Health Canada has released its New Classes of Practitioners Regulations (NCPR) that, once approved, would authorize NPs to prescribe controlled substances.
After the federal government gives the green light, it is up to each province/territory to enact provincial regulations.
The NCPR and provincial regulations will improve continuity of care and caregiver, enhance access to care, and will have a positive impact on the effectiveness of the health system.
The federal government introduced these regulations to “improve flexibility within the health-care system and the timeliness of service delivery in Canada," said the Honourable Leona Aglukkaq, federal Minister of Health, in a statement, adding that they will also “promote better continuity of care by removing barriers to access to these medications, where and when they are needed.”
Claudia Mariano, president of the Nurse Practitioners’ Association of Ontario (NPAO), says the proposed regulations will “remove federal restrictions, paving the way for provincial regulations to be developed and approved (by CNO).”
RNAO is pleased about the proposed regulations, but cautions that there are some exceptions contained in the proposed regulations that will mean barriers to access in some settings, particularly chronic disease management, palliative care, long-term care and harm reduction. NPs will not be allowed to prescribe heroin, cannabis, opium, coca and anabolic steroids (except testosterone).
RNAO has urged the federal government to remove these exclusions.
Given concerns regarding the potential risk of abuse, Health Canada is suggesting the limitations, RNAO CEO Doris Grinspun wrote to the federal government in June. “This is not sufficient grounds to restrict NPs’ prescribing abilities, from either a client-centred care or health system perspective.”
RNAO would like to see an amendment that authorizes NPs to designate an agent to handle controlled substances on their behalf. Without the provision, RNAO believes it will “present significant challenges for those NPs who are providing invaluable care in remote areas of Ontario, and who may require the transfer of controlled substances.”