CPSO is inviting feedback on the draft Delegation of Controlled Acts policy. The draft policy aims to clarify expectations around safe and appropriate delegation, and strengthen physician oversight over delegates. Key changes include:

• A clear policy expectation stating physicians cannot leave delegates to manage their practice independently.  
• Requiring physicians to be physically onsite to supervise delegates unless an exception applies, namely:  

1. 1. 1. 1. it has been deemed appropriate in the policy for the delegation to occur in the absence of a physician-patient relationship;
         2. another physician is onsite, or
         3. the physician determines the delegation is low risk.

• Ensuring consent discussions include informing patients that aspects of their care will be provided by a delegate.  

The draft also retains the amendments approved at the September Board meeting, which include:

• Clarification that an “anticipated” physician-patient relationship requires a physician to perform a clinical assessment within two business days of a new patient’s first encounter with a delegate.
• A list of exceptional circumstances in which physicians are permitted to delegate without an existing or anticipated physician-patient relationship.  

The companion Advice document offers guidance on the draft policy’s expectations, including on clinical assessments for the first patient encounter, onsite supervision by physicians, delegating to internationally trained physicians, and restrictions on the use of protected titles (e.g., “doctor”).

Your input is important to the development of our policies. Please provide your feedback through our consultation page by November 24, 2025.