Delegation

1. The determination and recording of the specifications of the eyeglasses, contact lenses, or subnormal vision devices to be provided to a patient.
   
   
2. The confirmation and recording of the appropriateness of the eyeglasses, contact lenses or subnormal vision devices to be provided or delivered to the patient.
   
   
3. The provision and recording of the necessary advice, counseling, and associated care to the patient about the use of the eye glasses, contact lenses or subnormal vision devices.

College of Opticians:

The College of Opticians continues to enforce the provisions of the Joint Report, the definition of dispensing it contained and the provisions it set out for delegation.

The College of Optometrists:

While this Report was produced jointly with the College of Optometrists, the College of Opticians cannot confirm that the provisions of the Report are in effect and enforced by the College of Optometrists. We have made several attempts to obtain information from the College on its current position on delegation and what it has transmitted to its members on the subject. No response has been forthcoming. Based on that we can only present what we know to have been the case:

The College of Optometrists has a Professional Misconduct regulation that prohibits delegation. Notwithstanding this regulation, the College distributed a document to its members that stated that “A member is responsible for all acts that are delegated.”

The same document took the position that “prescription ordering, lensometry and frame repair” are “business maintenance aspects of a member’s practice” and therefore “not a concern to the College and not germane to the question of delegation.” The document also said that unlicensed individuals may “assist and guide patients in the selection of ophthalmic frames” and “in the insertion and removal of contact lenses…”.

The College of Optometrists has released a new policy on Delegation (and Assignment) as of 2005.


The College of Physicians and Surgeons:

In a recently released policy paper on delegation, the College of Physicians and Surgeons took the following position:

“When controlled acts are delegated in appropriate circumstances this process can result in more timely delivery of quality health care, and can make optimal use of health care resources and personnel. In every instance of delegation the primary consideration should be the best interests of the patient. Responsibility for the delegation of the controlled act always remains with the delegating physician.”

The Policy then set out eight ‘guidelines’ for delegation. A copy of the current CPSO Policy Paper on delegation is available here.

Current COO Status

A discussion paper drafted by the College of Opticians on delegation was distributed to Council on September 12, 2003. The paper was based on our own policies from the “Joint Report” and incorporated some aspects of the delegation policy of the College of Physicians and Surgeons of Ontario and the delegation policy of the College of Respiratory Therapists of Ontario. In 2005 the Council struck an Ad-hoc committee to deal with the issue of delegation and develop a new policy paper on the issue for Opticians in Ontario. This committee has drafted a paper which was delivered to Council at the May 2006 Council meeting for approval to distribute to stakeholders for comment. All comments were reviewed by the Ad Hoc Committee and a policy was presented to Council at the September 2006 Council meeting for final approval. The document, in its final state was circulated in October 2006 to all Members of the College in Ontario and will replace the old position paper on delegation for Opticians in Ontario.

In the meantime, the College of Opticians has a delegation policy as noted above which is still in effect.