17 Jan 2023
Revised proposals have tightened requirements around the provision of physical examination as college officials argued their plans offer a “more robust framework” for the professions.
Allister Webb
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The RCVS has published revised proposals to its “under care” guidance for veterinary professionals ahead of a key meeting later this week.
The main change requires vets to have facilities for 24-hour physical examination or premises visits available, even if they do not provide them themselves.
Previous proposals had only required the provision of a follow-up service in the event that an animal’s condition does not improve or it suffers an adverse reaction.
But papers published ahead of a council meeting, where the issue is due to be discussed this Thursday (19 January), said the college’s standards committee had responded to consultation findings when it reconsidered the issue in the autumn.
The report said: “Many of the concerns voiced stemmed from a worry that the changes would result in POM-V medicines being prescribed by veterinary surgeons with no facility to physically examine the animal or inspect the premises.
“This has the potential to compromise animal welfare, as other veterinary surgeons who do have the facility and proximity to physically examine the animal and/or inspect the premises would be put under pressure to treat the animals in question when they may not have capacity to do so.
“Whilst the [standards] committee agreed that the proposed guidance consulted upon did address this concern by making it a requirement to have 24/7 in-person follow up care in instances where POM-Vs were prescribed remotely, it recognised that when embarking on a remote consultation, the veterinary surgeon does not always know what they will face.”
It added: “Whilst this represents a change to the draft guidance presented in the consultation, the committee decided that it can be justified.”
The proposed guidance argues that a physical examination may not be necessary in every case to enable safe treatment and prescription, and the issue would be one of individual veterinary judgement depending on the circumstances.
But it said a physical assessment would still be required when a notifiable disease is suspected and in all but exceptional circumstances when antimicrobials are prescribed to individual animals or groups of non-agricultural animals.
Many opponents of the college’s stance, including the BVA, have advocated adoption of the vet-client-patient relationship model, with an appropriate longstop point of up to a year, as a basis for future guidance.
But the papers claimed that would go beyond the terms of the current Veterinary Medicines Regulations, though a review consultation is expected to be launched imminently.
The college also suggested its proposals offered a “more robust framework” for remote prescription decisions.
The report said: “Under the current guidance, once an animal is under a veterinary surgeon’s care, there is no additional guidance on prescribing remotely and the factors to be taken into account when deciding whether this is appropriate or not.
“By way of contrast, the proposed guidance not only gives a framework, but also gives specific guidance on prescribing antimicrobials and controlled drugs, which those applying pressure can be directed to should the veterinary surgeon feel it necessary.”
More than 2,700 professionals took part in a consultation on the proposals, with the report indicating strong agreement with many of its key points.
A separate survey of animal owners, carried out by the polling organisation YouGov, found 66% of respondents were either very or fairly comfortable with remote prescription, though the proportion was slightly lower for pet owners (64%) than their equine counterparts (72%).
Fear of misdiagnosis was the main reason given by respondents who declared themselves uncomfortable with the idea.
