Anticipated Overhaul of Quality Oversight to Non-Hospital Medical Clinics

May 13, 2016 | Lisa Spiegel

The Minister of Health and Long-Term Care has indicated he intends to implement the recommendations set out in the recently released report by Health Quality Ontario (HQO), pertaining to its review of the quality oversight of non-hospital medical clinics (NHMCs) in Ontario. View the report.

The implementation of HQO’s recommendations would result in a legislative overhaul of Ontario’s current quality oversight/inspection regimes for NHMCs and would include the oversight of certain facilities performing medical procedures that are not currently subject to regulation.

The review considered the current regulatory regimes governing NHMCs, which are:

  1. the Independent Health Facilities Act (Ontario), which sets out the regulatory oversight of Independent Health Facilities (IHFs). IHFs include diagnostic imaging facilities, and ambulatory facilities providing dialysis, ophthalmic/cataract surgery, abortion and gynecologic surgery and vascular and plastic surgery; and
  2. Regulation 114/94 made under the Medicine Act, 1991 (Ontario), which establishes the regulatory oversight for various Out-of-Hospital Premises (OHPs) where the accepted standard of practice is to use certain types of anesthesia or sedation for the performance of procedures. OHPs include pain, endoscopy and cosmetic surgery clinics.

The HQO report recommends creating new legislation to consolidate the IHF and OHP quality/inspection programs, and to expand the quality oversight for certain NHMCs that offer procedures not currently subject to regulatory oversight. The report does not specify which procedures will become subject to regulation, but it is anticipated that various “high risk” procedures will be included. For example, the report comments that “in vitro fertilization, cystoscopy, Lasik eye surgery, sclerotherapy and non-permanent fillers fall beyond existing oversight measures under the current regime[s], despite posing relatively higher risks that may include infection, disfigurement and blindness.”

The recommended legislation envisions a regulatory authority with accountability placed with an Executive Officer. Additional recommendations include:

  • An Executive Officer authorized to establish rules and criteria for the program, act on inspection results, and communicate and coordinate information between public health authorities and professional regulatory colleges;
  • A requirement that clinic owners apply for registration and that registration be contingent upon passing an inspection;
  • A requirement that each clinic have a single point of accountability for quality oversight, which in all cases should be a regulated health professional;
  • A requirement that, as a condition of registration, the clinics report utilization, performance and quality data;
  • Standardized plain language online and in-clinic posting of summaries of inspection reports;
  • The requirement that clinics complete and post Quality Improvement Plans; and
  • Standardized, fair and timely enforcement.

We will be monitoring the development of this expected legislation and will continue to keep you updated on the regulatory requirements for IHFs, OHPs and other impacted NHMCs.


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