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14 Aug 2023

‘Under-prepared’ – vets brace for new guidance

Many vets still feel confused and under-prepared for implementation of the profession’s new “under care” guidance, only weeks before it comes into force, the BVA has warned.

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Allister Webb

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Many vets still feel confused and under-prepared for implementation of the profession’s new “under care” guidance, only weeks before it comes into force, the BVA has warned.

The claim was made after the RCVS confirmed it is making further changes to the guidance – specifically around the prescription of antibiotics – in response to professional feedback.

But while it has welcomed that move, the BVA said its view of the guidance as a whole was “largely unchanged”. Its president, Malcolm Morley, said the group was “seriously concerned about reports of widespread confusion across the profession” about the impact of the guidance on practising vets.

He said: “While the latest RCVS webinar provides useful interpretation of the guidance, many vets still feel inadequately prepared and overwhelmed by its complexity.”

Webinars

Details of the fresh considerations were outlined in the latest of two webinars hosted by senior college officials ahead of the implementation of the new guidance from 1 September.

The current agreed guidance requires a physical examination “in all but exceptional circumstances” when antibiotics, antifungals, antiparasitics or antivirals are prescribed to animals that are neither production, farmed aquatics or game.

The webinar, held on 17 July, was told the amended guidance would require a physical examination in all instances where such drugs are prescribed to non-production animals.

But it would also enable prescriptions to be made on the basis of test results taken at around the same time as the physical examination, or by vets who have access to test results or the findings of a physical examination carried out by a colleague.

The college’s junior vice-president, Linda Belton, argued the changes would help to address both broader ecological concerns about the profession’s work and one of the key reservations held by opponents of the college’s reforms.

She said: “The whole rationale around this is around getting good veterinary oversight around the prescribing of medicines where there is the potential for resistance development or environmental contamination. What we’re trying to really build here is effectively a VCPR [vet-client-patient relationship]. We’re not looking for a form to fill in or a box to tick, and it’s not something that can look forwards. It’s in the moment. It’s each and every time we prescribe.”

A college spokesperson later told Vet Times: “The concept, as described in July’s webinar regarding antimicrobials in non-production animals, has been agreed by the RCVS standards committee; the precise wording remains to be agreed and will be released shortly.”

Revised guidelines

The RCVS spokesperson added that the revised guidance would be ready “in time for” 1 September.

Dr Morley said the BVA was “pleased” by the antibiotic commitment and looked forward to further details in due course.

But he added the BVA had been “surprised” by the VCPR assertion because of the college’s persistent rejection of the concept during debates on how the guidance should be reformed.

He added: “As it stands, the guidance does not serve the best interests of animal welfare, access to veterinary services or the veterinary profession.

“Our position remains that the RCVS should have formally adopted the concept of the VCPR in the new guidance and defined it in a way that is fit for purpose now and in the future.”

Safeguards

However, speaking during the latest webinar, senior vice-president Melissa Donald said the rules offered safeguards against both AMR and the misuse of controlled drugs, as well as making allowances for technological advances.

She said: “Developing the guidance has been far from easy, but we believe it not only protects animal health and welfare, but also maintains public trust by ensuring the decision-making remains firmly in the hands of individual veterinary surgeons and works for all sections of the profession.”

Miss Belton also insisted that “sensible” decision-making would be accepted where vets sought to justify decisions taken in exceptional circumstances.

The issue has been another of the major areas of concern surrounding implementation of the new guidance. A number of example scenarios have been published by the college to help vets adjust to the new rules.