Category: Board & Committees

The College of Occupational Therapists of British Columbia held their 2020 annual general meeting on Friday, November 6, via Zoom. You can listen to the recorded virtual meeting including answers to questions the College received in advance of the event.

For your reference, please see the 2019-2020 Annual Report.

Questions answered in the virtual AGM:

1. How can occupational therapists better prepare themselves for participating on Primary Health Care Teams?
2. What does COTBC know about how health colleges will be restructured?
3. Related to question 2, with the proposed amalgamations, will there still be profession specific resources, competencies, and assessments, etc.?

This news post has been updated to include the answers to questions from the 2020 Annual General Meeting.

Question 1: How can occupational therapists better prepare themselves for participating on Primary Health Care Teams?

This is a timely question given the B.C. Ministry of Health has highlighted that one of their key objectives is to “create a primary care model that provides comprehensive coordinated and integrated team-based care” (2019/2020-2021/2022 Service plan, p.3).

The Canadian Alliance of Occupational Therapists highlights that primary care is a model of care that is comprehensive, team-based, and focused on a continuum of care; delivered by inter-professional teams providing continuity of service that is patient and family-centred and results in better patient outcomes and satisfaction.

In considering how occupational therapists can better prepare themselves for participating on Primary Health Care Teams, we thought it was important to acknowledge that here at the College, we are not the clinical experts in this area. As with any emerging practice area, we would encourage OTs to refer to their Essential Competencies as an anchoring framework. If you are working or considering work in primary health care, you might want to reflect on the following questions, which we thought could be helpful in assisting you to recognize where further professional development might be needed. It is not an exhaustive list, but just a starting point for reflection.

Unit 1 – Assumes Professional Responsibility

As the first step, this includes recognizing your individual responsibility to provide safe, ethical and effective practice, anchored within a commitment to your clients and the public, practicing within your scope of practice, and adhering to your Code of Ethics. Asking this question in the first place shows you are considering your professional responsibilities.

Units 2 Thinks Critically and Unit 3 Demonstrates Practice Knowledge

• How does your own knowledge, skill set, and personal limitations impact your ability to provide care in this model?
• How can you integrate your foundational OT theory into primary health care team practice, recognizing that client-centred practice, at the heart of the profession, aligns closely with the philosophy of primary care models?
• What regulatory obligations may impact your practice, given the interprofessional collaborative practice approach to primary care settings (e.g., scope of practice limitations)?

Unit 4 – Utilizes an Occupational Therapy Practice Process to Enable Occupation

• Are you able to communicate the nature of the occupational therapy services you can provide within this practice context?
• Are you able to develop a client centred occupational therapy plan within the context of the interprofessional team with realistic and targeted outcomes?
• Do you know who to refer to in supporting clients to receive other services? How to do this efficiently within the given primary health care team and broader health care system?

Unit 5 – Communicates & Collaborates Effectively

• Do you need to build your communication skill set to be able to empower open, honest, and clear dialogue with your clients, interprofessional team members, and other stakeholders?
• Are you familiar with documentation requirements within an interprofessional context? Are you familiar with emerging technology being used in this context and relevant privacy considerations?
• Are you familiar with setting team goals and priorities and learning from other professionals on your team?

Unit 6 – Engages in Professional Development

• Have you done a self assessment of your learning needs to work in this area of practice?
• Are you reviewing a variety of evidence-informed sources of information for up to date information on smart practices in the context of primary care?
• Do you demonstrate a commitment to continuing competence – developing a learning plan and integrating new knowledge into your practice when knowledge and skill gaps are identified?

Unit 7 – Manages Own Practice and Advocates Within Systems

• Are you able to appropriately supervise support personnel in the team-based context?
• Are you familiar with and engaged with system level and/or research initiatives related to primary care service delivery?
• Do you advocate for change where concerns or opportunities are identified?

We hope these reflective questions can provide a starting point for further considerations and information gathering. There are a number of other resources available to assist you – including but not limited to formal education opportunities, Health Authority resources, UBC’s Primary Health Care Program, courses through the professional association, and more.

Question 2: What does COTBC know about how health colleges will be restructured?

This question highlights that there are changes on the horizon for the model of health profession regulation in B.C. In May 2019, the Minister of Health established an all-party steering committee to provide advice on how to modernize the regulatory framework for health professions in B.C.

On August 27, 2020, following an extensive review and consultation process, the Minister of Health released the Steering Committee’s final report that outlined its recommendations to modernize the provincial health professions regulatory framework. The Steering Committee’s work aligned with the government’s goal of increasing transparency, patient safety, accountability, and public confidence in health profession regulation.

The Report describes six recommendations for changes within the following key areas:

1. Commitment to cultural safety and humility: Recommends ensuring cultural safety and humility are embedded within the regulatory framework. This may include improving the safety of the complaints and discipline process and creating standards that promote cultural competence of health professionals.
2. Improved governance: Recommends ensuring College Boards are focused only on public safety.  Changing board composition to an equal number of registrants and public members and eliminating elections and moving to a competency-based appointment process for board members are identified as ways to ensure the Board is attending to its public protection mandate.
3. Improved efficiency and effectiveness through a reduction in the number of regulatory colleges from 20 to six. Further details follow below.
4. Strengthening the oversight of regulatory colleges: Recommends the creation of a new independent body to provide oversight of health profession colleges. The role of the independent body includes board appointments and monitoring the performance of the six Colleges.
5. Complaints and adjudication: Recommends simplifying the complaints and discipline process in order to provide a clear focus on public safety, public notification, and strengthen public trust in regulation.
6. Information sharing to improve patient safety and public trust: Recommends improving how regulators can share information, such as enabling better sharing of information between colleges and other agencies to support public protection and transparency.

To address the question asked, it is helpful to look more closely at recommendation 3, which speaks to the reduction in the number of B.C.’s health profession regulatory colleges.

Figure 1, taken from page 13 of the Steering Committee’s Report, shows the proposed restructuring of the Colleges from twenty down to six and where occupational therapy regulation would be situated.

Figure 1: Adapted from “Recommendations to modernize the provincial health profession regulatory framework.” 2020. Province of British Columbia. Retrieved November 1, 2020m, from https://engage.gov.bc.ca/app/uploads/sites/578/2020/08/Recommendations-to-modernize-regulatory-framework.pdf

In the proposed framework, the six Colleges will include:

1. A Regulatory College of Complementary and Alternative Health and Care Professionals
2. A Regulatory College of Allied Health Professionals – where occupational therapists will be regulated, alongside, dietitians, opticians, optometrists, physical therapists, psychologists, speech and hearing health professionals, diagnostic and therapeutic professions (e.g., respiratory therapists)
3. The College of Pharmacists of BC (no change)
4. The BC College of Nurses and Midwives (amalgamated as of September 1, 2020)
5. A College of Physicians and Surgeons, including podiatrists (amalgamated as of August 31, 2020) and,
6. A College of Oral Health Professionals.

In the reduction of Colleges, COTBC becomes part of a multi-profession regulatory College.

The changes are intended to better align regulation with team-based care and promote consistency in standards across professions. Larger Colleges are viewed as more efficient in terms of access to the resources to conduct its activities. Larger Colleges are viewed to be more effective through harnessing the expertise and broader experience that can come with larger entities.

So what happens now?

The implementation of the multi-party steering committee recommendations rests with Cabinet and the Legislative Assembly. We do not yet know from the Ministry the final direction or timing for implementation of these recommendations.

In the meantime, COTBC has been in discussions with our other multi-profession college partners to explore what we can do to prepare for changes likely to come from the recommendations. Building on our strong foundation of working together will stand us in good stead for the interesting conversations to come.

In the interim, anchored by the values that have guided our College for the past 20 years, we will continue to act in the public’s best interest as we work to advance accountable health profession regulation in our changing world.

COTBC is committed to providing registrants with ongoing updates on how the health profession regulatory system is evolving in B.C. and working with our college partners to better serve and protect all British Columbians.

Question 3:  Related to Question 2, with the proposed amalgamations, will there still be profession specific resources, competencies, and assessments, etc.?

COTBC is reassured by the Steering Committee’s recognition of the importance of profession-specific knowledge and expertise in any future regulatory system. They recommend the creation of profession-specific councils within the multi-profession regulatory colleges to ensure that regulators have access to profession-specific expertise and to reinforce that understanding of professional context is important for effective regulation. The specifics of what this will look like are not fleshed out in the report other than to reinforce there must be a clear separation between the governing board and profession-specific councils.

COTBC believes that profession-specific expertise is critical for effective regulation and it is needed across all core regulatory functions – such as establishing standards of practice and addressing complaints. Less obvious, but as important, are the programs that support safe and quality practice. Practice advisory services, developing practice resources, and continuing competence programs must have relevance to a professions’ practice. With the recommendation of profession specific councils, it seems these activities may have a place in any future regulatory scheme. When appropriate, COTBC will be participating in discussions about the structure and functions of profession-specific councils.