Over the last two years, the Ontario government has worked with regulatory health colleges to make several changes to the scopes of practice of pharmacists, registered nurses, nurse practitioners and midwives.   

Through 2023, the scope of practice for pharmacists was expanded to include: 

• prescribing for minor ailments;  
• administering certain substances by injection and inhalation for treatment purposes; and 
• providing care related to the vaccination and treatment of COVID-19, influenza and Respiratory Syncytial Virus (RSV).  

Government continues to explore expanding pharmacists’ ability to treat more common ailments and communicate a diagnosis for specific minor ailments, administer more vaccines, and perform more point-of-care testing. 

Government has indicated that these changes are intended to support qualified health professionals in working to the full extent of their training and expertise.

Effective January 2024, registered nurses can: 

• complete additional education requirements to prescribe and administer certain medications, including birth control, drugs for smoking cessation, and travel medications to treat and prevent malaria and traveller’s diarrhea; and 
• administer medication for topical wound care and prescribe vaccinations for the flu shot and COVID-19.  

Government is also considering further scope changes for nurse practitioners to allow them to: 

• complete and sign mandatory blood testing forms for specific infectious diseases;  
• order and apply defibrillators and cardiac pacemaker therapy; and  
• order and perform electrocoagulation on skin conditions.  

In addition, proposed changes would allow nurse practitioners to certify death in all circumstances and allow registered nurses to certify death when the death has been expected.  

Finally, in May 2024, midwives were authorized to: 

• administer additional routine vaccinations (e.g. flu shots, COVID-19 vaccines, Tdap immunization);  
• prescribe treatment for nausea, vomiting and acid reflux; and  
• administer treatment for management of labour pain in a hospital setting.

Government has indicated that these changes are intended to support qualified health professionals in working to the full extent of their training and expertise, while allowing physicians to spend more time on complex care. As scopes of practice continue to evolve, physicians should do their best to ensure continuity of care when working with other regulated health professionals and support smooth transitions in patient care.