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Memo for NPs re: MSP Referrals

Linked below please find a memo regarding the removal of the MSP List for NP Referrals.

This change will allow NPs to refer to all specialists and for all tests that are within NP scope of practice reducing rejections from MSP substantially. The Ministry of Health website has been updated to reflect these changes. If there are any circumstances in which you find practice barriers related to the prior MSP List for NP Referrals please send that information to Fiona Hutchison (Fiona.hutchison@gov.bc.ca) who will follow up to ensure they have received the memo.

At Home Program (AHP) Guide Revisions

As of November 16, 2018 Nurse Practitioners will now have the ability to refer children for AHP Assessments and will be able to request equipment, supplies and therapies for eligible children.

Read the updated guide by going to:  At Home Program Guide (PDF).

Changes under the Laboratory Services Act (LSA)

Two decisions were made recently under the Laboratory Services Act (LSA) by the Ministry of Health for the following items:
  • LSA2017-034: Antinuclear Antibodies Testing (ANA), and
  • LSA2017-039: Chlamydia and Gonnorhea testing using Nucleic Acid Amplification Test (NAAT) for specimens collected by swabs.
A summary of these decisions can be found on the Laboratory Services website.

If you require any further information on this decision, please make a request to Laboratory Services at labservices@gov.bc.ca.

Thyroid Function Testing in the Diagnosis and Monitoring of Thyroid Function Disorder 2018

New BC Guidelines announcement (www.bcguidelines.ca)

Key changes to the 2010 guideline include:
  1. A laboratory algorithm which outlines changes to thyroid test ordering. If central hypothyroidism is being investigated "suspicion of pituitary insufficiency" should be included as a clinical indication and a request for fT4 (with or without TSH) should be indicated in the space provided on the standard out-patient laboratory requisition.

  2. Thyroid function test reports will include additional information. Laboratories in BC will be reporting trimester specific reference intervals as an appended comment on all women of child bearing age.

Read the updated guideline by going to: https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/thyroid-testing

New BC Guidelines announcement for C-Reactive Protein and Erythrocyte Sedimentation Rate Testing

The C-Reactive Protein and Erythrocyte Sedimentation Rate Testing guideline includes recommendations for the use of CRP and ESR as investigative tests in adults in primary care. Select Key Recommendations include (see full recommendation list):
  • CRP is the preferred first test to support a diagnosis of inflammatory or infectious conditions, rather than ESR. There is no indication for ordering ESR when CRP is elevated.
  • According to the British Columbia Laboratory Services Outpatient Payment Schedule, ESR will be performed only if a written indication is provided on the requisition. If CRP and ESR are ordered together, most outpatient laboratories will only perform CRP because only CRP is payable.
  • Clinical features that together may prompt a requisition for CRP are:
    1. unexplained symptoms or a deterioration of health status; and
    2. an inflammatory or infectious disease is suspected; and
    3. a specific diagnosis is not made effectively by other means.
BC Guidelines



Disability Tax Credit

The NP council of NNPBC would like to thank Diane Middagh and Michelle Sims for their contribution in putting together "A Nurse Practitioner Resource Guide To the Disability Tax Credit."

BCCNP scope of practice info on cannabinoid prescribing

"Cannabis, its preparations, and derivatives a. Nurse practitioners do not prescribe or issue a medical document for fresh or dried marihuana or cannabis oil. Note: NPs have full prescribing authority for synthetic cannabinoids (e.g. nabilone). Nurse practitioners who prescribe synthetic cannabinoids must meet the BCCNP standards, limits and conditions for prescribing controlled drugs and substances."

For additional information, please also refer to the following clinical practice guideline from Canadian Family Physician.