Ontario Enhancing Patient Care and Pharmacy Safety
Ministry of Health and Long-Term Care
Ontario is introducing legislation that, if passed, would strengthen the safety of the drug supply chain in the province's hospitals and further enhance patient care.
The government is following through on its commitment to implement recommendations contained in Dr. Jake Thiessen's review of the province's drug supply system. Earlier this year, Dr. Thiessen conducted a detailed investigation into the discovery of under-dosed chemotherapy drugs at four Ontario hospitals and one in New Brunswick.Expanding Ontario College of Pharmacists' Inspection Powers
Ontario is proposing legislation to implement recommendation 12 of Dr. Thiessen's report, which calls for amendments to the Drug and Pharmacies Regulation Act, to give the Ontario College of Pharmacists the authority to inspect and license hospital pharmacies, in addition to community pharmacies.
Currently, pharmacies in the community are overseen by the Ontario College of Pharmacists, whereas those within hospitals are the responsibility of individual hospital corporations. Expanding the College's authority to regulate hospital pharmacies will ensure they meet consistent standards across the province.
Specifically, the government's proposed legislation includes the following measures:
- Providing the Ontario College of Pharmacists with the authority to license and inspect pharmacies within public and private hospitals, in the same manner it currently licenses and inspects community pharmacies;
- Providing the College with the ability to enforce licensing requirements;
- Allowing the College to make regulations to establish the requirements and standards for licensing and inspection; and
- Providing government the ability to extend the College's oversight to other pharmacy locations in the future, as appropriate.
As a result of these changes, the Ontario College of Pharmacists will be able to conduct regular inspections of hospital pharmacies so they can monitor compliance with licensing requirements and standards.
Currently, other provinces including British Columbia, Newfoundland and Labrador, Prince Edward Island and New Brunswick require their pharmacy regulators to license and inspect hospital pharmacies.
Improving the Health System's Ability to Identify and Respond to Incidents
Ontario is also proposing changes that, if passed, would improve the health system's ability to quickly identify and respond to any future incidents that could affect patient care and safety by enabling better information sharing between regulatory colleges, hospitals and public health authorities. The changes include:
- Enabling health regulatory colleges to more readily share information with public health authorities for the purposes of administering the Health Protection and Promotion Act;
- Permitting health regulatory colleges to share complaints-related information with a hospital, obtained by a college's investigator;
- Requiring a hospital or employer to report to health regulatory colleges if a regulated health professional has voluntarily restricted his or her practice or privileges because of concerns regarding the member's conduct or practice;
- Allow the government to more quickly appoint a College supervisor in order to address any serious concerns regarding the quality of a college's governance and management; and,
- Provide health regulatory colleges the flexibility to focus their investigation of complaints to matters that that could constitute professional misconduct, incompetence or incapacity.
Implementing the Thiessen Report's Recommendations
On Sept. 12, 2013, the Ministry of Health and Long-Term Care established an Implementation Task Force to oversee the implementaion of Dr. Thiessen's remaining 11 recommendations.
The task force includes representation from a variety of health and government sector partners, including the Ontario Hospital Association, the Ontario College of Pharmacists, Health Canada and the Ministry of Government Services.
The task force is currently establishing timelines for the completion of its work.
Actions Already Taken to Safeguard Hospital Drugs
Following the discovery of under-dosing of chemotherapy drugs the government took immediate action by:
- Appointing Dr. Thiessen to determine the causes and provide recommendations to prevent future incidents from occurring;
- Requiring drug compounders to declare their regulatory framework, their accreditation, and their quality assurance practices;
- Requiring all hospitals to attest that quality assurance processes are in place for all drugs either purchased externally or prepared in hospital;
- Working with the Ontario College of Pharmacists, to amend Ontario Regulation 202/94 under the Pharmacy Act, 1991 to allow the college to inspect drug preparation premises where pharmacists and pharmacy technicians engage in or supervise drug preparation activities (such as reconstituting, combining, and mixing two or more substances without a prescription); and
- Amending Regulation 965 under the Public Hospitals Act to require hospitals to purchase or obtain drugs only from regulated or approved entities.