RCVS Review of “Under Care” and 24/7 Emergency Cover

A Response from the Veterinary Management Group

Introduction

The Veterinary Management Group (VMG) is the professional association for all those in leadership and management roles in the veterinary sector. We aim to empower and equip people and practices to learn, share and grow. Our membership represents a wide range of roles, including Practice Managers, Clinical Directors, Head Nurses, Partners, Area Managers, Regional Directors and much more; organisations from single-handed practices to multi-disciplinary referral hospitals; and charity, independent and corporate ownership.

VMG welcomes the opportunity to respond to this consultation in a crucial area of practice. As a non-clinical representative body, we have focused our research and report on the provision of 24- hour veterinary services (rather than questions around when a veterinary surgeon should or should not be permitted to prescribe POM-Vs).

General views on 24-hour provision

VMG agrees that the current general obligation for veterinary practices to make provision for 24- hour emergency first aid and pain relief is the best approach.

However, it is recognised that practices running their own out-of-hours provision face additional recruitment challenges on top of the existing shortage of qualified staff. There is a risk of creating (or reinforcing) a two-tier system where some practices chose to work only ‘office hours’, leaving those who feel a moral obligation to provide their own 24-hour service having to pick up the more challenging out-of-hours work – especially if neighbouring practices outsource to a more distant provider. This is a significant ethical predicament for those working in a welfare-focussed profession.

Another significant challenge is that of client understanding what ‘first aid and pain relief’ actually means, and balancing client demands with the need for veterinary staff to maintain healthy working habits. Owner education should focus on what to expect from out-of-hours services; and, in particular, there should be a requirement for all practices to clearly state to their clients what their arrangements are for 24-hour provision.

Some members suggested that there should be a guideline for the minimum distance (in terms of travelling time) within which 24/7 provision must be available from an animal welfare perspective; although it is acknowledged that this would be impossible in more remote areas.

Limited service providers

VMG believes that limited service providers (such as vaccination/neutering clinics, or equine reproduction practices) should make provision for 24-hour emergency cover proportionate to the services they provide, including adverse reactions or complications.

Similarly to the above, such providers should be obliged to clearly inform all clients of their arrangements for such cover, and clearly state if this is outsourced. Clear arrangements should be in place for the prompt transfer of clinical notes to or from providers.

Advice-only services

VMG believes that vets providing advice-only services should not be obliged to make provision for 24-hour emergency first aid and pain relief if they are providing only general advice and not carrying out remote consultations or dispensing medication.

Referral services

VMG believes that vets providing referral services should be obliged to make provision for 24-hour service availability; although it is acknowledged that this may not always be Specialist-led outside of normal working hours. All vets should be obliged to provide 24-hour emergency first aid and pain relief, which could be provided by a primary vet in a referral relationship. However, referral-level advice should always be available to the referring vet by phone (or similar immediate means) out-of- hours; and clear arrangements should be in place for the prompt transfer of clinical notes from the referral provider to the primary vet.

VMG, September 2022

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