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OSOT Responds to Minister's Consult on HPRAC Recommendations

Friday, February 13, 2009

OSOT responds to Health Minister's Consultation on Proposed Amendments to Physiotherapy Scope of Practice

View OSOT's January 30, 2009 Submission

Background
On Tuesday November 18^th, Health Minister David Caplan released a number of reports of the Health Professions Regulatory Advisory Council (HPRAC) including their report and recommendations on the physiotherapy scope of practice review which was conducted this summer. View HPRAC’s report An Interim Report to the Minister of Health and Long-Term Care on Mechanisms to Facilitate and Support Interprofessional Collaboration among Health Colleges and Regulated Health Professionals: Phase II, Part I.

HPRAC has largely supported the recommendations of the Ontario Physiotherapy Association and the College of Physiotherapists of Ontario. The Minister released this report (which includes recommendations regarding the scope of practice of dietetics, midwifery and pharmacy as well) for public consultation with a deadline for responses of January 31st , 2009. To view all HPRAC reports released for consultation click here.

In May 2008, the professions of Pharmacy, Midwifery, Physiotherapy, Dietetics, Medical Radiation Technology and Medical Laboratory Technology were invited by the Health Professions Regulatory Advisory Council (HPRAC) to submit recommendations for changes in scope of practice to enhance interprofessional collaboration and assist members to work to the maximum of their scope of practice. Submissions can be viewed at HPRAC’s website Interprofessional Collaboration Consultation page.

HPRAC’s focus on these profession’s scope of practice stemmed from the June 2007 referral of the Minister of Health and Long-Term Care which requested advice on a number of matters impacting the regulation of health professions in Ontario, including;

mechanisms to facilitate and support interprofessional collaboration between health Colleges;
the scope of practice of registered nurses in the extended class;
regulations concerning non-physician professions who prescribe and/or use drugs in the course of their practice;
framework and process for changes to drug regulations for non-physician prescribers;
the regulation of diagnostic sonographers;
consideration of an association model for personal support workers;
the regulation of dental assistants;
the regulation of paramedics and emergency medical attendants; and
the regulation of chiropody and podiatry.

A component of the Ministry’s interest in Interprofessional Collaboration is the interest to explore alternative health service delivery models that can maximize the health care dollar investment to provide access to quality services to Ontarians. Through their investigation of issues relating to Interprofessional Collaboration, HPRAC has recognized that limitations with the regulated scopes of practice may serve as barriers to maximization of the potential to promote interprofessional care.

The Physiotherapy profession has had the opportunity and challenge to consider ways and means for PTs to more effectively support priority health issues such as wait lists for hip and knee surgeries. Development and early evaluation of advanced practice roles for PTs to support services efficiencies in these areas have provided evidence for the capacity of PT’s expanded access to controlled acts to serve in roles that promote collaboration and service efficiencies.

Joint Submission of Ontario Physiotherapy Association & college of Physiotherapists of Ontario regarding Scope of Practice Review

View the Joint Submission of OPA/CPO, Strategic Solutions: Optimizing Physiotherapists Capacity in Ontario’s Health Care System, June 2008.

The OPA and CPO propose a new scope of practice statement which incorporates the function of diagnosis;

The practice of physiotherapy is the assessment of neuromuscular, musculoskeletal and cardiorespiratory systems to;

diagnose, treat and prevent disorders or diseases that cause or are associated with physical dysfunction, injury and/or pain;
develop, maintain, rehabilitate or augment function;
relieve pain; or
promote mobility and health

Additionally, the joint submission proposes 5 additional controlled acts or components thereof for the profession and the removal of limitations in certain other statutes (e.g. Public Hospitals Act, Health Insurance Act) to enable new orders and activities of physiotherapists.

OSOT's Response

View OSOT’s Reponse. The Society’s response is largely supportive of the physiotherapy proposal to amend the scope of practice for the profession of physiotherapy. We congratulate the profession on a visionary and thorough document. The Society raises several questions related to wording of the scope of practice and mechanisms for regulatory rigour related to the proposed model of practice relating to controlled acts. Perhaps most importantly, OSOT identified the PT model to be a flexible, dynamic model that could well apply to other professions. Furthermore, the Society asserts that movement forward on the PT scope of practice necessitates review and commitment to review scopes of practice in other professions….occupational therapy included in order to enable all professions to work to the full extent of scope and competencies to more effectively and collaboratively work to meet the health care needs of Ontarians.

OSOT’s Board of Directors has also committed to correspond to the College of Occupational Therapists of Ontario to request engagement in a collaborative working group to address the scope of practice issue for occupational therapy so that the profession may proactively position itself for review in the future.

We invite your feedback always. Contact Christie Brenchley, Executive Director cbrenchley@osot.on.ca