The Regulated Health Professions Act

The Regulated Health Professions Act (“the RHPA”) changes the way health professions in Manitoba are regulated. It will replace more than 20 statutes and bring all regulated health professions under one umbrella act. The RHPA sets out consistent rules and processes for governance, registration, complaints and discipline, and regulation and by-law making authority. Each profession-specific statute will be repealed when the profession is transitioned to the RHPA. Professional self-governance will continue under the RHPA and each profession will have a college, regulations, a code of ethics and standards to govern its members.

The RHPA sets out a new way of regulating who does what in the provision of health services based on the concept of controlling specific health care services or procedures. These health care services or procedures, known as “reserved acts”, are performed in the course of providing health care by competent health care professionals. The health professional must have the appropriate knowledge, competence and skills necessary to perform the act safely. There are 21 categories of reserved acts, including such activities as ordering screening and diagnostic tests, making a diagnosis and prescribing/dispensing/administering drugs, among others.

Profession-specific regulations under the RHPA will set out what specific reserved acts a profession can perform and any limits or conditions on the performance of these acts. Under the RHPA, reserved acts are not exclusive to any one health profession, and are intended to encourage the practice of inter-professional care.

The RHPA was proclaimed in 2014 when the College of Audiologists and Speech Language Pathologists (CASLPM) transitioned to governance under the RHPA. The College of Registered Nurses of Manitoba (CRNM) is the second college (and third profession) to transition to governance under the RHPA on May 31, 2018.

Until a profession transitions to governance under the RHPA, they will continue to be governed by their existing profession-specific acts and regulations. The RHPA provides that health professionals may continue to perform the reserved acts that are within their scope of practice under these acts and regulations.

Delegation of Reserved Acts

Under the RHPA, a health profession regulatory college may choose, by regulation, to permit their members to delegate the performance of reserved acts to other providers, including other regulated health professionals. The College of Audiologists and Speech-Language Pathologists of Manitoba, which has transitioned to governance under the RHPA, permits its members to accept the delegation of specified reserved acts. This is subject to certain conditions outlined in the College of Audiologists and Speech-Language Pathologists of Manitoba General Regulation under the RHPA.

The CRNM has determined that it will not permit its members to accept the delegation of reserved acts. This means that effective May 31, 2018, registered nurses will not be permitted to accept delegations of the performance of reserved acts from other regulated health professionals. However, registered nurses will have the authority to delegate specified reserved acts to individuals who are not regulated health professionals, subject to certain conditions outlined in the College of Registered Nurses of Manitoba General Regulation.

Professions that have not yet transitioned to the RHPA may continue to permit their members to delegate the performance of reserved acts to other regulated health professionals and other providers and accept the delegation of the performance of reserved acts from other regulated health professionals.

The College of Physicians and Surgeons of Manitoba Transitioned to RHPA

Profession-specific regulations for members of the College of Physicians and Surgeons of Manitoba (CPSM), bringing the practice of medicine under the RHPA, come into force effective January 1, 2019. The Medical Act will be repealed. By enacting the regulations, the medical profession becomes the fourth profession regulated under the RHPA, following audiologists, speech language pathologists and registered nurses.

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New Registered Nurses Regulations

Profession-specific regulations for registered nurses bring the profession under the RHPA came into force effective May 31, 2018. The Registered Nurses Act has been repealed. The new regulations define the scope of practice of the profession, including the reserved acts that nurses may perform. The legislation creates a new designation of registered nursing – the "authorized prescriber" [RN(AP)]. These nurses are authorized to independently perform the reserved acts of ordering diagnostic tests and prescribing medications for patient populations that require registered nursing care in the areas of diabetes health; travel health; reproductive health; and sexually transmitted infections and blood borne pathogens.

In 2015, public consultations were undertaken on the regulations as required under the RHPA. As a result of the feedback received in the consultations, a panel made up of respected leaders of the medical and nursing professions was established to provide advice to assist in the finalization of the reserved acts for registered nurses. The panel reviewed issues raised through the consultation process and consulted with key stakeholders, including regional health authorities, the College of Registered Nurses of Manitoba, the College of Physicians and Surgeons of Manitoba, physician and nurse stakeholders and labour organizations. The panel's report to the Minister confirmed the reserved acts were appropriate for the registered nursing profession and those of its recommendations that relate to the regulations are reflected in the regulations. View the report here.PDF (Please note that Appendix A of the report has been removed to comply with The Freedom of Information and Personal Privacy Act regarding the privacy of individual persons who appeared at meetings with the Panel.)

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News Release:

Minister Receives Report on Health Professions Advisory Council Review of the Performance of "High Neck Manipulation" by Regulated Health Professionals

The Health Professions Advisory Council has completed its review of the performance of “high neck manipulation” by regulated health professionals and submitted its report to the Minister of Health. 

The Council found that:

On the whole, the material provided to the Council does not generate sufficiently definitive or conclusive evidence which would lead to a prohibition of the performance by regulated health professionals of “high neck manipulation” as part of the larger Reserved Act. The evidence does indicate, however, that the performance of “high neck manipulation” or cervical spine manipulation does present a risk of harm to patients. This risk of harm must be understood by both the patient and the practitioner.

Both the jurisprudence review and the research literature review point to the need for the following actions to mitigate the risk of harm associated with the performance of cervical spine manipulation:

  • Action One: Ensure that the patient provides written informed consent prior to initiating treatment which includes a discussion about the risk associated with cervical spine manipulation.
  • Action Two: Provide patients with information to assist in the early recognition of a serious adverse event.

The Minister has accepted the Council’s findings.

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Province Receives Stakeholder Consultation Report on Paramedic Self-Regulation

Stakeholder consultations on the self-regulation of the paramedic profession are complete and the province has received the report from the consultant, Reg Toews.

To view the report, please click here.PDF