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Section 56 Exemptions for Providing Controlled Substances to Community Health Facilities
In 2018, Health Canada introduced a pair of subsection 56(1) class exemptions to the Controlled Drugs and Substances Act, one for nurses providing health care at a community health facility, and one for the person in charge of a hospital and/or pharmacist who supplies controlled substances to a community health facility:
- Subsection 56(1) Class Exemption for the Person in Charge of a Hospital and/or a Pharmacist who Supplies Controlled Substances to a Community Health Facility
- Subsection 56(1) Class Exemption for Nurses providing Health Care at a Community Health Facility
- Supplementary information: Subsection 56(1) exemptions
Under the s.56 exemptions, pharmacists are permitted to provide certain controlled substances to a community health facility, subject to the terms and conditions of the exemption. The exemptions also provide nurses with the authority to possess, sell, provide, administer, transport, send and deliver certain controlled substances in the course of providing health care services to patients in community health facilities, subject to the terms and conditions of the exemption. For more information on which settings the exemptions apply to, see the FAQs below.
When performing activities permitted under the s.56 exemptions, pharmacists must adhere to the terms and conditions in the exemptions, and all applicable College bylaws, standards of practice, and professional practice policies. When providing patient-specific drugs to a community health facility, requirements include (but are not limited to) the following:
- For drugs in the Controlled Prescription Program (CPP), the prescription is received on the prescription form approved by both the board and the College of Physicians and Surgeons of British Columbia per the Pharmacy Operations and Drug Scheduling Act (PODSA) Bylaws s.19(6).
- For drugs in the CPP, the prescription form is signed by the patient or the patient’s representative upon receipt of the dispensed drug as per the PODSA Bylaws s.19(6).
- The Community Pharmacy Standards of Practice, including assessing the prescription for appropriateness and completeness, reviewing the patient’s personal health information in PharmaNet, preparing and labelling the drug pursuant to each individual prescription, and consulting with the patient or patient’s representative at the time of dispensing.
- Prescription information is entered and recorded in PharmaNet at the time of dispensing and the patient record is kept current as per the PODSA bylaws s.35(1).
Where a pharmacist provides a patient’s prescription for a controlled substance to a community health facility (where the terms and conditions of the exemptions are met), a nurse working at the community health facility may sign the CPP form and receive the pharmacist-patient representative consultation, if authorized by the patient.
FAQs
The information provided here and in the FAQs is intended to guide pharmacy practice. Other health professionals should consult with Health Canada, their regulatory College and employer on their roles and responsibilities when handling controlled substances.