Scope of Practice Reform

British Columbia is implementing a new shared scope of practice/restricted activities regulatory model under the Health Professions Act similar to that adopted in Alberta, Ontario and Manitoba. This initiative is being guided by the reports and recommendations of the former Health Professions Council, particularly the report Safe Choices: A New Model for Regulating Health Professions in British Columbia (PDF, 1.8MB) delivered to government in 2001.

The new model is characterized by two essential elements: scope of practice statements and restricted activities

Scope of Practice Statements

Scope of practice statements are the concise descriptions, in broad, non-exclusive terms, of each regulated profession's activities and areas of professional practice. These statements describe in general what each profession does and how it does it. They are not exhaustive lists of every service the profession may provide, nor do they exclude other regulated professions or unregulated persons from providing services that fall within a particular profession’s scope of practice.

Restricted Activities

Restricted activities (formerly called reserved acts) are a narrowly defined list of invasive, higher risk activities that must not be performed by any person in the course of providing health services, except

  • registrants of a health profession college who have been granted specific authority to do so in their regulations, based on their education and competence, and
  • non-registrants who have been delegated the authority to perform the restricted activity, or who have been authorized to perform the restricted activity, by a  regulated professional that has been granted the restricted activity. *Please note: Delegation of restricted activities to non-registrants (including unregulated persons) must be authorized in bylaw by the health profession college whose registrants have been granted authority to perform the restricted activity, before such a delegation may take place.

Individual professions will be granted a list of specific restricted activities from a ‘master list’ as appropriate to their education and competencies, which may be performed while providing the services described in their respective scope of practice statements. The same restricted activities may be granted to more than one profession. Not all professions will be granted restricted activities. Unregulated persons or classes of persons may be exempted from the prohibition.

This approach abandons the historical notion of professional exclusivity in which legislation prohibits any person other than a member of the profession from performing certain services or procedures, except where another profession is also specifically authorized in legislation to perform them. Under the new model, many aspects of the scope of practice of each regulated profession may overlap, or be shared, with those of other regulated professions, and may also be performed by non-registrants or unregulated persons (to the extent that either no restricted activities are involved in the service, or the non-registrant or unregulated person is delegated or authorized to perform a restricted activity under supervision when provided for in the relevant health profession college bylaws).

This approach supports enhanced interprofessional and multidisciplinary practice and increased consumer choice, while maintaining patient safety and public protection.

Implementation Status

On November 21, 2006, the Ministry gave initial notice of the proposed Reserved Actions Regulation.

On December 12, 2008, the Ministry gave notice of a revised list of proposed restricted activities. This replaced the proposed Reserved Actions Regulation released in 2006.

On March 19, 2010, the Ministry gave notice of an updated list of proposed restricted activities (PDF, 137KB), to be added to the Health Professions General Regulation. This replaces the proposed list released in 2008.

As of October 19, 2012, regulations for the following professions incorporate the new regulatory model and the 2010 proposed list of restricted activities:

  • audiology
  • chiropractic
  • dentistry
  • hearing instrument dispensing
  • medicine
  • midwifery
  • naturopathic medicine
  • opticianry
  • optometry
  • pharmacy
  • podiatric medicine
  • nursing (registered)
  • speech-language pathology