‘The largest piece of legislation in British Columbia’: What exactly is in the HPOA for pharmacists?

On Saturday, Suzanne Solven, CEO and registrar of the College of Pharmacists of British Columbia, used her time at the B.C. Pharmacy Association’s annual conference to spell out what the province’s new Health Professions and Occupations Act means for working pharmacists in day-to-day practice. Walking attendees through the nuts and bolts of the new rules, she covered changes dealing with oversight and discipline—later touching on other work underway at the College, including efforts to deal with growing business pressures, and initiatives to crack down on drug diversion.“Our purpose is to protect the public—full stop,” she said. “We are not a member organization. We don’t advocate for the profession. We advocate for the public.”Under new management The new law, which came into force April 1, replaces the previous framework, the Health Professions Act, with a far more complex system of governance: while the former act had 56 sections, the new legislation has 645.“It’s the largest piece of legislation in British Columbia,” explained Solven. “It’s comparable to the federal Income Tax Act [in scope]—it is very complicated.”For pharmacy in particular, Solven said oversight is further complicated by the continued existence of a second statute, the Pharmacy Operations and Drug Scheduling Act. Under the new law, health profession colleges now fall under a government reporting structure, with college boards no longer elected in part by registrants—now referred to as “licensees.” Instead, all board members will be appointed by the provincial health minister, with seats split evenly between professionals and public representatives.Doing so brings new reporting requirements mandated by government, said Solven, including quarterly financial reporting and three-year budget forecasts, which may be subject to audit by the auditor general. Similarly, a new Health Professions and Occupations Regulatory Oversight Office will monitor how the colleges operate. While colleges will continue to investigate complaints, formal discipline hearings will now be handled by a director of Discipline to ensure consistency in disciplinary action. “It’s a great thing, because we should be accountable like every other public organization,” said Solven. “But it will come with some administrative burden.”Speed vs. risk Solven said a key focus for the college now is speed, acknowledging long-standing concerns that regulation has lagged behind practice.“We are five, 10 years behind. We get [an updated bylaw] out the door, we’re so proud of ourselves—but it’s already out of date by the time we roll it out.” The solution, she said, is building a more “agile” system—one that can respond faster without increasing risk to patients—thanks to “right-touch regulation,” which focuses on matching oversight to the level of risk, rather than defaulting to more rules.In keeping with that approach, the legislation reshapes some responsibilities for licensees. In B.C. pharmacists now have clearer accountability when delegating tasks to non-licensed staff. “If you practise and you are in the pharmacy that day practising, and you have your assistants, non-licensees, doing delegated functions, you are responsible for that delegation—not your manager, not your owner, your director,” said Solven. The act also expands duties to report concerns about colleagues, particularly in cases involving sexual misconduct, discrimination or competence issues. Employers who terminate staff for any of those reasons must now also notify the college. The act also introduces new support for complainants, including access to navigators and counselling services in cases involving trauma.When business trumps safetyAt the same time, Solven said the college is grappling with how business metrics are impacting pharmacists—meaning how demands such as prescription volume targets and performance goals are shaping daily workloads. Data gathered by the college suggests some pharmacists are working under conditions that may pose risks to patient safety. “We’re not against metrics,” said Solven. “Businesses have to have measures.” “But what we are hearing is that profit is trumping practice.”In some cases, Solven said they’ve heard cases of single pharmacists processing hundreds of prescriptions per day, while also managing clinical services such as medication reviews and adaptations. “You tell me if you think you could do that and not be at risk.”The result, she said, is mounting burnout and the potential for corners to be cut, raising concerns about errors that could harm patients.“One of these patients could be you,” she said. “Your children, your parents.”Solven says the college is still in the early stages of assessing the issue and has not introduced new rules. Instead, it is gathering data and consulting with regulators across Canada.Any response, she added, will require coordination across the system, including government, regulators and industry.“We need to solve this together.”

‘The largest piece of legislation in British Columbia’: What exactly is in the HPOA for pharmacists?

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