Personal support workers (PSWs) are frontline health care workers who provide a wide range of services, including assistance with the activities of daily living (ADLs) involving self-care activities, support with the instrumental activities of daily living (IADLs), such as house-keeping and managing finances, clinical care services, and acts delegated by supervising health professionals. In May 2011, in response to the growing role of PSWs in the delivery of health care services in Ontario, Canada, the Ontario Ministry of Health and Long-Term Care (MOHLTC) announced the creation of a registry for PSWs. The registry was subsequently opened for operation in June 2012.
The Ontario PSW Registry is one of a few similar registries in Canada (each province has jurisdiction over its health care workforce); similar registries have been implemented in British Columbia and Nova Scotia. Currently, the Ontario registry collects PSW contact information, information on education and training, and basic demographic information. The registry is also accessible to employers and to clients, families and caregivers who can use the registry to verify PSW registration status. Currently, registration is voluntary, but intended to be mandatory for all PSWs employed by publicly funded health care employers, starting with the home care sector.
The registry has a number of stated objectives: 1) to better highlight the work that PSWs do in Ontario; 2) to offer a platform for PSWs and employers of PSWs to more easily access the labour market; and 3) to provide government with the ability to track PSW information for human resource planning. Several contextual factors moved the creation of a PSW registry onto the formal government policy agenda: the increasing role and importance of the home and community care sector, where PSWs provide the majority of paid home care; the changing demands of an aging population, who prefer to age at home; and concerns about health system sustainability.
Reductions in the quantity of care delivered in institutional settings and shorter lengths of stay in hospitals have meant more persons with complex conditions are being discharged to the community, placing additional burden on community-based PSWs. This has exacerbated existing concerns about educational and employment standards, and public safety. The MOHLTC has stated that the registry will not act as a complaints body, but will establish a process for "reviewing, suspending or terminating PSWs' registration" to protect public safety. However, this process has not yet been established.
The registry is widely supported by PSWs and employer advocacy groups; however, it has been opposed by labour unions that suggest the registry does not address larger system issues (e.g., lack of standards in the home care sector and for training and education).
For an analysis of this reform, see: https://escarpmentpress.org/hro-ors/article/view/1181