Veterinary under care and 24/7 emergency care review

Closeup of doctor pouring eyedrops in dog's eye at veterinary clinic, photo by moodboard/Adobe Stock

Veterinarians in the UK sometimes differ on how the business of providing care should be regulated. The differences often come down to the practicalities and consequences of implementing regulations, which RCVS wants to help clarify.

What is the issue?

Changes in technology, organisational structures and practices, patterns of animal ownership, the expectations of animal owners and the wider public, and the pandemic have all contributed to an increasingly complex environment for veterinary practice. These developments raise questions concerning core aspects of the existing regulations and guidelines, including what it means for an animal to be ‘under care’ of a veterinary surgeon, and professional obligations for providing out-of-hours care.

How did we help?

The aim of this study was to collect evidence to support the review of the regulations and guidance RCVS, the Royal College of Veterinary Surgeons, should offer in relation to ‘under care’ and out-of-hours care. The research gathered information from members across the veterinary profession, using focus group discussions, in-depth interviews with key veterinary stakeholder organisations, and from a large-scale quantitative survey.

What did we find?

The research provides clear guidance regarding the attitudes and expectations of veterinary professionals towards the regulation of ‘under care’ and out-of-hours care. It identifies a shared common core of vets’ attitudes towards ‘under care’ and out-of-hours care, along with an expectation that regulations should reflect these values.

However, when asked to apply these values to specific cases, and when asked how they might handle tensions between them, there are nuances and differences that appear that are relevant to any consideration of future regulations. The report shows how these differences reflect the professional background and experience of vets with age, size of practice, type of practice and geographical location all being relevant.

When prompted to comment on why they hold differing views, the responses were often related to practicalities rather than principles; for example, the reasons offered for preferring that regulation should require physical examination prior to any diagnosis or treatment rather than allow other sources of evidence in addition show that all vets agree on the need for complete, recent and relevant evidence but differ about how in practice to best ensure this is available. We believe that this suggests that some differences are more apparent than real and reflect a different understanding of how regulations might work in practice

What should RCVS consider?

An approach to improving regulation which starts with a focus on the core activities of veterinary practice – the immediate care of patients – should gain wide agreement.

Many important differences concerning how the business of providing care should be regulated come down to the practicalities and consequences of implementing regulations. Greater attention might need to be given to explaining not only what is ‘right’, but also what is practicable (including unintended consequences). It is not possible to defend regulations that do not deliver the intended benefits or that cause unintended harm.

There remain differences that are not linked to practicalities where the discussion within the profession appears to be ‘unanchored’ and where leadership from the profession may be needed to establish what ‘good regulation’ looks like.

There were a small number of instances where the profession appears to hold inconsistent views. This may be another area where more propositional leadership within the profession could help build consensus. In the short run, however, regulators may need to take an approach which is not based on a consistent and fixed view from the profession.

This report also identifies ways in which communications with the profession on these issues might be targeted – showing what are common concerns, but also revealing how different groups of professionals have different attitudes.