfizer believes these regulatory changes will significantly enhance vaccine access, improve public health outcomes, and support a more resilient healthcare system in Ontario. We urge the OCP and Ministry to move forward with these amendments and consider even broader vaccine access while ensuring robust implementation and ongoing quality monitoring. We encourage all stakeholders to participate in this consultation and support these changes.
I fully support the expanded scope which will in turn take a lot of pressure off the healthcare system and increase patients access to help. Having said that, training and courses should be provided to guide us through the process to ensure clinical readiness and reduce errors and patients harm. Thanks
As a Dermatologist, I am very concerned about pharmacists properly diagnosing such a high number of skin conditions. Pharmacists are not trained and to perform a proper Dermatologic physical exam. They never learned a proper differential diagnosis for these skin conditions. For example, scaling on the scalp is not automatically seborrheic dermatitis (dandruff) — it can be a number of other conditions including eczema and psoriasis that physicians such as GPs or Dermatologists can diagnose and treat properly. I also cannot imagine a patient undressing in a pharmacy to show off their toenails looking for onychomycosis or their groin to diagnose a jock itch (tinea cruris). Most pharmacies do not have the facilities to offer patients adequate rooms with privacy and proper lighting to perform an examination. Pharmacists also cannot perform any testing to confirm suspected conditions (ex. performing a nail fungal clipping to see if fungus can be isolated in the lab), performing a skin biopsy to confirm the cause of a scaly rash. They also cannot offer the mainstay procedural treatments (ex. liquid nitrogen or cryotherapy for warts). Expanding the scope of pharmacists to diagnose skin conditions is not helping the greater good of the public. It will increase the revenue for pharmacists and be of limited benefit to patients by providing substandard care.
As a pharmacist with a large porportion of my practice as international students, I have seen that a large number of medications for minor ailments are available without prescription in other countries. If the government truly wants to reduce the burden on the health care system as a whole (let’s include the pharmacists) and have cost savings, reduce the regulatory burden on treatments. Make commonly used medications like Jublia and macrobid over the counter if all its needs is a checklist, patients are educated enough to use them. Some PPIs and fluconazole are already over the counter. And seriously – corns? Do you really want me to bill everytime I help somebody select plantar vs regular corn pads? as if I have time for that! Work with insurance companies to reimburse cetrizine 10 mg instead of making us cut it in half so they can get it on prescription and put the 20 mg OTC. Fluconazole is OTC yet I have to change it to 3 tabs x 50 so people can get it over the counter and they still see the doctor to get it on prescription so its covered, same as Dukoral. For once, lets not shift the burden from physicians to pharmacists like before but actually reduce the burden! Let pharmacists focus on their intended job instead of minor things too.
The last implementation of MA was only in 2023. Much Ontario evidence is model-based or early program data rather than long-term, controlled real-world outcome studies. That means estimated savings depend on assumptions (e.g., what fraction of pharmacy visits replace physician/ED visits). Ontario still needs ongoing real-world evaluations to quantify the true magnitude of the effect and confirm sustained system-level savings. This is all hypothetical based on program billing, which others have pointed out, could be flawed. I would urge OCP and the government to use evidence based money instead of just looking at cost savings and convenience. Of course, patients would rather walk right in immediately for an assessment and of course its cheaper to pay a pharmacy a mere $19 that a physician would be OHIP $75, but is there any evidence that care is equivalent and actually reduces the burden or does it just make it more convenient?
I don’t think it is up to pharmacists and Ontario College of Pharmacists to reduce the burden on family physicians. Let OMA take care of that. The family physicians seem well equipped to manage their own practices – I have seen many “let go” of patients they deem too complicated. Family physicians offices often close early on Wednesdays and are closed on Fridays, and all are definitely closed for an hour over lunch. Most of them rarely answer their phones. Family physicians require often 48 hours – 2 weeks notice to renew a prescription, yet pharmacists have to do it immediately. It is not the pharmacists duty to reduce the burden on family physicians. Many family physicians have reduced their staff and eliminated their nurses to save money since pharmacists do the vaccines now. Maybe we should push back and if family physicians require help they can rehire their own staff to do injections as that is within a nurses scope of practice! I find it incredibly ironic that family physicians never respond to my faxes for refills, yet when I notify them I have done a pharmacist authorized renewal (and therefore they have not cared properly for their patient and left them without meds) they sure can fax back a new prescription that same day. A 2021 study of hospital pharmacists (including in Ontario) found a burnout rate of 61.1% (using the Maslach Burnout Inventory). cjhp-online.ca +1 A qualitative + survey report by the Ontario College of Pharmacists (OCP) (“Under Stress and Duress”, 2024) found that many pharmacists feel “constant pressure … impacting their mental health … with several reporting experiences with extreme stress, depression, anxiety and exhaustion.” OCP Info According to a 2023 national survey by the Canadian Pharmacists Association (CPhA), 80% of pharmacists are “at risk of burnout.” Canadian Foundation for Pharmacy From the same CPhA-commissioned work: 1 in 3 pharmacists are considering leaving the profession, and half say inadequate staffing negatively affects their well-being. The rates of physician burnout are not even comparable! Although not Ontario-specific, the Canadian Medical Association’s (CMA) 2025 National Physician Health Survey (NPHS) provides a useful context: 46% of physicians reported high levels of burnout, down from 53% in 2021, according to preliminary data. Who should we be worried about reducing the burden on???
16% of all hospital admissions in the province are due to medication problems e.g. side effects, omission, errors, interactions. We should be focusing on these issues and fixing this problem (which pharmacists are best place to fix) rather than offering vaccine clinics. Pharmacists should be allowed to bill for service independent of pharmacies, and schedule appointments for their services. No other healthcare profession offers instant access for free or is denied a break in a 12 hour shift. We need OHIP numbers and pay per service just like all other health care providers. It is really the only way we can become independent of chains, and reduce the effect of corporate pressures. Get paid independent of the stock on the shelves so that we can fulfill our fiduciary duty.
Last year, I went for a job interview at the big chain store mentioned in the CBC article. The job would be 5 days a week, and on Saturdays working from 8 am – 10 pm (14 hours) with no break and as the only pharmacist. I was asked by the associate 3 times how many expanded scopes activities I could do in a day. There was no dedicated special pharmacist to provide expanded scope activities and I am assured by many colleagues that this is the case in many stores. I think that OCP should look to Nova Scotia and how they are ensuring proper staffing in pharmacies and ensuring labour laws are being followed by employers before adding additional tasks. Pharmacists are the only health care professionals that do not close for lunch or don’t require appointments and it is just not feasible to add more work, especially when the only financial incentives goes to the employer. How much of the $300 million was fraduently billed or not required? When I worked at the chain store just before covid we were told to prepare the medscheck before the customer walked into the store and attach to the prescription bag. Assistants were told to have the patient sign that they recieved their medication list and this was billed as a medscheck without the pharmacist even speaking to the pharmacist. I can’t help but extract to the minor ailments as to what the “assessment” would involve. Basically patients, no sorry- customers- ordering antibiotics like ordering fast food. “I get this all the time and Biaxin is the only thing that works for me”. Since January 2023, over 1 million assessments have been provided by Ontario pharmacies for the 19 minor ailments. The number of Ontario pharmacists practicing in community settings was 12,995 as of January 1, 2025. In 2023, 547,673 Ontario residents received minor ailment (MA) services from pharmacists. Do the math, with calculations excluding about half of the ontario pharmacists for those who work in hospitals or other settings, and see that these numbers can’t all be all legit minor ailments. I would love to see the breakdown of where the minor ailment assessments were conducted. If the government approves this expansion. I will be eagerly anticipating reading the CBC investigation about fradulent or pressured billings and quotas for minor ailments!
The proposed expansion of Ontario’s minor ailments program, which would authorize pharmacists to treat 14 additional conditions such as sore throats and shingles, is facing heightened scrutiny following revelations about Shoppers Drug Mart’s MedsCheck billing practices. The investigation exposing how pharmacists faced corporate pressure to meet financial targets for medication reviews has sparked fears that similar profit-driven mandates could influence the new prescribing powers. While the expansion aims to relieve pressure on the primary care system, critics and medical professionals are concerned that without strict safeguards, the “corporatization of healthcare” could lead to unnecessary assessments and treatments driven by revenue goals rather than patient necessity. https://www.cbc.ca/news/canada/toronto/shoppers-drug-mart-medscheck-billing-9.6981970#:~:text=Shoppers%20Drug%20Mart%20billed%20the,targets%20for%20the%20professional%20service. (Shoppers Drug Mart billed $81M for MedsChecks in 2 years when COVID services waned; Nov 18, 2025) https://youtu.be/xGgRdYWJjVY (Shoppers Drug Mart Accused of pressuring pharmacists; Feb 2024) This video/article is relevant because it details the investigation into corporate pressure on pharmacists to meet billing targets, providing the context for why there are concerns about expanding their billing capabilities for minor ailments. I do not support the expansion of the minor ailments program
As the scope of practice expands, it would be appropriate to review and update the Schedule 1 list of injectables to reflect current therapeutic needs. Treatments such as Leqvio are well suited to be administered in the community pharmacy environment. The dosing schedule is infrequent, the administration requirements are straightforward, and pharmacists already possess the necessary competencies and infrastructure to provide this level of care. Incorporating newer chronic-disease medications into Schedule 1 would reduce delays for patients who currently rely on limited clinic availability. It would also support broader health-system objectives by making evidence-based therapies more accessible. A revision of the injectable list at this stage would help ensure the regulatory framework keeps pace with the clinical realities pharmacists face.
I REJECT this proposal. Expanding Scopes of Practice WILL HURT patients, their families, government and allied health care professionals, in my sincerest thought. It will cost so much money with no return of benefit to the patient. Has anyone done the math to plan for the billions of dollars it will likely cost annually? Drugs alone are reported to cost billions of dollars. How much more money will it cost to pay the additional PHARMACY SERVICES’ including the proposed expanded scope of practice, including those allowed since 2023 when the first phase of minor ailments was announced or implemented? I imagine the answer is astronomical. I hope Government representatives who’s jobs concern this proposal are reading ALL the comments thoroughly, posted on the Pharmacists College website: https://ocpinfo.com/consultation/public-consultation-on-expanded-scope-of-practice/ There, it is loud and clear that there are many pharmacists begging to NOT allow minor ailment prescriptions. They are already burnt out since the authorization to prescribe for 13 ailments on January 1, 2023, and the further expanded list in October 2023. Listen to them! They are the front-line workers. They are saying ‘NO!’ to this additional proposal. I don’t want my pharmacist tired and distracted from phone calls and people approaching the counter while they are supposed to be counting my pills or putting the right medication in my containers. My opinion is to say ‘NO’ to all the minor ailment prescribing. No medical problem and NO Human Life IS MINOR! If a medical condition is deemed so be so ‘minor’ that someone who’s schooling did not train to assess, examine, order & interpret tests, diagnose & prescribe, can do it, then you might as well let all the drugs be available over the counter for patients to access at their own discretion, the same way it was revealed to the public that pharmacists can use their own discretion to decide whether they feel qualified to prescribe. HOW CRAZY IS THAT? Does it sound reasonable to say ‘Let all students in an undergraduate university degree wanting to go into medicine to start diagnosing and prescribing’ in attempt as a solution? It sounds really ridiculous to me. The point is that they have not received the knowledge, skills, experience to perform such a life-or-death job. Secondly, there would be no improvement to ACCESS: Neither quicker nor more easily. Pharmacies are requiring appointments to assess. You are better off encouraging patients to visit a ‘urgent care, walk-in, focused practise rapid access clinic where the point of these is NO APPOINTMENT. We need more of these in operation staffed by Doctors, prevent us from going to an emergency room. I am sorry, but it is all or none, for providing medical care. You can’t allow some conditions to a pharmacist. None of them should be allowed to be assessed by pharmacists. We need doctors taking care of our medical problems. We need pharmacists dispensing our drugs more quickly, with more instruction and without error. Pay each properly and respect each profession for their distinct scopes of practices. Don’t destroy their precious collaborative efforts.
“Data obtained by CBC News shows Shoppers Drug Mart billed the Ontario government’s MedsCheck program more than $81 million in a two-year period when Shoppers pharmacists revealed they were facing increased corporate pressure to bill for medication reviews. This speaks to a larger problem of corporatization of health care where the health care provider has dual loyalities, the loyalty to the corporation and the business and the loyalty to the patient. ” CBC news website NOv 18, 2025. In response to this, OCP states it has opened over 100 cases of corporate pressure. Now times that by 19 new minor ailments and billing incentives for that, plus $25 for a rapid strep test or $50 for a toe nail sample and imagine the scale of the coroporate pressure on pharmacists. I strongly recommend that OCP finalize the cases of corporate pressure and stop the corporatization of health care where diagnosis is involved.
If OCP and the government wants to reduce ER wait times, then take a hospital pharmacist and dedicate them to doing minor ailments in ER. Don’t put this extra work on a solo pharmacist, working alone, without tools or access to physicians, or even medical records, in addition to verifying prescriptions and doing shots. Hospital pharmacists are actually paid by the government and are under utilized, some don’t even actually see patients and call themselves Part A pharmacists. Hospital pharmacists also get their breaks and have enough time to see more patients, not having to answer constant phone calls from patients
As a practicing pharmacist, I fully support the OCP’s proposed amendments to the Pharmacy Act. Expanding pharmacists’ authority to assess and prescribe for 14 additional minor ailments, administer injectable partial opioid agonists and antagonists, and provide additional vaccines not currently listed in Schedule 3 will greatly enhance patient access to timely care and improve public health outcomes. I also endorse enabling pharmacy technicians to administer all Schedule 3 vaccines, which will help optimize the pharmacy workforce and support efficient vaccine delivery. These changes reflect the evolving role of pharmacy professionals and align with best practices in patient-centered care. I encourage the OCP and the Government of Ontario to ensure appropriate resources, training, and most importantly funding to be provided to support successful implementation. I look forward to continued collaboration to advance pharmacy practice for the benefit of all Ontarians.
As a patient living in Ontario and actively managing my cardiovascular health, I would like to take this opportunity during the expanded scope of practice review to request that inclisiran and other injectable therapies approved since October 2024 be added to Schedule 1 under Ontario Regulation 256/24. Inclisiran has been a game-changer in managing my cholesterol levels. However, pharmacists in Ontario are currently not authorized to administer inclisiran, simply because it is not listed on the Schedule 1. This creates unnecessary barriers to accessing care that could otherwise be delivered safely and conveniently by pharmacists. With the Ministry of Health currently reviewing the scope of practice for regulated health professionals, this is the ideal time to ensure that Schedule 1 reflects the most current and effective therapies available to patients. Updating Schedule 1 to include these therapies would improve access to care by allowing pharmacists to administer these treatments, support better health outcomes through more timely and convenient delivery and align the list with Health Canada approvals and current clinical practice. I respectfully ask that the Ministry and the Ontario College of Pharmacists take this feedback into account during the consultation period. Patients like me rely on innovative therapies and accessible care, and updating the Schedule 1 is a meaningful step toward that goal.
I completly support this new Roles or Expanded scope of Practice for Pharmacists. I think it will eventually reduce the burden on health care system and Physicians leading to early appointments for urgent cases
I think pharmacists are well-educated and clincially capable to implement the expanded scope changes. Unfortunately the issue that our association and college never targets is the burden of work put on community pharmacists daily with no added compensation. We keep getting expanded scope changes but lack the resources and compensation to effectively implement them. A staff pharmacist is expected to complete more tasks in a single day with less time, less resources, and not to mention hourly wages have not increased in the past 15-20 years ($40-45 in the GTA), more work and less pay = pharmacist burnout = worse patient outcomes. Pharmacists are the only healthcare professional where patients can call or walk-in at any time and speak direcly to the pharmacist, this is not the case with physicians, optometrists, dentists, or even at emergency deparment. So if the government wants to leverage the accessibility of pharmacists then they also need to compensate us appropriately, mandate fair working conditions, and better wages so we can prioritize patient safety and optimal outcomes.
This will reduce the burden on family doctors.
I think expanding the injections the pharmacists can administered is a great idea (accept narcotics) – a great opportunity for infusion centres and clinic pharmacies. I’m nervous about prescribing antibiotics and sleeping medications however. This may be difficult for antibiotic stewardship if they use multiple pharmacies and also lead to drug seeking behaviour for sleeping medications. Also PPI long term use may lead to hypomagnesemia and low b12 levels so there should be a stipulation that it has to be reassessed q6months or something like that. I’m afraid follow up like this will be lost – this is the hardest part of our jobs as workload is soo heavy that follow up gets forgotten about. I definitely do not want them to have to scrap samples of feet for testing. When it gets to the point of physical assessments I think we should draw the line. Liability can be soo high when you have to have the patient in a closed off room alone to do such assessments. The smoking cessation is however terrific…just a little nervous once again with not complete histories known and drugs that may lower seizure thresholds and drug interactions. There needs to be direct communication with the patient’s GP or other specialists to confirm medical histories before prescribing I believe. I haven’t taken any of the expanded scope training because I do not use this in the hospital setting however I still question if it makes us look very unprofessional if some pharmacies provide some services and others don’t. It is all over the map from what I hear. -however when advertising all of these new expansion of scope it should be stipulated that not all pharmacies may provide this service and have a list of pharmacist linked that do provide the specific service please – this should be mandatory!!!
I oppose this proposal. As a member of the public, i see my pharmacist working very hard. He used to be available for advice & consultation, but now he is bombarded with so much work that he is not available at all. The pharmacy is always crowded with customers waiting for flu/covid shots etc. I have patronized this pharmacy for years and i appreciate my pharmacist’s valuable & professional advice. But getting his availability for advice nowadays is so very difficult. Adding more workload will just force pharmacists to burnout & stressout! Besides, pharmacists cannot replace family physicians to diagnosis.
I think it is great to expand services , however for point of care especially for throat swabs and for fungal infections the consult rooms should have sinks and there should be no carpets on floor for ease of cleaning . There should be strict guidelines for cleanliness as the carpeted floors are only vacuumed. Further this really should be left for the doctors /chiropodists/nurses . The other conditions are fine , however there has to be consistency for all pharmacists to send copy of minor ailments to family doctors . This should be really reinforced in the learning modules snd other articles in pharmacy connection perhaps . The follow-ups are also difficult to fit in our busy environments and pharmacists are doing their best but not sure how consistent this is across all pharmacies. I really think also there should be mandated clinical hours to do this apart from dispensing especially in busier stores to keep patients safe . Thanks
I completely support this change. This will definitely reduce burden on our healthcare system especially hospitals.
The expanded pharmacy scope of practice will significantly improve patient access to timely and effective care. Pharmacists have demonstrated exceptional competence in managing medications, providing clinical assessments, and supporting preventive health services
You guys keep pushing us to do more, with no compensation, and not even a break that we are allowed to take, and the moment someone makes a mistake, because of the pressure and how busy we can get, you guys will have no mercy when it comes to fines, suspension and flagging profiles. This is getting out of hands and I would sure hope that you would take the hint that we as pharmacists are so over this!
I can’t see how we can fit any more work into our day. We cannot even keep up with the phone calls. Most people understand they need to book an appointment to see a doctor and that may take days (unfortunate) or that they may need to sit for hours at a walk in clinic (also unfortunate). The perception at a pharmacy? You can just walk right in at any hour: right when we open, right before we close at 11:57 pm, or at any other point in the day and there is no wait! You are just immediately served as though there was no one else ahead of you. This is unfair. There is too much pressure. We are being pulled in so many directions. The pharmacy is being touted as this very convenient place to go get things done at any time and quickly and we don’t have the supports in place to do this.
I fully support the continued expansion of our scope of practice. I do not support us being able to treat insomnia. I think this is a terrible idea. Insomnia is far too complex to be treated in the pharmacy setting. And at places like Shoppers and Rexall, that pressure pharmacists to give unneccessary treatment, something bad is going to happen
I agree with the proposed expansion of minor ailment prescribing for pharmacists and increased scope for injections by pharmacy technicians. I think the inactivated poliovirus vaccine (IPV) injection final booster for children aged 4 to 6 should be added to the list. I disagree with having pharmacists do nail clipping and throat swabs.
I have noticed that registered pharmacy technicians and retired pharmacists all think this proposal is great because they don’t have to do the work. As somebody else pointed out before, it appears that other provinces allow pharmacists to do more, but those minor ailment prescribing are optional! pilot projects done in specialized clinics. No other pharmacists do strep throat, insomnia, toe nail fungus. This is a temporary bandaid solution. Fix the real problem of the doctor shortage. I just read this morning that community pharmacy assessments are going to be more depth.”operations advisors also confirm that the identified processes are occurring consistently by conducting random reviews of patient profiles to look for documentation of allergies, medical conditions, indication for prescriptions, and communication with the patient.” I don’t even have time to speak to patients much less document all this information. And how does OCP propose I gather all this information – just from the patient? Without a centralized electronic medical record like the other provinces (another reason why they can do more ailments because they actually have access to patient records) the risk of malpractice in fragmented care is immense. I would strongly recommend that OCP first adress corporate pressures, ensure that standards are being consistently followed (why are they auditing if there is no concern) and pharmacy staffing is appropriate (like other provinces, nova scotia for example) BEFORE giving us more work!!!!!!!! This pharmacist will not conduct a single strep throat, nail fungus or insomnia consult
As a community pharmacist, I strongly support the proposed expansion of scope of practice for pharmacy professionals. These changes will provide patients with convenient access to care for common conditions at their local pharmacy, close to home, while allowing family doctors more time to focus on patients with more complex health needs. The success of the current minor ailments program, with over 1.8 million assessments completed, demonstrates that patients trust and value receiving care from their community pharmacist. Adding point-of-care testing such as rapid strep tests will enable same-day diagnosis and treatment, eliminating the need for patients to make multiple visits or wait for laboratory results. Expanding vaccine administration by both pharmacists and pharmacy technicians will improve public health outcomes by making immunization more convenient and accessible, particularly for working families who find it challenging to access care during traditional hours.
Commenting as a retired pharmacist. Scope of practice for pharmacists should be standardized across all provinces. Differences imply that pharmacists in all provinces are not equally qualified and/or some individual jurisdictions have lower standards by allowing pharmacists to do more. I don’t think either is the case but that is the perception it promotes. If decision making is truly based on good evidence, why would the same conclusions not be reached nationwide about what pharmacists are capable of doing – medical practitioners’ opinions aside. It seems to be a matter of politics and economics NOT what is best for patients. In these times of severe doctor shortages, every primary health professional should be enabled to contribute up to the maximum level of their competence. Time to think outside the traditional box.
Hello, my name is Marta and I believe that technicians should have their scope expanded to include administering Schedule 3 vaccines because they are already highly trained in medication handling, aseptic technique, and patient safety. Allowing them to give vaccines would improve access to immunizations, reduce wait times, and free up pharmacists to focus on more complex clinical tasks such as medication reviews and patient counselling. This change would make vaccination services more efficient while maintaining the same high standard of safety and care for patients. With pharmacists scope of practice recently expanded to include assessing and prescribing for minor ailments, their workload has increased significantly. Allowing technicians to administer vaccines would help balance responsibilities within the pharmacy team, improve access to immunizations, reduce wait times, and ensure patients continue to receive timely and safe care.
The proposed changes could improve patient care across Canada. Allowing Pharmacy Technicians to inject more vaccines and giving Pharmaicsts the open door to extend their prescribing privileges can allow for a better flow of continuity of care. How can this be done safely in pharmacies that are already burnt out? There is no time to breathe because of heavy work load and every time you look up there is an angry patient waiting as we asked them to give us 48 hours to complete a prescription! There is hardly any space to accommodate counselling stations, vaccination space and a compounding area that can maintain standards. Pharmacists don’t want to pay for a registered technician in most pharmacies so staffing is at lack therefore more pressures on employees. But back to prescribing. Where did the doctor go? We are taking away the importance of a doctors assessment. And let us all remember that not all doctors do all duties so why do pharmacists and pharmacy techs have to? Maybe a good thing to add to the changes would be for the member to assess if the workplace allows for injections based on current workflow. In order to communicate and facilitate these changes online educational videos, Teams/zoom meetings, and Tech Talks for members may be helpful. Just a thought does our insurance cover for injections and prescribing cases?
I realize that this is a consultation on these proposed minor ailments, but everybody is mentioned how much time they will save in ER and doctors offices wait times so I thought I would mention it here. How about the wait time in the pharmacy? People already have to wait for consults while I do flu shots. I am concerned I won’t have time to counsel because people will get fed up of waiting for me to do lengthy consults. Instead of letting pharmacists prescribe, how about just letting pharmacists assess if patients meet the LU code. For example, I have to fax MD to get LU code fluconazole when a patient has a yeast infection. How about some basic therapeutic interachanges – Omnaris is on backorder, I have to fax doctor to get it changed to Rhinocort and by the time I hear back, I’m out of stock of Rhinocort and have to fax them for another one. How about minor therapeutic interchanges to drugs in same class prescribed on ODB? THese would be more in keeping with the pharmacists scope of practice like they do in hospital and would reduce administrative burden on physicians and reduce wait times, allowing both the pharmacists and physicians to do their intended jobs. Instead of making pharmacists be physicians for somethings but still having the request ridiculous minor things to physicians?
I request to OCP to insist that the patients should go to the same pharmacy or we should have access to their previous medical history. Today, on November 9, 2025, I was working at Shoppers Drug Mart and I lady came for Minor Ailment Prescription. When I asked a few questions, I realized that her symptoms don’t sound like UTI so I suggested her to see the family physician. She was reluctant to go to family physician and said that I had similar symptoms a few days back and the pharmacist at other Shoppers Prescribed me antibiotic for it. Then she showed me a vial with label of Nitrofurantoin 500 mg BID for 5 days prescribed by a pharmacist on October 29, 2025. When I saw the vial, I explained to her that you were just prescribed an antibiotic 10 days back, so I can’t prescribe another antibiotic too soon as well as your symptoms are not consistent with UTI. In this case, I was lucky that the patient was little honest and mentioned that she was prescribed antibiotic for UTI by another pharmacist, but lots of patients hide the past history and be very demanding for antibiotic.
I support the proposed expansion of pharmacists’ and pharmacy technicians’ scope of practice, as it will improve access to care and help reduce pressure on hospitals, walk-in clinics, and physicians. However, proper training, oversight, and resources are essential to ensure safe and consistent care. Clear guidance, quality assurance processes, and adequate support for workflow and public awareness will be key to successfully implementing these changes while maintaining patient safety and confidence.
I agree 100% to add these scopes of practice in the pharmacy to decrease the load and waiting hours in the hospitals and lack of family doctors
These are few of the really important services that should be easily available to public without wait times. As a pharmacist, I appreciate and welcome the upscaling of pharmacist practices. As I provide sublocade injection services under doctors directive but this is very important service and should be provided and available to needed people. Thank you very much for increasing scope of pharmacy practices.
Canada has always prided itself on its public health care system. As a concerned citizen, I see this as a slippery slope into privitization of health care by the government, similar to the previous (failed) initiative of hip replacement surgeries in private clinics. Prescribers must retain autonomy over their decision to prescribe something without quotas and corporate pressure to bill. Just look at our neighbours in Quebec and the protesting physicians over bill 102 with prescribing quotas. The government is expecting to replace family physicians, opthalmaologists, dermatologists and public health nurses, without complete record access. My daughter is in nursing school and spent her entire first year learning physical assessment in practical stimulated labs. How will pharmacists be trained? I am appalled to read about pharmacists using liquid nitrogen spray. My family physician misdiagnosed my son’s molluscum as a wart and treated it with liquid nitrogen resulting in permanent scarring. Yet a pharmacist is expected to diagnose a wart? My friend’s son was recently put in prescipitated withdrawal at a methadone clinic because they injected the sublocade before doing the urine sample. Yet a pharmacist is expected to inject without a medical directive and guidance from a physician? I recently read an article that states “medication errors and adverse drug events have been reported to occur in more than 5% of prescriptions and 6% of patient admissions” in Ontario. That is what I expect from my pharmacist, not to clip my toenails or swab my throat. My physician has a wonderful nurse practitioner led clinic for that. What happened to training and increasing recruitment of nurse practitioners?
I won’t be seeing anyone for a minor ailment WITHOUT AN APPOINTMENT, and if I deem something inappropriate for me as a pharmacist to assess, best believe I will be referring them to a Dr. Whether or not I bill the “No Rx” fee doesn’t matter to me.
JOCK ITCH (TINEA CRURIS) can resemble and thus miss actual diagnosis of yeast vs psoriasis vs bacterial infection vs eczema or intertrigo. Each requires its own distinct management including different medications and for some of these conditions, completely opposite treatment. WART (VERRUCA) regardless of where it is located, can look like cancers such as keratoacanthoma or squamous cell carcinoma or precancerous skin lesion. Missing a cancer diagnosis would be devastating to the patient. You must not allow pharmacy staff to use liquid nitrogen spraying and spreading virus into the air onto people’s medications or in prescription containers. Furthermore, doctors typically would be paring/cutting/scraping skin with a blade to diagnose and treat, which typically leads to bleeding. Blood in pharmacy areas is not acceptable and neither is spraying & spreading virus (inhale? ) in the air or by direct skin to skin?- pharmacist to patient. So, treating or prescribing for warts MUST NOT be allowed in pharmacies. DRY EYE disease (XEROPTHALMIA) can be a corneal ulcer or autoimmune disease. These require urgent management by specialist doctors. Are pharmacies really going to have all the equipment (slit lamp etc. ) and tools (surgical blades, cryotherapy tanks, dermatoscopes) found in a properly set up doctor’s clinic? Have you asked how many doctors left practice due to rapidly increasing inbox messages due to pharmacies’ communications pertaining to the services by pharmacies which are billable to OHIP? Have you asked how many pharmacists are considering quitting their jobs? Have you asked how much money this is going to cost to the practitioners and government? Government MUST DENY the proposal for all ‘Minor Ailments’, for the greater good of the Ontario people. Government MUST REMOVE all diagnosing and prescribing allowances for anything approved as expanded scope of practice since 2023.
STOP THIS NOW!!! How many more ways can pharmacists tell you they are burned out? Did you not ask for surveys on CORPORATE PRESSURE? How about listening to the pharmacists. Encouraging pharmacists to prescribe for more minor ailments = CORPORATE PRESSURE. The list of minor ailments is unbelievable – shingles should be diagnosed by biopsy to ensure proper treatment and ideally patients should be referred to opthamologist if facial involvement. Also, they often require neuropathic pain medications that need laboratory monitoring. Is a pharmacist supposed to do all that in between checking prescriptions? Insomnia is a complex mental health problem that requires CBT as first line treatment. Pharmacists don’t have time to do full mental health assessments! I did not go to school to do injections all day long, which I already do. If I wanted to be a nurse, I would have went to nursing school. This is a ridiculous use of a pharmacists skills and expertise. Everyone here is ranting about pharmacist expertise, yet increasing pharmacist time vaccinating is a complete contradiction to using this expertise. Make it mandatory that pharmacy technicians give injections, not pharmacists. Every store should have to have a registered pharmacist technician on site at all times if you want pharmacists to do minor ailments. Pharmacists can’t do every step assessment, diagnose, prescribed, dispense – who is doing this independent double check that pharmacists were created for? When did this stop being enough? Doctors in our city say 2 weeks for a fax prescription renewal because they can’t handle the administrative burden, yet I am required to assess, authorize, prescribe and verify on the spot prescription refills for emergency supply. Doctors make scheduled appointments with dedicated time to assess patients, yet I am leaning over a counter in a loud pharmacy and supposed to assess somebody ‘s toenails and do a clipping? Why does every other health care profession get reduced burdens and it just gets piled on pharmacists? OCP has also made pharmacists the easiest profession to report with just a simple click so be prepared for complaints every time a pharmacist does not prescribe an antibiotic for a sick kid with a virus. Of course, that is assuming that pharmacists will be given an option by their managers to not prescribe and lose money.
As the Executive Director of a youth shelter, I witness the devastating effects of opioid addiction every day. The connection between addiction and homelessness is undeniable—and preventable. By authorizing pharmacists to administer monthly Opioid Agonist Therapy (OAT) injections, we can remove a critical barrier to care and save lives. Medications such as Sublocade not only reduce cravings and ease withdrawal, they also prevent overdoses—offering stability and hope to those ready to recover. In northern and near-north communities, access to a primary care physician is extremely limited, while access to pharmacies is far greater. Empowering pharmacists to deliver OAT would immediately expand access to treatment for those who need it most. Every day we delay this change, more people are lost to an entirely treatable condition. With daily medications, we ask those living with addiction to make 365 good decisions a year; with monthly OAT, we ask for just 12—and that difference can mean survival. I strongly support the proposed regulations allowing pharmacists to administer OAT injections. This practical, evidence-based step will save lives, reduce homelessness, and offer a path forward for individuals, families, and entire communities devastated by the opioid crisis.
To Whom It May Concern, I respectfully submit that a public consultation is not only warranted but vital before drafting new regulations to extend pharmacists’ scope of practice in Ontario. The current proposals, to authorize pharmacists to assess and prescribe for an additional 14 minor ailments, permit administration of injectable buprenorphine (Sublocade), expand access to publicly funded vaccines (Pertussis, Tetanus, Diphtheria), enable pharmacy technicians to administer all Schedule 3 vaccines, and explore pharmacist authority to order lab tests and conduct point-of-care testing all represent a logical and necessary next step for community pharmacy. However, for these measures to succeed in a sustainable, fair, and patient-centred way, a robust public consultation is essential. Summary of Key Recommendations 1. Ensure the public consultation has a meritocratic lens before finalizing regulations. 2. Establish a sustainable funding model that recognizes real operational costs. 3. Protect independent pharmacies to ensure equitable access and competition. 4. Align expanded scope with patient and system benefits for measurable outcomes. 5. Embed transparency and collaboration in the design of the new framework. 1. Logical Next Step in Scope Expansion Pharmacists in Ontario already assess and prescribe for 19 minor ailments (expanded in October 2023). Early data shows over 300,000 assessments and 255,000 prescriptions in just six months (University of Waterloo/OCP) show clear patient, pharmacist, and system benefits. Extending the model further is a natural evolution of pharmacists’ education, training, and community accessibility. 2. Existing Services Are Already Being Delivered Without Support As a practising pharmacist, I already administer Sublocade under a medical directive. This demonstrates both capability and readiness, yet exposes a serious gap There is no compensation for providing this service, and charging vulnerable patients creates both an ethical dilemma and ultimately forces Pharmacies to carry a burden, which furthermore is unfortunately something that the pharmacy industry in Ontario is used to experiencing. Pharmacies are absorbing costs and burdens including training, documentation, liability coverage, space, refrigeration, and workflow redesign, all without remuneration. The message is simple: the math needs to math. 3. Sustainable Funding Is Essential Ontario’s dispensing fee under ODB has not increased in over 15 years, eroding viability amid rising rent, wage increases (governed by the same provincial body that is asking for more from pharmacists), higher product costs, increased overheads and compliance burdens to name a few. If new responsibilities are added without corresponding equitable funding, quality and access will suffer downstream. A consultation must employ a meritocratic approach to explore realistic service fees, incentives, and cost-recovery mechanisms, ensuring that new services are financially and operationally viable all whilst taking into account regular inflationary adjustments to create long-term sustainability. 4. Protecting Independent Pharmacies and Market Fairness Independent pharmacies are vital for patient choice, rural access, and system resilience, yet they face increasing pressure from large chains and corporate networks. A fair expansion must guard against anti-competitive practices, such as margin squeezing, preferred-provider networks and patient-steering practices, all of which has recently been scrutinized by the Competition Bureau for anti-competitive practices that can drive independents out of business. The consultation should explicitly address market diversity and fairness to protect equitable access across communities. Maintaining a diverse provider base enhances system resilience. 5. Transparency, Legitimacy, and Patient-Centred Design This process should not be a top-down policy change but a collaborative design effort. Consultation should clarify: • Are the proposed 14 new ailments the right ones? • How will injectable buprenorphine and administration be funded and integrated safely? • Can vaccine expansion and technician administration be implemented feasibly? • How will lab-testing authority align with existing professional scopes and public health structures? These are not peripheral details, however, they are determinants of success. In summary, Ontario’s pharmacists are ready to meet the province’s growing need for accessible primary care, particularly in underserved areas. But readiness alone is not sustainability. Without adequate funding, operational support, fair competition, and system transparency, expanded scope will falter in the long-run. A well-designed public consultation process will ensure that the regulations not only authorize the services, but also enable them in a way that works for patients, pharmacists, business owners and the public interest. I strongly urge the OCP and the Ministry of Health to deliver in an equitable and fair way with sustainable patient-centred focus at the heart of the deliberations. Thank you for your attention and consideration.
The expanded scope of practice for RPh means patient care bringing more closer to patients. The Technicians are able to administer all the vaccines listed in Schedule 3 of General Regulation 256/24 under the Pharmacy Act, 1991. There will be more duties to Technicians in future, because Technicians are doing a great job within their practice scope towards patients care. Technicians involvement to care very much indeed in place in rural areas of the province. When Technicians are given more responsibilities that practice always need to align with more training and validation which ensures the confidence of the activities they have been entrusted to perform with the scope of practice. Thank you!
I don’t think pharmacy technicians right now. Have enough knowledge to prescribe the additional minor ailments. We would be qualified to administer the other injections.
A lot of patients walk up to me and ask for antibiotics for a sore throat. It would be helpful to be able to perform a Throat Swab and start them on Abx if it is Strep.
The following opinions are my own and not that of any organizations with which I am affiliated. I am happy to see further expansions proposed in pharmacist and pharmacy technician practice. To ensure strong public uptake of pharmacy injection administration services (which will reduce the burden on home & community care staff), I hope that injection administration is publicly funded as a reasonable rate that is financial sustainable/ beneficial for pharmacies while still allowing cost savings for the government. My next point refers to ODB coverage for medications that pharmacist can prescribe for the proposed minor elements. As an example, medications for onychomycosis are not ODB covered, nor are treatment options for dry eyes. Lastly, I would like close oversight on prescribing for acute insomnia. More specifically, will the prescribing authority includes zopiclonr; a drug that has potential for abuse.
I am in support of expanding the legislation to allow pharmacists (or trained pharmacy technicians working closely with a pharmacist) to administer all vaccines (no list). If more of the vaccines could be given (schedule II) without requiring a physician’s prescription that would avoid inappropriate use of Dr’s offices just for this purpose. To what extent a pharmacy or pharmacist chooses to provide this additional service should vary depending on the situation. There may be pharmacies in areas lacking in physicians that would benefit from being able to offer the service or pharmacies with such high volumes that they can have staff focused on this service in block periods un-interupted. Many pharmacies already overloaded may not routinely provide this service. Given the right situation appropriately staffed, we can offer a much higher quality of service at a lower cost than can be provided in physician’s offices and this will help with their workload allowing them to take more patients and focus on what they are trained to do “diagnose”. Make no mistake though, expecting overloaded retail pharmacists to just add this to a day where they can’t get to the washroom or grab a bite is only going to burn us out faster, result in increased risk of errors due to interruptions, and less public “ready access to their pharmacist”. Having said this, it is CRITICAL that no matter what happens, we MUST have a centralized computerized system for the documentation of a patient’s vaccines in Ontario based on a person’s OHIP number which is accessible by all health care providers and documentation is done by the person administering the vaccine. The issue with Measles vaccine where no one knows what they got is an example of the mess we are in. Patients don’t know when they got their last tetanus or what pneumonia vaccine they received. Currently, data on vaccines could be at the Dr’s office, Walk-in Clinic, Emerg, Public Health, or the pharmacy. It will get even more fragmented if we don’t have centralized software immediately. Whether it is Pandora or something else this must happen NOW. If we have to send a patient to their Dr to get a prescription for a vaccine and then they come to us for administration and then we need to fax them with the administration for their staff to enter it in his office chart is not efficient for the Dr.’s office. A major question is how will the new database be populated with their vaccine history?? Pharmacists/Pharmacy Technicians could play a role in back filing the patient’s historical data but will need to be compensated for this to make it sustainable and would need the support of the area physicians who help to provide the history from their records with the end goal of outsourcing the vaccine management to the area pharmacy. Like many new focused programs it takes a motivated pharmacist building a good physician relationship. I am against the idea of pharmacists “diagnosing”. We are not trained to diagnose and we don’t know what we don’t know. Cold sores and UTI’s where the patient knows what they have due to their personal history is one thing but diagnosing “rashes”, fungal nail infections, insomnia, etc is very different. We don’t have the environment, time, or diagnostic experience to manage these in a busy pharmacy. Starting treatment for a “rash” which changes how it looks makes the physician’s job that much harder when the hydrocortisone and clotrimazole doesn’t work 2 weeks later and also encourages resistance.
Ontarians, think WHAT DO YOU WANT AS AN ONTARIAN VISITING A PHARMACY? If I am wanting and thinking the following, I would bet that so do the majority of others want the same: A patient does not want to wait in a physical visible line. A patient does not want to arrive to the counter and be told to come back in hours or the next day. A patient does not want to think that the pharmacist just finished touching a patient (skin, groin, scalp,toes, nail, strep throat, lice, eggs etc.) immediately prior to counting our pills on the pill sorting countertop. A patient wants the pharmacist to have a fresh mind to do this very serious job requiring 100% concentration! A patient wants a pharmacist who can greet him/her with a smile and energy to explain how to properly take the medication that the doctor prescribed! It can be a matter of life and death!!! ‘Minor Ailment’ prescribing MUST BE REJECTED by government! Pharmacists are trying to tell you how overworked and tremendously busy their pharmacies already are. Increasing the number of tasks will lead to increased chance for error and dissatisfactions, which could lead to increased college complaints and in larger stakes cases, money spent on lawyers, not just by pharmacists but maybe by the college and government representatives. I almost wish I could state that I would guarantee that you would see how much MORE FRAGMENTED CARE WILL BE IN ONTARIO, how much MORE DOCTORS WILL QUIT, how much MORE PHARMACISTS WILL LOSE PLEASURE in their job & FIND ANOTHER JOB ! and how much more PATIENTS WILL GET ANGRESSIVE AND DISPLACE ANGER ONTO PROFESSIONALS while instead it should be appropriately directed towards the decision makers who are responsible for proposing this and/or who would be responsible for accepting it to be our catastrophic new way of suffering in Ontario. Government should be rejecting this based on CONFLICT OF INTEREST alone, let alone a NON doctor (pharmacist ) practising medicine (as a doctor would) without studying how to do so (1 hour modules won’t come anywhere close to being adequate or safe to take care of human beings ). Can not believe we (ONTARIO RESIDENTS) are having to endure this distress!
It’s great that are role as a Pharmacy Technician is expanding. On the other hand, It is bringing lot of responsibilities to handle these changes. The injection administration should be done safely and needs to add in the curriculum for students to have enough experience to master this skill and perform without any supervision.
1. Expansion of Vaccine Administration • Support for allowing pharmacists and pharmacy technicians to administer additional publicly funded vaccines to adults (COVID, flu, tetanus, diphtheria, pertussis, pneumococcal, shingles, RSV). • Recommendation to maintain Ministry of Health oversight for vaccine distribution and storage, especially if third-party distributors are used. • Emphasis on rigorous training and certification for pharmacy technicians, with supervision by pharmacists, to ensure safe vaccine administration. • Advocacy for robust quality control mechanisms for all staff involved in vaccine administration. • Importance of seamless information sharing with public health units and primary care providers to improve vaccine record-keeping and support health equity. • Recognition that the current proposal is limited to adults; recommend future consideration for adolescent and pediatric vaccine access. • Expansion will allow public health units to focus on priority groups (e.g., children under 18) and manage increased demand for RSV, COVID, and flu vaccines. • Suggest exploring mechanisms for a provincial vaccine registry to improve tracking and coordination. 2. Administration of Sublocade and Harm Reduction Services • General support for regulation allowing pharmacists (and potentially pharmacy technicians) to administer Sublocade and other opioid antagonists by injection, increasing access points for opioid use disorder treatment. • Note practical challenges with Sublocade administration (e.g., injection technique, privacy, comfort), but acknowledge successful implementation in other provinces (e.g., BC). • Recommend consulting with harm reduction committees and individuals with lived experience to ensure regulations meet client needs and expand treatment options. • Highlight need for clear guidelines on which medications are included (e.g., Sublocade, naltrexone, Suboxone) and prescribing authority requirements. • Expanded pharmacy scope could improve access for unattached clients and vulnerable populations who face barriers to primary care. • Encourage ongoing collaboration with community partners to address barriers to registration and care for opioid use disorder. 3. General Considerations • Stress importance of ongoing consultation and feedback from frontline providers and public health units as regulations evolve. Thank you.
I think Pharmacy Technicians should also be allowed to do POCT for sore throat in additional to injecting schedule 3 vaccine.
I don’t agree with administring injection of buprenorphine but I’m ok with the rest condoitioned to have a clear algorithm to follow like online mcq questionnaire that we reply and can attach to the patients file to support our Rx Thanks
Ontario has the most restricted scope of practice in canada. We need to mimic novassotia or quebec to allow us to work within full scope. The hospital act needs to be amended to allow hospital pharmacists to worrk within filull scope.
This changes will be such a huge difference in the pharmacy profession. It’s not only helping pharmacist to used their professional judgment and knowledge but also will open a new door for the public servants to access more health care services. Especially with the shortage of doctors and long wait time at the ER , recently and walk in clinics.
I fully support the proposed expansion of scope for pharmacy technicians. Administering injections is a technical, skill-based responsibility that aligns with our training and professionalism. This evolution in scope reflects the meaningful role technicians play in patient care and pharmacy workflows. However, expanding responsibilities must also acknowledge the increased workload, accountability, and professional expectations placed on technicians. Despite being essential to the pharmacy system, many technicians continue to face compensation gaps and limited recognition. To ensure sustainability and fairness, consideration should be given to improved compensation standards or a regulated minimum wage structure aligned with increased duties. I also appreciate the OCP’s commitment to public protection. At the same time, providing clearer guidance and structured support for registrants—especially in the event of unintentional errors—would help promote a fair and supportive practice environment. In summary, I welcome this advancement for our profession and believe it will enhance patient care. As scope expands, it is vital that this progress is paired with appropriate compensation, support, and recognition to ensure technicians can continue delivering safe and exceptional service.
I support the proposed changes, although I do think prescribing for acute insomnia via minor ailments is an odd condition to be advocating for when there are many other conditions with much higher efficacy and safety evidence that could be easily addressed by pharmacist minor ailment prescribing. Diphenhydramine is not a recommended sleep aid so it is concerning it appears in the draft regulations for the management of acute insomnia. I realize diphenhydramine is an OTC agent, but having it in the regulations suggestions it is being advocated for as a treatment option. I think pharmacy technician vaccination for all vaccines is a very reasonable initiative given that vaccination is a technical task. Vaccination by pharmacists is, in my opinion, a terrible use of pharmacist resources and their knowledge and skillset. I recognize that vaccination at community pharmacies makes sense from an access and convenience standpoint, but it really should be a task performed by a pharmacy technician rather than a pharmacist. While I realize there is no actual consultation on the things I am going to comment on next, I do feel there needs to be prompt attention given to addressing the below: #1: I strongly support pharmacist OHIP billing numbers so pharmacists working in all healthcare centres can work to their full scope with an avenue for compensation available in non-drugstore settings. The Health Canada Act Interpretation from January 2025 indicates pharmacist services should be covered by OHIP if the service is already covered by a physician… #2: I also strongly support having the Public Hospitals Act updated imminently to permit pharmacists in settings governed by that Act to work to full-scope practice. It is beyond frustrating that as an outpatient hospital clinic pharmacist I am much more limited in what I can do than my community pharmacist colleagues. #3: I strongly recommend a move away from prescriptive lists by pharmacists for prescribing and injection purposes. It makes no sense to have lists, especially when other provinces do not.
I fully support this expansion of our scope however under proportional increases in mandated staff support and additional protections against corporate business pressures. Under the current structure, although I believe it is not due to a knowledge or professional skill gap, it is not feasible.
I fully support this expansion of our scope however under proportional increases in mandated staff support and additional protections against corporate business pressures
Pharmacists’ scope should be expanded even more than this small new list. They should be able to treat much more including common chronic diseases like Hypertension and Diabetes. They should also be allowed to extend Rx refills beyond 12 months. Some provinces allow much longer. Why can’t Ontario pharmacists have the same scope expansion as those in Alberta??? There should be a standard across the country and pharmacists can easily fill the gap of primary care (such as GPs and Nurse Practitioners) as they deal with medications all the time. Pharmacists can do a lot and OCP should expand them a lot more especially with all the Pharmacy Care Clinics opening up across the country.
This expansion of scope is absolutely ignorant of the current state of community pharmacy in Ontario. With previous expansions introducing minor ailment prescribing, vaccinations, etc. on top of an already overwhelmed and in many places understaffed pharmacy practice, this proposed expansion would burden pharmacies further. Pharmacists and technicians are already overwhelmed. Many of these proposed minor ailments are not realistic to assess in a community setting (throat swabs and lab testing for strep, nail clippings for fungal infections, etc). This expansion is counter productive. It would not improve access to care, but rather just slow down and worsen quality of care due to the overburdening of pharmacy staff.
I agree with this amendment. green light
On behalf of my organization , I support the expanded scope of practice for pharmacists. I would also recommend additional training ( Mandatory training) to perform expanded scope of practice.
No more minor ailmentswithout compensation! Pharmacists are underpaid and undervalued already. I have been a community pharmacist for both independent and chain pharmacies for nearly 20 years and have not had a single pay raise and barely get inflation. When I was forced to do injection training, it was at my own expense for the course and travel. These proposed changes will likely require me to attend yet another course, take an unpaid day off, pay for my course and travel expenses for zero pay raise and more work. The alternative would be another useless online course to teach physical assessment skills in 1 day that nursing students and medical students practice for YEARS. I would have thought OCP and the government would have learned from the Medscheck scandals with all the fradulent billings that the private sector is full of corporate greed and quotas. Of course, the best predictor of future behaviour is past behaviour so prepare for more fradulent billings and quotas. Now, the physicians don’t even want a copy of the medscheck with updated med lists because of administrative burden, will they want all the copies of minor ailment prescribing? Of course not, this would be a burden to them for pharmacists to take care of their patients and let the physicians know. The result will be overprescribing and even more fragmented care. I can not think of another job that is not allowed to leave the premise during their work and is not allowed to close so the sole pharmacist can have a meal break, not to mention against labour laws. How is that safe for the public? Why would I want to take on any more work when I already don’t even have time to take a break to eat and just shove a bite of food in my mouth when I can and have to get interrupted if a methadone patient comes in. Many colleges are now closing their pharmacy technician programs due to lack of international students so good luck with getting registered technicians to do the injections. Oh wait, only hospitals hire registered pharmacy technicians, community is still able to hire underpaid and underqualified pharmacist assistants of the street to do “registered”pharmacy technician work.
I appreciate the proposed expansion of scope for pharmacy technicians, as administering injections is a skilled and technical task that reflects our professional abilities. However, this also increases workload and responsibility without matching compensation. Pharmacy technicians contribute greatly to pharmacy operations yet remain underpaid and undervalued. If additional duties are added, fair pay or a minimum wage standard should be considered. While I respect OCP’s focus on public protection, more guidance and support for license holders would help when honest mistakes occur. New responsibilities should come with fair recognition, not unpaid labour under public service.
College should step up for the pharmacist’s rights, rather than just abusing their skills and benefiting the huge corporations. What is the outcome of college’s actions on corporate pressure for medication reviews? We pharmacists are already working under huge stress. We are denied a raise in salary, we are denied vacations during the flu shots season and if someone decides to talk about it, they end up losing their jobs for no reason. I am totally against the expanded scope. This should be left for doctors as they are well trained for it.
According to my experience Pharmacist can save lives ,more scopes should be given because we are able to handle it . My experience with addiction treatment was beyond everything it was about keeping patients away from the hands of people with no mercy. giving sublocade will keep him /her , family and the community safe. Some people advise me not to do it because there is no financial benifit but my decision was to continue serving people and do the best for them ,therefore I contact Indivior company and asked them for training ,they welcome me as part of there team and gave me training. I contact the prescriber and let him know that I’m certified pharmacist I can help Dr. Mintz,Randle the owner of Hopewood clinic send me a letter of delegation to be able to help more people in need. I will keep serving people and I’ll be there when they need me. Tara
I think this would be very beneficial to patients and increase access to care. For myself specifically working in Addiction management, injecting sublocade as well as COMPENSATION for doing so would be highly beneficial. Many patients on sublocade can not afford the $20 injection fee most pharmacies charge, as such, I tend to waive this cost. However this should not be the case. For all injections, injection fees should be covered to increase the amount of patients receiving their injections from the pharmacy, as opposed to booking yet another follow up appointment with the doctor just for administration.
I agree that if OCP/government wants to make this work, payment structure needs to be changed. Pharmacists deserve a share of each they do, at least 50%. When I first started as a preceptor for U of T pharmacy, I used to get $1600 to take a student, then it changed to $800 preceptor/$800 site then nothing! How is that fair? Other teachers get paid. Again, another example of unpaid work. What is the limit for MA? How many assessments can get they can get for each ailment? This morning as soon as we opened, patient requested assessment for cold sores. I did the whole assessment in between checking prescriptions, flu shots, dispensing methadone. Didn’t have a chance to bill until after he left and SURPRISE! Therapy to soon for ODB, yet his private insurance paid for the Valtrex. So yet again no money! There needs to be clear rules and perhaps if its a simple as a “checklist” make forms that the patient checks the boxes off their symptoms and signs they don’t have red flags and one of the boxes says ” I have not had an assessment done at another pharmacy” in whatever time period (because I don’t even know the rules and can’t find them anywhere)!!! The vast majority of pharmacists do not work in the big box stores with the nicely already made Pharmacy Care Clinics that the chains made in anticipation of the new minor ailments and will have to do this on top of all our other work for no pay.
Proposal to expand scopes of practices must terminate immediately. As such, the government should not have any need to proceed with consultations. The comments below pertain to pharmacists/ pharmacies: Due to the push to have pharmacists do what only doctors should be doing, I have noticed increased wait times at pharmacies for people to pick up their prescribed medication. Line ups are sometimes visibly long and other times, even if you don’t notice the line, all the people they are dispensing for whether for consultations through phone or video, and what has been claimed online as forcing MedsCheck reviews on patients, is contributing to longer wait times, not to mention millions or more $ of unnecessary dollars ( depending on what period of time is being considered) paid out by the Ministry, that Ontarians are paying for through taxes. Get rid of the MedsCheck review billings by pharmacies. Put millions or billions (I don’t know how much has been billed to the Ministry or much it will amount to if not stopped ) of dollars into the Ministry of Health to put towards a better purpose. Repeatedly, I heard from a family member that either the pharmacy gives only a portion of what the doctor prescribed and pharmacist instructs to return at a later date to pick up the rest. This is increasingly becoming common and never used to be, as far as I could recall years ago. Do you realize what type of inconvenience this is for anyone, especially an elder person in their 70s, 80s or someone with mobility impairment ? Who amongst our leaders is going to have the compassion and intelligence to do things the right way that any reasonable person would consider to be ‘right’ after understanding what is at the core of the problem? I realize it may be an impossibility to please everyone. Who wants to be restricted from doing something? Noone. Of course, everyone would want to feel they are allowed to do more in their chosen professional fields, so naturally a few health workers (maybe the lesser experienced ones or technicians, and owner of pharmacies) would be glad NOW, but it seems that the greater majority are not. Those who may be glad now would in near enough time realize what a bad position they would be in their careers, I anticipate, if correct. You need to not do what is wrong and dangerous to the public. Expanding scopes of practices would make things much worse, for everyone, including you, government, patients, doctors, pharmacists, family of patients and every Ontario public member. It would be doing wrong and it is overly dangerous, in my firmly held opinion. There are too many people flocking to Ontario, and each year it seems to be getting more congested. I would argue that with more people comes more illness and disease. Without provincial government discussing how to terminate that with Federal government, our situation is making us ill and I don’t conceive how Ontarians will ever be properly taken care of. Now, pharmacies can’t seem to keep up with supply for the demand. Then, you would be causing us to wait even longer because pharmacists would be busy trying to diagnose and prescribe (laughable at times but because it is so disturbing. I guess that’s how the human body maintains balance) I don’t think you want to wait half an hour, one hour, three hours or be told “Come back tomorrow” to simply pick up the medicine you may need to immediately start. I don’t. I am shocked over this proposal and have lost too much sleep over it. I wish I would have the opportunity to look at the Health Minister’s eyes and Premier’s eyes and be fortunate enough to convince them of why they must not allow the proposal to pass. My voice would represent the majority of people in Ontario, I believe. Have you not experienced any of the points mentioned above, yet? It is too much deterioration of our health system, and more than what some of us can endure in Ontario, without thoughts of which other province or other country to flee to. Allowing pharmacists to examine people and diagnose them is out of this world WRONG to every Ontarian, including the pharmacists themselves of whom so many (other than maybe large chain companies who would be profiting ) have expressed severe concern over the rushed and pressured pharmacy work, and refuse more of it. So, who would you be doing it for?; Not the people of Ontario. As an Ontario patient at times and general public at other times, I don’t see, hear or experience a positive outcome in the expanding scopes of practices, from knowing what I know through my experiences. Pharmacists were once upon a time, patient, attentive and informative, with how to take their medicine. We could all say “Goodbye” to those times. Now, we would be faced with rushed, inpatient pharmacists and a lack of proper advice & printouts. Moreover, we would likely be recipients of increasing errors, some of which could make us quite sick or be lethal. I am so afraid for all our seniors, middle aged adults, and children. We are equal in the care we deserve. Doctors assess/examine/investigate/diagnose/manage/prescribe/counsel. Pharmacists dispense. This is what the people of Ontario want, need and deserve. For everyone’s best interest ( even those who don’t yet see it) end the proposal now. PLEASE!
• NASAL CONGESTION (viral rhinitis, rhinosinusitis) NO! to this propsal. Help us understand. A patient presents with ” a stuffed nose or painful cheek”, NOT ” I have a viral sinusitis”. Are you going to place the pharmacists through rotations at Doctors’ offices to learn from them and practise how to examine ears, nose, throat neck, and Lungs? Prior to that, will you put them in medical school and then in residency training? If this is not necessary according to you, then simply let any highschool student do online modules and expect them to do what Doctors are trained for and while you put that into action, close all medical schools because that will be a waste of everyone’s time and money. In my lifetime, I do not imagine I could hear any proposal more insane than this one. Worsening of the primary health care system has worsened since 2023 by trying to get pharmacists to practice outside their scope of practice at the time , as experienced by me. You can NOT separate one body part from another when ill. This is one of the most common conditions whereby harm is caused by people getting medicine from the pharmacy withOUT a Doctor’s prescription and associated counselling. If you think it is ‘minor’, you are wrong. Most sinus infections are reported to be viral and should not receive antibiotics, yet pharmacists might feel pressured to prescribe or recommend them. What’s the harm?: – Antibiotic resistance to the individual patient – Allergic reactions – Public health harm – SUPER BUGS to harm the rest of society – Adverse effects of medication – Insistence from patients for whatever medicine they are convinced they need, leading to incorrect treatment and angry patients when they don’t get what they want. – Delayed referral to see a Doctor which will lead to more visits and more money to be paid out by OHIP regardless of which practitioner. – time spent arguing with a patient about why particular treatments were or were not recommended. – If a misdiagnosis or wrong treatment advice occurs or disatisfaction by a patient is experienced, the pharmacist and pharmacy could face legal liability or disciplinary action. The proposal must be refused.
• HEAD LICE (pediculosis)- Disgusting to think that pharmacists would be expected to run their fingers through each individual hair strand trying to find lice and their eggs. Who will stop some pharmacists from doing it without gloves? If using a comb, that comb would be contaminated. It would likely be placed on the desk/countertop /surface of which the next patient will touch. If pulling hair strands or placing a comb through hair, then hairs containing lice or lice eggs could fall on the floor or pharmacist’s clothing, which could be carried to the section where pills are on the countertop. No thanks. I don’t want to swallow a pill with lice on it! If the comb is reusable, pharmacies would need to be mandated to have a dedicated separate room for autoclave machine and disinfection sink; A different room from which patients are allowed to enter. This is expected for medical clinics according to public health standards, so we should not expect it would be any different for pharmacies, right? If it is not determined to be lice ( because in reality it may be psoriasis, seborrheic dermatitis, contact dermatitis, fungal infection, eczema, hair debris or dry dandruff), how does the pharmacist bill OHIP for a medical condition that does not fall under their ‘minor ailment’ list? Worse than that, how will the pharmacist advise the patient on what to do? ” See a doctor because I can’t prescribe for ……. ” What a waste of money paid out by the government to pharmacies. I think that any reasonable person would imagine that a pharmacist is going to recommend a drug ( as opposed to no drug ), then, he/she will likely recommend a product that the pharmacy carries or a drug which matches a condition on the ‘minor ailment’ list. This proposal can not become the reality of our health care system. Those involved with promoting that pharmacists should assess, examine, diagnose, prescribe and dispense should be ashamed of their names and faces, forever.
What disregard for scopes of practices! The public at large wants good care; proper care, I imagine, as their first priority and then for it to be received promptly. ACCESS is what WALK-IN clinics staffed with walk-in DOCTORS are for. They don’t require appointments! There is no need to try to get pharmacists to do what only a Doctor may have been trained to know or do. Respectfully, I think government needs to get thoroughly educated to have a better understanding in order to avoid making a grave error in decision making with the proposal. If government wants the votes of public, they should support Rapid Access ( Walk-In’ clinic) Doctor clinics, which usually work under the same roof as pharmacies. It’s pretty ironic to think that some may have thought of walk-in clinics, care provided by Doctors, to fragment care, yet it has arrived this far to propose that pharmacists should do it. THIS WILL WORSEN PATIENT’S CARE AND ACCESS TO RECORDS BY BEING SPREAD OUT IN TOO MANY DIFFERENT LOCATIONS, not to mention the Family Doctors running away from the job more rapidly than currently, I think is reasonable to foresee. As a patient, I want a pharmacist to DISPENSE my drugs WITHOUT ERROR and without exposure of my drugs to strep throat, nail clippings and cheesy smelling skin scraping debris, nearby. Any pharmacy I can think of (except for few select large chained ones) has adjacent to it, a walk-in clinic with Doctors who serve on a first come-first served basis. It is my firmly held thought and anticipation that trying to make pharmacists multi-task from the point of assessing all the way to dispensing is going to create so much error (whether discovered or not), college complaints, law suits, patient harm, let alone the loss of joy of working in the profession. You can read the comments yourself about the numerous pharmacists refusing proposal points. The Ontario patient can not be expected to know exactly how a pharmacist’s training and a Doctor’s training differs. Without being informed, how can there be an accurate reflection of the true number of people rejecting the proposal? Don’t ruin the pharmacists’ service to patients by rushing them, distracting them, and exhausting their minds. It is imaginable that the pharmacist will leave the profession because of getting a taste of what it feels like to provide so much work, time and energy, for very unmatchable payout, PRIOR to arriving at the point of dispensing. By the way, what should be discussed with the public is the CONFLICT OF INTEREST of assessing and dispensing!!!! Incredible as to what is being proposed and what has been allowed. For the sake of all Ontarians, remove all ‘assessments’ and ‘prescriptions’ and let the pharmacists do what they chose to study- PHARMACY!; and let them do it well, with sound minds.
This expansion is beneficial for both the system and the patient. To maintain the credibility of the pharmacist’s role and mitigate potential harm from their significant contribution to healthcare, I suggest the following: The pharmacist should provide a copy of their certificate confirming successful completion of a training course..
As an educator and pharmacy technician, I wholeheartedly support the proposed regulatory amendments. These changes hold such promise; improving access to care, enhancing the pharmacy team’s efficiency by enabling pharmacists and technicians to work to full scope, and elevating the profession on the whole. At the same time, safe and effective implementation will require strong team-based pharmacy care models, workflow redesign (pharmacist at entry), and improvements to dispensary infrastructure to provide the safe and confidential spaces necessary to facilitate these services.
I think it’s a great idea having these conditions added to our scope of practice as we are already providing advice to patients for these ailments. Now there will be more tailored care. There will be a need for additional measures in pharmacies to manage infection control. With a good pharmacy management team this is possible! Nobody likes change, and “everyone” complains about the Healthcare in Ontario. This is our opportunity to make a difference for everyone. Looking forward to reducing our country’s health care burden!
We have been spoonfed that pharmacists are the most accessible health care providers and why is that? Because all other HCP require appointments to manage their time and resources to ensure things like meal breaks and bathroom breaks. None of this applies to pharmacists. The government is suggesting this bandaid solution since pharmacists are not unionized like nurses and don’t have a strong professional organization like OMA to support them. When nurses are forced to do extra work like in COVID, they go to their union and get increased responsibility pay. When OHIP doesn’t pay family physicians enough, they switch to dermatology, become locums or decrease their roster by firing complex patients. What can a pharmacist do? Nothing because they are private and unionized. All of the public college nurses just went on strike and whose responsibility did they become to do all their placement vaccinations? Pharmacists because the government has drastically reduced public health nurses to only doing vaccination for children under 2. When the goverment eliminated free STI treatment and public health nurses that is also shifted to the private sector. Pharmacists “stepping up” allows the government to cut Public Health nurses and funding. Now, they can cut family phyisicians, chiropodists, and nurses in the sake of patient convenience. I already have patients demanding that I do an emergency supply of medication for them because they are too busy to see their doctor, even when their doctor has same day appointments and I am threatened that they will report me to the college if I deny their demand. This will happen for antibiotics and strep tests too I am sure since it is only a single click to report a pharmacist and even the most simple complaint is a huge investigation. It’s really hard to continue to do work that is denigrated and not valued since if I do zero vaccines in a day or 30 vaccines in a day I get paid the same amount!
Just a request to OCP. Flu shots started at almost all pharmacies. Please visit any chain pharmacies and spend a 3 to 4 hours to observe if the pharmacist on duty has enough time to administer flu shots and at the same time check the prescriptions and counsel the patients, etc. Also please observe what type of arguments the patients do with the pharmacist and pharmacy staff. Thanks
I’m excited to hear about the additional 14 minor ailments that will help alleviate the burden on the healthcare system, such as reducing ER visits and wait times. Also, support the community on a timely basis when they need a healthcare practitioner.
The current direction appears to shift the healthcare workload from the public sector to the private sector, rather than addressing the shortage of physicians through increased residency positions — despite the fact that many qualified doctors remain unmatched across Canada. This shift places increased responsibility on private sector entities, particularly pharmacy owners and corporate chains, who naturally seek to increase revenue. As a result, pharmacists are being tasked with an expanding scope of professional services. Pharmacists are now expected to manage multiple complex responsibilities simultaneously: Accurately and efficiently checking prescriptions (as delays can lead to patient dissatisfaction or pharmacy transfers) Administering vaccinations Answering phone calls Providing over-the-counter consultations Entering prescriptions due to inadequate staffing And delivering minor ailment assessments All of this is often expected from a single individual working an entire shift without breaks — and often standing the entire day. If an error occurs under these conditions, the pharmacist is held accountable by their regulatory body, which cites the need to “protect the public.” However, true public protection begins with ensuring pharmacists are working in safe, supportive, and sustainable environments. Pharmacists find themselves caught between three competing interests: Business owners focused primarily on profit Regulatory colleges focused exclusively on patient outcomes Patients expecting fast, flexible service — sometimes at odds with clinical best practices It is crucial that regulatory bodies take a step back and engage directly with the realities of community pharmacy practice. Spending time in a busy pharmacy setting would provide critical insight into the actual challenges frontline pharmacists face daily. Ultimately, regardless of feedback from frontline professionals, it seems likely that the government will proceed with these changes. If so, it is imperative to consider the introduction of a new category of “Prescribing Pharmacists” — professionals with independent billing numbers, who are not required to work from a pharmacy setting in order to deliver care.
I feel that the pharmacists are already burned out and overwhelmed with the amount of work they have to do in a 12 hours shift. The pharmacists need full attention and no distractions to be able to properly assess for “ minor ailments”, do injections, check prescriptions, question interactions, review medications, go over hospital discharges, answer OTC questions, answer questions from doctors. Without a pharmacist doing only professional services, the risk of mistakes is very high. Also I don’t think we are trained or have the space to properly assess for some of those ailments- nail clippings, sore throat swab, shingles examinations. Maybe in dedicated clinics with pharmacists just assessing patients the addition of those new minor ailments would be successful , in a pharmacy with only one pharmacist on the shift the risks would be higher than the returns.
we have enough knowledge to do it and do more ….. If nurse practitioners are almost have scope of family physician !!!!!!!!! i am sure we can by far .
Providing assessments for Minor Ailments is a great initiative. It adds to the pharmacists clinical knowledge to help participate and relieve the pressure of an already burdened health care system. Pharmacists will have to be able to manage and balance the increased demand for professional services with the sustained demand for dispensing duties as well.
Some patients have already figured out the red flag prompts which prevents them from getting meds from MA. Also, pushback when referring patient to thier doctor, there is an expectation they will be guaranteed medication.
It is really important in terms of providing support to vulnerable patients. We provide Sublocade injections at the pharmacy with other OAT treatment as well. Many other pharmacists would like to provide injections after being trained at the pharmacy without medical order or directive from MD. We enabled OUD patients to manage their disorder without going to doctor’s office to inject it in timely manor. The legislation could save many lives everywhere. It is important as well to reimburse the pharmacist for this service as well.
I took the vaccine administration course and helped vaccinate patients during Covid. This was a rewarding experience and I felt adequately trained to perform the task. I support Pharmacy Technicians and the proposed expanded role of administering additional vaccines. As long as we are adequately trained and have the support of a pharmacist available for patient concerns and questions, it’s a wonderful way for Pharmacy Technicians to interact with patients and contribute directly to their care. In terms of the role expanding for the pharmacists to treat additional ailments, I have concerns about this. I spend a lot of time working in BPMH and patients are not always forthcoming or clear in terms of medication usage/history. I worry that patients are in too much of a hurry and will omit pertinent information and this could create a liability issue for the pharmacists. Retail pharmacy can be a zoo and sometimes you are lucky to use the washroom or eat your meal. I think this is too much to put on the pharmacist. They would need extra support to take on this role and how much cost is associated with that? Keep the prescribing and assessing in the hands of the physicians who are adequately trained to do so and let the pharmacist focus on the clinical assessment and appropriateness of the prescribed medication.
I’ve seen multiple people say this is the same as other provinces…IT’S NOT!! I reviewed BC minor ailments – there is no strep, insomnia, otitis externa and no fungal scrappings or swabs. Saskatchewan it is a pilot project with only 11 pharmacies participating for step and 27 for ear infections in DEDICATED clinics. Hello people – there is a pharmacist shortage in Ontario and we are BURNED OUT!!!!
I think this is an excellent suggestion that supports both the pharmacy technician and pharmacist scopes of practice. These changes to the scope of practice would be a positive step forward for the profession — allowing pharmacy technicians to take on more responsibilities will not only enhance their role but also improve overall workflow and efficiency within the pharmacy. By optimizing each team member’s scope, pharmacists can focus more on clinical and patient-centered care, while technicians can contribute more fully to the technical and operational aspects of dispensing and medication management. Ultimately, this creates a more collaborative, efficient, and patient-focused practice environment.
Expansion and recognizing a professional is a great way to move ahead. Educating professionals in the circle of care and informing public of the professional status is also important. While it is the community pharmacy technicians that are been given these responsibilities, the responsibility to get paid for their jobs and ability to work within a safe zone is important.
Last year, I unfortunately made a pretty simple dispensing error (two tablets instead of one in a blister pack). It was very busy and I was rushed. My first complaint in 10 years of working as a pharmacist. It took the OCP 9 months to investigate and its over a year later and I am still awaiting repayment from my liability insurance of almost $5000 in costs I have occured. Not to mention thousands of dollars in remedial courses I had to take on preventing dispensing errors. The patient involved was incredibly verbally abusive and threatening to myself and the staff on multiple occasions and that was acceptable to the OCP, because they protect the public not us. As a result, I am terrified about the liability and investigations if I were to make a diagnosing or prescribing error. This minor dispensing error required several trips to the lawyer, a month of writing a response to OCP and months of correspendence with the insurance company. I will not be participating in anything except the most straight forward UTI cases. I work at a pharmacy with a walk in clinic and there are always lots of spots for patients to been seen by doctors for strep throat, fungal infections, ear infections etc where they book 20 min for an assessment. Do you have an extra 20 minutes in your day to do a complete assessment? I don’t even get a lunch break! Our manager has already determined that the pharmacist prescribing would lose money for the walk in clinic since they get paid way more for the same assessment. I agree that we need to stop saying that the pharmacist is the most accessible health care provider. Doesn’t mean that the pharmacist is the most APPROPRIATE health care provider. For pharmacists that are unaware (as I was) about what is involved in the complaint process, I hope this serves as a warning for you and practice very carefully.
With the addition of more minor ailments under the Ontario pharmacists’ scope of practice, it is important to emphasize that pharmacists are not diagnosing diseases but conducting structured assessments to determine the most appropriate recommendations—whether pharmacologic or non-pharmacologic. This initiative has proven to be highly beneficial for the public, improving accessibility and reducing the burden on the healthcare system. However, a potential concern arises when patients intentionally ignore or conceal red flags to obtain quick treatment and avoid waiting times in emergency departments. Such situations could put patients at risk and might unfairly reflect on the pharmacist’s competence or clinical judgment. At the same time, many pharmacists are already experiencing burnout due to increasing workloads and competing responsibilities. Despite these challenges, the expanded scope allows pharmacists to strengthen their clinical skills through patient assessment and evidence-based decision-making. To ensure safe and effective implementation, the College should carefully weigh the risks and benefits of this initiative. Pharmacists should not be compelled to perform tasks beyond what their education and clinical training have prepared them for. Additionally, pharmacies offering minor ailments services should provide dedicated spaces that are free from technical and administrative distractions, allowing pharmacists to focus on patient assessment in a calm, private, and professional environment.
I am a busy dermatologist. I am very busy and am happy to have other health care professionals assist in patient care. However, the proposed changes in scope to pharmacists is very flawed. Is a pharmacist trained in diagnosing shingles/herpes zoster? Do they have a proper differential diagnosis? Do they have the ability to do a viral culture? Where will the patient’s rash be examined, in the store in front of other customers? Will they make the diagnosis by talking to the patient? Do pharmacists take a full history, including immunosuppression? Is a pharmacist trained on how to take a proper fungal nail scraping? Do they know the differential diagnosis of dystrophic nails? Can they do appropriate follow up and blood tests if necessary when a patient is on systemic antifungal therapy? Is a pharmacist trained on how to do a fungal skin test? Are they trained on how to approach therapy for fungal skin /nail/hair infections? Will a pharmacist do a detailed and careful scalp examination for lice? How will they examine a patient, over the high counter? Consider the following: Many times each week a pharmacist asks me to “OK” substituting a cream for an ointment, and will not do the sub without my permission. So these same pharmacists who do not feel comfortable substituting a cream for an ointment are going to be allowed to diagnose and treat the above skin and nail conditions? Most pharmacists I deal with are really great at what they do. However, these professionals are not trained in diagnosing and treating the above conditions, and mistakes will be make, to the detriment of patient care.
DOING MINOR AILMENTS REQUIRES PROPER ASSESSMENT. IT’S A TIME CONSUMING PROCESS. WITH HIGH VOLUME OF PRESCRIPTIONS THAT PHARMACISTS ARE DEALING WITH, IT MAKES IT ALMOST IMPOSSIBLE TO ASSESS PATIENTS PROPERLY. ON THE OTHER HAND PEOPLE THINK THAT MINOR AILMENTS ARE LIKE GRABBING AN OTC MEDICATION. THEY NEED TO UNDERSTAND THAT IT NEEDS TIME TO ASSESS THE CONDITION PROPERLY. USUALLY PEOPLE ARE IN A RUSH AND WANT TO GET THE MEDICATION THAT THEY WANT RIGHT AWAY.
We would also like to see movement away from lists of vaccines, drugs and specific tests in the regulations. This would reduce red tap/improve access to care (eg when new vaccines come to market or a new POCT) and better align with a move to standard of care expectations as seen in other provinces. -Those with authorization to administer by injection should be able to inject anything within their competency – Likewise, moving away from drug lists for minor/common conditions. Pharmacists should also be given the ability to prescribe vaccinations as this would help to protect the public and prevent the back and forth with the physician. Pharmacists have the ability to determine if an immunization is safe, effective and indicated prior to providing the vaccination so they would have the knowledge to prescribe immunizations that are recommended and agreed upon by the patient. Otherwise, we are happy to see that scope is expanding and that pharmacists’ value is being recognized.
For pharmacies with high prescription counts, doing more minor ailment prescribing will be an additional task that the pharmacist needs to do. Between dispensing and prescribing, which should be prioritised? How can the college support pharmacists and make sure that they don’t experience burnout due to an increase in workload with dispensing, vaccinating and prescribing. Pharmacists should be properly compensated in doing more and should receive proper training and support.
I do not support this ridiculous proposal for any of the ‘ailments’, based on the example below. • SWIMMER’S EAR (OTITIS EXTERNA) Let’s try to picture this – The patient will NOT present with ” I have otitis externa” or whatever other diagnosis it could be. A patient would present with ” My ear hurts”. So, you are suggesting to a pharmacist to do what a DOCTOR would be expected to do and that means to have an exchange of questions and answers then to examine before determing suspicion of one or a few potential causes : – a disease of the jaw, neck or throat or cancer contributung to infection. – referral from tooth problem ( and patient was feeling very warm as it is hot outside and he/she is overdressed, and sweating causing the canal and lobe to apear red ) – Infection spreading to skull base bone. However, what does the pharmacist advise if the ear is NOT suspected to be an external ear canal problem? Should the pharmacist say “I don’t think it’s a swimmer’s ear so sorry, I am not allowed to prescribe something for your problem” OR “You should see the doctor” ( the Doctor’s office is often if not always a few feet away ) That would mean the patient’s assessment would cause OHIP to pay both the pharmacist and the doctor. It already has been happening plenty enough since the start of pharmacists prescribing. What a shameful waste of tax payers’ $$ and of patient’s time. OR will the pharmacist recommend a treatment to address ‘swimmer’s ear’ because of feeling pressure to prescribe? In the meantime, the diagnosis is actually NOT an infection or ‘otitis externa’ . I doubt anyone would deny the conflict of interest in allowing a pharmacist to both prescribe and dispense. I can’t believe such a propsal exists. End the nonsense now!
Several of the items proposed to be diagnosed and treated by pharmacists would normally be diagnosed by physicians after a physical exam is done (At a minimum) and after specific investigations are performed – such as skin scrapings, viral cultures, dermoscopy. Specifically: – shingles (herpes zoster) —————- VIRAL CULTURE – fungal nail infections (onychomycosis) ———– NAIL CLIPPINGS – head lice (pediculosis) ——————- Physical exam with dermoscopy – dandruff (seborrheic dermatitis) —————- Physical exam – ringworm (tinea corporis) – —————- SCALP SCRAPINGS sent for culture – jock itch (tinea cruris) —————— SKIN SCRAPING sent for culture – warts (Verrucae – vulgaris, plantar; excluding face and genitals) ———— physical exam with dermoscopy Please do not add these conditions to pharmacists’ scope of responsibilities unless they will also be equipped with the necessary training and diagnostic tools to accurately make the diagnoses. Otherwise, this will not help the general public, it will only waste resources and ultimately delay/ hinder them from receiving proper care.
I think its crazy you are asking pharmacists to make diagnosis and treat. There are plenty of doctors who would be happy to do this. Pharmacists cannot make diagnosis like this. Are they going to do lab tests before they start prescribing. What if the sore throat is viral or mono? Are they going to swab before starting on antibiotics or give me diarrhea for 10 days with antibiotics for a viral infection? Also, all of those fungal infections should be confirmed before you start treating. How is a pharmacist going to diagnose jock itch if they aren’t trained to LOOK AT IT. What is this system coming to? There are thousands of doctors but you are using untrained pharmacists to give cheap subpar care and all that will happen is they will screw up and then the doctors won’t be able to tell what the rash was because it will be messed up by the wrong treatment. Who is in charge of this circus. I will be lodging a formal complaint. Please tell me how. Pharmacists don’t know how to diagnose. They know medications but they don’t know MEDICINE. Let the medical doctors do the diagnosing and go back to how it was. As it is, the pharmacists keep changing the medication my doctor gave me and its harming me because whet the pharmacist gives me doesn’t help and then I have to take off more time to see the doctor again.
My understanding is that pharmacists have very little training with respect to the diagnosis of some of these entities such as herpes zoster, onychomycosis, tinea cruris. There is a differential diagnosis that should be applied after a competent skin examination. Will there be an appropriate facility for examination? Diagnosis should precede treatment and should not depend only on self diagnosis. Some of the medications that are used have a significant cost to patients. Will viral tests and fungal scrapings be performed by pharmacists? What documentation will be required with respect to history, physical diagnosis and treatment and how long will this documentation need to be kept? (e.g. for physicians records need to be retained for patients 18 years of age and older for 10 years since the last clinical entry). There is a definite conflict of interest here as the prescriber will have a clear financial incentive to prescribe costly medications such as Jublia, and Valtrex with no accountability
I am truly delighted to hear these upcoming changes. They will not only use so highly trained and under used professionals but are also a blessing for ailing humanity. I strongly recommend to add following conditions in Pharmacist prescribing list where no complex diagnosis is required. 1. Birth control pills 2. All travel meds so travelling people don’t have to wait long times to book clinics. Prescribing, injections, dispensing all at one stop. How convenient would be that !!! 3. All vaccines so patients get protection ASAP. This will help in disease prevention. 4. Other common ailments to take off the loads from physicians and emergencies. I am so concerned about millions of Canadians who do not have a doctor available. I have seen miseries where people suffering from illness with no access to a physician. Pharmacists are highly educated and trained professionals and fortunately are readily available. Why w are taking so long to use them to their full scope and protect the ailing old age patients! We definitely need to speed up process of further expansions in scope of Pharmacists. Thanks
I have reviewed the draft regulations and am very happy to learn about the proposed changes. Pharmacists are a very accessible healthcare professional who are already taking a lot of burden off of our healthcare system by providing professional services. These additional minor ailment will further reduce loads on emergency rooms and walk in clinics where patients have to wait hours to be seen for a minor ailment. These changes will allow the critical patients to be seen by family physicians, hospital emergency departments or walk in clinics in a timely manner. Administering vaccines is a technical service which can easily be taken over by the pharmacy technicians freeing the pharmacist’s time for other professional services. I am looking forward to these changes hoping that they will not further increase the corporate pressure on the pharmacists. The most important thing is that the reimbursement for these services should be the same across all healthcare professionals. Doctors, NPs, Pharmacist etc all should be reimbursed equally for the same service provided. It should NOT be a tiered system where pharmacist are at the bottom of the reimbursement model.
If all para medical professionals as mentioned above would be playing the role of physician why do we exists as family doctors!!! Are we being replaced by these bodies !! Why do you keep training medical students ????? You should stop this plan immediately please !!! Thank you
The proposed changes are long due. Infact, there should be more prescribing authority to pharmacist along with proper training. Other provinces (i.e, Alberta) already allowing pharmacist and technicians to practice full scope. However, policy makers should consider reasonable compensation for this services. Lack of proper staffing and help at pharmacy level may increase risk of “Doing Harm” rather than preventing it.
The proposed changes are long due. Infact, there should be more prescribing authority to pharmacist along with proper training. Other provinces (i.e, Alberta) already allowing pharmacist and technicians to practice full scope.
I agree with the pharmacists being able to administer more of the vaccines but it requires two supports, 1) Dedicated block time for vaccine administration unless the pharmacy is not busy (are there any out there?). Trying to juggle phones, prescriptions, minor ailments, and vaccines at the same time is prone to errors. This is especially important where we are giving huge numbers of flu, covid, RSV, Shingrix, and now potentially Td and others. Even doctors offices block time for the RSV administration rather than just giving them between everything else. 2) We need a user friendly provincial vaccine documentation system based on patient’s OHIP number whereby all vaccines are updated by the health care professional. It’s a rare patient that knows when they received their last tetanus vaccine. If we can administer it, I suspect that there will be the corporate pressure to routinely ask patients, “Have you had a tetanus in the past 10 years” and if they don’t know, to just give it (for profit). How many doses will a patient get? Who will really pull it all together? If no centralized system, yes we can fax the Dr (assuming the patient has one and it’s more workload) but in some cases you are faxing to a hospital clinic and it’s unlikely to get to the patient’s record.
Allowing pharmacists to prescribe benzodiazepines and Z drugs for acute insomnia is VERY dangerous. They are grossly overused as it is. Pharmacists are trying to find time to deprescribe these drugs for good reasons but the time required for this is generally lacking. This leaves too many patients on these drugs for much longer than is appropriate. There is so much misinformation about insomnia. Please read about the non-pharmaceutical tools for sleep hygiene. CBT is best but our health care system is lacking these resources. There are other techniques. These are very addictive drugs that have significant risks for falls, memory loss, etc. for our seniors. You are trying to manage a shortage in the health care system but for at least this one you are creating more issues/problems requiring more risks and workload. You might think that you are looking at someone that has just lost their spouse and needs 10 days of zopiclone but in reality too many people will end up on these drugs saying “they have trouble sleeping lately” and need something.
I’m concerned about including onychomycosis unless pharmacists are only permitted to prescribe with a positive nail fungal scraping. There should not be the allowance to start treatment based on what appears to be a fungal nail infection while one awaits the results. While fungal nail infections are often the most likely, there are many other causes of thickened yellow nails e.g. psoriatic nails, lichen planus, yellow nail syndrome, nail trauma, contact dermatitis, nail malignancy, chronic paronychia, and normal aging. There will be the corporate profit pressures to just prescribe Jublia with the many refills generated to complete the 48 week course. You are also exposing the patient to a lot of daily work for what might not even be onychomycosis. If pharmacists will be able to prescribe terbenafine then we will need to be able to order liver function tests and be responsible to do the follow-up of the results and the same for 3-4 week repeat testing. Do we have the computer systems and consistent workforce to ensure this all happens?? There is no urgency for nail infections. Will profit oriented businesses take the time to explain to patients that the success of the topical treatments, is mediocre and frequently comes back?
As a patient, it’s convenient for me to get flu shot and covid vaccines at the pharmacies, but whenever I go to chain pharmacies, i.e. either Shoppers or Rexall, there are always a lots of patients waiting to get flu shot as well as other patients to fill prescriptions. Lots of time, it takes 45 minute to 1 hour to get flu shot because there is only 1 pharmacist on duty who has to check prescriptions and administer vaccines. For the last couple of years, I have been seeing the sign that a few minor ailments can be treated by pharmacists at the pharmacies. A few months back, my 4 years old son had eye infection so I took him to nearby Shoppers Drug Mart and I was told to make appointment because the pharmacist was busy doing prescription, so I had to go to the nearby walk-in clinic. As a patient, I believe that pharmacists have good knowledge about medical conditions and medicines and they are helping the community for the last few years by administering flu shots and other vaccines and now by prescription for some minor ailments. During Covid time, when the doctors’s offices remained closed, pharmacists were always available to help the patients. It’s my experience and feeling that the pharmacists would like to help the patients but they are already overwhelmed due to their high workload. I REQUEST ALL THE COMPANIES TO PROVIDE GOOD AND STRESS-FREE (IF NOT 100% THEN AS MUCH LESS AS POSSIBLE) WORK ENVIRONMENT TO THE PHARMACISTS SO THAT THEY GET ENOUGH TIME TO DO ALL THEIR WORK, I.E., CHECKING PRESCRIPTIONS, ADMINISTERING INJECTIONS, AND PRESCRIBING FOR MINOR AILMENTS.
As a Program Manager for Vaccine Preventable Diseases (VPD) in northeastern Ontario, I fully support the proposed expansion of pharmacists’ and pharmacy technicians’ scope of practice, particularly the provisions that would enable them to administer additional routinely offered vaccines. In many northern and rural communities, access to primary care remains limited, and pharmacists often represent the most accessible, trusted, and consistent point of contact for residents seeking immunization. Expanding their ability to administer a broader range of vaccines would directly strengthen Ontario’s immunization infrastructure and enhance vaccine equity across the province. From a public health perspective, this change would: Increase vaccine accessibility and uptake by offering residents more flexible and convenient opportunities for vaccination, particularly outside of regular clinic hours or in communities where public health-led clinics are less frequent. Support rapid deployment during seasonal and emergent campaigns (e.g., influenza, COVID-19, RSV, Mpox, or other outbreak responses) by leveraging an existing, trained network of community-based immunizers. Reduce the operational burden on public health units, allowing us to focus on surveillance, program planning, high-risk population outreach, and cold-chain management. Promote consistent coverage across regions, especially in smaller or remote communities where public health and primary care resources are stretched thin. Pharmacists have already demonstrated success in supporting routine and seasonal immunization programs with professionalism and adherence to vaccine storage and handling standards. Expanding their authorized vaccine list would further integrate them as key partners in Ontario’s immunization strategy—ultimately helping to protect more Ontarians, more efficiently, and closer to home.
We are already doing majority of these in BC successfully. It will benefit the people of Ontario if implemented. I strongly support this initiative.
I would be very careful with adoption of these new minor ailments. I have been providing minor ailment treatments thus far for a few conditions. Our decisions are solely based on the patient’s description of the health problem and we prescribe treatment without actually establishing the diagnosis. We lack diagnostic tools as well as the actual medical knowledge on how to confirm that the patient’s description of the problem is in fact the minor ailment we are allowed to treat. Take the example of otitis externa. If you see a physician, your ear would be examined with otoscope and the diagnosis would be established without a doubt. We are not able to do this in the pharmacy. Some of the minor ailments we already treat effectively with OTC products. Take example of tinea corporis and tinea cruris. Both conditions could be treated with a variety of OTC medications. The only benefit of prescribing them would be the insurance payment and most drug plans do not pay for them anyways. A few prescription options for these ailments are usually reserved for more serious cases that again we have no ability to confirm. I find that our workload will hardly allow for more time spent on treating additional conditions. This issue can be addressed by increasing the payment from $19 to somewhere between $30-40 per assessment. This would allow us to use more pharmacist overlap hours and it will still be far bellow physician’s compensation
Expanding R.Ph.T. vaccination capabilities makes sense to help alleviate the workload for pharmacists. Interns should not be able to do it unless they have been certified in their program, and their preceptor is also certified to teach for injections. Expanding on some of the ailments listed makes sense. Shingles and others listed, which can escalate depending on where they are found on the body, do pose some concerns. Are these ailment tests going to be covered by the province? Will the community pharmacies be able to warrant more staff to help with the change in workflow? If compensation isn’t available or enough to aid in adding more employees to the workflow flow then maybe the focus should be put to finding ways to better support the Pharmacy staff working with the already new influx of changes.
REJECT THE PROPOSAL IN IT’S ENTIRETY The proposal would not be helping Ontarians in the way some might think. It is my firn belief that it is hurting them, although you and they may not realize that yet. Perhaps within a few years policy makers might become aware of suffered harm and resentment by pharmacists and public members due to practitioners practising in a different scope of practice from what formal training originally entailed. Hopefully, for everyone’s sake, individual law suits or class action ones won’t need to be dealt with. What might seem ‘minor’ to a NON-Doctor can be so many other serious things to a Doctor. You should have serious consultations with Doctors. Lend your ears well and let them help you to help the residents of Ontario. Let’s imagine: Would it be foolish and tremendously dangerous to direct policemen to enter burning buildings to fight fires, when all the policeman is educated, trained and skilled in is policework rather than having received firefighter training? Do you take your car to a ‘Car Wash’ when what it needs is a mechanic? People want help with their medical problems. For that, they need Medical Doctors. If you want votes by the ‘people’, the people will vote for this. Let’s inform everyone to stop saying that pharmacists are more accessible than a doctor. Are you forgetting that WALK-IN clinics served by Doctors exist for this purpose? That is easy access! Government needs to support more of them. For the most part, as per my observation, where there is a pharmacy, there is a Doctor’s clinic- usually ‘walk-in,’ in the same building. This ‘walk-in’ Doctors’ clinic has been the traditional easy access! Why would any leaders or advocates not value these clinics instead of seeming to try to abolish them? Don’t ruin the profession of pharmacy Let pharmacists work in an unrushed manner and without the need to touch patients. If you pay a lot of money for an exotic vehicle ( High Taxes for Health Care by Doctors) but are provided with a toy car ( pharmacists playing ‘Doctor’), would you be worried, disappointed or feel angry ? Although you might be able to fit inside and drive the toy car, would you feel safe on a real road? Unless you make pharmacists do many years of MEDICAL + Residency schooling and major board exams separate from pharmacy school, then according my thought process, they have no role in assessing, diagnosing or prescribing. They should be permitted only to dispense! You should find the proposal severely troubling if there is an overwhelming amount of pharmacists themselves rejecting the proposal ( from the conments I read so far on the internet. ). This topic is spreading to the public too. Representatives tasked with making decisions on this proposal, Reject the proposal in it’s entirety.
WHY NOT to allow the preposterous proposal: • SHINGLES (herpes zoster) – when affects certain areas, it is considerate an emergency. Medications to treat this condition can damage kidneys. Pharmacists don’t have access to the patient’s blood test results prior to determining proper prescriptions. • ACUTE INSOMNIA- a pitfall would be to aassume it’s from a single cause. It requires a lengthy history and detailed physical examination. There are numerous potential causes. Expect to take at least 15 minutes to assess; An assessment a pharmacist has not been trained for. Does it make sense to make customers who are in line to pick up medicine wait until ‘assessments’ are done? • FUNGAL NAIL infections (onychomycosis)- very disgusting to think that pharmacists would be touching medication tablets after they touched people’s feet and toenails. Just because you would rebut by saying well they can wash their hands, noone will know when they don’t and likely they won’t given that i have not yet seen sinks in the pharmacy room. Is it going to be mandated by law that ‘consultation’ rooms MUST have a sink for pharmacists and patients to wash hands? Do you realize that these rooms are actually not only for ‘consultations’? Examinations, tests and procedures would be occuring in them. Would they be mandated to abide by the same rules as expected for doctors’ rooms? Deny the proposal.
As a pharmacist in Ontario, I truly support expanding the list of minor ailments we’re able to prescribe for. Every day, I see how much of a difference it makes for patients — improving access, saving them time, and taking pressure off emergency rooms, doctors, and nurse practitioners. We genuinely care about helping our patients and are highly trained to provide this kind of care safely and effectively. That said, there’s still a big concern with the current compensation model. In most cases, the payment for minor ailments services goes to large corporate chains instead of directly to the pharmacists who are actually providing the care. Many of us don’t own our pharmacies, so we’re not fairly compensated for the time, effort, and clinical judgment that go into these consultations. If pharmacists were compensated directly, it would not only be fair but would also encourage more of us to dedicate time to these services — ultimately leading to even better patient outcomes. I really hope OCP considers both expanding the list of minor ailments and advocating for a fairer compensation model that properly recognizes pharmacists for their work.
Expanding the pharmacist scope yet again will likely cause more errors in community pharmacies since pharmacists are already overworked. Has OCP reached out to community pharmacies to see how the minor ailments prescribing has gone and if there has been an increase in errors since having it implemented? I would be concerned about staff burnout and patient safety.
Its a great idea in fact the scope should be expanded to a little bit more ailments . It helps the patients a lot ; I truly felt helpless at times before this advent when they don’t have a family doctor or a weekend or their doctors away on holidays . We have saved a boatload off from hospitals and urgent care and charging next to nothing fee from Govt . Pharmacists are a crucial part of the health circle , they know when to refer a patient to doctor or emergency many of them understand fully how to diagnose these minor ailments through their years of practice and symptom presentation . I am truly enjoying helping my patients but Pharmacist need their proper validation with an increased pay throughout Ontario like our neighbors in the south who only dispense but get paid double than us here . We should be able to provide for our family with a carefree mind while being busy with our patients
Its a great idea in fact the scope should be expanded to a little bit more ailments . It helps the patients a lot i enjoy helping them and seeing them helpless at times when they don’t have a family doctor or a weekend or their doctors away on holidays . We have saved a boatload off from hospitals and urgent care and charging next to nothing fee from Govt . Pharmacists are a crucial part of the health circle , they know when to refer a patient to doctor or emergency many of them understand fully how to diagnose these minor ailments through their years of practice and symptom presentation . I am truly enjoying helping my patients but Pharmacist need their proper validation with an increased pay throughout Ontario like our neighbors in the south who only dispense but get paid double than us here . We should be able to provide for our family with a carefree mind while being busy with our patients
It is great to see more minor ailments prescribing is coming under our scope, which enables us to use our learned knowledge better to serve Ontarians. I hope they add therapeutic substitutions to our scope as well which comes useful in many urgent situations. OCP also must look in to standardizing the pay for Pharmacists. Many other professions have standard pay but ours do not. Also, the minor ailments prescribing fee should directly go to the prescribing pharmacist as they are using their knowledge and expertise to provide care. But in many locations we get nothing. Please push for better standards of pay and direct compensation for minor ailments prescribing for pharmacists.
As much as this would decrease with time at the the doctors office and help a lot of Canadians with their health, the pharmacist providing this service should be compensated, that is the only way to make sure most pharmacists will be in board. If the pharmacist providing this service is paid and not the organization. The organization should be compensated also as the working environment and other tools need will be provided by the organization . In overall, to ensure that the pharmacist is not just being used as a tool by the company and government, they should get a fee for service compensation and this should cut across all government funded services.
While I support expanding the pharmacist’s scope to enhance access to care, I must emphasize that these new responsibilities will significantly increase workload in an already overextended environment. Pharmacists are currently balancing high prescription volumes, patient counseling, clinical documentation, vaccinations, and compliance tasks — often without any increase in staffing support. In corporate and chain settings, we continue to see staffing reductions, extended hours, and performance pressures that prioritize metrics over patient safety. Instead of investing in adequate pharmacist and technician coverage, some organizations have cut support staff “to the bone,” used student volunteers instead of experienced pharmacy assistants, leaving pharmacists isolated during peak workload periods. Under such conditions, every new assessment, injection, or prescription authorization comes at the expense of time otherwise dedicated to verifying prescriptions, managing interactions, and preventing dispensing errors. Without mandated minimum staffing standards, this expanded scope risks compromising medication safety, increasing burnout, and endangering both pharmacists and patients. Implementation should therefore be contingent on enforceable workload and staffing guidelines, corporate accountability measures, and funding structures that allow pharmacies to hire and train additional qualified staff. Expansion without such safeguards will undermine the very goals of improving access and quality of care.
I feel as though it would be beneficial to see the technician scope of practice include injections in schedule 3. It would help to alleviate some of the work off the pharmacists to achieve better workflow and increased safety and patient care in the pharmacy. However, the minor ailments for pharmacists can be seen as beneficial to patients, it can put all of weight onto the pharmacist and potentially lead to burnout. I also don’t think pharmacists should be clipping nails to further their findings, if that’s how it will be just eliminate prescribing for onychomycosis.
I am writing to express my support for the proposed expansion of the scope of practice for pharmacy professionals in Ontario. These changes represent an important step toward improving timely access to care and optimizing the skills of pharmacists and pharmacy technicians. However, I recommend that the following points be addressed to ensure the success and sustainability of the proposed changes: Pharmacy Design Requirements: There should be accompanying regulations or guidance outlining physical design standards for pharmacies offering minor ailment prescribing. Dedicated consultation areas, privacy standards, and workflow accommodations will be essential to maintaining professional integrity and patient confidentiality. Authority to Order Vaccines: Pharmacists should be explicitly authorized to order vaccines, not only administer them. This would reduce supply disruptions and improve responsiveness to community vaccination needs. Inclusion of Chronic Disease Management: The proposal focuses heavily on episodic or minor conditions but omits the pharmacist’s role in ongoing medication management for chronic diseases. Pharmacists are well-trained to adjust, optimize, and monitor therapy in collaboration with prescribers. Enabling such authority would significantly improve health outcomes, reduce system burden, and advance the government’s goal of better access to care. In summary, I support the direction of this proposal but urge the Ministry and College to consider additional provisions that ensure practice environments are properly equipped, vaccine access is streamlined, and pharmacists’ clinical expertise in chronic disease management is fully utilized.
I was a family health team pharmacist for 5 years before the position was eliminated by budget cuts. If the government truly wants pharmacists prescribing, they should be embedded in primary care with assess to the same medical records (EMR) and increasing collaboration with physicians rather than imposing this on dispensing community pharmacists. I would encourage the government and OCP to read Lisa Dolvich’s article Better together: Where are the pharmacists in Ontario’s primary care plan? (available at https://healthydebate.ca/2025/06/topic/better-together-pharmacists-ontario-primary-care-plan). Quoting Lisa “The budget rightly prioritized the health workforce shortage and the need to expand medical school seats and programs for future physicians and nurses. But there is also an urgent need to expand opportunities for domestically trained future pharmacists. In fact, while community pharmacists are among the most accessible health-care providers, Ontario has the smallest ratio of pharmacists per 100,000 persons, lower than any other province in Canada. To compound the issue, recent reports from Health Canada and Ontario-based health workforce studies have shown an annual shortage of more than 600 pharmacists in Ontario. This shortage exceeds the number of domestically trained seats we have in the province. Support for training more pharmacists, which we urgently need, is missing.” OCP should advocate for addressing the pharmacist shortage and increasing training and spots for pharmacists in primary care!
I fully support the additional expanded scope of practice list.
I would strongly encourage OCP and the government to read Better Together: where are the pharmacists in Ontario’s primary care available at https://healthydebate.ca/2025/06/topic/better-together-pharmacists-ontario-primary-care-plan/#:~:text=But%20there%20is%20also%20an,any%20other%20province%20in%20Canada. And also reread OMA response to the proposed minor ailments in 2023 – increasing community pharmacist minor ailment prescribing leads to increased fragmentation of the health care system and increased administrative burden to physicians (already at 19 hours per week). Physicians do not want this. How about focusing on the pharmacist shortage rather than the physician shortage (which is already accounted for in the budget by increasing seats in medical schools) To quote Lisa Dolvich ” In fact, while community pharmacists are among the most accessible health-care providers, Ontario has the smallest ratio of pharmacists per 100,000 persons, lower than any other province in Canada. To compound the issue, recent reports from Health Canada and Ontario-based health workforce studies have shown an annual shortage of more than 600 pharmacists in Ontario. This shortage exceeds the number of domestically trained seats we have in the province. Support for training more pharmacists, which we urgently need, is missing.” OCP should focus on pharmacists needs not physicians!
Let’s be honest here…OCP has already made up their mind and are doing this regardless of the feedback so they can post it on their beautiful new website. I am so glad to see that pharmacy technicians support this, but let’s be honest here the majority work in hospital so they don’t even see the vast majority of vaccines we see in community practice. Let’s be honest here, the ER is going to use this. I have already seen pharmacists in the ER doing minor ailment prescribing for UTIs. Let’s be honest here, when I go to ER I want to see a doctor, not a pharmacist. So OCP wants to make me a doctor? Then give me the title. I graduated right before the PharmD program and was 1 year out from any bridging program. Now, it takes 3 years and $100 000 to get a title of PharmD yet I can teach for their courses. Give us the pay, titles and respect we deserve. I think my 20 years of experience more than suffices for any PharmD placements, considering I have taught dozens of students. Equal work for the job we are doing
As a practicing community pharmacist, the proposed changes to the minor ailment program are concerning for various reasons. Firstly, given OCP’s mandate is to protect the public, have there been any consultations with pharmacists about how the current minor ailment program is going? Per my knowledge, there has been no effort to find out how pharmacists are managing having this additional responsibility along with managing the dispensary, dispensing OAT, answering questions and all of the tasks we do on an everyday basis. As evidenced from these comments, we have not been heard about our experience and yet there are proposals to add more minor ailments. As many have already mentioned, there is concern about patients learning that one pharmacist won’t be prescribing and then going to another pharmacy with different answers. There is no system in place to monitor this other than if it is caught during billing, which is a time consuming process. Additionally, what sort of training/equipment/staffing is the college going to be mandating that pharmacists/pharmacies have? Does the college have a way of assessing if pharmacies have adequate staffing ratios for their volume and services? If pharmacists are expected to continue to add on tasks with no additional pharmacist overlap, the quality of all the services provided in a pharmacy is bound to decrease. As we know, business pressures result in pharmacies being staffed to the bones while expecting the maximum in terms of filling prescriptions and providing more and more services in the same amount of time and with the same amount of staff. This is inherently going to create a system that is overworking and burning out individual pharmacists, which will ultimately have an impact on patient safety and care. Alberta has a process in which pharmacists apply if they want to engage in prescribing – in which they demonstrate their processes and abilities. Ontario has no such process for prescribing by pharmacists. If there are pharmacists who work in environments that allow them to do these services, then why not have a similar process by having them apply? Compensating the individual pharmacist who prescribes rather than the pharmacy is also another way to help alleviate pressures and still allow pharmacists who feel they have the knowledge, skills, and time to assess for prescribing. Some of the minor ailments suggested in this proposal are not “minor”. Shingles is not a minor ailment as it has potential for complications beyond what a pharmacist can manage. If I understand correctly, the acute insomnia drug tables would allow pharmacists to prescribe benzodiazepines and Z drugs – this is incredibly concerning as I do not believe that these are medications that should be started by pharmacists given their potential for dependence. The question is who is going to be managing patients that have potential complications from these “minor ailments”. Some of the minor ailments in this list such as mild headache, calluses/corns, dry eye have medication options that are OTC already – adding these to the list puts the expectation with the public that pharmacists can provide more than OTC, resulting in frustration and time being consumed unnecessarily when we already answer these as OTC questions. Ultimately, while the idea of minor ailment prescribing may seem great to some on paper, it seems short sighted in terms of the actual benefit patients get from it and concerning from a pharmacists perspective given the lack of addressing the widespread pharmacy workload and staffing concerns. Why not let pharmacists do what we do best and use that to help address the health care concerns? Pharmacists are the medication experts of the health care teams. If there was renumeration for pharmacists adapting and renewing prescriptions, that would save time and ensure more timely care for patients. If there was a way for pharmacists to be more involved and working alongside physicians, a pharmacist may be able to help create a taper plan for getting a patient off benzodiazepines, for example. There are many ways to utilize a pharmacist’s skillset that goes beyond prescribing for a list of ailments that a large majority of pharmacists do not think is appropriate.
Let’s be honest here…OCP has already made up their mind and are doing this regardless of the feedback so they can post it on their beautiful new website. I am so glad to see that pharmacy technicians support this, but let’s be honest here majority work in hospital so they don’t even see the vast majority in community practice. I have already seen pharmacists in the ER doing minor ailment prescribing for UTIs. Let’s be honest here, when I go to ER I want to see a doctor, not a pharmacist. So OCP wants to make me a doctor? Then give me the title. I graduated right before the PharmD program and was 1 year out from any bridging program. Now, it takes 3 years and $100 000 to get a title of PharmD yet I can teach for their courses. Give us the pay, titles and respect we deserve. I think my 20 years of experience more than suffices for any PharmD placements, considering I have taught dozens of students. Equal work for the job we are doing
I think all these recommendations are great for the healthcare system, especially enabling pharmacy technicians to administer all the vaccines that pharmacists are allowed to administer.
The proposed changes would provide patients with better access to care. Positive changes can provide positive outcomes. I support the suggested changes.
The Danger When You Don’t Know What You Don’t Know’ To assess and prescribe for 14 additional minor ailments is NONSENSICAL Here’s why: • SORE THROAT (acute pharyngitis) Infectious Mono – no exam bed! No exam bed means you can’t examine to assess spleen involvement. To an athlete or non-athlete who receives blunt trauma to the spleen which can rupture, this is Life threatening! Epiglottitis- Life threatening! Measures to secute the airway might be needed. The examination itself could cause the airway to obstruct. The pharmacist is not trained to have a crash cart for airway intervention, ready to use. Rapid Strep test processing time to obtain the result is typically 5 to 10 minutes once the sample is collected. Do a few to figure out how fast you would want to exclude it from your practice. • CALLUSES & CORNS- often caused by underlying bony deformities. Proper management might involve referring to a pedorthist, or recommending the proper orthotic or footwear. So, do not think that salicylic acid or pads are the most appropriate treatment options. • HEADACHE (mild) Serious causes can initially appear mild and delaying proper evaluation can have grave consequences. Some potential causes: Mild or slow brain bleed Brain tumor Brain abscess Artery by temple inflamed -(blindness if untreated) Scenario- labeled as migraine or tension headache -> No neuroimaging is ordered because of not being a doctor to sort out other signs or symptoms, and the patient is prescribed something that the pharmacy has to offer -> Within hours or days, the patient collapses or dies from a ruptured aneurysm ( recall -a mild headache ). When not equipped to figure things out, don’t forget that failure to write a referral letter to a specialist Doctor can lead to a malpractice claim. The scary thing is that a pharmacist can not be expected to know what he/she does not know. END this wild fantasy proposal NOW.
As a patient, I really appreciate the expansion of services that pharmacists and technicians provide as they’re the most accessible healthcare professional compared to doctors and nurse practitioners. I trust my pharmacist’s knowledge more than my doctor who’s be reached to rewrite their precisions because dosing errors or lack of effectiveness have been found. However, it’s also clear that the pharmacists and technicians are often stressed and burnout, which is also concerning. The pharmacists don’t even have proper or full breaks, which makes no sense and is not in line with workplace safety standards. It’s hard to imagine how much more pharmacists and technicians will be pushed to their limits when additional responsibilities are added. For them to truly help the public and patient care effectively, there needs to be new and real change that supports and advocates for the pharmacists and technicians. This includes higher pay and safer staffing ratios, as well as their direct involvement in the rollout of new services. OCP needs to better advocacy for pharmacist staff. The current system seems to prioritize corporate metrics over the well-being of the pharmacy staff, which is not sustainable and not safe.
Expanding patient care services is commendable, but addressing pharmacist and technician burnout is essential as many are overworked and overloaded. OCP and OPA have not yet fully advocated for higher pay or safer staffing ratios to carry out these activities in a safe and effective manner. Fees from new ailments and tests are directed to the company and its leadership, increasing business pressures and corporate metrics without actually supporting the frontline staff. How can there be true buy-in when pharmacists and technicians are not directly involved in the rollout process?
Proposal is SEVERELY FLAWED Pharmacists will NOT be more quickly or easily accessible. ‘Access’ does not mean it is right or safe or effective. Not cheaper either; I think it will cost the government much more money than they realize. For the same problem NOT managed correctly the first time around, it might require another 3 or more encounters. Doesn’t this hold true for so many aspects of our lives? If you don’t do things properly the first time around, it often leads to more money and time being spent later? Another concern is that nothing has been or is currently limiting patients from seeing both the doctor and the pharmacist on the same day ( which already has occurred), so for colleagues who split profit from the pharmacy, this might be an attractive and acceptable proposal, yet for the actual practitioner serving the patient, well surprise when the pharmacists start receiving more complaint letters. The pharmacist might wonder ‘Why am I taking the liability of doing what a doctor should be doing’? OR for the pharmacy owner or practitioner if it were to apply, when the time arrives to get paid- voila! a rejected OHIP claim because the patient saw another practitioner who billed OHIP for the same fee/service code or diagnostic code on the same date ( as has been reported by the doctor)? The proposal would be fragmenting the health care system devastatingly worse than it already is. I am scared for Ontarians. They are going to be so much flustered than they already are and angry at those responsible for letting them be disserved and pharmacists will be ‘burnt out’ and fed up. Customers are increasingly waiting too long to receive their dispensed prescription, and now the people would have to wait for pharmacists to finish examining and doing tests on a patient? All the time, energy, costs for supplies, documentation and communications with e.g patients’ workplaces; Workplace Safety Insurance Board ( yes, even skin rashes at times may require a WSIB form to be completed ); Doctors (any specialty not just Family Med); Lawyers ( yes, law firms request medical records often from the walk-in clinic, for various reasons, not just pt. harm complaints !) which go into one encounter alone would deter the pharmacist away from pharmacy in just a short amount of time. Furthermore, for every one direct encounter with a patient, expect there to be another few hours (2? 3? ) sometimes, of directly unpaid for work. EVERYONE NEEDS TO UNDERSTAND THAT everything involved when doing things properly and according to expectations by the medical licensing body, to have one encounter alone, coupled with the relatively poor pay by OHIP, and unpaid work, is A COMMONLY HEARD REASON WHY WE HAVE PLENTY OF FAMILY DOCTORS NOT MENTALLY, EMOTIONALLY OR TIME-WISE ABLE OR WILLING TO PRACTISE IN THEIR CHOSEN SPECIALTY OF FAMILY MEDICINE. We have so many more Family Doctors in Ontario than it what it may superficially appears as, and people are mistakenly thinking there is ‘a shortage’. It must be critically analyzed. Do you know how many are out of work and wishing they can just work in their chosen specialty training as opposed to seeking alternative means to earn a descent income, not so out of alignment to the high stakes nature of the job? You would be creating the same problem for pharmacists. They might drop out faster than you or they can currently conceive; That is, the pharmacists who are the ones dealing with direct patient interactions, as opposed to maybe the pharmacy owners who don’t, or perhaps higher level stakeholders who might not be engaging in the frontline work. Cancel the proposal immediately.
I encourage expanded scope for pharmacists, it is helpful to the community and our healthcare system saving time for doctors and hospitals for critical cases. I lived this experience with our last scope of minor ailments where patients appreciates the service and mentioned many times that pharmacist listen to them more than doctors. I am really proud to be part of this practice and improving our healthcare system and willing to work with the expanded scope in the near future hopefully.
I would definitely recommend this expanded scope of practice. We are already treating these medical conditions from OTC and BTC options we have. It should have been there since at least two years. I’m not sure what we are waiting for.
Totally agree with the expanded services, as per daily encounters with patients, it is highly needed and Pharmacists can handle it professionally
1. Treating Minor ailments: Not sure if the equipped and comfortable to treat minor ailments, also this would further increase the pressure on he Pharmacists. If there are provisions made for training them in terms of minor ailments then yes. I also do not think that Shingles is a minor ailment, as is always associated with underlying disease condition or some Complication. Also the Pharmacies should be equipped with the space and technology to carry out such tests and not to mention the time and support in the pharmacy to carry out the tasks, which would entail qualified personnel in the pharmacy to assist. In addition, there should be no targets laid down to be achieved for the pharmacists. 2. To provide injectable agonists and the vaccines- I support the two as can be useful. Not sure if the injectable partial opioid agonists and antagonists is very important as pharmacists are not first responders. So the number of times that they would put it to use would be limited. 3. In regards to scope of Technician , practise I agree. They should all be provided with the injection training in-order for this is to be possible. In addition if added to school curriculum the interns would be able to do so. Would definitely help to take the practise Load of the Pharmacist shoulders as they have a vital role in doing patient counselling which is very important from patient point of view.
I do not feel that Pharmacists are equipped with the proper tests and equipment to accurately diagnose patients. I do not feel comfortable when having symptoms such as shingles or strep throat, that the Pharmacist has the correct tools to provide the proper treatment. Female patients may not like if male pharmacists ask them to show Shingles.
As a person who have connections with pharmacists, I know how much some are under pressure. They work and earn money without incentive or bonus or even increase in their income. Please advocate
More MI is helpful but not agreed with vaccines and injections as pharmacists are not nurses
FINALLY, we are seeing pharmacists being given the opportunity to practice what they have been learning in school for a few decades now. Most issues are ones we already discuss regularly during unpaid OTC consults (for which we have to refer to doctors for prescriptions on occasion- this would solve this inefficiency). To the naysayers complaining about workload, liability, inability, lack of follow-up/communication with family MDs, etc. Surely, you don’t think a walk-in clinic spending 1-2 minutes per patient is doing a better job at assessing these conditions. Surely, you don’t think forcing patients to wait 8-16 hours in a emergency room to access basic healthcare makes sense, while far more serious cases are delayed because of the countless, unnecessary ER visits because patients in Ontario (and the rest of Canada) CANNOT get timely care. Does it make sense to force people to go to ER for a sore throat, which would cost the government $200-400 and wastes a doctor’s precious time? Furthermore, many family doctors penalize patients for going to walk-in clinics for these issues so they are left either suffering, waiting in ER for 16 hours, or causing the family doctors to get charged by the MOH. The ONLY people who should be upset by this proposal are the walk-in clinics that love these soft ball cases, when really they should be using their long years of medical school for more complex medical issues. Sorry, but their plight is not worth the complete destruction of our healthcare system. If we do not move quickly enough, this country’s healthcare system will collapse as more and more boomers get into their later years and require much more complex care. Oh and did I forget that Canada has a massive, growing debt problem? A single minor ailment taken care of at the pharmacy level easily saves a hospital $300-400. Multiply that by hundreds of thousands of cases.
If regulations change such that pharmacists are able to prescribe for more MA, OCP should mandate it such that corporations can not put a target/quota for ‘professional services’. OCP should also stipulate that the pharmacist performing these professional services not be dispensing during such shift. In a busy pharmacy work environment, it is already stressful having to dispense hundreds of scripts daily (and doing so accurately!), providing injections, prescribing for 19 MA, and dealing with a multitude of disruptions; adding 14 more MA and POCT would increase the risk of dispensing errors as pharmacists rush to get all the tasks completed. To minimize the risk, there should be a dedicated ‘professional services’ pharmacist on duty that can focus solely on prescribing or conducting POCT. In the real corporate world, however, where profits matter more than the work load on the pharmacy team, this would be unlikely and therefore would put patients at harm. OCP should restrict corporations from requiring dispensing pharmacists to prescribe or do POCTs and only allowing those functions to occur when an extra pharmacist/intern is on duty.
Generally, expanding the scope of practice for Pharmacists and Pharmacy technicians sounds like a great opportunity to ensure better accessibility to healthcare. As a Pharmacy Technician, I am excited to administer all vaccines listed in Schedule 3. However, with a larger number of minor ailments to treat, a broader spectrum of vaccines to administer, and the requirements for lab tests and follow-up tests, the workload for the Pharmacists will be tremendous. I support the changes, but with efficient workload adjustments. Thank you!
I agree fully with the proposed changes for minor ailments and laboratory/POC testing. Allowing for rapid strep testing is a step in the right direction. As a tech working in a hospital pharmacy, sore throat is a common ailment seen for ED patients. With so many Ontarians without a family care provider, allowing pharmacists to perform these tests and prescribe will help ease the burden on Emerg departments. With that being said OCP and MOH need to regulate the services to ensure corporations are not taking advantage and placing pressure on staff to meet certain billing quotas. I believe extensive training/courses, an exam or certification should be part of this process and it should be optional as to whether the OCP member wants to opt in or out. Separate sterile spaces need to be part of the pharmacy floor plans and inspections need to be performed to comply with IPAC.
I fully support the proposed changes for pharmacists and pharmacy technicians. As a pharmacy technician myself, I am very interested in completing the necessary requirements and registering as a pharmacy technician authorized to administer vaccines under pharmacist supervision. I would also like the college to grant pharmacy technicians access to perform strep tests, HbA1c, lipid tests, and other point-of-care testing in the future. Will pharmacy technicians receive fair compensation for administering these vaccines? In my opinion, if pharmacists are being allowed to prescribe for minor ailments, they should receive proper training, fair compensation, and be protected from corporate pressure
POINT OF CARE TESTS & SUBSEQUENT ORDERING OF such tests: Pharmacists are often operating with only one counselling room. Here, procedures such as injections are being performed. Who is disinfecting surfaces prior to the next patient walking in? NAIL SCRAPING/CLIPPING I don’t want to be aware that my or other people’s prescription bag containing medicine or the pills themselves, they would need to put in their mouths, or compounded creams to be applied on their genitalia, or on skin, has come into contact with the fine debris in the air from nail scrapings or clippings, possibly containing fungal spores, whether it be by falling onto the medicine solution/gel caps, tablets/box/blister pack or by being inhaled by customers picking up medicine at the pharmacy. Do you realize how dangerous and irreversible inhaling fungal spores can be? Do you want cut toenail pieces and scraping of the skin + it’s smelly often infected excretions, flourishing near the pills patients, you and I would need to put in our mouths? This also means potential fungal spores being inhaled by pharmacy staff and customers. Infectious disease means that INFECTION PREVENTION AND CONTROL (IPAC) STANDARDS will need to be abided by. Who will be monitoring the pharmacy for compliance? Will you be mandating the disclosure upon annual renewal, just as doctors need to do? Who is going to ensure that every pharmacy is equipped with an autoclave machine; that proper cleansing/disinfecting/sterilizing solutions are being used- to disinfect the instruments (nail clippers, nail scrapers (around the nail and underneath it); and that there is an approved ventilation-ducts system; and that there is the mandated separate room required by public health for the ‘reprocessing’/disinfecting of the tools used to touch the patient’s body tissues (e.g nail clippers and scrapers ) ? INJECTIONS/VACCINATIONS Injection means potential for exposure to blood. Look at the blood evidenced on gauze, cotton and/or bandaid – yes, blood is blood, regardless of the amount. Blood means potential for infectious disease. THROAT SWAB Do you realize that some patients tend to gag and/or cough when sticking the swab in their throat, resulting in projectile saliva or a piece of white exudate/ streptococcus flying through the air? This can end up landing on pharmacy staff, counter tops and medications. This MUST not be allowed in our pharmacies in Ontario. As a matter of fact, I would argue that these two point of care tests should be done by patients themselves in home and dropped off directly to the lab. Simple step by step instructions can easily appear in written/digital format to accompany the specimen tube (throat) or kit (fungal test). It is repulsive to think that patients, pharmacy staff and customers walking by the pharmacy are potentially inhaling streptococcus and fungal spores or unknowingly touching these bodily fluids (blood), excretions (skin/keratin/fungus/bacteria) and exudates (strep infected pus). It can get carried from room to room and air to surface, by soles of shoes or direct hand contact. You are encouraged to STOP wasting time, effort and government’s money on this ludicrous proposal. During this review process, you need to reverse and not allow any future allowance to pharmacists to assess, examine, investigate/test, diagnose or prescribe. Their sole job should be to dispense and dispense with caution! That in itself is a huge responsibility. Ontario is in a very bad state, worsening by the expanded scopes of practice leading to increasing the administrative burden on doctors, which is one of the top priorities supposed to be reduced. Who is responsible for steering the Ministry of Health down a horrific path? Thank You if you took the time to read the comment. It is written out of the best intention for the greater good of Ontarians. Take Care of your health!
NO! I disapprove. The proposal is shocking, tremendously wrong and dangerous. Not only do I disagree with extra expanded scope of practice, but the 19 medical conditions allowed to be prescribed for, need to be reversed. No medical condition is minor. Do not take this suggestion lightly. As people who experience harm will seek compensation, everyone involved in decision making will be expected to assume responsibility. I consider it foolish for government to even entertain the proposal for ‘minor ailments’ prescribing. I recommend that previous ones need to be removed from the pharmacy scope of practice. This can be done; The same way they were handed over on a silver platter, is the same way it can be reversed. HOW CAN YOU HAVE A PRE-DETERMINED DIAGNOSIS first, then work backwards to say that you can assess for it? E.g patient shows a discoloured toenail. Patient is not expected to know the diagnosis. The pharmacist likely will not be able to differentiate that it may be a cancer (melanoma of nail). Pharmacist ‘assesses’ and decides that it may be a bruised toenail; then what? Does the pharmacy bill OHIP for toenail fungus/‘onychomycosis’? Obviously, they would bill under one of the approved ‘minor ailment’ OHIP billing codes. I am thinking that this would lead to inaccurate records of the types of service/diagnostic codes on that patient’s ‘Personal Claims History (PCH)’. Moreover, the amount of money which will be wrongfully paid out by the ministry of health will be astronomical. Secondly, it is imaginable that if it took a doctor approx. 12-15 yrs (4 yrs undergrad + 4 yrs medical + 1 year study for board exam + 2 – 5 yrs residency + 1 year study for final board exam = 12 yrs – 15 yrs) to acquire a licence to be deemed eligible to practise medicine, then it is so wrong to read that ‘clinical education courses are optional’ for the pharmacist to prescribe for minor ailments; In other words, NO mandatory training! Pharmacists are being advised to ‘play’ the role of doctor, thus to practise medicine in addition to pharmacy? The liability/legal risk – A pharmacist should be mandated to pay extra malpractice insurance to be held accountable to the public. Will you ensure they pay CMPA/Canadian Medical Protective Association, for when there is a patient complaint that requires such help? They should have double the malpractice insurance policies since they are being asked to practice two regulated health care professions (doctor and pharmacist). It should be made mandatory for pharmacists to pay the CPSO/College of Physician & Surgeon of Ontario annual dues and be upheld to the same stringent policies that regulate medical practice, in attempt to protect the public. Aren’t patients entitled to a doctor when they need medical help? ‘The Canada Health Act (CHA) is federal legislation that sets the conditions for Canada’s publicly funded health insurance programs. To receive full funding, provincial and territorial health plans must cover medically necessary hospital and physician services.’ I would argue that it seems that Ontarians are being denied their right to a doctor. How so? By indirectly allowing patients to be penalized (by negation of funds to doctors in certain types of enrolment models leading to those doctors ‘derostering’ such patients ) when visiting a walk-in (WHO IS A FAMILY/Emerg DOCTOR) doctor, yet encouraging the public to seek medical service by a pharmacist (who is nowhere nearly as suitable) by expanded scopes of practice since 2023. When are you going to inform the public of these comment opportunities through the news/t.v, to allow them to be informed and have a right to post their say, which will be taken into consideration in this frightening proposal?
We are already working under a lot of pressure from the corporations to earn a livelihood for our families. Stop making cheap doctors. College must fight for the rights of pharmacist, not for the corporations. I a not against expanded scope, I am more worried about the pressure pharmacists will be facing from the corporations, patients and other care takers. College must think about the pharmacists and also make a plan to compensate the pharmacists for what they bring to the table.
As a member of the public – I think it is all amazing. As a tech: -the tech expanded scope is great -the pharmacist expanded scope – as a tech, I worry that they will be under time pressure to complete all their tasks without sufficient regulated pharmacy staff
I never thought of shingles as a minor ailment? When would the pharmacist be able to prescribe travel vaccines and birth control, these are way needed than prescribing for a condition like shingles that I believe need more attentive care that is beyond the community pharmacy capacity!!!!
As a pharmacy technician I agree on the propose changes to the scope of practice for pharmacy technicians (enable pharmacy technicians to administer all vaccines listed in Schedule 3 of Ontario Regulation 256/24 under the Pharmacy Act, 1991). I would also suggest a course on minor ailments for pharmacy technicians to better support and help pharmacists.
I do not support these changes. This is beyond what a pharmacist can safely manage. Expanding the role of the pharmacist, a largely privately funded healthcare profession, is not the solution to the lack of funding and resources being given to our public healthcare system. Patients should be able to see a physician or otherwise properly qualified healthcare provider when they’re sick, not a pharmacist who isn’t properly trained to do so. This isn’t a solution to our broken healthcare system – it’s a cheap bandaid that will put people in danger while ignoring the root issue. Shingles is NOT a minor ailment. The workflow of a pharmacy cannot safely accommodate proper strep tests. Pharmacist prescribing for sore throat and AOE opens the door to antibiotic over-prescribing and increases antimicrobial resistance. This expansion will hurt patients and pharmacists alike. I’m extremely disappointed.
I support the expansion of scope with a few comments. There cannot be a set formulary of drugs to prescribe for the condition. If the treatment is appropriate then pharmacists should be allowed to prescribe the drug. Also there needs to be something in the College regulations preventing the corporate entities from setting quotas, targets, budgets or whatever other name they want to use. At the end of the day the pharmacist must have the authority to decide if they feel they should provide the patient with a treatment.
This legislation and proposed changes to scope of practice effectively eliminates the vast majority of what is the practice of family medicine. Family medicine physicians are highly skilled and trained to recognize illnesses the possibility that a minor illness might be a presentation of a major illness. It also effectively eliminates effective counseling on lifestyle issues that currently are causing a great majority of illnesses. I did not go to pharmacy school I would never do their profession. They did not go to medical school nor residency to become a family doctor so however they are suddenly qualified scientifically and objectively to perform the role of a family physician. Which not only encompasses so-called minor illnesses but realizes that my analysis can sometimes reveal signs that represent early warning signs of a catastrophic illness which could be prevented or treated early. Example psoriasis masquerading as a rash treated as a rash and the potential life altering complications arising from untreated psoriasis can ultimately lead to a significant impact on the quality of life and ultimately mortality. It also totally destroyed the continuity of care family medicine physicians develop unique ongoing intense interpersonal relationships which ensure the establishment of continuity of care which would be nearly impossible to replicate with system rotating pharmacies/pharmacist that apply different standards for the same illnesses. Another major concern is who is the custodian of the medical information and where is this to reside. Will pharmacies be required to maintain the records in a safe secure location for the same length of time that the College of physicians and surgeons of Ontario does? And how will the patient access their complete medical file if it is spread across a multitude of various pharmacies? Apart from that human trauma there is the cost that this is going to generate in the long-term on the already strained healthcare budget. When minor illnesses which are really major illnesses subclinically are not really recognized the costs are immense. Vaccinations are not just vaccinations they represent a chance for complete physical cognitive and lifelong establishment with a therapeutic bond with the patient which will never be replicated at the counter of the pharmacy as the consultation rooms are never used thus majority of vaccinations are given at the counter- example flu shots. Also your pharmacy is going to be allowed to refer to specialists and when will they know how and why. I encouraged the committee to uniformly reject this proposed change in scope of practice. Is there any question as to why there are no family doctors and no prospective family doctors enrolling in family medicine residency programs. This proposal reflects the death of family medicine as a profession with this legislation and now becomes nearly complete. If not totally complete.
Dear Sir/Madam I believe pharmacist play a key roll in patient;s heath interest and decrease pressure on clinics and hospital. It would be a great idea if pharmacist authorized to do certain minor test for instance throat swab and prescribe any proper medication in case needed.
This is dangerous. As a physician I have already cleaned up a number of messes caused by pharmacist prescribing inappropriate medications for misdiagnosed conditions. THIS MUST STOP. You are risking the health of citizens by pawning off patients to undertrained individuals in the name of cost saving. SHAME ON YOU
I Highly support the proposed changes above and even more, like managing Erectile Disfunction, and prescribing/initiating Birth Control Pills, and finally, funding the A1C and LIPID Profile Point of Care Testing that pharmacist can do in few minutes to support patients quality of like and have the patient informed about their conditions control. The college MUST keep in consideration to have a close eye on the corporate and should impose some king of a regulation that MUST PREVENT these corporates from imposing TARGETS and AGGRESSIVE PLANS on these patients’ services.
I fully support the proposed changes for pharmacists and pharmacy technicians. I myself, a pharmacy technician, is very interested in completing and registering as a pharmacy technician who can administer vaccines under pharmacist supervision. Thank you.
The liability that comes with conditions like shingles or even strep throat doesn’t seem aligned with the professional fees being paid to pharmacies. This might be good news for independent pharmacies looking forward to more prescriptions. However, it sounds alarming for chain pharmacy pharmacists and technicians who are already under pressure from heavy workloads. Although I strongly believe that pharmacists are well-trained and capable of handling these responsibilities, the gap between a physician’s compensation for diagnosing the same condition and that of a pharmacist just doesn’t make sense.
The College should focus on more pressing issues like corporate pressure and insurances forcing patients to use a preferred pharmacy. That is the College’s role, not turning pharmacists into doctors and technicians into nurses. Focus on PHARMACY PRACTICE! I have seen zero progress on either of those issues and they both just worsen. Our patients are sad to leave us but their insurance gives them zero choice. Stand up for pharmacists instead of corporations who are building clinic settings inside of grocery stores and replacing physicians with pharmacist led clinics because they are cheaper.
Once again, the OCP has put pharmacists in a terrible position. As mostly ununionized workers, we have nobody to stand up for our rights. If we complain that this is unfair workload, then we are not doing our part to alleviate the burden on the health care system. Since the unexpected announcement of yet more minor ailments, I have been already been recieving multiple requests for strep and ear throat prescriptions since patients do not want to wait to see their MD or haven’t taken the time to find out about after hours clinics that their family doctors offer becuase presenting to a pharmacist with zero appointment and no wait time whenever they want is easier. What about watchful waiting for ear infections? Nope, their child woke up an hour ago with a sore ear and they are at the pharmacy at 9:05am demanding a prescription because they are going away this weekend and they don’t want their kid to be sick while they are away, can’t we just give them something in case? They get all their prescriptions here, they are good customers. They feel entitled to get a prescription because they are CUSTOMERS of the pharmacy NOT patients to be assessed. I already have random acquaintances texting me or IM me asking for something for strep throat at all hours of the day. What about my work life balance? I had a patient just the other day who was seen at walk in clinic and they told her that her strep was negative so she stopped her antibiotics. She then developed severe peritonsillar absess and required ICU admission. I strongly believe that if pharmacists give strep tests without the adequate time and resources to educate and assess all the possible differential diagnoses issues like this will become all to common. I have no doubt that pharmacists would be quite capable with the proper training to examine ears and throats, however its not practical in the current practice setting. People keep writing that we have to have goals to aspire to and then practice sites will change to accomodate that. In my twenty years of practice, this has certainly not been the case. There has been zero accomodations and just added workload. I am a sole pharmacist on shift at a community pharmacy verifying 250 prescriptions per day, doing methadone and vaccines. I already have a medical directive to inject sublocade under strict supervision of properly trained and informed addiction specialists. I report to them when the injections are done and they assess the appropriateness of the injection. I can’t tell you how many times that patients have requested a sublocade injection and the doctor has told me it is not appropriate for various reasons (patient urine dip positive etc, missed doses). I STRONGLY believe that all sublocade patients should be assessed by a physician before EACH dose and a urine dip before EACH dose. Pharmacists do not need the independence to do sublocade as most of us already have medical directives that protect us from liability! Giving somebody a sublocade injection before they have been stablized properly or if they don’t disclose using can precipitate LIFE THREATENING withdrawl. Its not just another injection! Just writing this feedback has taken me well over a hour to do at work, yet I am supposed to document every indication for every medication despite the physicians not writing it on the prescription and the patients mostly unaware of the indication or don’t feel the necessity to disclose to the pharmacist why they take each one when they have been on it for years and nobody has asked before. Again, I only hear about this new practice expectation at our pharmacy inspection with zero heads up from OCP. The rationale I am given from the inspector- this new documentation requirement arose because a patient who had diet controlled gout got a prescription for hydrochlorothiazide and it worsened his gout. Somehow this was the pharmacist’s fault (not the physician nor the patient). I can probably tell you of at least a hundred patients in my practice who are on this combination. Putting the indications in the software system is an exercise in futility as it does not alert any warnings anyway. If OCP wants this new standard, give us time to do this and document. I recall that a least a decade ago, hospital pharmacies were forced to hire only registered pharmacy technicians yet community pharmacies can still hire uneducated teenagers to perform the same work. Its wonderful that pharmacy technicians are getting an expanded scope of practice to become public health nurses and do injections but realistically how many vaccines are done in hospital? A few COVID shots? When will OCP start to regulate that registered pharmacy technicians have to work in community pharmacies to free up pharmacists from checking hundreds of blister packs and doing injections? Right now all OCP is doing is allowing the government to reduce the number of public health nurses paid by taxes to the private sector for pharmacists who are privately paid to do all the injections. Now all the STI treatments are no longer provided free of charge from our local public health unit and I am giving ceftriaxone injections and charging patients for antibiotics that should be free of charge because it is in the public interest. This government is not interested in what is in the best interest of the patient, only what is in the best interest of the budget! Shame on OCP for not standing up for the public and just allowing the most accessible health care professional take all the burden!
I Agree and Recommend all of the Mentioned Change for the Scope of Practice to Ameliorate the Health outcomes to the Public
I am in 100% support of the scope for vaccines opening up to technician’s! This is going to help workflow and take load off the pharmacists. However; I do not support the new MA’s and POCT testing, there are already a lot of MA’s currently; and introducing POCT testing is too much. It will impact workflow and patient care significantly. Pharmacists still need to do their regular dispensing. The only way this can happen is if retail chains/franchise provide the extra pharmacist to do this and pay them accordingly.
Yes please proceed with these changes. Thanks.
Okay
Yes
I do not support the proposed expansion of scope for pharmacists and pharmacy technicians. While the intent to improve access to care is understandable, this proposal ignores the real conditions inside most community pharmacies. There is a consistent pattern in this profession: new responsibilities are added, but pay, staffing, and safety considerations never follow. This plan continues that pattern. Adding new duties—especially vaccine administration for technicians and expanded prescribing for pharmacists—may sound efficient on paper, but in practice, it introduces real risks. Pharmacies are not equipped to manage symptomatic patients or perform procedures that blur into diagnostic territory. Many operate with a single counselling room that doubles as an injection space, often with poor ventilation and no separation between infectious and non-infectious patients. Introducing throat swabs or minor-ailment assessments in such settings compromises both staff and patient safety. The issue of compensation cannot be ignored. Under the current system, fees for services like minor-ailment prescribing or injections are paid to the pharmacy, not the professional performing them. Pharmacists and technicians carry the workload, documentation, and liability—without seeing any of the reimbursement. In contrast, physicians are compensated directly through models such as fee-for-service, capitation, or blended payments that recognize their clinical time. Yet these proposals continue to assign pharmacists medical-level responsibilities without corresponding pay, training, or infrastructure. Expecting professionals to shoulder additional medical duties without fair, direct reimbursement is unsustainable. It devalues clinical labour, accelerates burnout, and sends a clear message that expertise in pharmacy is cheap. Liability remains another unresolved issue. These new services require clinical judgment, follow-up, and documentation traditionally reserved for physicians or nurses. When adverse outcomes occur, who bears responsibility—the pharmacist, the corporate owner, or the College? Without clear protections, that burden will fall squarely on individual practitioners. For technicians, expanding vaccine authority across all Schedule 3 vaccines may appear to elevate the role, but in reality, it simply increases workload and exposure risk without addressing training, workflow, or pay. Every past expansion has come with promises of opportunity, yet technicians remain among the most under-recognized and underpaid professionals in the healthcare system. There is no reason to believe this time will be different. Beyond the professional impact, the broader system consequences deserve scrutiny. Pharmacies are not designed as mini-clinics, and pushing them in that direction stretches already thin teams even further. The idea that expanded pharmacy services will “reduce pressure on the healthcare system” assumes pharmacies have excess capacity—they do not. Adding new clinical responsibilities without guaranteed funding or staffing support is not a solution to systemic healthcare shortages; it’s a redistribution of the burden. Before any expansion proceeds, there must be commitments to have: • A direct reimbursement framework so professionals are paid for clinical services. • Minimum infrastructure and infection-control standards. • Defined liability coverage. • Safe-staffing requirements. Without those foundations, this proposal risks worsening burnout, eroding patient safety, and pushing more skilled professionals out of the field entirely. For these reasons, I strongly oppose the proposed scope of practice changes.
Please also make sure you post your feedback on the MINISTRY WEBSITE. We need our opinions shared beyond OCP. https://www.regulatoryregistry.gov.on.ca/proposal/52093
SHINGLES IS NOT A MINOR AILMENT!! MISSED DIAGNOSIS – PATIENT CAN BE BLINDED. AND IMAGINE THE LIABILITY ON THE PHARMACIST. WILL THE COLLEGE PROTECT YOU WHEN YOU HAVE A PATIENT COMPLAIN THEY WERE MISTREATED FOR SHINGLES? STREP THROAT TESTING IS NOT A MINOR AILMENT Do we want contagious patients walking in WITHOUT MASKS EXPECTING TO BE SEEN IMMEDIATELY. NO!! Even my doctor’s office tells us you MUST wear a mask if sick. Sometimes the Dr will refuse to even see you! Why should we be the ones taking all the abuse. And for what? So patients can complain to the college and then open a case against us because we care about our safety as well as ensuring our workflow is safe. FUNGAL TOE IS NOT A MINOR AILMENT!! Until pharmacists are: 1. INDIVIDUALLY reimbursed for each service or given increased wage 2. STAFFED correctly according to script count 3. RESPECTED as a healthcare professional This should never be proposed If the College cares about patients safety: 1. Make regulations that help us so we can help patients. Such as ensuring a minimum# of staff according to work volume 2. Reflecting before adding unnecessary regulations that add work pressures and stress on pharmacists 3. Push to increase the ODB fee. Increase the minor ailment reimbursement fee. 4. Implement regulations that protect pharmacists. You want us to see more patients for “minor” AILMENTS? Then APPOINTMENTS should be made mandatory!! Pharmacists should not be forced to accept walk-ins for any service!!
I have a feeling that there are large corporate pharmacies lobbying for this increase in scope due to large investments being made in “clinic” format pharmacies … That’s just opinion. I could be wrong but I’m shocked that this is being proposed. If it’s true I expect an excellent wage increase for the pharmacists.
I am in favor for the extended scope of practice for Registered Pharmacy Technicians. It would help very much the patients and the pharmacist. Thank you for proposing.
I support the proposed inclusion of all schedule 3 vaccines to be adminstered by Pharmacy Technicians and the additional vaccines not currenly listed in Schedule 3 for Pharmacists, however I do not support the additional minor ailment nor the administration of injectable partial opioid agonists and antagonists. With the high stress to the healthcare system nowadays, the expanded scope of practice that pharmacists can do now definitely help the public in getting assessment and medications they need for simple conditions. However, this really adds tremendous workload to community pharmacies which the governement does not recognize, and we are not paid in a fair fee structure/model on the assessments we do. Minor ailment is defined as a common, short-term health condition that can be managed with minimal treatment or self-care strategies, typically without the need for lab tests or a doctor’s visit. The proposed change added laboratory and point-of-care tests (POCTs) which definitely not minor ailment cases anymore. Swabbing throats and collecting nail clippings should not be an expanded scope for pharmacists.
As a chiropodist, I am shocked to see these proposed changes. Assessing fungal infections and taking nail clippings are not a simple task. Our regulations only allow chiropodists to prescribe a limited amount of topical antifungals and no oral antifungals as these require assessment by a physician, yet you are proposed untrained pharmacists can do this in between checking prescriptions? Sounds like a cash grab to me.
I do not support including laboratory and point-of-care tests (POCTs) in the expanded scope of pharmacy practice. These activities go beyond pharmacists’ training and the operational capacity of most community pharmacies. Implementing lab testing would add regulatory and quality-control burdens and blur professional boundaries with laboratory and diagnostic services. Pharmacists already contribute significantly to patient care through assessment, prescribing, and medication management. The focus should remain on strengthening our dispensing, medication management, and current clinical offerings rather than expanding into laboratory testing.
I support the proposed changes. I would also like to add for pharmacy technicians to have mandatory CPR and First Aid training and allow to inject vaccines without pharmacist present physically as far as available virtually for any questions.
Allowing pharmacists to assess and prescribe for more minor ailments is a great change that will benefit patients and the healthcare system. Pharmacists are highly trained and capable of safely managing these conditions. However, I would like to see the drug formulary expanded even further to include more common medications that would benefit patients even more. I also fully support authorizing pharmacy technicians to administer all Schedule 3 vaccines. As their role expands, it’s important that technicians receive fair compensation for their additional responsibilities and that injection training is built directly into their formal education programs. Integrating this training into the college curriculum will ensure new graduates are prepared to safely and confidently deliver these services. At the same time, I think it’s essential to acknowledge the implementation costs associated with expanding the scope. Many pharmacies will need additional training, workflow adjustments, and digital tools to support these new services. Providing grants or funding support to help cover these costs would ensure consistent, safe, and equitable implementation across all communities, including independent and rural pharmacies.
Yes I highly recommend proposed expanded scope of practice which allows pharmacist to provide more patient care and their clinical knowledge can be best used for betterment of the society relieving pressure on health care system.
If additional minor ailments are added I suggest looking at the fee structure AND how this is rolled out to the public. Pharmacies are very busy and after the last minor ailment program campaign rolled out people walked in with the impression they would be seen right away by the pharmacist and could get very angry and verbally abusive if that was not the case. We need to stress in any public campaigns that people should CALL THE PHARMACY for an appointment. The reality is that the college has a mandate to protect the public but does not support pharmacists very well. Many of us work for corporations that push us to the breaking point to “do more with less” and meet certain quotas. Before the college asks pharmacist to do more they need to support us with regulations, such as pharmacists/script ratios. Corporate greed is hurting our pharmacist and technicians, we are more stressed than ever before and we only need to look towards our neighbours to the south to see how quickly the profession can devolve when left to the corporations. In order to protect the public the college needs to do more to support our pharmacists and technicians. Currently it is up to individual pharmacists to uphold the standards of the college. The reality is this is very difficult to do when you have a corporation breathing down your neck and at times holding your job and livelihood over your head. Also, pharmacy consultation rooms are not the environment to be swabbing throats and collecting nail clippings.
I support the proposed expansion of the scope of practice for Pharmacy Technicians, as it aligns with the evolving needs of our healthcare system and can improve patient access to care. Allowing Pharmacy Technicians to administer the vaccines listed in Schedule 3 will enable us to play a more active role in immunization efforts and help increase vaccination rates, especially during public health emergencies. This proposed expansion will also help recognize the valuable role Pharmacy Technicians play in supporting public health initiatives.
The recent expansion of the scope of pharmacy practice in Ontario—particularly the inclusion of Minor Ailments (MA) prescribing—is a significant and commendable step forward. It reflects a growing recognition of pharmacists’ clinical expertise and their potential to contribute meaningfully to the healthcare system. This initiative not only empowers pharmacists but also enhances patient access to timely care, reduces strain on traditional healthcare settings, and aligns with broader public health goals. Ontario’s Readiness and Comparative Lag Pharmacies across Ontario are well-equipped to implement these changes. The infrastructure, staffing, and professional competencies required to deliver MA services are already in place in most community pharmacies. However, despite this readiness, Ontario remains behind other provinces such as Alberta and Prince Edward Island, where pharmacists have been granted broader prescribing authority and are more deeply integrated into primary care delivery. In these provinces, pharmacists routinely manage chronic conditions, prescribe independently, and are reimbursed for their clinical services—setting a benchmark that Ontario should aspire to meet. Barriers to Adoption: Motivation and Compensation A critical barrier to widespread adoption of MA services in Ontario is the lack of direct financial incentive for pharmacists. While corporate pharmacy chains often encourage—or even pressure—pharmacists to provide these services, the absence of additional compensation undermines motivation. Pharmacists are expected to deliver clinical care without any increase in pay, recognition, or autonomy. This disconnect between responsibility and reward has led to reluctance among many pharmacists, with some opting to refer patients to clinics rather than provide MA services themselves. It is important to emphasize that these services are provided by individual pharmacists—not by the pharmacy as an institution. Therefore, the current model, which compensates only the business entity and not the healthcare provider, is fundamentally flawed. Recommendation: A Direct Reimbursement Model To address this issue, I strongly advocate for the implementation of a direct reimbursement model. Pharmacists should be assigned individual billing numbers, similar to physicians and nurse practitioners, allowing them to bill the government or insurance providers directly for clinical services rendered. This approach would: • Recognize pharmacists as independent healthcare providers. • Ensure fair compensation for clinical work. • Encourage broader participation in MA programs. • Improve service quality and accountability. Such a model would also enable regulatory bodies and policymakers to track service delivery more accurately and assess the true impact of expanded pharmacy practice. Enhancing Clinical Competency: Mandatory Training and Certification As the scope of practice expands, it is essential to ensure that pharmacists are adequately prepared to deliver high-quality care. I recommend the introduction of mandatory clinical training and certification programs for pharmacists who wish to engage in advanced practice. These programs should focus on: • Diagnostic skills for minor ailments. • Patient assessment and triage. • Communication and documentation standards. • Legal and ethical considerations. By investing in professional development, we can ensure that pharmacists are not only willing but also fully capable of delivering safe, effective, and evidence-based care. Systemic Benefits: Access, Efficiency, and Cost Savings The expansion of MA services offers numerous systemic benefits: Improved Access: Pharmacists are more numerous than physicians and nurse practitioners, and they often work extended hours, including evenings and weekends. This makes them highly accessible to patients seeking care for minor conditions. • Reduced Burden on Clinics and Hospitals: By managing minor ailments in the pharmacy setting, we can alleviate pressure on community clinics and emergency departments, allowing these facilities to focus on more complex cases. • Cost Efficiency: MA services provided by pharmacists are significantly more cost-effective than equivalent services delivered in physician offices or hospitals. This translates into substantial savings for the healthcare system. The Path Forward To fully realize the potential of expanded pharmacy practice, we must address the structural and financial barriers that hinder adoption. The current reimbursement model is the single greatest obstacle. Pharmacists must be empowered not only with the authority to provide care but also with the means to be compensated fairly for it. I urge policymakers, regulatory bodies, and professional associations to prioritize the development of a direct billing framework and to invest in clinical training programs. These changes will not only benefit pharmacists but also enhance patient care, reduce healthcare costs, and strengthen the overall resilience of our healthcare system.
As a pharmacy technician I agree with the fact we should be administering all vaccines. I do not agree that they should change the age restriction from 5 to 2 years old. I feel that will impede affective patient care and put more burden on family doctors offices.
I support the proposed inclusion of all schesule 3 vaccines to be adminstered by Pharmacy Technicians and the additional vaccines not currenly listed in Schedule 3 for Pharmacists BUT NOT the additional minor ailment nor the administration of injectable partial opioid agonists and antagonists. Pharmacists need extra time (time that they lack) to accurately assess patients of their conditons not just quickly read through the checklist and confirm with patient that their self diagnosis is correct. Most of the time patient just answer “Yes” to questions but then when the answer needs to be a “No” then they change the answer to what is required in order to be qualified under the criteria to get the medication. I feel like administration or injecting partial opioid (agonist/antiagonist) will put the pharmacy staff at risk. We are already getting verbal abuse from angry and extremely agitated patients picking up their opioids how much more if pharmacist have to adminster/inject them. No, thanks.
I appreciate the effort but there’s too much of a risk. I am a medical doctor before I became a pharmacy professional. For pharmacy technicians to inject more, even though trained, still carries a risk especially the ones working in a community setting. I suggest to undergo CPR training. For Pharmacists to add more conditions for minor ailments, patients are more than just lab results and algorithms. Their conditions should be seen as part of a whole before ruling out and considering the present complaint as a single disease entity. With that being said, clinical eye can be acquired thru more trainings and school work. Additional years of studying may gear pharmacists eventually to “diagnose” more minor ailments.
I strongly believe that expanding the list of minor ailments, including strep throat assessment and testing, is a very positive step for the pharmacy profession. It empowers pharmacists to use their clinical skills more effectively, reduces unnecessary visits to walk-in clinics and emergency rooms, and helps patients receive timely care. This will significantly reduce waiting times for patients and provide them with more convenient treatment options. It also helps lower the overall cost to the healthcare system by managing common conditions at the pharmacy level. However, to ensure the success of this expanded scope, there should be a better funding model in place. Adequate compensation would allow pharmacies to hire more staff and dedicate proper time and resources to provide high-quality care. In addition, the Ontario College of Pharmacists (OCP) should develop clear, step-by-step procedures and policies to guide pharmacists in assessment and documentation. Finally, introducing a structured education or certification program for pharmacists—specific to these new ailments and tests—would ensure consistency, safety, and confidence in service delivery. Overall, this initiative will strengthen the role of pharmacists in the healthcare system while maintaining patient safety and accessibility.
On behalf of the Canadian Association of Pharmacy Technicians (CAPT), here are comments regarding the proposed expansion of pharmacy technicians’ vaccination authority and the consultation on laboratory and point-of-care tests (POCTs) for minor ailments in Ontario pharmacies. 1. Expanding Pharmacy Technician Vaccination Authority CAPT strongly supports the proposal to enable pharmacy technicians to administer all vaccines listed in Schedule 3 of Ontario Regulation 256/24 under the Pharmacy Act, 1991. Rationale A. Increased Access to Care: Expanding this authority would significantly improve public access to immunizations across Ontario, especially in rural and underserviced communities. It leverages the existing, highly accessible infrastructure of community pharmacies. B. Optimal Skill Utilization: Pharmacy technicians are highly trained, regulated healthcare professionals whose education includes comprehensive training on the safe and proper technique for administering injections. Many are already authorized to administer COVID-19, influenza, and Respiratory Syncytial Virus (RSV) vaccines under the current regulation. Expanding this list recognizes their competence and allows them to practice to the full extent of their education and training, which is a key priority for CAPT. C. Pharmacist Time Optimization: By authorizing pharmacy technicians to administer a broader range of vaccines, pharmacists’ time would be freed up to focus on patient-centred clinical services, such as prescribing for minor ailments, complex medication management, and comprehensive clinical assessments, thus improving the efficiency of the healthcare team. D. National Harmonization: CAPT advocates for the standardization of injection authority for pharmacy technicians across all Canadian jurisdictions, viewing this proposal as a critical step toward national harmonization and improving the utilization of the profession across the country. Recommendation: CAPT urges the Ministry of Health and the College to proceed immediately with regulatory amendments to grant pharmacy technicians full injection authority for all Schedule 3 vaccines. 2. Laboratory and Point-of-Care Tests (POCTs) for Minor Ailments CAPT is generally supportive of the Ministry of Health’s request for feedback and recommendations on potential laboratory tests and POCTs to support minor ailments assessments. This is a crucial step for the ongoing evolution of the Minor Ailments Program. Role of POCTs in Minor Ailments Allowing pharmacy professionals to conduct relevant POCTs would enhance the accuracy and safety of minor ailment assessments and prescribing. Currently, minor ailments are generally characterized as conditions that “lab results aren’t usually required” for. Authorizing POCTs would enable a more definitive diagnosis in appropriate cases, which could include: a)Rapid Strep Test b) Urine Dipstick (Urinalysis) c)POC Glucose/A1c CAPT recommends the following in the context of POCTs for minor ailments: A. Inclusion of Pharmacy Technicians: As regulated professionals authorized to perform other POCTs and to pierce the dermis for blood sampling (e.g., for glucose, A1C, and lipids), pharmacy technicians should be explicitly included in any regulatory changes under the Laboratory and Specimen Collection Centre Licensing Act (LSCCLA) to conduct the technical aspects of these new POCTs. B. Role Delineation: The assessment, interpretation of results, and subsequent prescribing for the minor ailment must remain the responsibility of the pharmacist. The pharmacy technician’s role should focus on the technical execution of the test, specimen collection, and quality control, thereby supporting the pharmacist’s clinical decision-making. C. Targeted and Relevant POCTs: The initial implementation should be limited to the most clinically relevant and established POCTs that directly inform the assessment of the 14 proposed minor ailments. An evidence-based approach must be taken to ensure test utility and cost-effectiveness. D. Training and Standards: Any new authorized POCTs must be accompanied by mandatory, standardized training for all performing pharmacy professionals and clear quality assurance standards, to maintain patient safety and test reliability. Recommendation: CAPT encourages the Ministry to authorize POCTs relevant to minor ailments and to explicitly include pharmacy technicians in the scope of practice for conducting the technical collection and analysis tasks associated with these tests.
As a member of OCP, I truly support the expanded scope of practice for pharmacists and pharmacy technicians. This will help the public in getting a timely treatment sooner than later. Additionally, will pharmacy technicians get any new roles or responsibilities?
I would say that is great startup for both pharmacist and pharmacy technician. I support this decision about to go with minor ailments and for pharmacy technician do admistration for all vaccines. Yes, please ask the board to approved this decision. Thank you
It will be great for additional minor ailment conditions pharmacist can prescribe. There are few reasons 1. Its already a shortage of Doctors which delay patient care sometimes,if pharmacist have extended scope of practice patient can get treatment right away as most pharmacists prescribe on walk in basis 2. It will reduce burden on health care too. 3. There are always exclusions and pharmacist’s professional judgement involved. If pharmacist cant properly diagnose conditions or if any red flags Pharmacist has to refer pt to dr. In conclusion, It will be great step if pharmacist can be given authority to prescribe more minor ailment conditions .Strongly agree.
To mirror some other pharmacist’s responses, pursuing this direction of expanding scope requires a shift in billing structure and higher level methodology in how clinical services & expanded scope is performed. On the surface these changes seem great, but they continue to neglect the root problems within our healthcare model and the role pharmacists play while worsening the day to day working conditions of pharmacists. I may not have the answers, but all of the time being spent focusing and deliberating on expanding scope in various ways is a waste of time right now. The deeper issues must be investigated to change the direction pharmacy and healthcare in this province are heading, and expanding scope is not one of those deeper issues at this stage. To believe a pharmacist can maintain their primary role as a prescription verifier and medication counselling & drug advising expert while effectively carrying out the expanded scope is complete delusion. OCP continues to fail to uphold their mandate and purpose towards public safety and directly towards the pharmacists by not appropriately enforcing and supporting regulatory frameworks that ensure practicing pharmacists are upheld to a valid minimum standard. Minimum standards set by OCP for counselling alone are largely not met on a regular basis across the province. I do not understand how this level of systemic negligence has continued for so long and continues to go on without serious acknowledgement. One area pharmacists are likely meeting minimum standards is in prescription verification, and even this I believe is fundamentally flawed as almost no prescription comes to a pharmacy with a diagnosis in writing or verbally from the prescriber. If we are to meet minimum standards of ensuring a Rx as a whole is appropriate for its indication, yet we are unable to diagnose medical conditions, how are we determining every prescriptions indication? Professional judgement when our professional scope does not include diagnosis for the vast majority of conditions we dispense drugs for? From this perspective nearly every Rx filled in Ontario without a prescriber indicating a diagnosis in writing or verbally has broken OCP’s minimum standards. It is completely inappropriate to be basing a medical diagnosis off of whatever a patient tells us from what they may or may not recall from the prescriber. Regarding expanded scope and professional services, prohibiting pharmacists from being able to bill independently is creating numerous issues. It permits pharmacy owners, who are not liable for the services provided, to receive payment for those services while not being liable for any of the respective standards associated with the service. This unfairly puts the burden of liability on the pharmacist and not on the owner of the pharmacy. This fosters work conditions where owners pressure such services from their pharmacists while skirting any liability concerns, unfairly punishing pharmacists who genuinely care about these standards and wish to serve and protect the public. OCP should know this well, given their recent efforts to uproot systemic corporate pressures that undermine the pharmacists professional judgement and ability to provide safe and effective care. Yet OCP continues to do nothing regarding billing practices, which continues to give the owners power over the pharmacists when it comes to performing these services. Independent billing, at this stage in the progression of our expanded scope, would greatly assist in separating the dispensary role of pharmacists from the professional services role. Interruptions, distractions, lack of staffing and operational issues (specifically environmental distractions, operational process issues, staff distribution) all increase error probability and the highest potential for consequential errors comes from the dispensing, verification, and data input which are roles performed or supervised by a pharmacist. These roles are all disturbed and interrupted by performing professional services. OCP should be aware of this as well from their own data collected through the AIMS program. There are a lot of issues with this program however, I would like to note here that this program is apparently mandatory, yet in 2019 when rollout was completed not even 90% of pharmacies were “onboarded” (I cannot find a more recent data point in my brief search). This does not represent the actual active participation of the pharmacies involved in this “mandatory program”, which I last saw being below 60% (I cannot find the OCP page previously stating this data at this time, perhaps its been moved considering the 404 message I get). Additionally, the program is heavily focused on the dispensing role of pharmacies/pharmacists and has not been adapted to incorporate the numerous new issues presented with the ever expanding scope. Despite these shortcomings, OCP should know the obvious trends arising over the last decade, that increasing expanded scope services without separating them from Rx verification, dispensing and other dispensary related roles is a major issue that will only increase errors and harm the public as well as pharmacists. Independent billing is one way to help initiate the separation of these two highly different services and increasing pharmacists ability to perform their roles with appropriate integrity and attention to uphold OCP’s standards. OCP needs to act on this data in a meaningful way to support its protection of the public and the conditions in which pharmacists provide care for those public members. Other pharmacists have sent feedback mirroring these points, while highlighting many other relevant and key systemic issues festering across our broken healthcare system. It should be apparent that expanding scope is not in any way an answer to any of the fundamental problems Ontarians face when trying to access and experience higher quality healthcare, or just basic healthcare for that matter. This largely increases work load and expectations on pharmacists directly without benefitting them, their respective working conditions, nor the general public as these services are not executed in a timely and effective manner given the underlying conditions on the operational & staffing side of things. From feedback from members of the public here, its clear that setting a consistent and clear message is missing. Unfortunately, it is not the pharmacists at fault but the higher corporate entities that take advantage by advertising misleading claims about these services being provided while inappropriately staffing their pharmacies to actually carry out these services in an appropriate and timely manner. There are exceptions, but generally they remain exceptions rather than the average. Pharmacists regularly bear the brunt of verbal and physical abuse from patients, along with burnout problems, that stem from the corporate choices to understaff pharmacies while promising timely services that are impossible for the understaffed and inappropriately operationalized team to uphold. If timeliness of services was part of the minimum standards OCP attempts to uphold, perhaps there would be a shift from the owners in staffing decisions & operational workflow to support executing these services in a way that is in line with their advertising and messaging. Having one pharmacist on duty in many of these settings should automatically void provisions of the vast majority of professional services. To put the onus on the pharmacist to actively turn down patients in providing these services when staffed as the only pharmacist is not appropriate. Particularly when it is the corporate entity advertising these services in misleading ways and punishment in various direct and indirect forms coming from corporate levels when these services are not conducted despite their inappropriateness due to staffing issues.
I welcome the updated proposed minor ailments, I feel as though that many of the additional minor ailments are recommendations that we already make. I think that the rapid strep test will help alleviate the stress on the healthcare system. If the test comes back positive I feel as though we should be able to prescribe antibiotics for it as it would not make sense having to refer them after a positive test result….Additional changes that I think would help alleviate challenges would be being able to make therapeutic substitutions (I.e when there are back orders), allowing to prescribe for travel medication, and allowing us to order certain blood work
Yes i m in favour of proposed changes and addition of more minor ailments.
Absolutely agree with the changes. I think it’s great for a retail pharmacy and letting pharmacy technicians practice fully on their scope of practice
A huge step toward better and accessible healthcare
Pharmacists are not doctors Pharmacy Techs are not nurses We do not need an expanded scope. Doctors don’t want pharmacists to have an expanded scope. Stop wasting money on this Stop wasting time on this Stop wasting effort on this Stop wasting energy on this
As a pharmacy technician, I agree with the addition of more vaccines to the pharmacy technician scope, as long as the technician is trained for that (which is already the case). I am not sure if the retail pharmacies are well staffed for the addition of these new expectations, though. If there was an oficial staffing recommendations (such as a pharmacy with one staff pharmacist and one tech can only do this amount of work, if there is an extra staff, then they could do this amount of work; or if this extra service could only be offered by pharmacies with two staff pharmacists at a time, for instance), then maybe we could see an improvement in the service delivered and less burden to the staffing.
As a pharmacist , I approve this expansion of scope , actually the public was calling for it from years ago. As a pharmacist we recommend also to expand the authority of prescription for the old minor ailments. we recommend to be able to perform the quick test of streptococcus in the pharmacy instead of sending patient to lab.
As a Registered Pharmacy Technician, I appreciate the opportunity to provide feedback on the proposed scope of practice changes for pharmacists and pharmacy technicians. I commend the College for continuing to expand and evolve our professional roles in a way that enhances patient access to safe and timely care. Regarding the proposed changes: Pharmacists’ Expanded Prescribing and Administration: Allowing pharmacists to assess and prescribe for additional minor ailments and to administer injectable partial opioid agonists and antagonists will further support timely care and public health efforts. These initiatives strengthen pharmacists’ ability to serve as accessible healthcare providers and will benefit patients who face barriers to primary care access. Expanded Vaccine Administration by Pharmacy Technicians: The proposal to enable pharmacy technicians to administer all vaccines listed in Schedule 3 is a welcome and progressive step. Pharmacy technicians have consistently demonstrated competence and professionalism in handling, preparing, and administering vaccines within current limitations. Expanding this responsibility will: Improve workflow efficiency in pharmacies. Reduce patient wait times and increase vaccine accessibility. Allow pharmacists to focus on clinical services such as medication reviews, prescribing, and patient consultations.
Shingles, insomnia, strep throat … minor ailments? Seriously? Patients have brought pictures of genitals and other parts of the body to pharmacist in order to access minor ailment prescribing. The times when the pharmacist discussed patient to describe their symptoms and not show the pics, were met with anger, hostility and threats from patients. And now these – throat swab cultures, rapid strep testing, nail clipping/scraping for culture and microscopy …? How patients would react if the pharmacist refuses to assess a condition for some reason that would be perceived as personal health can only be imagined. But government, including OCP, is in the interest of the patient and the public. Pharmacy professionals are the most easily accessible healthcare practitioners = most easily insulted, bullied and threatened by patients. Healthcare funding cuts seams the easy (easiest) target to government’s revenue conservation. And over the years such cuts to healthcare has continued to make the government to involve pharmacist in non-medication patient care, with the pharmacist minor ailment prescribing in the community coming to be trumped as helping to timely needed care. And accessing Pharmacist prescribing for minor ailment is taken/seen by the patient as shopping for a grocery item. The skills to manage queasiness and squeamish that are endowed in and or/training acquired by the drs, nurses and other healthcare professionals do not seem to be considered in expanding the pharmacist scope into some of these non-medication care areas. We the pharmacists are medication management specialists. And in community care, as we have stepped out to help in managing minor health conditions, could we stay within that framework please. Close to half of this new list are not minor/trivial medical conditions/issues.
I support the proposed scope of practice changes for both pharmacists and pharmacy technicians. These changes will contribute positively to patient care and the profession as a whole. I am writing to express my support for the proposed scope of practice changes for pharmacists and pharmacy technicians. I believe these changes will positively impact the delivery of patient care, enhance the role of pharmacy professionals, and contribute to the ongoing evolution of our practice. I have reviewed the proposed changes, and I am in favor of allowing pharmacists to assess and prescribe for additional minor ailments, administer injectable opioid medications, and offer more vaccines. I also support the inclusion of pharmacy technicians in the administration of vaccines listed in Schedule 3. As a pharmacy technician, I would also like to suggest that we be provided with lab coats or distinct attire, separate from pharmacy assistants, to reflect our expanded role and professional responsibilities.
I think this is a step in the right direction. With lack of family physicians it helps patients on the spot and clears up emergency rooms. As for the injections for the technicians, it helps knowing we can do them all and not have to bother the pharmacist if they are busy with something else!
Yes to technicians immunizing
I agree with expanding more minor ailment except the one for headache cause headache may need more investigation and more diagnosing tests .otherwise I agree with the rest .
Personal opinion: New services should follow updated standarized training at university/college level and updated practice settings to build public trust. Pharmacy business is still adjusting workflow effiencies with most recent MA prescribing, not logistically ready to provide additional services at highest level of quality. Will the School of Pharmacy program change with this proposed expanded scope? Pharmacy technician programs have developed to incorporate injection training, would pharmacist programs develop similarly? I think what would bolster credibility and trust in the eye of the public is to have standardized and accredited training for the expanded scope. As a technician administering vaccines, I have experienced and seen colleagues experience negative hesitancy from patients who are unwilling to accept injection service from an RPhT. We are still building trust. I also see patients seeking MA consultation and being directed to either schedule an appointment or come back when pharmacist (overlap) is scheduled. The workflow is still developing. As a member of the public, I would prefer to go to a clinic to get specialized care. I perceive retail pharmacy as retail over healthcare; as a technician I believe in the growth of pharmacy practice and the competency of Pharmacists and Technicians to train and practice in this expanded scope. The re-design of pharmacy practice is worth more thought and consideration.
I would like to see a more expanded role for pharmacy technicians. Any talk about added drug destruction to our role? This is a task that we can take off the work load of a pharmacist.
I agree with this expanded scope of practice in regards to minor ailments.
Subject: Strong Support for Proposed Expansion of Pharmacy Scope of Practice To Whom It May Concern, I am writing to express my unequivocal support for the proposed amendments to Ontario Regulation 256/24 under the Pharmacy Act, 1991, which aim to expand the scope of practice for pharmacists and pharmacy technicians throughout Ontario. These forward-looking changes reflect a commitment to patient-centered care and a more agile, accessible healthcare system. I commend the Ministry of Health and the College for initiating this vital consultation. The proposed regulatory enhancements will empower pharmacists to assess and prescribe for 14 additional minor ailments—such as acute pharyngitis, mild headaches, shingles, and fungal infections—conditions that are frequently encountered and well-suited to management within the pharmacy setting. This expansion will ease the strain on primary care and emergency services, while enabling patients to receive timely, convenient treatment from trusted healthcare professionals. I also strongly support the authorization for pharmacists to administer injectable partial opioid agonists and antagonists, including buprenorphine. This is a critical step in improving access to evidence-based treatment for opioid use disorder, particularly in underserved and high-risk communities. Further, expanding the list of vaccines pharmacists can administer and enabling pharmacy technicians to deliver all vaccines listed in Schedule 3 will significantly strengthen Ontario’s immunization infrastructure. These changes will enhance public health responsiveness, increase vaccine uptake, and improve convenience for patients seeking routine and seasonal immunizations. I appreciate the College’s efforts to solicit feedback on laboratory and point-of-care tests relevant to the proposed minor ailments. Integrating these diagnostic tools into pharmacy practice will enhance clinical accuracy and support safe, effective care delivery. In conclusion, I fully endorse the proposed amendments and urge their timely adoption. Expanding the scope of practice for pharmacy professionals is a meaningful step toward a more efficient, equitable, and responsive healthcare system in Ontario. Sincerely, TATHAGATA KHASTAGIR
I totally disagree with any additional minor aliments . There is already a lot that pharmacist can handle. We re not paid adequatly to do this minor aliments. Lot of documantion amd time takes us away from our already busy schedule to do a 19.00 minor aliment. Plus if i want to do this on a regular basis then i need an extra staff to join the team. 19.00 recived from this is not going to pay for the extra help you bring for minor aliments. Some of the minor aliments are out of scope of pharmacist prescribing. As one of the collegue said that there more chances of pharmacist being sued for negligence and in a court of law your multiple choice questions are not good enough. The platform offered minor aliments itself are not up to standard of prescribing prescription drugs. All Pharmacist needs a lot of training before anymore minor aliments added to list. A review need to be done on the ones that are already on the list and take some off first before adding any more
I think with the increase workload this is unrealistic ask for a pharmacy team that is already busy. May bannered Pharmacy’s have high expectations from their skeleton staff, often requiring them to do more with less resources. Most patients do not understand this and think that it is unacceptable to wait 1/2 hour to see a pharmacist yet it is normal to wait 4 hours for a walk in clinic to see a physician. The ads that go out paint and unrealistic picture of what actually happens in a pharmacy. That the staff is just waiting for someone to walk in and need our help. I cannot count the times I have been yelled at our spoken to condescendingly to our staff and this just adds added pressure to our teams As educated as pharmacist’s are they do not possess the correct skills for diagnosing patients. This is just a band-aid solution that is waiting to fail
I would like to suggest that the scope of practice for pharmacy technicians be expanded. Pharmacists are currently carrying a heavy workload and significant responsibility, which can lead to increased stress and reduced efficiency. Expanding the technician’s scope would allow certain appropriate responsibilities to be delegated, improving workflow and enabling pharmacists to focus more on clinical tasks and patient care. This change would benefit both pharmacy professionals and patients by creating a more balanced and effective work environment.
In theory these changes would off load physicians and emergency rooms. However, this may for some pharmacies increase the work load of an already understaffed work place. Smaller community pharmacies who are not currently utilizing the skills of Technicians will triple their work load. And eventually there staffing costs as the need to employ Technicians increases. The already busy pharmacies (SDM/Costco/walmart) may see a shift to even longer wait times to speak with a pharmacist or receive prescriptions in a timely manor. Say good by to a 20 minute wait time for a new RX after hospital discharge or surgery. The changes in SOP for Technicians only makes sense. We are trained in SC/IM injections so why not utilize this training more effectively. This would assist the pharmacists and free them up to do more clinical verification.
I welcome the additional professional responsibility as a pharmacy technician and as a patient, any services that can be taken care of by a pharmacist would save so much time and take some pressure off of the walk in clinics and ER’s.
I support the proposed expansion of the scope of practice for pharmacy professionals, as it has the potential to improve patient access to care and enhance the profession’s contribution to the health system. However, I believe the regulatory framework should also address some of the systemic barriers that impact pharmacists’ ability to exercise independent professional judgment. Specifically, enabling direct billing would help ensure that pharmacists can make decisions based on professional and clinical considerations, rather than being influenced by corporate policies or performance pressures tied to service quotas. Additionally, I recommend that the College consider mandating a minimum Pharmacist-to-Assistant (or Technician) ratio for any pharmacy providing expanded services. This would help ensure that pharmacies are adequately staffed to provide safe, high-quality care and prevent situations where corporate employers reduce staffing while increasing service expectations. These measures would protect the integrity of pharmacist-led care and better align regulatory changes with the realities of front-line practice.
I am excited about the changes proposed by Ontario College of Pharmacy in regards to Expanded scope of Pharmacists and Pharmacy Technicians. I think it will reduce work load from the doctors and nurses and will enable easy and safe access to patient care.
I think these changes are important and should happen. With the lack of accessibility to doctors or walk in clinics in my area, it would be a huge help. Being a military spouse, we are often without resources to get simple solutions for ailments without going to emerg. As to the pharmacy techs injecting, I think it’s about time we do it here. Other provinces allow us to inject a whole line of things IM to relieve some pressure off of the pharmacists. We already can give 3 IM injections, it would be a huge help if we could give them all, rather than trading out during flu season with the pharmacist to administer shots we currently cannot. It works great in the maritimes, as I was in NB and was able to administer IM shots, so the pharmacist could counsel on the different shots while I prepared and then administered, so they could stay in the dispensary where they are needed to be
I do NOT support this proposal. I believe this proposal is negligence on the part of OCP in their mandate in protecting the public. These proposed “minor ailments” are well beyond the scope of a pharmacists training. Pharmacists are not trained in diagnosis, although many like to believe they are because they read the introduction and signs and symptoms section of Dipiro. To properly diagnosis strep throat, it will require lab testing and diagnostic experience, this is outside of our scope. A POC test is not a substitute for proper lab testing; hence why in Medicine it is not utilized. This proposal only further increases the risk of harm to the public by increasing the risk of antimicrobial resistance developing by allowing practically all antibiotics to be prescribed under this proposal. If you had concerns about COVID, wait until treatment resistant pneumonia becomes the main issue. It increases the risk of harm of adverse reactions occurring due to clinically unnecessary medications being prescribed. It increases the risk of abuse and harms by allowing benzodiazepines, and other sleep agents like zopiclone to be prescribed. It risks harms to patients through misdiagnosis of signs and symptoms of more serious conditions. Pharmacists do not have medical histories of patients to ensure proper diagnosis and safe prescribing (For those that think they will be able to do this, is lying to themselves especially when corporate pharmacy starts putting pressure and time constraints on your assessments, then gives you an algorithm check list to go through – which I would add 90% of pharmacists are using and going through it mindlessly). Why hasn’t the college inquire about how pharmacists currently do minor ailments – perhaps its in fear that they will find they are using a checklist, with out critical thinking being applied. For those that say we will get the ability to order tests – that is not a good thing; in a system so fractured and broken, overloading labs with potentially inappropriate tests will risk a failure in a lab system, so when your are waiting for a lab test for a time-sensitive serious illness and they are backed up it will be the pharmacists fault. Stick to what you are trained in, which is to ensure that medications are dispensed safely for the right reason and preventing medication errors. Pharmacists are not the solution to this broken healthcare system, the government needs to correct these issues at the core – redesigning the system from scratch to ensure that Ontarians have a family physician, that ERs operate efficiently by using rapid assessment zones that leverage the use of nurse practitioners and physician assistants to do assessments, develop regional booking systems for procedures instead of having your general physician send out referrals to multiple local hospitals hoping one gets back first for your procedure or specialized test. Pharmacists jumping on these proposed solutions for the healthcare system problems will only lead to more problems. If this proposal does go through then the pharmacist that did the prescribing should be directly billing the OHIP, not the pharmacy. This will remove the incentive from corporate pharmacy to pressure and force you to meet quotes (Which was the case for the MedsCheck program). It would create personal accountability to the OHIP program allowing for government auditors to identify abuse of the program, and make each participant financially liability. Your liability insurance should then be tied to your choice in being a participant or not. If you are directly billing OHIP then you solely liable, and then the onus can only be placed on the pharmacist – this would do more in ensuring a pharmacist properly documents, takes histories, and attempts to make a diagnosis – in court a checklist will not suffice.
This is a good move in healthcare perspective. This will reduce burden on health system as pharmacies will be able to administer more vaccine efficiently without taking away pharmacist from their usual duties. All Retail pharmacies will have to reconsider the wage scale for pharmacy technicians if they want techs to administer injections. Currently, techs are underpaid in most retail pharmacies compared to hospitals. I am all in for this new opportunity and growth of pharmacy field.
It’s very important to have an easy access to health care from pharmacists as they are the most accessible providers we usually find to help us .
I am currently injecting a long acting injection for schizophrenia through medical order of psychiatrists. I have two patients on Abilify Maintenna. Their compliance to treatment has been night and day when I decided to step in and make it more accessible to them. They had challenges booking an appointment to nurses and doctors for timely injection. Patients are able to maintain remission longer than usual. Prescribers and family members are all happy that this service is available and accessible in the pharmacy.
Support Pharmacists in Expanded Scope of Practice The expanded scope of practice for pharmacists is a clear win for both the healthcare system and patients, offering immediate and long term cost savings and shorter wait times. However, as pharmacists take on greater clinical responsibilities, they must be fairly compensated. Increased prescription fees and higher reimbursement rates are essential to sustain the profession and support the delivery of high quality, timely care, especially in independent pharmacies. Pharmacists are highly trained professionals providing essential frontline care. To protect the integrity of the profession, pharmacies should be owned and operated by pharmacists, not corporations focused solely on profit. Corporate ownership often limits professional autonomy and hence compromises patient safety. No other healthcare professionals; doctors, dentists, or nurses work for big-box retailers. Pharmacists must reclaim control over their practice, advocate for fair compensation, and ensure pharmacy remains a patient centered, pharmacist led profession.
As a community pharmacist in Ontario, I am very pleased to see the Ministry of Health’s proposal to expand the scope of practice for pharmacy professionals. These changes will allow pharmacists to better support patients’ needs, especially during a time when many Ontarians struggle to find a family physician or face long wait times for care. By authorizing pharmacists to assess and prescribe for more minor ailments, administer additional vaccines, and play a greater role in harm reduction and testing, this proposal will significantly improve access to timely, safe, and patient-centered care. In my community, where many patients have difficulty accessing a primary care provider, this expanded scope will make a real difference in helping patients receive appropriate treatment quickly and efficiently. It would also be greatly appreciated if the Ministry of Health considers appropriate compensation for pharmacists providing these expanded services, recognizing the time, expertise, and responsibility required to deliver high-quality patient care. I fully support these regulatory amendments and appreciate the Ministry’s recognition of the vital role pharmacists and pharmacy technicians play in strengthening Ontario’s healthcare system.
I support the move to empower the pharmacist , I am from a rural location where there is no walk-in clinic and scarcity of doctors. I see people suffer everyday it will a great help for my community. It will definitely reduce the burden over the hospital emergencies .
To add to my last point, I am fine with it but 1. Increase risk of infection to public such as the throat swab. If you want pharmacists doing throat swabs, it needs to be in a clinical office setting with an appointment and NOT in a busy community pharmacy where patients can just walk in without a mask while the pharmacist is busy doing 100 other tasks. 2. The pharmacists should have the RIGHT TO REFUSE if they do not feel comfortable or safe, or if they are busy, they should be able to refuse without facing backlash. I can see a pharmacist saying no due to their already heavy workflow and patients complaining to OCP about how they were refused service. Not all of us consent to these increases in scope. 3. I was never trained to scrape a toenail or inspect a toe scrape. Leave this to doctors. Why are we the ones taking the jobs doctors don’t want? I can get behind empirical treatment and then having the patient seeing a Dr. for a toe scrape inspection. 4. Pharmacists are not trained or should not be required to look at jock itch. This is going to put so many pharmacists in uncomfortable positions and increases liability. 5. If you want to increase scope, all pharmacies, Especially corporate chains, need to increase wages for their pharmacists.
I fully support the initiative as I feel we are already providing most of these consultations as no cost (except for perhaps an OTC sale the service might generate). Such a model will provide a framework for a formal documented consultation along with a payment model for the expertise shared and time spent.
I think it is great step moving forward to help our patients especially in some communities where patient have no choice, but to visit hospital to get assessment for minor ailments. We are already helping our patients for many of minor ailments listed, making patients population aware and formal way of documentation of assessment and treatment will help us to enhance patient care.
I used to get fill my prescriptions at Rexall pharmacy in London. Last year, in November, I was prescribed an antibiotic for strep throat and I took that prescription to my regular pharmacy and I was told to wait 3 to 4 hours. I questioned then why it will take up to 4 hours to get a prescription of antibiotic filled so I was told that there are very busy doing flu shots and only 1 pharmacist on duty so the waiting time will be 3 to 4 hours. Then I went to an independent pharmacy and filled my prescription there within 15-20 minutes. I didn’t complain against the pharmacist because I understand that just 1 pharmacist on duty can’t do flu shots and prescriptions at the same time. A few months ago, my daughter had eye infection and I called a couple of nearby Shoppers Drug Mart to see if the pharmacist can prescribe antibiotic eye drop and they asked me to bring my daughter during specific time when there are more than 1 pharmacists on duty so I went there at that time and pharmacist prescribed her eye drop. I request to all the companies that if they offer any services then please make sure that patients get prescriptions on time and other services too.
I think it’s fine but pharmacists have the right to choose which tests to refuse or not. I am most definitely not swabbing throats or looking at toe scrapings, or assessing anyone’s bodily parts for fungal disease.
Its great initiative by college to allow Pharmacist and their staff to work with Increased scope of practice that helps to patients and helps to reduce over all burden to doctor’s offices.
– The new additional minor ailments are good additions and can be assessed and prescribed by pharmacists. – authorizing pharmacists to administer injectable partial opioid agonists and antagonists (specifically, buprenorphine) In my opinion this is not a wise decision; the risk , the time needed and nature of this kind of patient/ medication will be a great obstacle and most probably will lead to more issues than benefits.
I wholeheartedly support all of these proposed modifications. Expanding the scope of pharmacists’ practice to include the diagnosis and treatment of more minor ailments will significantly enhance the quality of patient care. Furthermore, this approach will greatly support small, independent pharmacies that often struggle to compete with larger chains. This must be implemented within a healthcare system that prioritizes patient well-being, ensuring adequate financial compensation for both pharmacists and pharmacy technicians. Additionally, empowering pharmacists and pharmacy technicians with greater authority, such as the ability to administer vaccines, will further strengthen the system and ensure comprehensive patient care. Thanks
I am excited to see this proposal. As a healthcare professional, I couldn’t be more proud to practice during these times. We can do and should do as much as we can to serve Canadians.
I think this a very good step. With these minor ailments it will be very easy for the patients to get the care they need instead of waiting for doctor for days . We are already doing 14 minor ailments and with this addition the pharmacist can definitely ease lot of burden on healthcare system but at the same time pharmacists should be fairly reimbursed . We are very excited to start new minor ailments as we are already doing other minor ailments every day
I think this a very good step. With these minor ailments it will be very easy for the patients to get the care they need instead of waiting for doctor for days . We are already doing 14 minor ailments and with this addition the pharmacist can definitely ease lot of burden on healthcare system but at the same time pharmacists should be fairly reimbursed
I think this a very good step. With these minor ailments it will be very easy for the patients to get the care they need instead of waiting for doctor for days . We are already doing 14 minor ailments and with this addition the pharmacist can definitely ease lot of burden on healthcare system
I think this a very good step. With these minor ailments it will be very easy for the patients to get the care they need instead of waiting for doctor for days and days
I am excited to get these extra services as they will provide better care for my customers. I think more needs to be brought forward as it will support the changing needs in healthcare in Ontario., just like Alberta. I would like extra conditions like styes, athletes foot, prescribing vaccines, diabetic supplies and birth control. I believe with the expansion of services and dispensing technicians that the layout of pharmacy design will adapt to the extra role. Design will not change without a goal just like any other service. We need to move with the needs of the public which is very different than when I started pharmacy, just filling prescriptions doesn’t work with maintaining pharmacy’s usefullness, in helping the people we serve, in the climate we live in now.
Yes, i agree on all the new proposals, Also urging for looking in increase compensation for all the ailments we treat and injection services we provide (same to what doctors are reimbursed)
I’m fully confident that we as trained pharmacist can do all the suggested minor ailments to help our patients and to provide extra patient care .
I am in full support of this change. With so many patients left without access to family doctors and with lengthy wait times at walk-in clinics, pharmacists are in an excellent position to help bridge this gap in care. We already prescribe and manage many of these conditions in our daily practice — it’s time we are recognized and compensated for it. This initiative is not meant to replace a patient’s primary care physician, but rather to provide timely care for those suffering from minor conditions, allowing physicians to focus on more complex cases. Pharmacists are well trained to assess, manage, and, when appropriate, refer patients to the right health care professional. We are more than capable of handling these minor ailments safely and effectively, improving access and outcomes for our patients.
I am so overwhelmed by the number of angry strangers walking into my place of practice each day demanding I prescribe them something and harassing/slandering me publicly on social media when they don’t meet criteria. We pushed for scope expansion in the 2010’s and we weren’t good enough. The corporate push for a narrative that portrays us as unsung heroes for their profits, while employers refuse rph overlap unless it’s for an insulting level of compensation, is sad and disrespectful. The floodgates an additional 13 minor ailments will open for me when I already work 60h/week and to find out about it on the news makes me wish I didn’t rewrite my jp to come back to Ontario. By the way I’d rather be unemployed than “scrape a fungally infested nail”. My guess is that after finally paying my 10 years of student loans off after 8 years of higher education, i probably will be. 🙁
Pharmacist should be fairly reimbursed as the other health professionals for offering the services.
Are you guys crazy? Herpes zoster is not a minor condition nor is it something we should be expected to treat. We are not diagnosticians. Following a flow chart is not the same as a physical exam. Even if these changes are implemented this is not something I would ever be comfortable doing. But then the public will see us as the ‘bad guy’. Please, have some common sense.
OCP defines a minor ailment as “a health condition manageable with minimal treatment or self-care, typically short-term, with no need for lab tests, and a low risk of masking a more serious underlying condition”. Strep throat essentially fails all of these conditions 1) Easily identifiable – Clinical symptoms overlap with many other conditions including viral pharyngitis; visual exam alone cannot reliably confirm. Diagnosis requires a lab or point-of-care test (rapid antigen test or throat culture) to confirm Group A Streptococcus.Untreated bacterial infection can lead to serious, potentially life threatening complications (e.g., rheumatic fever, abscess). Self-reported symptoms only (sore throat, fever, white spots, swollen glands) has a sensitivity and specificity of ~50–60% and ~40–60% Patients overestimate bacterial cause; only 10–20% of adult sore throats are true Group A Strep (GAS). Clinical scoring systems (Centor or McIsaac), when applied by trained clinician has sensitivity of 65–85% and 70–80%. Requires physical assessment; even TRAINED clinicians cannot distinguish viral from bacterial reliably without a test. In community pharmacy there is a lack of time, training and appropriate resources for clinical scoring and physical examination. Given the lab delay time of 3-5 business days for a strep test, pharmacists should not be placed in a position to rely on self reported symptoms or clinical scoring systems while patients and corporations apply external pressures to bill for a prescription. In Saskatchewan, pharmacist prescription for strep has been rolled out as a pilot project in 2025 with 11 pharmacies in Saskatchewan have been selected to provide strep throat testing + prescribing (i.e. full service: assessment, rapid test, and prescribing). Will OCP do a pilot project first with pharmacies willing to provide such services or just force it on everyone like the last roll out of minor assessments? I would suggest advertising to the public as available at selected pharmacies only, because I will not be offering such services until I get paid $60 like physicians do. Equal pay for equal work!
although this sounds very exiting, I still have several concerns that pharmacists were not trained to diagnose a disease. Some of these ailments are ok like treating dandruff, warts, and other simple ones that i believe many of the pharmacists are dealing with already on daily/weekly basis. However, when it comes to nail clipping, throat swabs, and other more advanced conditions, i strongly believe that more trained health care providers trained to diagnose diseases will be more appropriate ( physicians, nurse practitioners, physician assistants, etc.) In addition, this will add more burden on the retail pharmacist who are already very busy and squeezed for time.
As I read the responses in support of new minor ailments being added to an already lengthy list and the further expansion of our scope of practice I can’t help but wonder if these people commenting are greedy Head Office shills for large chain pharmacies, pharmacists not even practicing community pharmacy or those pharmacy owners completely motivated by money. Much of the training pharmacists go through to to be able to meet the requirements of the expanded scope of practice are woefully inadequate. Many involve just watching a 5-10 YouTube video and then relying on computer software to make decisions. When the time comes that our scope of practice includes setting broken limbs, sewing or removing stitches heck might as well include open heart surgery for $19 it’ll be time for this pharmacist to retire.
I oppose to this new expanded scope. Pharmacists are already handling 19 Minor Ailments on top of all regular & other expanded scope of responsibilities. Adding 14 more MA will create tremendous stress, burden & workload and will be very difficult to manage in a already overwhelming & understaffing environment. Line-ups in pharmacies may become longer than lineups in supermarkets. OCP/government need to slow down & implement these steps gradually in stages in a very carefully thought-through & reasonable pace/manner. Suggestion is to just add 3 MA (headache, insomnia, dry eye) and give pharmacists Vaccine prescribing authorities. I’m against administering partial opioid agonist/antagonist, as pharmacists are involved with numerous other vaccinations/injections already and will not be able to handle more. Authorizing regulated pharmacy techncians to perform vaccinations might be the only positive outcome of this proposal. Doing Strep Tests, Throat Swabs & Nail Clipping for culture should Not be a pharmacist’s responsibility, as we have No training nor the time to perform these. This is definitely way too much for a community pharmacist to handle at one time. Corporate welcomes it because of the profitability and this will result in even more targets & demands from corporate head offices. The expectations & demands from the general public will be overwhelming if this expanded scope goes through as they will flock to pharmacies rather than waiting/calling their family physicians. This will create exploded chaos And can lead to many pharmacists quitting, retiring or changing careers, leaving healthcare altogether. Many pharmacists are already burnout & disenchanted due to their unreasonable workloads and stress in their hectic work environments of fulfilling so many different tasks. It’s a downward spiral that will lead to even more negative issues in the Healthcare realm. OCP should understand all this & make every effort to Support & Protect this Profession from burnout & demise. Please consider this very carefully before implementing. Thank You!
Acute pharyngitis and strep testing is not as simple as just doing the test and writing a prescription. Approximately 30% of the population is a strep carrier and rapid strep tests can’t differentiate infections from a colonized state. Hence, in 30% of the population (who will virtually never get strep throat), the test will always be positive. Additionally, parents often think young children have sore throat when they have croup. Also, children under 3 yo are often colonized with group A strep so should never be swabbed or treated for strep throat except in cases where guidelines (e.g., IDSA) highlight appropriateness. If permitted to do throat swabs and prescribe antibiotics for strep throat, criteria for testing should be required and documented such as the Centor Score (Modified/McIsaac criteria) or other validated screen. Herpes zoster typically requires antiviral and pain medications. I would recommend clear drug and dosing guidelines as well as a requirement to evaluate for reduced renal function and appropriateness of use of glucocorticoids and agents such as gabapentin which could be abused or prescribed inappropriately without having full medical history of patients. As considerations, steroids are problematic if patients are immunocompromised or are at risk of dissemination of certain fungal infections, patients with compromised renal function should be carefully dosed with acyclovir, topical acyclovir should not be permitted, gabapentin has numerous cautions, and opioids should not be permitted. Onychomycosis often requires oral therapy that needs liver function and other monitoring. Unless such access will be available, therapies should be restricted to topical therapy only. Pharmacists should also be able to differentiate concerning nail findings such as melanoma and splinter hemorrhages which would rule out fungal issues and necessitate more complex medical follow up. Pharmacy technicians giving vaccines should be required to be certified in a comprehensive program to give injections because such administration is not a benign act. Even though nursing performs such acts and they are trained to physically examine and treat patients, dangerous outcomes of inappropriate administration have occurred. Patients will need to have legal recourse if such effects occur. I would also recommend that pharmacist prescribing such prescription medications should be required to notify patients’ primary care provider or other medical provider to ensure there are no care or worsening information gaps. Additionally, as a pediatrician and pharmacist, based on pharmacist and ‘Minute Clinic’ prescribing I have observed in the US, many such prescribers don’t have the clinical knowledge to do such prescribing especially when they don’t have full lab capability and patient medical record access. I remain concerned about the chain pharmacy powers to push pharmacists to make more revenue without providing the necessary training or support to ensure prescribing is done safely and appropriately with documentation of records similar to what is required of physicians.
I am excited to get these extra services as they will provide better care for my customers. I think more needs to be brought forward as it will support the changing needs in healthcare in Ontario. I would like extra conditions like styes, athletes foot, prescribing vaccines, diabetic supplies and birth control. I believe with the expansion of services and dispensing technicians that the layout of pharmacy design will adapt to the extra role. Design will not change without a goal just like any other service. We need to move with the needs of the public which is very different than when I started pharmacy, just filling prescriptions doesn’t work with maintaining pharmacy’s usefullness, in helping the people we serve, in the climate we live in now.
I do not support this proposal. Pharmacists are overworked as it is, and this would only make lines and wait times worse. Not only that, but from other feedback it is clear that many pharmacists are unhappy with this change. I’d rather have my local pharmacy be able to fill my prescriptions quickly and consistently rather than having overworked, burnt out workers leading to quitting and closures.
As a community pharmacist, I would like to express my strong disagreement with the proposed expansion to the list of minor ailments. The Ontario College of Pharmacists first and foremost needs to slow down and realize that the expansion of a pharmacist’s scope of practice needs to be done at a reasonable pace. The College also needs to recognize that pharmacists are just that – pharmacists. During my schooling I was never taught how to collect specimens from a patient. Pharmacists are not nurses. We are not physicians. I’m sure that the vast majority of community pharmacists are already overworked and overburdened under the current scope of practice with limited human resources and ever growing demand and expectations from the general public. If the proposed expansions are made to the list of minor ailments, I foresee an explosion in demand for minor ailment prescribing such that a chain community pharmacy like mine will be expected to be both a full time dispensary and a full time walk-in clinic, with likely no increased staffing provided from the corporate level. The College needs to acknowledge the strain that already exists on pharmacy professionals, and realize that piling more work onto pharmacists will inevitably cause burnout and consequently only exacerbate the current problems with the healthcare system in Ontario. Pharmacists are already doing more than their fare share. It’s saddening to me that the College seems to be far too out of touch with the average registrant’s work situation to be aware of this. If these expansions are ultimately forced through, it is imperative that the College require designated managers and corporate pharmacy owners to increase staffing levels to ensure the services provided are actually of acceptable quality.
I am not in favor of this new list of Minor ailments. We are already having short staff( company always talks about control the wages) and incresing targets( for medchecks, minor ailments). And above all these pressure, patients want their medicines in few minutes( they don’t like to wait for their medicines). If you want pharmacists to do these type of services, they should have new position under goverment umbrella. ( paid by government not by company) . Because no one think about Pharmacist low pay and more work. And also We didn’t have any specific training for this proposed scope of practice.
This proposal needs to be implemented in stages as some of the minor ailments are already part of OTC counselling, now anything related collecting samples for lab over is a big stretch as we don’t have the training neither the time as it is with the current situation (work overload, staff shortages) , never mind the patients demands , the threats and verbal abuse. In addition strept testing, physical assessment (jock’s itch seriously?!!!) Should be done by physicians as we don’t get paid enough for that Also administering injectable opioids should be done in the proper clinic setting, and the pharmacy is not set up for that. Additional training and resources must be provided as well as additional financial support, not the current environment where everyday pharmacists are just expected to juggle hundreds of tasks and still ensure patient safety dispensing hundreds of prescriptions on a regular shift I can’t see how the pharmacist’s that stated the “strong” support this changes have a realistic view of the pharmacy landscape at this time Stressful work, heavy workload, corporations quotes for professional services , shortages of drugs and staff, patients verbal abuse No difference on wages related to years of experience and not increase on the wages with the additional responsibilities Just another band-aid fix for the ongoing healthcare crisis
I am in support of the proposed change.
The proposed changes make me livid. Allowing sore throat, nasal congestion, headache and swimmer’s ear alone will turn pharmacies into 1/2 pharmacy 1/2 walk-in clinic. I don’t know how it’s expected of us to squeeze this into a an already very busy full-time job? Myself, I wanted to be pharmacist because I wanted a healthcare profession that didn’t have to touch people like a nurse or doctor would. The thought of swabbing throats of sick patients and taking samples of nail clippings from people’s feet (or even looking at their feet) makes me nauseous. Besides, we don’t even have proper or private exam rooms that can be cleaned easily. Some of the purposed changes are already things we counsel for OTC, but turning them into minor ailment consults means the patients come in expecting to leave with a prescription treatment and get so upset if we advise an OTC. Headlice for instance, can still be treated OTC and avoid all the time it takes to document a minor ailment and fax to patient’s GP. All this time that adds extra workload to us as staff pharmacist (who are already burnt out in most cases) and zero reward (payment directly to pharmacy owner). The proposed minor ailments would cause more consults than the current list (sore throat alone) and if we don’t have the time because we’re trying to do our original job description, and have to ask people to come back in 1 hour, some of them get so upset that we risk losing that patient at our pharmacy (despite their willingness to wait 1-2 hours as expected at a walk-in clinic). The first set of minor ailments has caused us to require a zero-tolerance sign in the pharmacy and put strain on patient relationships and I can see it getting worse with more ailments added. Perhaps have a pharmacist work at current walk-in clinics who can take all of the minor ailment consults and speed up the rest of the walk-ins for the physicians.
I’m strongly opposed to including a throat swab in the expanded scope of practice. It will force a lot of patients with viral and bacterial infections into pharmacies seeking help whether it’s appropriate or not. Patients are not required to wear masks, which puts vulnerable patients attending pharmacies for COVID-19 or Flu vaccinations, or for biological training/pickup, at risk. This is because all services are performed in the same small room with inadequate ventilation and no proper disinfection. Waiting areas will become contamination fields. It will also put staff at risk as well. Acute infections like strep are better managed in the doctor’s office where they can perform proper differentiated diagnosis and where doctors can protect themselves properly and able to manage workflow much better by having prescreening and appointment system vs a walk in for all in the pharmacies. I’m also opposed to including dry eyes and onicomicosis since dry eyes can be treated with OTC medications and pharmacists are not able to perform tests that will help patients meet the LU criteria for ODB covered patients. Jock itch can be treated with OTC medications and pharmacists should not have to prescribe medication without doing a physical exam.
I support all the proposals except nail scraping procedure
I am in favour of the expansion of scope, however I also feel training should be structured, mandatory, and thorough for anyone engaging in prescribing. Pharmacists are not all the same, just like Physicians are not. If a pharmacist wants to assess and prescribe for Pharyngitis they should be able to after they complete a mandatory course on that specific ailment, declare competency, and pass an exam related to it. This should be the case for every ailment offered. This would build public trust and allow pharmacists to “specialize” so to speak. There are some that want to dispense only and that is ok! There are some that want to assess and prescribe most of their day and that is ok too! In fact, why not add chronic disease management in already? Just so long as a rigorous training program is included I see no reason why it should not be. I’d like to be able to prescribe for diabetes independently because I have extensive diabetes management knowledge and have a CDE as well. I should be allowed to focus my practice on this and be given full scope. I’d do at least as well as an average Family Physician, in diabetes management, if not better. Why not other ailments that other provinces have? I’d be ready to take a course on birth control prescribing and able to help those patients too, forget the piecemeal approach. Give Pharmacists full scope of practice with the condition that additional mandatory rigorous training is required for each additional scope taken on.
I am in support of the proposed changes related to the management of minor ailments. However, I am opposed to the inclusion of injectable partial opioid agonists and antagonists—specifically buprenorphine—within the proposed scope of pharmacy practice. We pride ourselves on providing accessible and compassionate care to all individuals. Pharmacists remain readily available to assist patients without the need for appointments. Patients are welcome to visit the dispensary with their concerns, questions, and prescriptions, and we are committed to delivering care at the highest professional standards. That said, I strongly advocate for the establishment of a dedicated clinic space for the management of minor ailments. These responsibilities should not be added on top of existing duties. On average, we serve between 150 to 200 patients per shift, in addition to performing injections and managing minor ailments. Expanding the scope of responsibilities without allocating specific time and space will increase the risk of burnout and may lead to errors in patient care. It is also critical to address the reality that pharmacists are significantly underpaid for the responsibilities they carry. Burnout combined with inadequate compensation does not—and cannot—lead to better healthcare outcomes. If additional responsibilities are to be introduced, a revised workflow must be implemented to support them. Furthermore, I strongly urge the adoption of a zero-tolerance policy toward verbal abuse and threats directed at pharmacy staff. Thank you for considering this feedback.
Minor ailments expansions are great idea. However, most community pharmacies are not set up for appointment based practice. Most of the time, only one Pharmacist on duty. How can one person do the dispensing and assess patients. In an ideal world, if the minor ailments are to expand, pharmacies would need a designated Pharmacist for the minor ailment and one in the dispensary only. However, having two RPh on duty does not make business sense. Great expansion on minor ailments, but Pharmacists will be overworked.
This expanded scope is long overdue. Although in retail it definitely adds more stress to a pharmacy team it really saves the visits to the local hospitals for more serious health related issues . I honestly could see a few clinics being opened that provide , prescribe and dispense only for minor ailments and injections
i am strongly endorsing this initiative. waiting time for family physicians are frustrating. Pharmacists are knowledgeable about those ailments and tests and could be of a great support to the medical system in Ontario. it has been proving successful in other provinces for many years. we are not reinventing the wheel. Here is a snapshot on a Friday morning Etobicoke General Hospital William Osler Health System Wait Time Unavailable 31 waiting 51 in treatment
I am all for minor ailment prescribing, but isn’t the definition of minor ailments that they don’t require diagnostic tests? Most pharmacies are not set up to follow up with diagnositic tests and the multitude of follow up it requires!
I can easily forsee an increase in malpractice claims and complaints to OCP regarding strep tests.I work at a pharmacy located next door to a walk in clinic. Most patients do not want to pay $25 for a rapid strep test and will wait for the lab swab. The current processing times for lab swabs is 3-5 business days. People expect their swab results the next day and the clinic receives many patient complaints regarding the length of time to get strep results.. If there is any delay in responding to a positive swab (ie missed, recieved after business hours, too busy to call patient) that could result in a significant delay in initiating or extending treatment duration to 10 days. Untreated strep can have serious and even deadly consequences. In my experience, OCP already is overburdened with complaints. It takes them almost a year to deal with the simpliest of customer complaints. Pharmacists deserve to have their complaints handled in a timely manner. How will OCP handle a huge influx of complaints?
Should we not include minor ailments assessments that are already authorized in other provinces (such as birth control/emergency contraception)? I would like it to also complement with other provinces regulations so that it is more seamless care across Canada. I support expanding the scope of practice for pharmacists to be able to assess and prescribe all minor ailments.
Onychomycosis – we should be allowed to prescribe compounded antifungals as well – the cost for the two drugs mentioned is a major barrier. Compounded Ketoconazole Nail Lacquer is approx 1/5 the price of efinaconazole.
Acute pharyngitis should not be included as a minor ailment. My primary concern is antimicrobial resistance. While many prescribers don’t perform a strep-throat swab prior to prescribing for strep, I’m concerned that patients will come in with expectations that pharmacists can easily prescribe an antibiotic for this condition. I think the medical management should be limited to pain/symptom control (suspicion of viral source) with agents like benzydamine mouthwash.
The expansion of scope for both pharmacists and pharmacy technicians is an excellent step forward in improving patient care and optimizing healthcare resources. It allows pharmacies to play a larger role in addressing system gaps and meeting community health needs. That said, the current workload associated with these new responsibilities is becoming unsustainable. For example, even a seemingly “minor” clinical service can take up to 30 minutes for a pharmacist to complete when performed thoroughly and in compliance with standards. This is time-consuming in an already busy environment, and it places significant strain on workflow, staffing, and patient wait times. Pharmacists and technicians are fully supportive of using their training and skills to improve care, but appropriate compensation and staffing support must be in place. The level of responsibility, clinical decision-making, and time commitment required is not aligned with current reimbursement rates or support structures. Expanding scope is the right move, but without fair remuneration and recognition of the time burden, it risks burnout and reduced sustainability for pharmacy teams.
Really good initiative. Strongly support
What’s in it for Pharmacists? As a practicing pharmacist, I fully support the expanded scope of practice — it represents meaningful progress for patient care and a more efficient healthcare system. However, the reality on the ground tells a different story for pharmacists themselves. We are already working under significant pressure, with chronic understaffing being the norm in many community pharmacies. The expectation to take on additional responsibilities such as minor ailment prescribing, renewals, and assessments — all without a corresponding increase in staffing or structural support — is simply unsustainable. While this expanded role is a clear win for the government (cost savings) and corporations (increased billable services), it places front-line pharmacists in an increasingly risky and exploitative position. I am deeply concerned that this will inevitably lead to: Increased dispensing errors, due to task overload and divided attention. Reduced time for patient counseling, which undermines our role as accessible healthcare providers. Burnout and attrition, further exacerbating staffing issues. From a financial perspective, pharmacists are being asked to do significantly more without any increase in compensation. If we are expected to provide consultation-level services — services that would otherwise be billable in a physician’s office — then fair compensation must follow. I propose that a portion of each consultation fee, particularly for minor ailments and renewals, be directly allocated to the prescribing pharmacist on top of their fixed wage or salary. This model would: Recognize pharmacists’ clinical expertise. Incentivize quality patient care. Ensure sustainability of these expanded services. If we truly want to evolve the profession in a way that benefits both patients and providers, then pharmacists must be meaningfully included in the value equation — not just used as a cost-saving solution.
i agree with the proposal to add services to expanded scope of practice. it will reduce wait time for patients drastically
Keep adding on more stress to pharmacists is something that is not acceptable. Pharmacists are already juggling millions of tasks everyday and adding more things to do with no real compensation but causing stress and burnout is selfish!
I have serious concerns about the proposed expanded scope of practice minor ailments. Ailments that require pain management prescribing and have long term consequences ( shingles) should never have been considered a minor ailment. If you have been a pharmacist for even a short time , you know patients always think they have strep . Please don’t put me in a position where I have to say no and suffer verbal abuse from demanding Mom’s . Strep belongs in a doctor’s domain . As do ear infections . If you want an explosion in antibiotic prescribing ( which is exactly what we have been fighting against), go ahead and let minor ailment prescribing begin! And toenails – ewwww! Go see a doctor ! When will the madness stop? I suspect you will see a lot of disillusioned pharmacists who hate their job even more than they do now . And if you think doctors resent us now , wait until you see the next round of animosity. But by all means let techs inject away ! As long as they do all the paperwork , charting and physician notification too . I shouldn’t have to do that for them – they are more than capable. As a final note , please ensure that pharmacists can refuse minor ailment prescribing without repercussion . Corporations and even private pharmacies should not be able to mandate minor ailment prescribing for profit any more than they did with Medchecks.
What is the incentive to do more work with added liability? Out of the goodness of my heart? To relieve the burden on the healthcare system? What about the burden on me? I don’t even get a break on a 9 hour shift. People lined up waiting for their prescriptions while I do endless vaccines and now they will have to wait longer for their prescription while I explain that no, I am not going the prescribe you antibiotics for strep throat because I can’t visualize your throat without an otoscope! And I don’t get paid for it!
yes approved , provided that we will be able to refer patient to lab test to confirm diagnosis for certain minor ailments
My concern is; how are pharmacists going to have the time to safely implement all of these additional responsibilities into an already busy workplace environment? This may improve access to care, but we must ensure that this care is of the best quality. In addition, a lot of pharmacists will need further education to diagnose on a deeper level than what they already do. How will pharmacists as an individual (not as a corporation or as a pharmacy owner) be remunerated for this additional training? I am concerned for the added stress on individual pharmacists and the pressure from pharmacy corporations to pharmacists to deliver this service so they improve their bottom line, as opposed to the individual pharmacist who does not. Definitely a major conflict of interest. This needs to be fair and sorted before implementation of these changes. Pharmacists do not need this additional workload and stress.
Letter of Concern Regarding Proposed Expansion of Minor Ailments Prescribing Subject: Request for Essential Physician Feedback Prior to Expanding Pharmacist Scope of Practice I am writing as an actively practicing Pharmacist in Ontario, and a registrant of the College, to provide feedback on the proposed amendments to Ontario Regulation 256/24 under the Pharmacy Act, 1991, which aim to authorize pharmacists to assess and prescribe for 14 additional minor ailments. While I support efforts to enhance patient access to care, I share the systemic concerns previously voiced by the Ontario Medical Association (OMA) regarding the rapid expansion of prescribing authority without established mechanisms to ensure seamless and safe integration into the broader health system. Specifically, the concerns about patient safety risk, fragmentation of care, and a lack of unified medical records remain critically relevant (1) Recommendation: Essential Review of Current Program Before proceeding with the approval and implementation of the proposed 14 new minor ailments, I strongly recommend that the College and the Ministry of Health conduct a focused review and actively solicit data-driven feedback from Ontario physicians—particularly those in family medicine and emergency departments. The objective of this consultation should be to formally document physicians’ experiences with the current minor ailments program (for the 19 authorized ailments) over the past year. Key areas to investigate include: • Red Flags/Safety Concerns: Have physicians observed any concerning patterns, such as inappropriate prescribing, patient misdiagnoses, or management decisions by pharmacists that led to negative outcomes? • System Fragmentation: What is the administrative burden and clinical impact of managing patient records and follow-up when prescriptions originate outside of the patient’s primary care chart? • Clinical Outcomes: Anecdotal evidence or, ideally, aggregated data on patient referrals, complications, or delayed diagnoses that may be linked to the initial pharmacist assessment. Moving forward with a significant expansion to 33 minor ailments without first validating the safety and efficacy of the initial program, as reported by our physician colleagues, may exacerbate existing risks and undermine the goal of collaborative, integrated patient care. I urge the College to prioritize this interprofessional feedback loop to ensure that the continued evolution of the pharmacist’s role is built on a foundation of proven safety and system integration. (1) OMA Ontario Medical Association Pharmacists prescribing for minor ailments Frequently asked questions OMA economics, Policy and research Jan 19 2023 https://www.oma.org/siteassets/oma/media/public/faqs-on-pharmacists-prescribing-for-common-ailments.pdf “The OMA has been raising concerns about this change to the Ontario government (including the Ministry of Health, the Minister of Health and the premier’s office) since 2019. The OMA has highlighted several concerns to the government including, but not limited to, patient safety risk, fragmentation of care, conflict of interest, a lack of unified medical records, and added administrative burden on physicians. Our concerns and recommendations were not addressed by the government.”
I greatly appreciate the ongoing expansions in scope for both pharmacy technicians and pharmacists. However, at my current workplace, pharmacy technicians are not permitted to administer vaccines—including the COVID-19 vaccine—despite the fact that I completed an OCP-approved certification course in 2021. This raises an important question: how can these regulatory changes be implemented in a way that prevents business owners from restricting licensed professionals from practicing to the full extent of their scope? In addition, compensation must be addressed. The pay scale for pharmacy technicians does not reflect the increased level of skill, responsibility, and workload that accompanies these expanded roles. Another key consideration is whether these scope changes will become mandatory rather than optional. Without consistency across the profession, progress may be limited. Regarding AIMS, it is a valuable safety initiative in principle, but its effectiveness depends on consistent audits and enforcement. Based on daily observation, I estimate that only a small fraction of errors—perhaps around 1%—are formally reported. Many errors caught by technicians before medications leave the pharmacy, or by other healthcare workers in hospital settings, go undocumented. This often occurs due to time pressures, lack of enforcement, or fear of blame, rather than an understanding that reporting is an educational opportunity. Proper reporting allows governing bodies to identify patterns, address systemic issues, and ultimately prevent future errors. At the core of our work, ensuring the right patient receives the right medication, dose, and route—safely and promptly—remains the highest priority, particularly in hospital environments where timing is critical. In short, laws and expanded scopes lose meaning if they are not enforced or supported. Corporations often continue to prioritize speed over safety, creating risks for both patients and healthcare professionals. Meaningful change requires improvements in staffing, mandatory audits, transparent error reporting, fair financial compensation, and enforcement of scope-of-practice rights. Otherwise, if corporations are permitted to override or restrict the legal scope of licensed professionals, the entire purpose of scope expansion is undermined. Kind Regards,
There should not be a further extension of scope of practice. I want the pharmacist to confirm the right medication has been dispensed and that drug and disease interactions have been evaluated and the physician consulted where necessary. There is insufficient staffing of both pharmacists and auxiliary staff in far too many pharmacies because management is not putting patients first.And OCP is not requiring minimum professional staffing numbers based on billings. I absolutely do not want a pharmacist diagnosing an eye condition. Or a couple of other “minor” conditions already approved (eg uti). And, getting to the new additions, such as genital warts, will they be doing a physical examination? Will they have another member of the “team” present in their tiny consulting room? Or can one just give one’s opinion of their own condition and the pharmacist charge for a consult and fill the prescription they write? Most pharmacists seem to be under a lot of pressure. They are sometimes working multiple locations in the community to acquire enough hours. They do not need this extra workload and stress.
Reading the above proposed changes does nothing but cause me anxiety. I don’t feel excited about expanding my scope of practice, nor will I participate in the expanded scope if it is approved. My time at work is already stretched so thin that I can barely provide quality care in the areas I already participate in. Despite the numerous scope expansions for pharmacists over the last few years, there have been no staffing changes to support it in my pharmacy. I have been providing feedback to the college for years indicating that corporation run pharmacies are pushing their pharmacists too hard with professional service quotas, but it wasn’t until a pharmacist had the nerve to make a televised statement about it, that the college decided to take action. I do not want any of these added responsibilities until somebody does something to regulate the corporations in community pharmacy. They should not be allowed to dictate a monetary goal for their pharmacists to achieve in professional service billings. The laws seem to change so quickly when it comes to expanding our scope of practice, but yet I’ve seen no legislation changes to prevent corporate pressures. This is the area that I would like to see significant change in. It would improve not only the quality of patient care, but the mental health of a lot of pharmacists, as well.
Absolutely disagree it’s too much load on the pharmacist with no benefits . Benefits only goes to owners or corporate
I do not support the expansion of minor ailments. Pharmacists are under a lot of pressure already. Customers get upset if you try to explain why they need a referral and some try to lie their way into getting a prescription. On top of that there is claw backs from ODB if there is not follow up note on patient profile. And ODB is only reimbursing pharmacies $19. Walk in doctors are not expected to do all this work and their hours and responsibilities are not as extensive. Unless if there is another pharmacist present , or it is a “pharmacist run clinic” , I do not support any expansions to minor ailments program. OCP needs to consider the best interest of pharmacists as well. Adding more and more tasks and not requiring pharmacists to have lunch breaks , overlap, regular 8 hour shifts like all other organizations is unfair.
Absolutely I don’t agree on the extra minor ailments to be added, we are not trained enough or have enough skills for those diagnosis and it’s extra workload on the pharmacist to deal with
I am not comfortable being responsible for differentiating conditions that may cause blindness or hearing loss. If I had wanted to be a doctor, I would have gone to medical school. I am busy enough with my actual job, could we focus on that?
I highly encourage the broadening of our scope of practice , being a pharmacist in Muskoka in a rural area I can tell for sure that Increasing our scope of practice had helped hundreds of people that are unable to see or have a doctor . People are also less panicked and for some areas who don’t have hospitals like where I work. I highly support our college in all the decisions and I think our college is honestly saving our health care system from falling apart Thanks Marlin Henin
Absolutely disagree with more expansion of scope. Unless you are going to separate the dispensary from clinical services, dumping more and more tasks onto pharmacists to try and fix our broken healthcare system is just going to increase medication errors and decrease quality of care. The focus should be on changing the floundering model of community pharmacy before burdening pharmacists with all of these tasks that were initially meant for other health care professionals. In addition, many of these conditions are not appropriate for pharmacist prescribing. There is no way a pharmacist can adequately assess and prescribe for jock itch when they aren’t doing a physical, which a physician/NP would be able to do. There should also be mandatory prescribing certification for every single minor ailment, so that in order to prescribe for that condition, the pharmacist has the proper recent training and certification to do so. I’m just baffled at the lack of understanding OCP seems to have for both pharmacist workload and patient safety when it comes to minor ailment prescribing. If OCP works in the public interest, burdening pharmacists with an ever increasing workload with a lack of proper certification and training is NOT in the public interest. Tired, burnt out and scrambling pharmacists lead to reduced quality of patient care and mistakes, which no one wants. I am the biggest advocate for patient safety, and I also have so much respect for our profession. We are extremely undervalued and deserve both recognition and the ability to practice to the highest standards of care, as well as use all of the knowledge and expertise we have. We did not go through a decade of university schooling to clip someone’s toenail to send a sample. We went to school to become medication experts, and to use this knowledge to help patients with drug therapy and prevent dangerous medication incidents. I have so much more to say, but I’ll finish by saying pharmacists need their own billing numbers and for PharmD graduates to be able to call themselves doctors. We earned the degree and are not given the respect or designation we deserve, especially with all the extensive clinical care we are now responsible for. Pharmacists should be recognized the same way as any other prescriber, especially if you want us to be prescribing for umpteen different conditions.
The expanded scope of practice is getting out of hand. Ear infections? We were never taught how to diagnosed ear infections nor examine the ear. Most pharmacies are not equipped to be used as examining rooms, nor to house samples to be sent to labs. I don’t think you’re accounting for the logistics of the whole process. You need to ensure that cooperations provide the staff and funding for pharmacist to perform these minor ailment assessments properly, otherwise cooperations will just take advantage of pharmacists and force them to meet more service quotas but not provide the resources for us to perform two roles at the same time, namely, play doctor and fulfilling the responsibilities of the dispensary. Doctors are not required to play dual roles but why are we? With already the demands of providing services (medschecks, minor ailments , injections) and our normal roles as pharmacists , we are making more dispensing errors and feeling completely burnt out. Sure for OCP, you might think that’s for us to sort things out with our employers, but a lot of the time we’re powerless, and if OCP doesn’t look after pharmacists then what will become of the profession?
Sure, it believe as a pharmacist we can help more for many things that can make doctors more focused on better assessment and follow up for people in need with chronic conditions instead of wasting time and resources include $$ for these conditions.. but I believe pharmacist should get better compensated for doing all extra services and to be able to have their own direct billing number as mostly now goes through pharmacy ..
Full support for the proposed changes
I do not support the addition of several of the ailments in the new list. While pharmacists are experts in the safe use of medication, we have not received adequate training to be experts in providing diagnoses as well. In order to safely treat conditions such as pharyngitis, otitis externa, and xeropthalmia we must rule out other conditions by means of physical examination. These skills are not within our current practice model. The public must also be clearly informed that this list represents conditions pharmacists will be paid to assess, but that treatments are still likely to be with OTC agents which insurance plans do not cover. Despite the current sentiment, being a pharmacist that focuses on safely running a dispensary, ensuring prescriptions are accurate and appropriate, and educating patients, is not a waste of resources.
I welcome these additional minor ailments, but only if they also come with the ability to do the required POCT or lab testing. The costs of these tests must also be reimbursed. I do believe pharmacists are educated enough either provide these services as is, or educate themselves to be comfortable to do so. Hospital wait times are too long and walk in availability too limited. We are in a great position to make a real difference in the health of Ontarians during these difficult times.
Indeed. Based on my experience practicing in Alberta with APA, it is clear that Ontario would greatly benefit from expanding the scope of pharmacists. Given the significant strain on our healthcare system, enabling pharmacists to practice to their full potential would enhance patient access to care and alleviate the burden on other providers.
This is awesome. I congratulate and appreciate OCP for taking all these steps towards broader scope. It’s blessing for ailing humanity. Next up could be meds which do not require much complex diagnosis like all vaccine and travel meds, birth control pills, etc. this will save patients much time and will be extremely convenient. It’s also a milestone in disease prevention. Thanks again.
Supporting the addition of 14 new minor ailments for Ontario pharmacists is a positive step toward improving access to timely care and easing pressure on the broader healthcare system. Pharmacists are highly trained and well-positioned to manage these common conditions, especially in communities where access to physicians may be limited. Expanding their scope allows patients to receive faster treatment, helps reduce unnecessary emergency room visits, and promotes a more efficient use of healthcare resources. However, successful implementation will require clear clinical guidelines, proper training, fair compensation, and effective collaboration with other healthcare providers. Ensuring patient safety and continuity of care should remain a priority as pharmacists take on this expanded role. Overall, this move has the potential to significantly benefit patients and the healthcare system when supported with the right infrastructure and oversight.
Nice additions to our scope of practice. Would love to help people in community where I can see the emergency room wait time is approximately 5-6 hours and regular doctors are very busy due to not much doctors in the area. I wish additional educational course would be provided to specifically focus on these additions.
Also, I don’t agree with giving expanded scope of practice for Registered Technicians for additional injection privileges for Schedule 3 drugs. They don’t have the pharmaceutical knowledge on SEs to adequately inject these medication. I rather be there in person than be interrupted by Technician if the patient has any question or concerns about the drugs listed in Schedule 3.
I’m excited to hear about the proposed expansion of scopes of practice for pharmacy professionals in Ontario. Pharmacists have the skills, training, and clinical expertise to offer more comprehensive care and improve access to essential health services in our communities. These changes recognize our potential to contribute meaningfully to patient outcomes. That said, it’s crucial that reimbursement models also reflect the time, effort, and responsibility involved in delivering these expanded services. Fair compensation is key to ensuring sustainability and encouraging widespread adoption across independent pharmacies. Thank you for advocating on our behalf and for the opportunity to share feedback.
There is no moving forward with providing additional publicly funded vaccines unless a centralized and province wide vaccine repository can be accessed and added to by community pharmacists. THIS SHOULD BE MANDATORY PRIOR TO GOVERNMENT LEGISLATIVE APPROVAL. Protecting the public is the mandate of the OCP, and thus OCP should be demanding that such a system is in place prior to approval of any further vaccine initiatives. Patients are not reliable historians regarding their vaccine history. Communicating back and forth with physicians by fax, phone or Prescribe-IT is time consuming and contributes to the paperwork burden that our physician colleagues continue to push back on. I have received a great deal of feedback from my staff, including pharmacists and pharmacy technicians. There is zero comfort level providing further vaccine services (especially publicly funded ones) without some type of visibility into the patient vaccine history. I just cannot wrap my head around how OCP thinks this would be appropriate from a patient safety standpoint. OCP should be demanding this type of system be put into practise.
No to the following additional minor ailments: Sore Throat, Herpes Zoster, Acute Insomnia, Onychomycosis, Otitis Externa. Pharmacist do not have enough training for these type of conditions. I do not want additional Rx privileges to prescribe antibiotics or antivirals for pharyngitits or Shingles. (I’m not purchasing an otoscope or looking inside someone mouth or TCA/orexin rx prescibing for insomnia) Those condition still require more skilled diagnosis that physicians have (or NP). If OCP or OPA wants pharmacist to do these the above minor ailments ( also these existing ones:Contact Dermatitis, oral thrush, impetigo), I believe that pharmacist need specialized training with a doctor or NP to gain adequate skills to prescribe those (specialized category, or practical exam to pass to be allow those minor ailments)
I am not agree with this change due to increasing responsibility with out difference in pharmacist hourly rate it will not be fair , also it will be very hard for solo pharmacist
Although ontario is far behind other provinces but , but this is an excellent addition that needs fine tuning . 1- part of fees to be directly billed to performing pharmacist . 2- Patients has to be informed that this is an extra work for the pharmacist that he/she isn’t obliged to perform . 3- Fees must increase (anyway will be cheaper than emergency or family doctor fees )
Pharmacists must be encouraged to refuse unnecessary prescribing without fear of facing backlash from patient complaints that are not justified. Pharmacy employers and The College must support pharmacists’ decisions to not prescribe without fear of disciplinary action. As some of these conditions are more complex, consistent training should be required and may result in only a subsection of pharmacists able to prescribe. 1. I have concerns about antibiotic stewardship for pharmacist prescribing of antibiotics for acute pharyngitis. Recommend that the criteria include only prescribing when there has been a positive strep test, never on speculation. And then wondering who will pay for that test. 2. Prescribing medications for acute insomnia has potential for misuse. I can’t see how this would be very helpful in removing the burden from other prescribers. Patients with chronic insomnia will pressure pharmacists to extend, renew and continue prescriptions meant for short term use. CBT for insomnia is the first line choice for chronic insomnia.
The college should also consider the addition of pharmacist ordering and interpreting lab test to further support minor ailment prescribing and safe medication practices
Amazing progress. Thank you for all your efforts. A few of The proposed minor ailments are treated with over the counter meds, headaches, corns, calluses…etc. I believe Ontario residents, with the current wait times and Docs shortages, need a lot more than this list, and quick. Instead of reinvesting the wheel, can we copy Alberta or other provinces who went through this before us and skip unimportant steps to provide rapid access to medical help to Ontario residents? Thank you. Nader.
I am writing to provide feedback on the proposed amendments that would authorize pharmacists to assess and prescribe for 14 additional minor ailments. While I appreciate the intent of increasing accessibility for patients, I do not support these changes in their current form, for the following reasons: 1. Workload and Pharmacist Well-Being Pharmacists are already experiencing overwhelming levels of responsibility, particularly in community settings. We are expected to dispense medications safely, provide patient counselling, manage drug interactions, conduct med checks, administer vaccines, and address various clinical issues. Adding more minor ailment prescribing responsibilities without addressing workload and staffing realities will further increase stress, fatigue, and burnout. 2. Patient Expectations and Impatience Many community pharmacies operate on a walk-in basis. Patients often expect immediate service, even for complex consultations that require thorough assessment and careful consideration. Expanding the scope to include conditions such as acute insomnia, headaches, or shingles—conditions that require nuanced evaluation—will inevitably lead to longer wait times and greater patient dissatisfaction when pharmacists cannot meet these expectations promptly. This will put pharmacists in increasingly difficult positions and strain pharmacist-patient relationships. 3. Inadequate Reimbursement and Compensation Reimbursement for pharmacist prescribing services in Ontario is significantly lower compared to other provinces. For example, provinces like Alberta and Saskatchewan have established funding models that more appropriately recognize the time and expertise required for minor ailment prescribing. In Ontario, the current compensation does not accurately reflect the workload or clinical responsibility, and expanding the list of ailments without adjusting funding will further devalue pharmacists’ professional services. 4. Quality of Care Concerns Conditions such as headaches, shingles, or insomnia are not always straightforward to diagnose. They can be symptoms of more serious underlying conditions that require careful assessment and sometimes diagnostic tools that are not accessible in a pharmacy setting. Without proper infrastructure, adequate training, or referral pathways, there is a risk of misdiagnosis or delayed care. Expanding the scope without addressing these gaps may compromise patient safety. 5. Systemic Solutions Needed First Before expanding the scope, there must be structural changes to ensure sustainability and safety, including: • Adequate reimbursement aligned with other provinces • Increased support staff and regulated pharmacy technician involvement to reduce dispensing burden • Appointment-based models to ensure pharmacists have sufficient time for clinical consultations • Clear clinical pathways for referral when conditions exceed pharmacists’ scope
OCP is not there for pharmacist. I do not agree with the added burden of extra ailments. Pharmacist are already so stressed and have to do so much already.I am not trained and not paid enough. No raise or bonuses given last year by shoppers, while corporations are making money on pharmacist cheap labour. OCP should be fighting for direct or better renumeration for pharmacist not adding extra stress. I run around most days like a headless chicken, moving from one task to another without time to even have a break to eat. More ailments, no no no
I do not see anything in the regulations that suggests pharmacists will be required to undergo physical assessment training prior to assessing for pharyngitis. Best practice dictates that testing for Group A Streptococcus – RADT or throat culture – should only be performed in patients who have a Centor score of 3 or greater. Since the Centor score is a combination of patient-reported symptoms and provider-identified signs (i.e., swollen anterior cervical nodes, tonsillar swelling or exudate), most patients will not be able to have a fulsome assessment without physical assessment. Pharmacists in Ontario currently do not receive adequate training on how to differentiate between virally-induced tonsillar erythema and tonsillar swelling/ exudate. Learning this skill requires more than simply attending an online CE course – it requires hands-on practice with real patients. Since GAS testing cannot differentiate between colonization and infection, its use should be limited to patients who have a high pretest probability for GAS infection – i.e., only those with a Centor score of 3 or greater. What safeguards will the College put in place to ensure that Ontarians do not receive unnecessary antibiotic therapy as a result of well-meaning pharmacists substituting GAS testing for physical assessment? Allowing pharmacists to prescribe for GAS pharyngitis without requiring they have the necessary physical assessment skills seems to be at odds with Canada’s commitment to antimicrobial stewardship.
Absolutely not! We are not provided with adequate training to take on these minor ailments and injections. We are not comfortable taking this on because the lack of training can cause an unwanted outcome in which we become accountable. Do not do this. Unless you plan on providing extensive mandatory training
I do not agree with the proposed regulatory changes. Pharmacists already carry a significant amount of responsibility in their current scope of practice, and these additional responsibilities would only increase that burden without any clear plan for fair compensation or support. While I recognize the intention to improve patient access to care, the reality is that pharmacists are already managing complex clinical responsibilities alongside operational demands in pharmacy practice. Expanding prescribing authority to include 14 additional minor ailments, administering buprenorphine, managing more vaccines, and taking on laboratory/POCT responsibilities further increases workload and liability. This is not sustainable without a corresponding adjustment in pay, staffing, and infrastructure to ensure pharmacists can deliver this care safely and effectively
Why are pharmacists being hired as the cheap labour to do the jobs doctors are too lazy to do? THey get paid to do nothing and have since the pandemic while the system breaks and the college uses the overburdened pharmacist to fill the void ? How does this help the public and on top, they don’t allow pharmacists to do it properly, even though most could do it better than most nurses and doctors since we actually care about the quality of care. Broken system needs to be reformed, pay only for results, not to have practitioners do nothing but sit on the couch at the cottage. Plenty of doctors, just none that work or care. Pharmacists can’t fix that
What will be the purpose of the newly proposed minor ailments, if most of the solutions to them, that we’ll be allowed to offer,… are OTC and not covered by drug plans, in the first place??
Please pay the pharmacists directly for Minor Ailments, Medschecks, Flu Shots, and Other Injection. Thanks
The pharmacists who work at the Chain Pharmacies and some who work at busy Independent pharmacies are already overwhelmed due to busy workflow. I still would like to support the Expanded Scope of Practice, but at the same time, I don’t want to compromise with the quality of my work. I strongly recommend that for all the services, i.e., Medscheck, Flu shots, injections, Minor Ailments, the consultation fee should be paid directly to the pharmacists and not to the pharmacies. If this is not possible then all the pharmacies should utilize this extra revenue in order to provide extra hours to the pharmacists so that pharmacists can provide all these services without making any dispensing errors and being stressed. Also, it’s my request to OCP to put a message on the Website for the patients that these all are Minor ailments and not major ailments or life threating situations. Also, we pharmacists must have strong authority to refer to their family physicians if there are red flags or if we are not comfortable to prescribe for something. It’s already there, but no one patients wants to go to their doctor. Lots of parents wanted me to prescribe Antibiotic Eye Drop to their kids because someone in their Kid’s school had eye infection so they were worried that their Kid may also catch eye infection. Ever since, we got authority to prescribe for Minor Ailments, lots of patients have asked me to diagnose if they have chest infection, throat infection, middle ear infection, etc. Can OCP and Ministry of Labor work a little bit in favor of the pharmacists and implement a few things. 1. We pharmacists work 12 hour shift and we get flat pay for the shift. We don’t get paid overtime if we work more than 8 hours/day. Can you please amend the law so that all companies and private pharmacy owners pay overtime to the pharmacists? 2. Lots of time, we have to stay 5 to 10 minutes more than our shifts, but we don’t get paid for that extra time. Can you please ask all the chain pharmacies to pay the pharmacists if the pharmacist work few minutes extra? 3. Pharmacists don’t get break and we work at lest 8 to 12 hour shift. No one company wants to provide at least 1 break of 30 minutes to the pharmacists. Can you please help us to get at least 1 break/day? Thanks
As a community pharmacist, I will support the expanded scope of practice (and lots of other pharmacists) will support if the consultation fee for minor ailments and also for all the injections including flu shots is directly paid to the pharmacists and not to the companies. The patients have been very demanding for the last few years and their expectations are going up and up. All the pharmacies are already busy with prescriptions and OTC questions and lots of chains are reducing the working hours. This situation is already overwhelming for a lots of pharmacists who work at the chain pharmacies and adding more scope of practice will add lot of mental stress to the pharmacists. We will welcome College’s initiative to support the patients, but at the same time, we request College to think about the pharmacists as well. How it is fair to the pharmacists that we spend extra time on prescribing for minor ailments and injections and at the same time, the patients want their prescriptions ready in 5 to 10 minutes. Do we really need to compromise with the quality and not do our job properly and not maintain Standard of Practice? We really need the College and Ministry of Labor to ask all the chains and independent pharmacy. 1. We pharmacists work 12 hour shift and we get flat pay for the shift. We don’t get paid overtime if we work more than 8 hours/day. Can you please amend the law so that all companies and private pharmacy owners pay overtime to the pharmacists? 2. Lots of time, we have to stay 5 to 10 minutes more than our shifts, but we don’t get paid for that extra time. Can you please ask all the chain pharmacies to pay the pharmacists if the pharmacist work few minutes extra? 3. Pharmacists don’t get break and we work at lest 8 to 12 hour shift. No one company wants to provide at least 1 break of 30 minutes to the pharmacists. Can you please help us to get at least 1 break/day?
As a community pharmacist, I DO NOT agree with proposed expanded minor ailment for pharmacists. I believe this a “band-aid” solution for the current shortage of family physicians in this province. With these expanded minor ailments, I believe the public would start to self diagnose their condition and furthermore dishonestly respond to the prescribing pharmacist’s assessment. Currently, most community pharmacies do not have the necessary equipment to diagnose some of these ailments. There will be higher chance of misdiagnosing patients. Misdiagnosing a patient’s condition can have long term detrimental ramifications on their health. In order for the proposed additional minor ailments to be reasonable, pharmacist need to be give adequate time to conduct each assessment (appointment based model like physicians) in a private room, fair compensation to the pharmacist for each patient seen $, necessary medical supplies and equipment to diagnose. Community pharmacists already have a lot on their plate. More consideration is required on the logistics of how these proposes changes will come into effect. Thank you
When will the college for once think about pharmacists. Instead of the ministry of health fixing their lack of leadership and incompetence, we are being penalized for cheaper labour. Do not tell me it’s about patients, it’s not because the ministry is giving more money per service for doctors than pharmacists. For once the college needs to stand up and defend us, defend our profession and dignity for once! If you need us to do prescribing then pay us as much as the doctors fees if they claim it’s about patients. Let us have a billing number. Implement a percentage, if we work for a chain then let them have a percentage from our prescribing fee. Enough is enough! We were only suppose to dispense and counsel patients , then you added injections and were fine, then you added some minor ailments and we stayed quite then covid 19 testing came along and we risked our lives swabbing infected people! Now you want us to start clipping fungal nails and swap infection throats! This time have the decency to advocate for our rights! ENOUGH to abuse this wonderful profession, enough burnout. ENOUGH is ENOUGH!
It is great to add expanded scope of practice as the decline in family physicians for the general population. It will be more feasible to get timely care.
I am not comfortable with the proposed expanded scope. Two reasons- 1. Pharmacist are not trained to do differential diagnosis, many of these condition has similar symptoms with many other condition, there are huge chances of misdiagnosis. In fact currently many patient provides false information just to get antibiotics for UTI and other conditions, pharmacist cannot verify those answers. If pharmacist deny prescribing because of red flags patient often become abusive and put more pressure on mental health of pharmacist. I don’t want anymore extra work right at this moment considering more risk to patient. 2. Currently pharmacist are not getting any compensation for doing minor ailment assessment or any type of professional services (medcheck, vaccination etc). The fee for assessment is being absorbed by the store or store owner. Pharmacist does not get any part of it. While pharmacist working with the same amount of salary for years (with zero increment) without getting any compensation for extremely overloaded task of doing minor ailment assessment and other professional services. I feel like our work increased multi fold (may be 3-5times more) within same time window (8 hour standard duty) with same compensation by employee. All in all all compensation will go to Shoppers Drug mart or chains like that. Whenever we ask for raise, the company denies and tells us to go somewhere else if we cant afford it. This is completely unfair. Overall, pharmacist needs more training and knowledges to perform these assessment of proposed expanded scope (minor ailments) and compensation should be directly paid to pharmacist (not the owner or store).
Excellent initiative by college, cannot wait for the approval. Adding birth control will be a good idea and also it is fair to say to increase the compensation from the government. The amount of work pharmacist does on day to day basis for that we as a pharmacist deserves to get paid more.
As I understand, the College is always placing patients first, which is commendable. However, I would also ask you to carefully consider the additional pressure this places on already overworked and overwhelmed pharmacists. Adding more tasks will only increase our regular heavy workflow, not to mention the responsibilities of pharmacy managers who must balance both clinical and management duties during their shifts. While I recognize that these changes may benefit patients and help reduce stress on the healthcare system, the question remains: who is looking after the well-being of pharmacists? Without proper support, these additional responsibilities will only heighten burnout and workplace stress. Before approving and implementing such tasks, there should be a clear framework for additional funding or mandated incentives for pharmacists to be given per prescription. It is not sustainable to continue adding responsibilities without appropriate compensation or resources, as this results in added stress at no extra pay.
This proposed scope of practice expansion for both Pharmacists and Pharmacy Technicians would be absolutely amazing! It would allow us to be able to provide more needed services to the public! The Pharmacists scope of practice regarding the Minor ailments would be essential due to the lack of family practitioners! I hope this scope of practice expansion takes place and I can’t wait to hear the results!
I support the expansion of the scope of practice. It is absurd that we can now prescribe but I am not able to do any therapeutic substitutions. I need to fax and wait sometimes a full week to be able to change a drug to another that’s the same.
I strongly support the proposed regulatory amendments that would enable pharmacy technicians to administer all vaccines listed in Schedule 3 of Ontario Regulation 256/24 under the Pharmacy Act, 1991. Allowing pharmacy technicians to provide this service will increase access to timely vaccinations for patients and alleviate the workload on pharmacists, enabling them to focus on clinical services and patient care. This will also optimize the use of pharmacy technicians’ training, skills, and knowledge to better support Ontario’s health care system.
I’m always open to expanding our scope of practice but fungal nail infections? Please no. And the issue is that pharmacists themselves gain nothing other than more pressure, how am i supposed to do these services while still running the pharmacy, sometimes without even an assistant. I’m not being compensated for any of these services, so do i wanna provide more? Of course but I also don’t wanna do it for free
Hello, I am excited to hear about this possible expansion of prescribing practices. I look forward to osteoarthritis, birth control, prenatal care, and vertigo. Perhaps you may consider including these as last minute additions! I have a few notes: In the regulation, dicyclomine is written as dicyclonine. This may cause problems down the line. Limited Use codes apply for some drugs that are listed. Can you clarify for my sake and the public’s, whether a pharmacist is authorized to provide a Limited Use Code (so long as the conditions apply of course)? I’d also like to add (in a public setting) that it is inappropriate for the same professional work to be compensated less and less (in the form of a dispensing fee that has not been raised in over a decade and which is not tied to inflation at the very least).
The real issue with the health care system is a shortage of family physicians. There are many internationally trained physicians that have to undergo ridiculous red tape to become licensed. Also, the requirements and GPA to get into medical school these days are too high. My family doctor had an average in the 60s in university and was amazing family MD for 30+ year.s Let the doctors do physician work and get paid for it. Unless OCP is going to mandate that pharmacists are paid like physicians, stop making pharmacist private paid physicians. This is supposed to be a publicly funded system not shifting the burden to corporation that make health care for profit!
We do not get paid enough by the government to do these, I find the reimbursement for filling prescriptions is even not enough, we have not had a raise in our fees for decades and continue to be asked to do more for less. The people who go on strikes get all the money, maybe you should consider how much Pharmacists actually do to prevent overload on emergency settings. We were there during Covid and did so much while all doctors closed doors and still will not do any Covid vaccinations!!!!
I agree with all the ailments except acute sore throat. I have considerable apprehensions about this when switching from a patient centre model to customer driven model. 1) antimicrobial resistance – pressure from corporations to prescribe antimicrobials for a profit, customers “shopping” between pharmacies for viral pharyngitis demanding an rx, patients requesting prescriptions for sinusitis and/or other infections and saying throat is sore 2)CORPORATE PRESSURE!!!! don’t we have enough already 3) delays at labs, delays in lab pick up for ++++more swabs, having to go to other pharmacies – already takes 3-5 business days for a throat swab 4) lack of computer system/methods/times to follow up on labs and samples – how to upload results to charts, flag that patient needs to be notified? administration time – following up on other pharmacists swabs if I am off who will follow up? will I be liable if a patient is not notified by a colleague? 5) already added vaccines – 3+, enough is enough!!! unless you are going to make it so that community pharmacies have to hire REGISTERED PHARMACY TECHNICIANS there is no time for THIS!!! 6) toe nails are gross – again I don’t want to see it, are they going to strip down and show me their feet in the middle of the pharmacy? how am I going to follow up on the lab results
All proposed changes would benefit the patients. All proposed changes will enable the pharmacists provide better access to care faster and effectively.
As an injection trained pharmacy technician, I feel it only makes sense to expand our scope to include all schedule 3 vaccines. Allowing technicians to due the technical work of injecting a vaccine only helps to free up pharmacist time.
What about the risk of infection for immunocompromised pharmacists like myself? I’m already exposed daily to a lot of infections and having to do swabs just takes the risk up so much higher
Why don’t we let professions do what they are trained to do. DOctors to diagnose, nurses to adminster and pharmacists to give the right drugs. If the system is so broken that people have to do things they are not trained to do, why not get them doing that? What are taxpayers paying for, unqualified other professions to do the job some refuse to do??
I’ve been wanting this for 2 yrs now, I’m so excited for this.
To the College of Pharmacists, Thank you for the opportunity to provide feedback on the proposed regulatory amendments to Ontario Regulation 256/24 under the Pharmacy Act, 1991, regarding the expansion of scope of practice for pharmacy professionals. I am supportive of the Ministry of Health’s efforts to broaden patient access to care by enabling pharmacists and pharmacy technicians to assess and prescribe for additional minor ailments, administer a wider range of vaccines, and provide treatments such as buprenorphine. These changes have the potential to reduce barriers to timely care and strengthen the role of pharmacy professionals in the health system. At the same time, I would like to highlight an important consideration: for these changes to be implemented effectively and sustainably, the associated funding and compensation structures must adequately reflect the time, expertise, and resources required. Assessing and prescribing for additional minor ailments, performing point-of-care testing, and expanding vaccination services will require significant pharmacist involvement, clinical judgment, and follow-up. If the funding model is not aligned with the actual workload, it risks undermining both the quality of patient care and the willingness of professionals to fully embrace these expanded responsibilities. I encourage the Ministry and the College to work with stakeholders to ensure that: 1.Compensation for minor ailment assessments and expanded services reflects the time and expertise required. 2.Appropriate funding is allocated for training, equipment, and workflow adjustments needed to integrate new services effectively. 3.Clear guidelines and standards are established to support safe, consistent delivery of these services across practice settings. With proper support, I believe the expanded scope of practice can bring meaningful benefits to patients and the health system as a whole. Thank you for considering this feedback. Sincerely,
1-community pharmacists are already doing so much with minimal support on shift. One pharmacist is handling dispensing, counselling, prescribing, vaccinating and methadone dispensing. Adding more to the plate will just put us at increased risk of making mistakes and burning out. 2-pharmacist are not being compensated for the increased scope of practice and liability. The stagnant rate of pay for community pharmacists does not align with the rest of healthcare professionals who work in a hospital settings and get compensated fairly on yearly basis. 3-population expectations are always beyond our scope, which puts pharmacists at harassing situations almost on daily bases. College and social media/news always FAILS to provide the limitations and leaves it the pharmacists to deal with it. I feel exhausted and overwhelmed just reading the amendments. I absolutely don’t support this expansion of scope without fair increase in pay, and assistance of the college and news outlets in outlining the limitations these ailments come with (for example we can take a swap for sore throat but not prescribing for it..etc)
I would love to be able to help patients by expanding my scope of practice. However, the reality in community pharmacy is very different from what looks good on paper. In most pharmacies, there is only one pharmacist on duty at a time. In an average 10-hour shift, that pharmacist is already verifying 100+ prescriptions (new and refills), counselling patients, making clinical recommendations, administering flu, COVID and many other vaccines, and managing minor ailments. Since 2020, our workload has increased significantly, but we are expected to complete all of this with the same staffing levels we had five years ago. This imbalance has created enormous stress and pressure, which is neither fair to pharmacists nor safe for patients. The College must address workload and corporate scheduling pressures before adding more to our plates. Pharmacists should not be rushed into providing extra services simply because the province lacks enough doctors. Many patients also come in with misinformation about minor ailments, which takes even more of our time to correct—time that could be spent ensuring safe and accurate prescription care. If no additional labour hours or workplace resources are mandated, it is not reasonable to expect pharmacists to absorb more responsibilities. While independent pharmacies may benefit from these changes, corporate settings leave pharmacists with unsustainable expectations and little support. Until I feel that my workplace is providing the resources necessary—whether through staffing or hours —I cannot support these changes.
While I agree that the proposed changes to the scope of practice would significantly improve patient access to acute care I have much hesitation surrounding how pharmacies will support pharmacists in performing these tasks. I feel that corporate pharmacies already run on lean staffing and that pharmacists time and attention will be spread too thin. So much of our expanded scope has drawn attention away from our classical role of pharmacists without addressing the existing hurdles of daily practice. Other expanded scope practices such as therapeutic substitution, and ordering lab work would address current pitfalls and shortcomings of patient care. Putting more onto the plates of pharmacists does not seem like the most suitable next step.
Add ear infections to the list!!!!!
In my previous post, I emphasized the importance of structured training, OHIP-based remuneration, and chronic disease care in pharmacist scope expansion. But the numbers tell the story best: • A simple physician visit (A007) is billed at $27.70 — for example, renewing a blood pressure medication. • A moderate assessment (A008) pays $53.30 — for example, adjusting diabetes medication after reviewing blood sugars. • A complex assessment (A009) pays $79.20 — for example, reviewing labs and medications for a patient with diabetes, CKD, and hypertension. Meanwhile, pharmacists receive just $8.83 as the ODB dispensing fee, unchanged for nearly 15 years. Studies confirm pharmacies are losing money on every ODB prescription, forcing many to close despite ongoing investments in automation, staff, and training. Solution: Introduce a pharmacist OHIP billing model tied to the same physician codes — but at 70% of the physician rate, with the payment split between the pharmacist and the pharmacy: • Simple (A007 equivalent) → ~$19.50 total → $13.65 to the pharmacist, $5.85 to the pharmacy. • Moderate (A008 equivalent) → ~$37.30 total → $26.10 to the pharmacist, $11.20 to the pharmacy. • Complex (A009 equivalent) → ~$55.40 total → $38.80 to the pharmacist, $16.60 to the pharmacy. This approach would save OHIP money, improve patient access (especially in rural areas), and ensure sustainability by compensating both the professional and the infrastructure that supports care. Ontario cannot expand pharmacist scope on a foundation that is financially unsustainable. Aligning pharmacist payments fairly — while still saving the system money — is the only path forward. I encourage colleagues and stakeholders to add their voice to the consultation before the deadline
While the proposed expansion of pharmacist scope into additional minor ailments is a positive step, I strongly encourage the OCP to consider a broader, longer-term framework that prioritizes mandatory structured training, sustainable remuneration, and chronic disease care. 1. Mandatory Structured Training under CPSO Supervision To ensure high-quality, safe care, any expanded scope must be tied to a mandatory, standardized training program overseen in collaboration with the CPSO or equivalent medical body. This safeguards competence, supports interprofessional trust, and ensures pharmacists are fully prepared to manage more complex responsibilities. 2. Payment Structure via OHIP Pharmacists providing clinical services should be remunerated directly through OHIP, with a portion allocated to the pharmacist for professional care and a portion to the pharmacy for site overhead. This model minimizes conflict of interest, protects pharmacists from corporate pressures, and aligns incentives toward patient outcomes rather than volume. 3. Focus on Chronic Disease and Long-Term Care While minor ailments are important, the real opportunity lies in empowering pharmacists to contribute more meaningfully to chronic disease management. This includes ordering and interpreting laboratory tests, making dose modifications under structured protocols, and providing ongoing medication optimization. Such a role would relieve pressure on overburdened primary care, improve continuity, and yield better long-term outcomes for patients. 4. Expanded Access to Other Essential Services Pharmacists should also be supported to provide injections for medications and vaccines (services traditionally limited to physicians), as well as emergency medication supplies and renewals when a physician is not accessible. In addition, pharmacists have delivered over-the-counter counseling free of charge for years, and it is time to recognize these services within a fair compensation framework that values their contribution to public health and system sustainability. By combining structured training, fair and transparent funding, and expanded responsibilities in both acute and chronic care, Ontario can ensure that pharmacist scope expansion truly enhances patient-centered, high-quality care while maintaining accountability and interprofessional collaboration. N.B.: Dispensing fees have remained unchanged for nearly 15 years, unlike the fees of other healthcare providers. Health authorities are aware of this through their own data, which clearly shows a rising number of pharmacy closures due to bankruptcy or inability to sustain ongoing losses under the current ODB/OHIP and private plan structures. Recent studies by the Ontario Pharmacists Association confirm that pharmacies are losing money on every ODB dispensing fee. Despite this, pharmacies continue to invest in automation, training, and efficiency improvements to survive and keep their doors open to the public. Without fair adjustment and recognition of dispensing services, the sustainability of community pharmacy care will remain at risk.
Yes Please include all Minor Ailments Prescribing
I am completely opposed to prescribing which i see as the responsibility of the physicians. These responsibilities cannot just be passed over to pharmacists who are not interested in taking on the extra liability. Find another way to fix our health care issues and compensate the pharmacists properly for the actual work they are already doing.
This expansion is scope is a great move towards involving Pharmacy Technicians more in patient care. Technicians’ interventions in clinical, following to a clinical training, ought to be a part of future discussions in expansion scope as well. This will not only alleviate the burden of Pharmacists, but also let the Technicians take more responsibilities and provide optimal care.
The work environment should be improved before expanding the scope of the pharmacist. The consulting room is not suitable for giving injections because if there is emergency we have to let the patient lies on the floor as there’s no other place. Pharmacists lack basic human rights by being exempted from rest periods, overtime, joining a union….etc. The business oriented bosses who think business wise and quantity wise are abusing our profession and putting too much pressure on the pharmacists. The bottom line: Improve work environment before expanding the scope of the pharmacist.
Given the broad(er) range of conditions covered, it might be time for OCP to formulate guidelines on operating a pharmacist-led clinic
Adding more to the plate of overworked and underpaid pharmacists is not the answer. Much is required of us with simple dispensing, how are we to do all these additional tasks without the support?
Yes agree with proposed changes.
Will make our health care system better accessible and reduce wait times.
While the government has succeeded in convincing the public that expanding the scope of practice for pharmacists is in the public interest, let’s not forget their true motivation. Cost reduction. Corporations also benefit by cracking the whip on pharmacists and see this as a new revenue stream. The true losers in all of this are the pharmacists themselves who must suffer through increased stress and workload performing many of the jobs Nurse Practitioners and Physicians also do, but for a fraction of the reimbursement.
Great next steps to fill the gaps in our health care system. Keep going. There is so much more we could be doing. When I am on duty at the FHT the reception can slot patients in with me for those ailments keeping them out of emergency!
The proposed changes are embracing the evolving role of the pharmacists. I support the addition of the new minor ailments. As a pharmacist working in a specialized HIV ambulatory care clinic, I would like to proposed a few amendments on the schedule 1. 1- in the antiviral section, the listed drugs are rarely used. Enfuvirtide has been discontinued this year. It can be removed. 3 injectable drugs could be added: – cabotegravir/rilpivirine: the first and only complete HIV parenteral therapy – cabotegravir: for PrEP – Lenacapavir: a twice yearly SQ injection for HIV therapy and soon PrEP. 2- antibacterials I would like to see a clarification for penicillin G. Benzathine Pen G is available and it is unclear if it is included within this legislation, but should be in my opinion. Thank you for your consideration Pierre
Personally I think no pharmacist would be interested in dealing with 100 times more responsibility and workload without getting paid for it, just like doctors do. And the only one benefiting from scope expansion would be the store owners and franchise pharmacy chain owners who will get paid and leave the pharmacist with a ton of extra demand. Additionally, Me as a pharmacist am not interested in nail clipping or performing a strep test and putting myself in an even increased risk of infection transmission. I think the college should maybe think about the pharmacists wellbeing for once.
The College is not reporting on a critical issue which can negatively affect the public in all areas of the province. The issue is the growing use of Preferred Provider Organizations, PPO’s also known as Preferred Provider Networks, PPN’s. These organizations affect patients choices of where they choose to fill their prescriptions. In some cases the lack of choice by a patient may require driving long distances to fill an RX. Please let us know what OCP is doing to prevent these groups from operating. I understand that Quebec has already banned them. Thank you.
I am in full support of this minor ailment expansion initiative.
Those are great changes, but we still need access to patient lab reports Please create a streamlined process to give community pharmacists access to the clinical viewer, the present system for getting access is broken and cannot be navigated
As a pharmacist the last thing I want to do is examine toe nails…and take scrapings or clippings. Even if it ends up added to the list , I’ll ask a coworker do it. To me a nurse is better trained for that than I am. I do have to wonder if this was added to the list simply because the Rx topical treatments are rarely harmful (and in my opinion, would be better off moving to a schedule 2 status). Regardless, I disagree with it. For the ear infections, I think it should be ALL ear infections… But. I would appreciate a caveat of extra mandatory training …also mandatory otoscope on hand to evaluate. I would not want to treat an outer ear infection that is actually delaying treatment of an obvious middle or inner ear infection. That said….with proper mandatory training and mandatory tools….it would be good to see this be listed as ear infection and not just outer ear (swimmers). I believe it was Alberta that created a second level of pharmacist prescribing …to allow, for example, the ordering of labs. Only those trained and certified in that level are permitted to use that part of expanded scope. I think something similar for this (and maybe for some others in the entire list) would make sense as a way to protect the public. Only those “qualified” would have the right. Perhaps the new PharmD are receiving training in school with respect to taking manual blood pressure readings….or examining ears….but older BSP like me are not trained. DECADES ago, RPh in southern US received training to diagnose and treat ear infections. We can do it now but don’t sell us short. Needing a second visit to a doctor for treatment of an inner or middle ear infection will cost more not to mention delay in treatment if a pharmacist is over zealous in proclaiming it to be an outer ear problem. Right now, little harm is expected by using polysporin OTC and then consulting Dr if not working. But changing the action to “pay RPh for minor ailment, possibly charge OHIP+ or ODB for the first Rx….and then not long later charging OHIP again for a doc or ED visit…and a second Rx (or two)….that’s wasteful and inefficient. Let’s get it right from the start!!
it would be beneficial to see the scope of practice expand and give pharmacy workers the chance to perform tasks that are benefiting society.
OCP continues to be an organization in decline. Despite the reasonable pushback from the members who pay the exorbitant salaries of the ‘leaders’ of this organization, rest assured that all of these changes will be implemented whether we like it or not. OCP’s very helpful guidance will be to continue to use our professional judgement. OCP stopped listening to or serving its members a long time ago.
Thank you for the opportunity to provide feedback on the expansion of pharmacists’ scope of practice. I fully support the goal of improving patient access to care; however, I believe that clear requirements and supports are essential to ensure this change is safe, effective, and sustainable. Training and Certification Before pharmacists begin prescribing for additional minor ailments, completion of approved training or certification should be a mandatory requirement. Importantly, this training should not be broad or generic, but directly related to the specific therapeutic areas covered under the expanded scope (e.g., dermatology for skin conditions, infectious diseases for prescribing antimicrobials, etc.). Including injection-related competencies where relevant will also be key. This approach ensures pharmacists have the focused clinical knowledge to prescribe safely, while also giving them the confidence to apply their skills effectively in practice. Support for Small Pharmacies In addition, I encourage OCP to consider developing practical guidance for small or independent pharmacies on how to integrate these expanded responsibilities into already busy workflows. This could include sample workflow models, staffing considerations, or recommended best practices to help pharmacies implement changes without overburdening pharmacists or compromising the quality of care.
i think it would be beneficial to see the scope of practice expand and give pharmacy workers the chance to perform tasks that are benefiting society.
Absolutely not. Why are we as a profession so insistent on taking on more without any commensurate compensation? Are we so desperate to burn out of this job? Unless you are able to stop corporations from using this expanded scope as another way to pad their profits (which I know is not possible as nothing has changed regarding MedsChecks), this can only result in sub par care for everyone. We are medication experts and it is hubris to think we can diagnose. Stop accepting toe nail scraps just because you think more means more.
As an active technician working in both hospital and retail pharmacy settings, it will be great expansion of scope of practice and also a good opportunity for technicians to extend their services by providing all eligible vaccination to public. It will also reduce burden from pharmacists during vaccination seasons. Only thing is, big corporate pharmacy chain will have to increase pay rate for technicians in retail settings. As of now, there is over $10 per hour wage difference between hospital and retail pharmacy for technicians. Workload is also higher in retail and wage is less which is concerning. OCP needs to make sure technicians doesn’t get exploited in corporate retail pharmacies.
Unless you plan on amending the laws so that pharmacists get paid for doing these additional services, I highly doubt the vast majority of PRACTICING pharmacists are entertained by these changes. No one wants more liability risks when they are already swamped doing everything else with no additional tech hours. The system is broken. Simply handing off responsibilities due to a crumbling healthcare system is just going to make the eventual collapse even worse.
Most pharmacies are not well-staffed and have only a pharmacist assistant ot technician on duty with a pharmacist. Enabling pharmacy technicians to administer all vaccines listed in Schedule 3 of Ontario Regulation 256/24 under the Pharmacy Act, 1991, may disorganize the flow
I think working at McDonalds might be less stressful at this point lol
I would prefer us get paid for the services we went to school for. We haven’t had a raise to our paid fee by the governemrnt in 20 years. Have you had a raise in your job. Let the doctors and NP do the prescribing. It’s seems like this is a waste of our time especially since lots of these are already OTC recommendations anyways. How about fees for extensions or our dispensing fee
There is no reason for us to be clipping people’s toenails. Do doctors do that?? Is there potential harm from the provision of topical anti fungals for suspected nail fungus? Also, the community already asks us for counselling on acute insomnia and headaches. The only thing that will come of classifying them as minor ailments is the community expectation for prescriptions to treat such conditions. Please do not give me that headache- I’m happy to help patients and don’t need these minor ailments creating scenarios for pharmacist harassment.
any chance of tying the amount of resources to pharmacies taking on these minor ailments, etc High volume pharmacies without pharmacies are feeling pressure to do it all (injections, methadone, minor ailments). Potential for more errors as pharmacists scramble to accommodate everyone.
While the proposed expansion of pharmacist prescribing for minor ailments can improve access, it must be balanced against the reality that pharmacists are already overloaded with dispensing and clinical responsibilities. Expanding scope without mandated workload adjustments risks burnout and reduced quality of care.
Testing for sore throat at pharmacy is not a viable option and buorenorphine injection as well not a viable thing to do it in the pharmacy as you need proper assessment and require careful investigation
I think we have enough in out plate .
I welcome the additional expanded scope of practice list, but at the same time we need to be compensated well for that . We are lifting from the shoulder of doctors and health system and we are happy to help. Pharmacist rates in Ontario have to be higher and comparable to those in Alberta as we are also prescribing like them. We are HCP working so hard for our patients health and we have to be valued as other HCP who are very well paid by the government. Again Iam as a pharmacist very interested in the prescribing role and I need to be valued same as the other provinces and other HCPs. Thank you
I do NOT agree with this expanded scope. Stop trying to turn us into cheap physicians, we are NOT! Let doctors do their stuff and instead expand scope on med reviews, reconciliations, opinions. Allow therapeutic monitoring.
I would urge caution of including shingles on this list. If mismanaged there is significant risk of pain and disability for months or years. I feel that doesn’t fit the criteria for a minor, self-limited condition. I would also argue that strep throat is similar, unless the exact criteria to allow a pharmacist to prescribe is quite narrow (ie. within 48 hours of symptoms starting). It should be kept in mind that once patients are aware of the criteria, they may not report accurate information in hopes of avoiding an ER visit and getting a minor ailment Rx instead. This may not be within OCP’s authority, but I would appreciate if we could be paid for services we currently do without being reimbursed (eg. B12 injections) in addition to an ever expanding scope.
Sounds like a reasonable plan if executed correctly
Need as much feed back from pharmacist and technicians as possible
Need more time and better pay for connoducting the new test and diagnostics Plus additional training materials and courses work
Need to resource pharmacist and tech time to do the test and diagnose ailments
Pharmacists are more than qualified to prescribe for these conditions and definitely qualified to inject public vaccines on behalf of public health units. These regulations should come into effect without delay.
Sounds like a responsible amendment and would provide better access for patients need ability for fast and effective lab results
Agree
Remuneration of $19 is far from enough to provide adequate compensation for most minor ailments considering the time it takes to perform these to a level of proper patient care. Many of these additional minor ailments also are for common conditions treated with OTC products and therefore are not worth adding to our scope. Other conditions, leading more often to prescription only products, would be far more valuable for our healthcare system.
Adding more area for pharmacists to provide consultation, surely, reduces physician workload so they can be available on other section of medical care, however, it puts so much pressure on pharmacist’s duty. More work for the same hours of work and increases risk of reduced patient care. Also, some areas like sore throat and shingles are more advanced than pharmacist’s scope of practice. To my opinion, these can be done perfectly at some special pharmacies like how compounds are treated now.
Hello, This continued expansion of pharmacist scope focusing on acute ailments is disappointing and frankly a bit ridiculous. We are not trained or qualified to diagnose shingles or insomnia disorders. Benzos? Really? We are not trained to examine ears for otitis externa. These patients need a physician who can do a proper differential diagnosis. The priority should be on chronic care. Why can we not order bloodwork for LFTs? Potassium? Kidney function? There is a huge shortage of family doctors in northern Ontario where I practice. It would be far more beneficial to be able to support patients in their long-term health journey. It is approaching useless to me that I can “prescribe” OTC products for hemorrhoids but cannot support an increasing number of patients with diabetes who have not primary care provider. Being able to manage medications for diabetes and hypertension would be a far better use of our time and education than taking toe-nail clippings. Regards, Amanda
Dear OCP, As a community pharmacist practicing in Ontario, I would like to share my experiences and concerns regarding prescribing for minor ailments. While this expansion of scope has created opportunities to better serve patients, it has also brought significant challenges. Most importantly, pharmacists have not been given additional time or resources to accommodate these services. The same staffing and workload remain, yet expectations have increased. On weekends in particular, when neighboring pharmacists may be unavailable, the burden on a single community pharmacist can be overwhelming. Although I do not feel pressured by my organization, there is strong pressure from the public. Patients often expect us to prescribe for conditions beyond our scope, and when we explain our limitations, some respond with threats or hostility. Many patients misunderstand what pharmacists can and cannot do. For example, L&A county general Hospital, signage indicates that pharmacists can prescribe for tick bite assessments, but this does not reflect the complexity and limitations of such cases. Nurses sometimes direct patients to us without clarifying whether it is within our scope, which places pharmacists in a very difficult position. I believe OCP has an important role to play in addressing these issues. At present, it often feels like OCP’s focus is on protecting the public but not supporting the pharmacists who are members and pay fees. For example, when complaints are made, the process can feel punitive rather than collaborative, as if decisions are predetermined. By contrast, the College of Physicians and Surgeons of Ontario (CPSO) is seen by many doctors as both protective and supportive. Pharmacists deserve similar support. My requests are: 1. Public Awareness: OCP should lead efforts to educate the public about the meaning of “minor ailments,” including the limitations of pharmacists’ scope of practice. 2. Support for Pharmacists: OCP should consider how to better support pharmacists when we are faced with unreasonable expectations, threats, or misunderstandings. 3. Complaint Process: OCP should ensure its complaint and discipline processes feel fair, balanced, and focused on resolution, not punishment. At present, pharmacists are spending large amounts of time explaining why we cannot provide certain services. This increases stress, delays patient care, and adds anxiety to already demanding workdays. Pharmacists are healthcare professionals, but we are also human beings. We need the College’s advocacy and support to ensure we can provide safe, effective, and sustainable care for our communities. I am sharing this feedback constructively and in good faith. Please keep this confidential and ensure it does not affect my employment. I hope OCP will take steps to build greater trust with pharmacists by balancing patient protection with genuine support for practitioners.
Adding more responsibilities to pharmacists without addressing fair compensation for their time, training, and liability is not reasonable. It is essential that pharmacists themselves—not just the pharmacies—receive appropriate remuneration for the additional workload and professional risk associated with these expanded duties. Pharmacies must also be better reimbursed for their clinical services to afford hiring clinical pharmacists or increasing pharmacist hours to meet the demands of this significantly expanded scope of practice. Currently, the government pays substantially more for the same medical services when provided by other prescribers, such as physicians or registered nurses. For the sake of patient safety, optimal health outcomes, and to ensure the success and meaningful impact of this scope expansion, the Ontario College of Pharmacists (OCP) should advocate to the Ministry of Health for equitable compensation for pharmacists. The government pays significantly more money for the same medical issues to other prescribers, such as registered nurses or physicians. For the patient’s best outcome, patients’ safety and making this expansion in the pharmacist’s scope of practice successful and meaningful for the public, OCP should advocate to the ministry on that item
The legislation doesn’t go far enough… continuing care of prescription treatment and availability of the pharmacist to modify treatment is necessary to care for all those people that cannot see an MD for over a year… pharmacist should not be limited in their ability to continue existing treatment…. As a retired pharmacist, the amount of people left in a lurch and unable to Even just get a form signed, shows how much the system is in disarray… And yet the government continues to support monopolistic one caregiver models. Pharmacist are the only health professional that you can walk in off the street and have the opportunity to get advice why not facilitate that model even more…. There are many advantages to the Mexican model which some people feel excessive but at this point without able to see an MD …. Pharmacist are still underused.
The legislation doesn’t go far enough… continuing care of prescription treatment and availability of the pharmacist to modify treatment is necessary to care for all those people that cannot see an MD for over a year… pharmacist should not be limited in their ability to continue existing treatment…. As a retired pharmacist, the amount of people left in a lurch and unable to Even just get a form signed, shows how much the system is in disarray… And yet the government continues to support monopolistic one caregiver models. Pharmacist are the only health professional that you can walk in off the street and have the opportunity to get advice why not facilitate that model even more…. There are many advantages to the Mexican model which some people feel excessive but at this point without able to see an MD …. Pharmacist are still underused.
Yes please. It is really helpful to the health system. I am currently a pharmacist at Newfoundland and almost we do all those tasks for our patients. It is very appreciated
It makes zero sense to swab for strep if we can’t prescribe antibiotics to treat strep. We should also be able to inject AND prescribe all vaccines. Just a further strain on the system to see a physician to get the prescription for both scenarios listed above. And why initiating oral contraceptives or treating erectile dysfunction isn’t on this list, I do not know.
Expanding access to OAT, specifically XR buprenorphine is essential – Many RAAM clinics have a number of more stable clients attending for continuation of XR buprenorphine that could be served in a more convenient location at the point of dispensing which would also help to minimize logistics of medication transport.
Why not simply follow the proven models in Alberta and Nova Scotia and have a separate designation for a more expanded and complete scope. Assign it a course which must be completed before the designation and that’s that. This crawl into integrating a further expansive role is not helpful to anyone Make a clear pathway emphasizing patient safety and a more comprehensive role. Help the system.
I fully support these changes. As a former pharmacist, we need to ensure all health professionals are working to the highest level of their practice. This will alleviate stresses on the health care system i from minor ailments.
I do not support these new changes, ESPECIALLY the POCT/laboratory testing and the injecting of partial opioid agonists and antagonists. Some of the new minor ailments I also do not support as I feel doctors are better equipped to actually test and examine patients whereas we’ll be going by what patients say
This is too much. Corporation will try to push us on this. We either need to get paid directly or be put under the government umbrella and be paid OHIP. We are being asked to replace doctors. If I wanted to be one, I would’ve become one. The current list is already enough!
Do not agree to the proposed changes we are already overworked and understaffed. The public expects minor ailments as requirement from pharmacist and demands to be seen immediately. I do not approve injection of sublicade this should be done at specialty pharmacies only. Stop adding services when our pay rate stays the same
Pharmacist or technician do not need an additional responsibility on administering vaccine or providing minor ailments. I think college needs to understand that Pharmacy is not McDonald’s and Please don’t make one. We are underpaid and overworked and do not need unwanted additional responsibilities.
As an injection trained pharmacy technician, I feel it only makes sense to expand our scope to include all schedule 3 vaccines. With the expansion of pharmacists scope, it would reduce their workload and the stresses associated. It is a small portion of the tasks pharmacists do, allowing technicians this would put the technical aspects of injecting where it belongs.
While the proposed expansion of pharmacist prescribing for minor ailments can improve access, it must be balanced against the reality that pharmacists are already overloaded with dispensing and clinical responsibilities. Expanding scope without mandated workload adjustments risks burnout and reduced quality of care. Clear safeguards are also needed to mitigate conflict of interest. Special recognition, credentialing, and training pathways should be established for clinical pharmacists to ensure competence and support system trust. These measures will help realize the benefits while protecting patients and providers alike.
Fantastic idea and should go even further to more minor ailments