Shaping the Future of Respiratory Therapy: Scope of Practice Proposal Update

One of the RTSO’s strategic priorities is to advocate for the advancement of the respiratory therapy profession in Ontario. We are pleased to provide an update on an important initiative that has the potential to influence the future of respiratory therapy practice across the province.

In October 2023, the Ontario Ministry of Health introduced a new process for regulated health professions to submit proposals for changes to their scope of practice. Recognizing the significance of this opportunity, the RTSO Board of Directors, in collaboration with the CRTO, took action to help shape the future of respiratory therapy practice in Ontario.

Since that time, considerable work has been undertaken to develop a comprehensive proposal that reflects the evolving needs of patients, healthcare systems, and the respiratory therapy profession. A critical component of this work was engaging with our members to better understand the challenges, opportunities, and priorities within practice.

We would like to sincerely thank everyone who participated in our surveys and consultations. Your insights, experiences, and thoughtful suggestions have played a vital role in shaping the proposal. The strength of member engagement has helped ensure that the submission is grounded in the realities of clinical practice and positioned effectively within ongoing policy discussions.

While the review process continues, the proposal has helped establish a strong foundation for future discussions about how RTs can continue to contribute to accessible, high-quality patient care across Ontario.

We will continue to keep members informed as this work progresses through its next stages and look forward to sharing further updates in the months ahead.

Proposal Overview
1. Updating the Profession’s Scope of Practice Statement

Current

The practice of respiratory therapy is the providing of oxygen therapy, cardio-respiratory equipment monitoring, and the assessment and treatment of cardio-respiratory and associated disorders to maintain or restore ventilation (s.3, RTA).

Proposed

The practice of respiratory therapy is the assessment, treatment, monitoring, maintenance, and prevention of cardiorespiratory and associated disorders.

Rationale

  • Greater flexibility for evolving practice
  • Legislative consistency across regulated health professions
  • Clearer interpretation for employers, patients, and interprofessional teams
  • Reduced need for future legislative amendments

2. Authorizing Targeted Controlled Acts

a. Applying a Prescribed Form of Energy (e.g., diagnostic ultrasound, defibrillation, cardioversion, nerve conduction studies)

Rationale

  • Energy-based technologies are now core to respiratory therapy practice
  • Reflects modern clinical realities in assessment and treatment

b. Performing Tracheostomy Tube Changes

Rationale

  • Restores authority previously impacted by regulatory changes
  • Enables delegation and clarifies scope (reinsertion vs. insertion)
  • Protects continuity and safety of patient care

c. Allergy Challenge Testing

Rationale

  • Aligns with RT expertise in bronchoprovocation testing
  • Improves access, reduces wait times, and enhances system efficiency

3. Granting Limited Prescribing Authority

Scope includes:

  • Oxygen
  • Inhaled respiratory medications (e.g., bronchodilators, corticosteroids, biologics)

Rationale

  • Aligns with existing education and clinical competencies
  • Supports timely, patient-centered care

4. Granting Limited Ordering Authority

a. Ordering Chest X-rays

Rationale

  • Enables faster diagnostic decision-making
  • Supports RTs’ frontline role in patient deterioration

b. Ordering Ventilation (initiation, titration, discontinuation)

Rationale

  • Reflects RT specialization in ventilation management
  • Reduces delays and improves patient outcomes

5. Establishing an Advanced Practice RT – Anesthesia Assistant Role (APRT/AA)

Rationale

  • Clarifies scope and competency expectations
  • Enhances patient safety and system transparency
  • Aligns with regulatory approaches in other professions
Progress to Date

Phase 1

March 19, 2025

Formal notification submitted to the Ministry of Health (MOH) of intent to submit a proposal.

Phase 2

April 14, 2026

Proposal formally submitted to the MOH.

May 6, 2026

Initial meeting with the Manager of Health Workforce Regulatory Oversight Branch.

May 21, 2026

Presentation at:

  • CSRT Conference
  • National Alliance of Respiratory Therapy Regulatory Bodies (NARTRB)

May 28, 2026

Meeting with Ministry of Health leadership. (Chief of Staff, Senior Policy Advisor & Senior Stakeholder and Caucus Relations Advisor).

June 1, 2026

Meeting with Liberal Opposition MPP (Critic for Training, Colleges and Universities & Long-Term Care).

June 4, 2026

Meeting with the Office of the Premier (Deputy Director of Health Policy).

Phase 3 – To be determined

Following the Ministry’s review and analysis of the proposal, the assigned policy advisor will communicate the Ministry’s decision regarding whether the proposal will proceed to Phase 3 of the process, which involves the Regulatory Submission and focuses on broader consultation and jurisdictional comparison, including consideration of labour mobility implications and alignment with practices across other jurisdictions.