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RCVS Council Approves New ‘under Care’ And Out-of-hours Service Guidance
1 year ago 
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Following a wide-ranging, lengthy and comprehensive review, the Council of the Royal College of Veterinary Surgeons (RCVS) yesterday [Thursday 19 January 2023] approved new guidance on the interpretation and application of an animal being under the care of a veterinary surgeon, and the provision of 24/7 emergency cover, ensuring that it protects animal health and welfare and complies with legislation.
The new guidance, which will come into effect later this year, was approved by a majority of RCVS Council members (20 for and three against – see Note to Editors 2) at its meeting on Thursday 19 January 2023, held at the University of Nottingham School of Veterinary Medicine. It follows an extensive review process including consultations with the veterinary professions, animal-owning public and sector stakeholders, legal advice and independent research. The final 10-week consultation was launched last July and was accompanied by a survey conducted with a sample set of 2,000 UK animal owners via the polling company YouGov as well as outreach with stakeholders in the agricultural/ livestock sectors.
The new guidance contains a number of safeguards to protect animal health and welfare and maintain public trust by ensuring that decision-making remains firmly in the hands of individual veterinary surgeons, as to what they, in their professional judgement, consider appropriate in a specific situation. A number of these safeguards were updated following feedback from the consultations and include those that:
- require that veterinary surgeons who have taken animals under their care should have the facility available to physically examine the animal and/or visit the premises of animals under their care. Where a veterinary surgeon is not able to provide this themselves they should have a written agreement in place, agreed in advance with another provider to undertake this service;
- require that veterinary surgeons should be prepared to carry out, within an appropriate timeframe, any necessary investigation in the event that the animal does not improve, suffers an adverse reaction or deteriorates;
- provide guidance on what veterinary surgeons should consider in relation to deciding whether they should undertake a physical examination before prescribing POM-Vs;
- require veterinary surgeons to carry out a physical examination where notifiable diseases are suspected, and when prescribing antimicrobials (as defined by the World Health Organisation to include antibiotics, antivirals, antifungals and antiparasitics) and controlled drugs unless there are exceptional circumstances.
The Under Care Review was launched in 2019, although its progress was delayed by the pandemic, and grew out of the joint RCVS and British Veterinary Association (BVA) Vet Futures project, including discussions about the future of telemedicine and remote prescribing within the veterinary sphere, as well as a recognition that the current guidance is not applied in a number of situations. In addition, legal advice provided to the RCVS stated that the College’s then interpretation of the terms ‘clinical assessment’ and ‘under care’ was problematic.
As a result of the evidence and information gathered through the review, including legitimate concerns and comments raised via the consultation process, proposals were put forward that ‘under care’ involved a veterinary surgeon being given and accepting responsibility for an animal and that a ‘clinical assessment’ should be interpreted as including both in-person and remote assessments. The key being that a clinical assessment should provide veterinary surgeons with sufficient information to be able to prescribe prescription-only veterinary medicines (POM-Vs) safely and effectively. According to the proposals, the issue of whether a physical examination is necessary should be a matter of judgement for the veterinary surgeon in each individual case, bearing in mind a number of factors. In terms of the review of the RCVS guidance on providing out-of-hours care, the guidance from the RCVS for veterinary practices, including advice-only services, remains the same. For limited service providers, the requirements for out-of-hours care also remain the same, albeit with some additional wording defining limited service providers.
The approach, which has now been approved by RCVS Council, is consistent with the legal advice and has significant safeguards to ensure that animal health and welfare remains the utmost priority.
Melissa Donald, RCVS President, who was Chair of the Standards Committee during much of the Under Care Review process, said: “This has been a long journey and I thank all my colleagues on the RCVS Standards Committee, the RCVS Registrar Eleanor Ferguson and her team in the RCVS Standards & Advice Department as well as the research team within the RCVS and the external research agencies for all their hard work on this process. I would also like to thank all the individual members of the veterinary team, the veterinary organisations and the members of the public who took the time to get involved in this complex process.
“While we understand that not everybody will be happy with this outcome, I would like to provide reassurance that many, many hours of thought and consideration have been put into how it will affect veterinary practitioners across all sectors, and animal health and welfare on the ground, while ensuring that the guidance is legally sound and consistent with the current legislation.”
Due to the fact that the Veterinary Medicines Directorate has stated its imminent intention to carry out a consultation and review of the Veterinary Medicines Regulations (VMRs), RCVS Council also decided that the new guidance will be implemented no earlier than 1 June 2023, and no later than 31 December 2023. These dates will be subject to a final review at Council’s March 2023 meeting.
Linda Belton, Chair of Standards Committee, added: “We are keen that we to help the profession better understand the guidance and its impact ahead of its implementation. Therefore, we will be using this intervening time to prepare additional case studies, FAQs, advice and learning materials to help veterinary professionals understand how the new guidance should be followed within their sectors. We also look forward to working with the British Veterinary Association and any other veterinary organisations to ensure their advice and resources are consistent with this new guidance. In the meantime, those with any questions about the new guidance should email [email protected].”
Further information about the College’s additional case studies and resources will be available in due course. Further details about the Under Care Review, including explainers and supporting documents, can be found at www.rcvs.org.uk/undercare, including a full report on the results of the final consultation process.
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