Concerns over ‘inappropriate prescribing’ after ‘under care’ vote

One of the UK’s biggest veterinary companies has warned new “under care” guidance does not go far enough to prevent the emergence of “inappropriate prescribing behaviours”.

The RCVS said the measures, which were approved last month, will be monitored and could be the subject of a future review.

But, although it acknowledged some of the profession’s concerns had been addressed, the CVS Group said questions remain about how breaches of the updated guidance on remote prescribing will be resolved.

The comments come after the company warned in its consultation response to the original proposals that present RCVS structures would be “insufficient” to maintain animal welfare and public confidence.

Protection

In a statement, the group called for “further guidance and legislative developments to protect our professional responsibilities”.

It continued: “We remain concerned that the updated guidance does not address the regulatory challenges we identified around the detection and reporting of inappropriate prescribing behaviours that may be detrimental to the public interest in the reputation of our profession.

“We urge the RCVS to continue to review this process and we would welcome the opportunity to contribute to future consultations to ensure legislative reform appropriately protects our professional responsibilities.”

Open to review

An RCVS spokesperson said: “As with any of our guidance, it remains open to review in the future.

“For the time being, we will be monitoring the impact of the under care guidance changes via enquiries coming through to our advice team and taking note of any concerns raised, and will, of course, also consider any feedback we might receive from stakeholders.”

Revised measures – including a requirement for vets to have 24-hour physical examination and premises visit provision available before taking an animal under their care – were approved by RCVS council in January.

But, while it welcomed the changes made following the consultation process, CVS also endorsed the views of bodies such as the BVA in advocating adoption of the vet-client-patient relationship (VCPR) model. Although the college argued the model would impose requirements beyond those contained in the current Veterinary Medicines Regulations (VMRs), the company said it would remain at the heart of its own work.

Listened to

The group said: “We recognise that the RCVS has listened to and considered much of our profession’s concerns in the recently approved amended guidance.

“It is reassuring that the requirement to physically examine a patient remains a key part of taking an animal under your care as a veterinary surgeon.

“However, we believe that inclusion of the stronger concept of the VCPR would enable the guidance to better serve clients and protect animal welfare.”

VCPR

Similar concerns about the rejection of the VCPR model were raised by VetPartners, which told Vet Times its view of the issue had not changed following the January council decision.

But while another large care provider, IVC Evidensia, said its view was also unchanged by the revisions, it expressed greater optimism as it argued the reported health condition was key to an individual vet’s judgement on the question of conducting a physical examination.

It said: “Experience throughout the pandemic and in other jurisdictions strongly suggest veterinary surgeons recommend physical examinations in a very high proportion of patients where prescriptions are required.

“This professionalism and overall attitude to risk suggests that should the consultation be implemented, animal welfare will be maintained, while veterinary surgeons will have the ability to make a nuanced judgement and not to perform a physical examination if they judge on balance that the welfare to the patient is better met this way.”

Review

The revised under care guidance is due to be implemented at some point between the beginning of June and the end of this year, subject to a further review at the next council meeting in mid-March.

But the BVA has led calls for that to be delayed further while a review of the VMRs, for which a consultation process has now begun, is completed.