December 2016
News

Have your say: NPs’ authority to prescribe controlled substances

We are seeking your feedback about proposed changes to regulations and by-laws to enable nurse practitioners (NPs) in Ontario to prescribe controlled substances.

To give your feedback, read the summaries below and complete the online feedback form by Tuesday, Feb. 14, 2017.

Proposed regulation changes: Summary

Currently, NPs in Ontario do not have the authority to prescribe controlled substances. The proposed regulation changes will expand their scope of practice to include prescribing controlled substances.

To support safe implementation of this new area of practice, the proposed regulation includes a condition that NPs must meet educational requirements before they can prescribe controlled substances.

The education covers competencies related to safe, effective and ethical prescribing, and managing clients who are treated with controlled substances. This education will build on NPs’ existing competencies by addressing the unique risks associated with controlled substances.

To prescribe controlled substances, NPs must also meet existing conditions in the regulations under the Nursing Act, 1991.

Read the proposed regulation 275/94 (General) under the Nursing Act, 1991 (shown in red font).

When will the changes take effect?
We do not have an exact date for when the regulation will take effect.  The College and the Ministry of Health and Long-Term Care are aiming to have regulations in effect by March 31, 2017. However, this is not a firm date. It depends on when the College’s Council and government approves the proposed regulation, and it becomes law.

Proposed by-law changes: Summary

The proposed by-law changes will enable the College to post and remove information about prescribing and managing controlled substances on an NP’s profile on the College’s public Register, Find a Nurse. This ensures that the public, employers, other health care providers and stakeholders can find out whether an NP is authorized to prescribe controlled substances.

The information that will be posted on an NP’s profile depends on:

  • if they have met the education requirements as defined in the regulation

  • if there is a Health Canada notice about the NP

Posting information about the education requirement
Prescribing controlled substances is a high-risk activity that will become part of NP scope of practice when the regulations are approved. It is in the public’s interest to indicate when an NP does not have the competencies to safely perform this high-risk activity.

On the day the regulation takes effect, if the College has not received evidence that an NP completed an approved controlled substances course, the Register will state that the NP is “entitled to practise with restrictions.” As well, the restriction will be described. For example: “cannot prescribe controlled substances because controlled substances education has not been completed.” If the NP completes approved education later on, the restriction will be removed from their registration status.

Posting information about Health Canada Notices
The proposed by-law changes also allow the College to post and remove information about Health Canada notices. These notices are letters Health Canada sends to inform pharmaceutical companies and pharmacies that they must not:

  • sell or provide a controlled substance to an NP; and/or,

  • fill an NP’s prescription for a controlled substance(s).

These notices are also sent to the NP’s regulator, the College of Nurses of Ontario.

There are several triggers for Health Canada notices. These include a request from the College because the NP breached a rule of conduct, or is found guilty of a designated drug offence or an offence under the federal regulations.

Read the proposed changes to the College's by-law (shown in red font).

When will the proposed by-law changes take effect?
The by-law changes will not take effect until the proposed regulations become law.

Next steps
Give your feedback by completing the online feedback form by Tuesday, Feb. 14, 2017.

Council will review your feedback before its meeting on March 8, 2017. Then, Council will decide whether to approve the proposed regulation and forward it to government for approval.          

If you have questions about the proposed regulation and by-law changes, and how they could affect your practice, read the Q&As under "Resources" at http://www.cno.org/en/trending-topics/nps-and-prescribing-controlled-substances/.

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