Promoting & sustaining
public confidence
in veterinary medicine
public confidence
in veterinary medicine
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Promoting & sustaining
public confidence in veterinary medicine |
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1. Accessibility, accountability and transparency are expected of every self regulating profession. All legislation governing the various professions is designed to meet these requirements and to protect the public interest by ensuring a high level of education and training combined with personal and professional integrity. The Veterinary Surgeons Act 1966 which governs the veterinary profession is no exception.
2. Rights and responsibilities go hand in hand. For this reason on admission to membership of the Royal College of Veterinary Surgeons, and in exchange for the right to practise veterinary surgery in the United Kingdom, every veterinary surgeon makes the following declaration:
"Inasmuch as the privilege of membership of the Royal College of Veterinary Surgeons is about to be conferred upon me I PROMISE AND SOLEMNLY DECLARE that I will abide in all due loyalty to the Royal College of Veterinary Surgeons and will do all in my power to maintain and promote its interests.
"I PROMISE above all that I will pursue the work of my profession with uprightness of conduct and that my constant endeavour will be to ensure the welfare of the animals committed to my care."
3. These promises acknowledge the obligation of every veterinary surgeon to observe the provisions of the current RCVS Guide to Professional Conduct, and in so doing to make animal welfare their overriding consideration at all times.
1. Your clients are entitled to expect that you will:
a. make animal welfare your first consideration in seeking to provide the most appropriate attention for animals committed to your care
b. ensure that all animals under your care are treated humanely and with respect
c. maintain and continue to develop your professional knowledge and skills
d. foster and maintain a good relationship with your clients, earning their trust, respecting their views and protecting client confidentiality
e. uphold the good reputation of the veterinary profession
f. ensure the integrity of veterinary certification
g. foster and endeavour to maintain good relationships with your professional colleagues
h. understand and comply with your legal obligations in relation to the prescription, safe-keeping and supply of veterinary medicinal products
i. familiarise yourself with and observe the relevant legislation in relation to veterinary surgeons as individual members of the profession, employers, employees and business owners
j. respond promptly, fully and courteously to complaints and criticism
(Patient, in this context, means any animal under the care of a veterinary surgeon acting in his or her professional capacity)
1. A veterinary surgeon must:
a. treat all patients of whatever species, humanely, with respect, and with welfare as the primary consideration
b. if in practice, take steps to provide 24-hour emergency cover for the care of animals of those species treated by the practice during normal working hours.
This applies equally to veterinary surgeons working in:
i. charities providing veterinary services
ii. neutering and vaccination clinics and other limited service providers (see Part 2E - Running the Business - Limited Service Providers) and
iii. referral practices (see Part 2D - Maintaining Practice Standards - 24-hour Emergency Cover), including those in universities
Emergency cover means, at least, immediate first aid and pain relief.
With prior arrangement, preferably confirmed in writing, 24-hour emergency cover may be provided by, or in conjunction with, one or more other veterinary practices.
c. when on duty providing 24-hour emergency cover:
i. not unreasonably refuse to provide first aid and pain relief for any animal of a species treated by the practice during normal working hours
ii. not unreasonably refuse to provide first aid and facilitate the provision of pain relief for all other species until such time as a more appropriate emergency veterinary service accepts responsibility for the animal
iii. not unreasonably refuse to accept responsibility for an animal from a colleague, in order to provide first aid and pain relief for that animal
Clients of another practice may be directed to their own practice, at least in the first instance.
Whether attendance away from the practice premises is essential, or not, is the decision of the on-duty veterinary surgeon taking into account the needs of the animal and the relevant health and safety issues (see Annex 3A, '24-hour emergency cover')
d. having reached a provisional diagnosis taking into account the animal's age, the extent of any injuries or disease and the likely quality of life after treatment, make a full and realistic assessment of the prognosis and the options for treatment or euthanasia based on welfare considerations
e. if the owner cannot afford private treatment and may be eligible for charitable assistance, re-direct the animal for further treatment to a charity where possible, supplying full details of the case in the proper manner
f. maintain proper standards in practice premises and equipment, and in relation to inpatient care and supervision
g. prescribe medicinal products responsibly
h. a veterinary surgeon must not cause any patient to suffer
i. by carrying out any unnecessary mutilation
ii. by excessive restraint or discipline
iii. by failing to maintain adequate pain control and relief of suffering
iv. by neglect
(Your client in this context is the person who requests your professional services for an animal)
1. The provision of veterinary services creates a contractual relationship under which the veterinary surgeon should:
a. ensure that clear written information is provided about practice arrangements, including the provision, initial cost and location of the out-of-hours emergency service, and information on the care of in-patients
b. take all reasonable care in using their professional skills to treat patients
c. keep their skills and knowledge up to date
d. keep within their own areas of competence save for the requirement to provide emergency first aid
e. maintain clear, accurate and comprehensive case records and accounts
f. ensure that a range of reasonable treatment options are offered and explained, including prognoses and possible side effects
g. give realistic fee estimates based on treatment options
h. keep the client informed of progress, and of any escalation in costs once treatment has started
i. obtain the client's consent to treatment unless delay would adversely affect the animal's welfare (to give informed consent, clients must be aware of risks) (see Annex 3E, 'Consent forms specimens')
j. ensure that all staff are properly trained and supervised where appropriate
k. ensure that the client is made aware of any procedures to be performed by support staff who are not veterinary surgeons (see Part 2F, 'Treatment of animals by non-veterinary surgeons')
l. recognise that the client has freedom of choice.
2. The professional/client relationship is one of mutual trust and respect, under which a veterinary surgeon must:
a. maintain client confidentiality
b. treat the client with respect, and observe professional courtesies
c. avoid conflicts of interest
d. give due consideration to the client's concerns and wishes where these do not conflict with the patient's welfare
e. provide fully itemised accounts if requested.
3. Veterinary surgeons must ensure that all their professional activities are covered by professional indemnity insurance or equivalent arrangements. Such cover may be held individually or through an employer.
4. Veterinary surgeons must continue their professional education by keeping up to date with the general developments in veterinary science, particularly in their area of professional activity and must maintain a record of CPD undertaken as evidence of so doing.
5. Employers should encourage and facilitate participation in CPD programmes.
6. New graduates must be supported and assisted by senior colleagues until they are confident of their own ability to provide a full professional service. It is strongly recommended that employers of new graduates support their continued development through an appropriate appraisal system, to enable them to complete the RCVS Professional Development Phase (PDP).
7. Those returning to practice, or changing direction, must undertake appropriate training to ensure that they are competent to do so.
8. Veterinary surgeons must:
a. ensure clients are able to obtain prescriptions, as appropriate
(A veterinary surgeon may prescribe a medicine of category Prescription Only Medicine, Veterinarian, [POM-V] only following a clinical assessment of an animal under his or her care; a prescription may not be appropriate if the animal is an in-patient or immediate treatment is necessary.)b. subject to any legal restrictions, ensure there is adequate provision of information on medicine prices, including the current prices for the ten relevant veterinary medicinal products (see paragraph 10) most commonly prescribed during a recent and typical 3 month period, to provide clients with a fair and representative illustration of the practice's medicines prices
c. provide the price of any relevant veterinary medicinal product stocked or sold, to clients, or other legitimate enquirers, making reasonable requests
d. if requested, inform clients of the price of any medicine to be prescribed or dispensed
e. where possible and relevant, inform clients of the frequency and charges regarding further examinations of animals requiring repeat prescriptions
f. provide clients with an invoice that distinguishes the price of relevant veterinary medicinal products from other charges and, where practicable, provide clients with an invoice that distinguishes the price of individual relevant veterinary medicinal products
g. advise clients, by means of a large and prominently displayed sign or signs (in the waiting room or other appropriate area), with reference to the following:
"Prescriptions are available from this practice.
You may obtain relevant veterinary medicinal products from your veterinary surgeon OR ask for a prescription and obtain these medicines from another veterinary surgeon or a pharmacy.
Your veterinary surgeon may prescribe relevant veterinary medicinal products only following a clinical assessment of an animal under his or her care.
A prescription may not be appropriate if your animal is an in-patient or immediate treatment is necessary.
You will be informed, on request, of the price of any medicine that may be prescribed for your animal.
The general policy of this practice is to re-assess an animal requiring repeat prescriptions for/supplies of relevant veterinary medicinal products every XX months, but this may vary with individual circumstances. The standard charge for a re-examination is £XX.
The current prices for the ten relevant veterinary medicinal products most commonly prescribed during XX [a typical 3 month period] were:
[The ten relevant veterinary medicinal products and prices listed.]Further information on the prices of medicines is available on request."
h. provide new clients with a written version of the information set out in the sign or signs referred to in paragraph 7, which may be set out in a practice leaflet or client letter
i. on a continuing basis, take reasonable steps to ensure that all clients are provided with a written version of the information set out in the sign or signs referred to in paragraph 8g, which may be set out in a practice leaflet or client letter.
j. from 31 October 2008, a reasonable charge may be made for written prescriptions; such prescriptions for POM-V medicines may be issued only for animals under the care of the prescribing veterinary surgeon and following his or her clinical assessment of the animals.
A veterinary surgeon must not discriminate between clients who are supplied with a prescription and those who are not in relation to fees charged for other goods or services.
" relevant veterinary medicinal product" has the same meaning as in The Supply of Relevant Veterinary Medicinal Products Order 2005; in brief, these are medicines of category POM-V, excluding medicated feeding stuffs.
(The veterinary profession has a vital part to play in terms of education and protection in matters of animal welfare and public health)
1. Veterinary surgeons must:-
a. ensure the integrity of all veterinary certification (see Annex 3D, 'Certification: 12 principles')
b. ensure that medicines are used responsibly , particularly in food producing animals
c. report to the appropriate authority any suspected occurrence of a notifiable disease
d. report to the appropriate authority any suspected adverse reaction to medication
e. base any tender submitted for veterinary services on considerations which will ensure that these can be provided at a proper professional level and without compromising public health or animal health and welfare
f. co-operate with colleagues and other health professionals when appropriate
g. promote responsible animal ownership
h. use their professional status to provide only factual information to the general public about veterinary products and services.
i. ensure that all their professional activities are covered by professional indemnity insurance or equivalent arrangements. Such cover may be held individually or through an employer
2. A veterinary surgeon, veterinary nurse or other who has concerns about the competence of a colleague is encouraged to discuss the matter with the senior veterinary surgeon of the practice. If the matter cannot be resolved with such an approach, any concerns should be brought to the attention of the RCVS Professional Conduct Department.
(Overtly poor relationships between veterinary surgeons undermine public confidence in the whole profession.)
1. Veterinary surgeons must:
a. always liaise with colleagues where more than one veterinary surgeon is involved in or has responsibility for the care of a group of animals
b. provide all relevant clinical information promptly to colleagues taking over responsibility for a case
c. provide proper documentation for all referral or re-directed cases
d. refer cases responsibly (see Annex 3P, 'Referrals')
e. if advertising, do so in a professional manner and only in accordance with the relevant legislation.
2. Veterinary surgeons must not:
a. speak or write disparagingly about another veterinary surgeon
b. obstruct a client from changing to another veterinary practice
c. discourage a client from seeking a second opinion
1. Veterinary Surgeons should be sufficiently familiar with and comply with relevant legislation including:
a. the Veterinary Surgeons Act 1966 and associated orders and statutory instruments
b. the Animal Welfare Act 2006 and Animal Health and Welfare (Scotland) Act 2006 and associated subordinate legislation, including legislation on mutilations (permitted and prohibited procedures) and tail-docking (dogs) (see Annex 3R, 'Tail-docking (dogs)')
c. the Veterinary Medicines Regulations 2006 and the Supply of Relevant Veterinary Medicinal Products Order 2005 and associated legislation as it applies to the use, prescription, sale and supply of veterinary medicinal products
d. Health and Safety at Work (including the Working Time Regulations), Radiation Protection, Control of Substances Hazardous to Health and other similar legislation as it applies to veterinary practice
e. the Data Protection Act 1998 as it applies to professional and client records
f. employment, Inland Revenue, VAT and social security legislation as it applies to veterinary practice
g. the Animals (Scientific Procedures) Act 1986 (see Annex 3B, 'A(SP)A and VSA interface')
h. any other relevant animal health or welfare legislation relating to animal health, disease control, animal breeding, public health and zoonoses, and
i. legislation relating to all forms of discrimination, including but not limited to race, sex, disability, sexual orientation, religion and age.
2. Veterinary surgeons must be aware of their responsibilities as witnesses to fact, as professional witnesses, or as expert witnesses in any civil or criminal proceedings in which they may be involved (see Annex 3N, 'Professional witness')
3. Veterinary practices must carry third party insurance for the protection of the public.
4. Veterinary surgeons wishing to apply for a Home Office licence for procedures which may be regulated by the Animals (Scientific Procedures) Act 1986 are advised to contact the RCVS for information (see Annex 3B, 'A(SP)A and VSA interface').
(The Veterinary Surgeons Act 1966 imposes on the Preliminary Investigation Committee responsibility for considering every complaint made against a veterinary surgeon, and where the allegations might justify removal or suspension from the Register, referring the complaint to the Disciplinary Committee.)
1. All clients should be actively encouraged in the first instance to discuss any problems which they may have with the veterinary surgeon treating their animal, or to ask for an appointment to talk to the practice principal
2. A sympathetic approach should be used in response to a complaint rather than immediate denial and defensiveness. An expression of sorrow that an animal has died or that someone is distressed by what has happened is appropriate and does not in itself amount to an admission of liability
3. Veterinary surgeons must:
a. respond promptly and constructively to any request from the RCVS for comments in relation to any allegation or complaint made against them. Failure to do so may in itself be held to amount to professional misconduct
b. be prepared to explain and justify to clients or colleagues any action or decision taken in the course of their professional activities.
4. A veterinary surgeon's name may be removed from the Register if:
a. they have been convicted of a criminal offence in the United Kingdom or elsewhere the nature of which, in the opinion of the Disciplinary Committee, makes them unfit to practise veterinary surgery
b. the Disciplinary Committee has found them guilty of conduct disgraceful in any professional respect
c. their registration has been obtained fraudulently
d. their annual retention fee is unpaid.
(Section 19 of the Veterinary Surgeons Act 1966 restricts the practice of veterinary surgery to registered members of the RCVS subject to a number of exceptions.)
1. A veterinary surgeon must:
a. be aware of the exceptions as they apply, for example, to:
i. the animal owner, a member of his household or his employee, who may carry out minor medical treatment
ii. the animal owner or person engaged in caring for animals used in agriculture may carry out medical treatment or minor surgery not involving entry into a body cavity
iii. listed veterinary nurses in accordance with the Veterinary Surgeons Act 1966 (Schedule 3 Amendment) Order 2002
iv. veterinary students in accordance with the Veterinary Surgeons (Practice by Students) (Amendment) Regulations 1993
v. registered farriers in accordance with the Farriers (Registration) Acts 1975 and 1977
vi. physiotherapists, chiropractors, and osteopaths in accordance with the Veterinary Surgery (Exemptions) Order 1962
vii. blood sampling under the Blood Sampling Order 1983 as amended
viii. animal husbandry trainees over 17 years of age in castration of male animals, disbudding of calves and docking of lambs' tails
ix. the ability of anyone to administer emergency first aid to save life or relieve pain or suffering
b. be aware of the limitations on treatment by equine dental technicians, cattle foot trimmers and other similar paraprofessionals
2. Treatment by acupuncture, aromatherapy, homoeopathy or other complementary therapy may only be administered by a veterinary surgeon who should have undergone training in these procedures. At present, it is illegal for them to be given by practitioners who are not veterinary surgeons.
(See also amplified guidance in Part 2F, Treatment of animals by non-veterinary surgeons.)
1. The veterinary surgeon/client relationship is founded on trust, and in normal circumstances a veterinary surgeon must not disclose to any third party any information about a client or their animal either given by the client, or revealed by clinical examination or by post-mortem examination. This duty also extends to associated support staff.
2. In circumstances where the client has not given permission for disclosure and when the veterinary surgeon believes that animal welfare or public interest are compromised the RCVS may be consulted before any information is divulged.
3. Permission to pass on confidential information may be express or implied. Express permission may be either verbal or in writing, usually in response to a request. Permission may also be implied from circumstances, for example in the making of a claim under a pet insurance policy, when the insurance company becomes entitled to receive all information relevant to the claim and to seek clarification if required.
4. Registration of a dog with the Kennel Club permits a veterinary surgeon who carries out surgery to alter the natural conformation of a dog, to report this to the Kennel Club.
5. Case records including radiograph films and similar documents are the property of, and should be retained by, veterinary surgeons in the interests of animal welfare and for their own protection. Copies with a summary of the history should be passed on request to a colleague taking over the case.
(N.B. Where a client has been specifically charged and has paid for radiographs or other reports, they are legally entitled to them. The practice may however choose to make it clear that they are charging not for the radiographs, but for diagnosis or advice only. In appropriate circumstances they may be prepared also to provide copies of the radiographs)
6. The Data Protection Act 1998 gives anyone the right to be informed about any personal data relating to themselves on payment of an administration charge.
7. At the request of a client, veterinary surgeons must provide copies of any relevant clinical records; this includes relevant records which have come from other practices, if they relate to the same animal and the same client. It does not include records which relate to the same animal but a different client. Where any significant expense is involved in providing such copies, as there might be, for example, with the provision of radiographs, a charge can be made. Expense should not be a reason for declining to provide copies.
8. It follows that the utmost care is essential in writing case notes or recording a client's personal details to ensure that the latter are accurate (particularly in relation to financial details) and that the notes are comprehensible and legible.
9. Disclosure of records may be ordered in disciplinary or court hearings, and the RCVS may request copies of case records routinely in the course of investigating a complaint.
1. The RCVS has no specific jurisdiction under the Veterinary Surgeons Act 1966 over the level of fees charged by veterinary practices unless they are so extreme as to constitute disgraceful conduct. There are no statutory charges and fees are essentially a matter for negotiation between veterinary surgeon and client.
2. There are a number of fee related issues which raise ethical concerns, on which the following guidance is offered:
Re-direction to charities
Discussion of fees
Invoices
Securing payment for veterinary services
Pet insurance
Unpaid bills
Holding an animal against unpaid fees
3. All charities have a duty to apply their funds so as to make the best possible use of their resources and animal owners or keepers seeking assistance will have to satisfy the almoning rules of the charity concerned. They should first contact the charity to confirm that they are eligible for assistance, and the veterinary surgeon must ensure that the animal's condition is stabilised so that it is fit to travel to the charity, arrange a suitable appointment and provide a referral letter with full details of the animal's condition and any treatment already given.
4. If the client does not fall within the almoning rules of local charities, and no other form of financial assistance can be found, euthanasia may have to be considered on economic grounds.
5. Discussion should take place with the client, covering a range of reasonable treatment options and prognoses, and the likely charges (including ancillary or associated charges, such as those for medicines/anaesthetics and likely post operative care) in each case so as to ensure that the client is in a position to give informed consent. It is wise for any estimate to be put in writing and to cover the approximate overall charge for any procedure or treatment including VAT, pre and post operative checks, any diagnostic tests, etc. The owner should be warned that additional charges may arise if complications occur.
6. If the animal is covered by pet insurance, it is in the interests of both veterinary surgeon and client to confirm the extent of the cover under the policy, including any limitations on cost or any exclusions which would apply to the treatment proposed.
7. If a quotation as distinct from an estimate is given it may be binding in law.
8. If during the course of treatment it becomes evident that an estimate or a limit set by the client is likely to be exceeded, the client should be contacted and informed so that consent to the increase may be obtained. This applies equally to treatment in referral centres.
9. All invoices should be itemised showing the amounts relating to goods and services provided by the practice. Fees for outside services and any charge for additional administration or other costs to the practice in arranging such services should also be shown separately. See Part 1, D, paragraph 7 for the invoicing of relevant veterinary medicinal products.
10. A client is the person who requests veterinary attention for an animal, for example when a veterinary surgeon is called to the scene of a road traffic accident by the police or by the RSPCA, the organisation in question will be liable to pay for any emergency treatment and for the call out even if the animal owner is subsequently identified (because the owner had no opportunity to consent to treatment). This applies equally to any member of the general public taking in a stray or injured animal whose owner is unknown.
11. When dealing directly with the owner, or the owner's agent whose consent to treatment must be given, it is important to obtain that consent in writing on a properly drafted form which should include any estimated charge (see annex, Consent forms specimens)
12. Many animal owners take out insurance to cover veterinary fees. Since this is offered by a number of specialist and other companies, it is prudent for a practice to display a range of promotional literature so as to avoid any implication of bias, financial advice, or brokering. If commission may be paid to the veterinary surgeon or support staff if a particular policy is taken out, this should be disclosed.
13. Pet insurance schemes rely on the integrity of the veterinary surgeon who has a responsibility to both the client and the insurance company and any material fact which might cause the company to increase the premium or to decline a claim must be disclosed.
14. When treating an animal covered by pet insurance the fees charged must be at the normal practice rate and any additional or administrative charges shown separately. In cases where the bill is sent direct to the insurance company, a copy should be sent to the client.
15. A veterinary surgeon is entitled to charge a fee for the provision of services, and where the fee remains unpaid, to place the matter in the hands of a debt collection agency or to institute civil proceedings.
16. In the case of persistently slow payers and bad debtors it is acceptable to give them notice in writing (by recorded delivery A.R.) that veterinary services will no longer be provided.
17. Although veterinary surgeons do have a right in law to hold an animal until outstanding fees are paid, the RCVS believes that it is not in the interests of the animal so to do, and can lead to the practice incurring additional costs which may not be recoverable. This right should therefore only be exercised in extreme cases and after discussion with the RCVS.
1. Veterinary practices should provide clients, particularly those new to the practice, with comprehensive written information on the nature and scope of the practice's services, including:
a. the provision, initial cost and location of the out-of-hours emergency service
b. information on the care of in-patients
c. the practice's complaints handling policy
and could also provide full terms and conditions of business, to include for example:
d. surgery opening times
e. whether open or by appointment
f. fee or charging structures
g. procedures for second opinions and referrals
h. use of client data
i. access to and ownership of records
2. The major consideration in choosing a practice title is that it should not mislead the public as to the nature or extent of the services offered.
3. All publicity must be legal, decent, honest and truthful in compliance with the general law and the British Codes of Advertising Practice and Sales Promotion.
4. Publicity must not be of a character likely to bring the profession into disrepute, e.g. unsolicited approach by telephone or visit; nor must it compromise the clinical care of animals.
5. Medicines may be advertised and medicine prices may be published, in accordance with the legal restrictions in the current Veterinary Medicines Regulations. Any publicity for authorised veterinary medicinal products of category Prescription Only Medicine, Veterinarian (POM-V), must indicate that a veterinary surgeon may only prescribe such medicines lawfully following a clinical assessment of an animal under his or her care (see Part 2H, paragraph 5, The use of veterinary medicinal products). In addition, a veterinary surgeon should only prescribe medicines appropriate to, and only in sufficient quantity for, the patient's needs. The selection of an appropriate veterinary medicine is a matter of clinical judgement for the prescribing veterinary surgeon.
6. Only veterinary surgeons currently listed as RCVS Recognised Specialists may call themselves such. Veterinary surgeons may call themselves 'specialists' provided they can substantiate such a claim. Similarly, although veterinary surgeons may indicate that their practice is wholly or mainly restricted to a particular species, they must ensure that specialist status is not implied where this is not the case.
7. Veterinary surgeons can make a worthwhile contribution to the promotion of animal welfare and responsible pet ownership by taking part in public life, whether in national or local politics, community service, or involvement with the media (including press, television, radio or the internet).
8. In commenting to the media veterinary surgeons must ensure that any statement is factually correct, distinguishing clearly between personal opinion or political belief and established facts. They should be careful not to express or imply that any view is shared by the profession at large unless previously authorised by the RCVS, BVA or other professional body.
Continuity of care in veterinary practice
Attendance away from practice premises
Euthanasia of a healthy animal
Euthanasia without the owner's consent
Sporting events
Destruction of injured horses
Destruction of 'dangerous' dogs
1. All practice premises must be clean and safe for staff, clients and patients, with waiting facilities and at least one dedicated consulting room. They must be adequately equipped for the services offered by the practice.
2. Details of the RCVS Practice Standards Scheme are set out in the annex RCVS Practice Standards. ‘RCVS Recognised Veterinary Hospitals' (RCVS Practice Standards Scheme, Tier 3) must conform to the standards laid down by the relevant practice standards.
3. Veterinary surgeons who knowingly or carelessly permit anyone to practice illegally on their premises may be liable to a charge of disgraceful professional conduct.
4. Membership of the Royal College of Veterinary Surgeons is a legal requirement for anyone practising veterinary surgery in the United Kingdom. It is the duty of any veterinary surgeon employing professional staff to ensure that they are registered by inspecting the original RCVS certificate of membership or by checking with the RCVS.
5. When employing Veterinary Nurses to undertake Schedule 3 procedures, it should be confirmed that their names are currently on the List of Veterinary Nurses maintained by the RCVS. As provided in Schedule 3 of the Veterinary Surgeons Act and the RCVS Guide to Professional Conduct for Veterinary Nurses, a 'veterinary nurse' means a person whose name is entered in the List of Veterinary Nurses, maintained by the RCVS.
6. Veterinary surgeons should ensure that their support staff are competent, courteous and properly trained. In particular they must be instructed not to suggest a diagnosis or give any clinical opinion, to maintain confidentiality, and to discharge animals only on the instructions of the duty veterinary surgeon. They must pass on any request for urgent attention to the duty veterinary surgeon and be trained to recognise those occasions when it is necessary for a client tospeak directly to a veterinary surgeon.
7. Referral practices must provide 24-hour availability in all their specialities, or they must, by prior arrangement, direct referring veterinary surgeons to an alternative source of appropriate assistance.
8. Appropriate post-operative or in-patient care must be provided by the referral veterinary surgeon, or by another veterinary surgeon with similar expertise (and at a practice with similar facilities); unless agreed otherwise with the client and provided that the welfare of the patient is not compromised.
9. Once an animal has been accepted as an in-patient for treatment by a veterinary surgeon or practice, responsibility for the animal remains with that veterinary surgeon or practice until another veterinary surgeon or practice accepts the responsibility.
10. Primary practices and out-of- hours emergency service providers must provide uninterrupted treatment of an in-patient, if it is considered that the animal is not fit to be moved.
11. Where an animal needs continuous in-patient care, a veterinary surgeon should not leave the animal until appropriate care is provided by a suitably qualified (eg MRCVS or Listed VN) colleague.
12. It is recognised that critically ill animals will sometimes need to be moved in order to receive appropriate treatment and primary practices should have appropriate transport and transfer arrangements in place. This may necessitate trained staff travelling with the animal.
13. When considering the transfer of critically ill animals, veterinary surgeons should consider the long term care that may be required and avoid, so far as possible, the need for such animals to travel more than necessary.
14. Where it is necessary and appropriate to transfer an animal between the primary practice and an out-of-hours emergency service provider or vice versa, the responsibility is that of the veterinary practices involved, not the client. Normally, the practice from which the animal is transferred is responsible for the transfer or arranging the transfer.
15. The transfer of a critically ill animal between practices should be in the animal's best interests, not for the convenience of the practices involved.
16. Clients often request attendance on a sick or injured animal away from the practice premises. It must be recognised that in some circumstances it may be desirable to do so. On rare occasions, it may actually be necessary on clinical or welfare grounds.
17. The decision as to whether attendance away from the practice is essential or not, is solely for the veterinary surgeon concerned, having carefully balanced the needs of the animal against the relevant health and safety issues for the practice personnel.
18. Case records should include details of examination, treatment administered, medication prescribed and/or supplied, radiographs, the results of any diagnostic or laboratory tests and advice given to the client. It is prudent to include notes of telephone conversations, fee estimates or quotations, consents given or withheld and contact details.
19. Good communication skills in professional and support staff are essential to good veterinary practice.
20. Veterinary surgeons must endeavour to ensure that what both they and their clients are saying is heard and understood on both sides, and encourage clients to take a full part in any discussion. Explanations should be given wherever possible in non technical language and if there is any doubt as to whether the client has understood, this should be recorded.
21. Informed consent, which is an essential part of any contract, can only be given by a client who has had the opportunity to consider the options for treatment, and had the significance and risks explained to them. Cost may also be relevant to the client's decision. If it is anticipated that any procedure will be performed by a veterinary student, a listed veterinary nurse or other member of the support staff the client should be made aware of the fact.
22. If the client's consent is in any way limited or qualified or specifically withheld, veterinary surgeons must accept that their own preference for a certain course of action cannot override the client's specific wishes other than on exceptional welfare grounds.
23. When arrangements have been made to bring an animal under the Animals (Scientific Procedures) Act 1986 for experimental investigation, the client should be made aware of the general provisions of the Act so that informed consent can be given, (see Annex 3B, A(SP)A and VSA interface and Annex 3E, Consent form specimens)
24. Euthanasia is not, in law, an act of veterinary surgery, and may be carried out by anyone provided that it is carried out humanely. No veterinary surgeon is obliged to kill a healthy animal unless required to do so under statutory powers as part of their conditions of employment. Veterinary surgeons do, however, have the privilege of being able to relieve an animal's suffering in this way in appropriate cases.
25. From time to time veterinary surgeons may face difficulties. For example, an owner may want to have a perfectly healthy or treatable animal destroyed, or an owner may wish to keep an animal alive in circumstances where euthanasia would be the kindest course of action. The veterinary surgeon's primary obligation is to relieve the suffering of an animal but account must be taken not only of the animal's condition but also the owner's wishes and circumstances. It should be recognised that clients are capable of making informed and conscientious decisions concerning the future of their animals. Thus the client is an important contributor to the decision. To refuse an owner's request for euthanasia, therefore, may add to the owner's distress and could be deleterious to the welfare of the animal.
26. Just as relevant are a veterinary surgeon's concerns about an owner's refusal to consent to euthanasia where an animal's immediate welfare is compromised. After full consideration of all the relevant issues, veterinary surgeons can only advise their clients and act in accordance with their professional judgement. Where, in all conscience, a veterinary surgeon cannot accede to a client's request for euthanasia he or she should recognise the extreme sensitivity of the situation and make sympathetic efforts to direct the client to alternative sources of advice. Where an animal's welfare is compromised because of an owner's refusal to allow euthanasia, a veterinary surgeon would be justified in informing the client of other action which might be taken.
27. The Animal Welfare Act 2006 (which applies in England and Wales), the Animal Health and Welfare (Scotland) Act 2006 and the Welfare of Animals (Northern Ireland) Act 1972 contain provisions to safeguard the welfare of animals. For animals in distress, there are no provisions in these Acts which specifically authorise a veterinary surgeon to destroy an animal. Under the 2006 Acts, powers to destroy an animal or arrange for its destruction are conferred on an inspector (who may be appointed by the local authority) or a constable. A veterinary surgeon may be asked to certify the condition of the animal is such that it should in its own interests be destroyed. An inspector or constable may act without a veterinary certificate if there is no reasonable alternative to destruction and the need for action is such that it is not reasonably practical to wait for a veterinary surgeon.
28. Under the Welfare of Animals (Northern Ireland) Act 1972, the police may summon a veterinary surgeon, or take action themselves, where the owner refuses to give consent or is absent.
29. The veterinary surgeon should obtain a written and signed instruction to destroy from the officer in charge, including his identity number and the log number of the incident at a given police station.
30. However, a person may commit an offence if an act or failure to act causes an animal to suffer unnecessarily. If, in the opinion of the veterinary surgeon, the animal’s condition is such that it should, in its own interests, be destroyed without delay, the veterinary surgeon may need to act without the owner’s consent and should make a full record of all the circumstances supporting the decision in case of subsequent challenge.
31. Where the veterinary surgeon is asked to destroy an animal injured in a sporting event, the opinion of a professional colleague, if available, should be sought before doing so. Veterinary surgeons officiating at sporting events should consider:
a. whether the owner will be present and able to consent to euthanasia if necessary
b. whether the owner has delegated authority to another to make that decision in their absence and
c. whether if damages were sought for alleged wrongful destruction they would have adequate professional indemnity insurance cover. (Ref: the Horseracing Regulatory Authority [formerly the Jockey Club] Instruction J17 and FEI Article 1009.15)
32. The British Horseracing Authority's (BHA) Rules of Racing, which apply to BHA-regulated events, state:
‘Where, in the opinion of the attending veterinary surgeon, a horse is so severely injured that it ought to be humanely destroyed, the Owner or the Trainer should, wherever possible, first be informed. However, the veterinary surgeon may proceed with humane destruction, without reference to Owner or Trainer, in order to prevent undue suffering to the horse. Before taking this action the veterinary surgeon should, wherever practicable, seek a second opinion.’
(Ref: the British Horseracing Authority Instruction J17 and FEI Article 1009.17)
33. Under the Dogs Acts of 1871 and 1906, the Dog Control Act 1966, the Dangerous Dogs Acts of 1989 and 1991, the Dangerous Dogs (Amendment) Act 1997 and the Dangerous Dogs Order (Northern Ireland) 1991, a destruction order may be made by the Court ,or Justice of the Peace, or Sheriff, and the destruction of a healthy animal is normally involved. In these circumstances a veterinary surgeon asked to destroy a dog should, unless there is a genuine threat to human safety, request a written and signed order from one of the appropriate statutory authorities.
34. All veterinary surgeons should recognise when a case is outside their area of competence and be prepared to refer it to a colleague whom they are satisfied is competent to carry out the investigations or treatment involved. They should also be aware that the client has a right to request a referral or second opinion. Care must be taken not to give the impression to the client that the referral is to an 'RCVS recognised specialist' if this is not so. The initial contact should be made by the primary veterinary surgeon, and the client then asked to arrange the appointment (see Annex 3O, Referrals).
35. The distinction between a second opinion and a referral should be clearly understood by both veterinary surgeon and client. A second opinion is for confirmation of diagnosis, whereas a referral to a referral practice will be for diagnosis and possible treatment, after which the case will be referred back to the original practice. Neither a second opinion veterinary surgeon nor a referral practice should ever seek to take over the case.
36. The referring veterinary surgeon has a responsibility to ensure that the client is fully aware of the level of expertise of the referral veterinary surgeon, for example as a 'specialist' by experience, a certificate holder, or an 'RCVS recognised specialist'. The referral veterinary surgeon should discuss the case with the client and report back to the primary veterinary surgeon.
37. A full case history and instructions as to the particular reason for referral should be supplied, together with an indication of the client's wishes and responsibility for the fees incurred. Any further information which may be requested should be supplied promptly.
38. Veterinary surgeons should not use a referral as an opportunity to pass on difficult clients, or known bad debtors.
39. Although both veterinary surgeon and client have freedom of choice, as a matter of professional courtesy and in the interests of the welfare of the animals involved a veterinary surgeon should not knowingly take over a colleague's case without informing the colleague in question and obtaining a clinical history.
40. When an animal is initially presented a veterinary surgeon must ask whether it is already receiving treatment, and if so, when it was last seen, and then contact the original veterinary surgeon for a case history. It should be made clear to the client that this is necessary in the interests of the patient. If the client refuses to provide this information the case should be declined.
41. In an emergency it is acceptable to make an initial assessment, and administer any essential treatment before contacting the original veterinary surgeon.
42. Veterinary surgeons should be prepared to discuss their client's concerns directly with them, involving the practice principal if appropriate. If at this stage the difficulty cannot be resolved the aggrieved client may then be referred to the RCVS.
1. The traditional methods of running a veterinary practice, either as a single handed veterinary surgeon or through a partnership, have evolved and expanded to meet the changing needs of the profession and its clients.
Speaking or writing about colleagues within or outside the practice
Examinations on behalf of a third party
Veterinary surgeons employed by commercial and industrial organisations
Disputes between veterinary surgeons
2. In terms of section 19 of the Veterinary Surgeons Act 1966, only registered members of the RCVS are permitted to practise veterinary surgery in the United Kingdom. Similarly only holders of registrable qualifications are entitled to register.
3. The College's jurisdiction applies to each individual member whose responsibilities in terms of this Guide apply, whether they are employed as an assistant, in a corporate body or other organisation, or working in a partnership.
4. Veterinary surgeons may now enter into partnership with non-veterinary surgeons. It is however essential that the partnership agreement includes a clause reserving all clinical decisions to the veterinary surgeon partners.
5. All obligations incumbent upon any single practice apply equally to practices based in pet superstores.
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6. On the death of a single handed veterinary surgeon or sole owner of a practice, another person may continue to run the practice as manager for the executo or personal representatives of the deceased veterinary surgeon for a reasonable time. 'Reasonable' in this context will vary according to individual circumstances, but the RCVS is always ready to offer advice and assistance if the need arises.
7. Animal welfare must always be the first consideration and veterinary surgeons working in such practices must:
a. have the appropriate facilities required for any small animal practice providing a similar service
b. ensure that a full pre-operative examination is carried out to establish fitness for surgery and freedom from intercurrent disease. If a disease is identified the animal must be re-directed to its regular veterinary surgeon, or to an appropriate animal charity for treatment BEFORE surgery
c. make provision for 24-hour emergency cover for the entire post-operative period during which complications arising from the surgery may develop
8. Vaccination clinics must similarly:
a. have the appropriate facilities required for these services in small animal practice
b. carry out a full health check, and contact the animal's regular veterinary surgeon if it is already under treatment
c. give advice on feeding and worming as part of the vaccination programme
d. make provision for 24-hour emergency cover for the period in which adverse reactions might arise
9. The law requires employers to provide a written statement relating to the terms and conditions of employment within eight weeks of the start of employment, and an employee should be advised in writing of any subsequent changes to their terms and conditions of employment.
10. No veterinary surgeon should speak or write disparagingly of a colleague to a third party, since the effect is to undermine public confidence in the profession.
11. This does NOT however apply to evidence given in a court of law and in instances where professional negligence or misconduct may be involved and where in the interests of justice, everyone must be able to speak freely.
12. When asked by an insurance company or similar body to examine an animal already undergoing veterinary treatment, the attending veterinary surgeon should be notified of the time and date on which the examination is to take place. If asked to perform a post-mortem examination the primary veterinary surgeon should be notified and given the opportunity to provide any information which they feel may be relevant. The post-mortem report, however, is the property of the client.
13. In the case of examination of a horse before purchase, it is advisable that the vendor's veterinary surgeon does not carry out the 'Examination on Behalf of a Purchaser' but it may be that for reasons of distance, particular expertise, or because both vendor and prospective purchaser are clients, the vendor's veterinary surgeon may beasked to carry out the examination. Any danger of conflict of interest must therefore be avoided by ensuring that:
a. the purchaser is made aware that the vendor is also a client and has no objection
b. the vendor agrees to permit the disclosure of anything relevant in the case history (If permission cannot be obtained then the vendor's veterinary surgeon should not act)
c. it is made clear to both parties that in this instance the veterinary surgeon is acting on behalf of the purchaser and that information derived from the examination is confidential to the purchaser alone.
14. Where different veterinary surgeons are treating the same animal or group of animals, each may prescribe medicines for administration to those animals. Each must, however, keep the other informed of any examinations of the animals, relevant clinical information and medicines prescribed (whether medicines are supplied or not), so as to avoid any danger that might arise from conflicting advice or adverse reactions arising from unsuitable combinations of medicines (see Part 2H, The use of veterinary medicinal products).
15. Even where two veterinary surgeons are treating different groups of animals owned by the same client, it is still advisable for each to keep the other informed of any problem which might affect their work.
16. Any veterinary surgeon employed by a commercial organisation, and required to visit a farm, must notify the regular practice of the proposed visit and report any findings or advice given which will be relevant to the day to day veterinarycare of the animals. Members of Animal Health (formerly the State Veterinary Service) should keep the regular practice fully informed of any matters relating to any developing disease or animal welfare problem about which official action is to be taken or of any relevant significant or developing disease. Unless this information is provided there will be a danger of conflicting and possibly detrimental advice being given.
17. In the interests of the whole profession veterinary surgeons are advised to make every effort to resolve their disputes out of court.
18. This may involve an informal procedure such as mediation or conciliation where an independent person is chosen by the parties to assist them in reaching a mutually acceptable solution. Neither a mediator nor a conciliator has any power to impose a solution.
19. Arbitration is also an alternative to litigation, the object of which 'is to obtain a fair resolution of disputes by an impartial tribunal without unnecessary delay or expense' (Arbitration Act 1996). It is a formal and binding procedure where the appointment of an arbitrator is frequently made in consultation with the Chartered Institute of Arbitrators. It is prudent to include a clause in partnership agreements or contracts between principals and assistants which provides for arbitration after other forms of dispute resolution have been tried and before recourse to the courts. The clause will normally specify the method of appointing the arbitrator and the rules.
1. The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practise veterinary surgery. 'Veterinary surgery' is defined within the Act as encompassing the 'art and science of veterinary surgery and medicine' which includes the diagnosis of diseases and injuries in animals, tests performed on animals for diagnostic purposes, advice based upon a diagnosis and surgical operations which may not necessarily form part of a treatment. These restrictions are in the interests of ensuring that animals are treated only by people qualified to do so.
2. A veterinary surgeon must be aware of the exceptions which allow non-veterinary surgeons to treat animals, in particular:
Physiotherapists, osteopaths and chiropractors
Other complementary therapists
3. Veterinary students, as part of their clinical training, are required to undertake acts of veterinary surgery.
4. The Veterinary Surgeons (Practice by Students) (Amendment) Regulations 1993 identify two categories of student, full time undergraduate students in the clinical part of their course and overseas veterinary surgeons whose declared intention is to sit the MRCVS examination within a reasonable time. The Regulations provide that students may examine animals, carry out diagnostic tests under the direction of a registered veterinary surgeon, administer treatment under the supervision of a registered veterinary surgeon and perform surgical operations under the direct and continuous supervision of a registered veterinary surgeon.
5. The College has interpreted these as follows:
a. 'direction' means that the veterinary surgeon instructs the student as to the tests to be administered but is not necessarily present
b. 'supervision' means that the veterinary surgeon is present on the premises and able to respond to a request for assistance if needed
c. 'direct and continuous supervision' means that the veterinary surgeon is present and giving the student his/her undivided personal attention
6. The Veterinary Surgeons Act 1966 (Schedule 3 Amendment) Order 2002 extends the exceptions to include qualified veterinary nurses whose names are on the List of Veterinary Nurses maintained by the RCVS and student nurses. Student nurses are those enrolled with the RCVS for the purpose of training at an approved centre or practice.
7. Under this exemption the privilege of giving medical treatment and carrying out minor surgery, not involving entry into a body cavity, is given to:
a. listed veterinary nurses under the direction of their veterinary surgeon employer to animals under their employer's care. The directing veterinary surgeon must be satisfied that the veterinary nurse is qualified to carry out the medical treatment or minor surgery (see paragraph 3)
b. student nurses under the direction of their veterinary surgeon employer to animals under their employer's care. In addition medical treatment or minor surgery must be supervised by a veterinary surgeon or listed veterinary nurse and in the case of minor surgery the supervision must be direct, continuous and personal. The medical treatment or minor surgery must be given in the course of the student's training
8. A veterinary nurse or student veterinary nurse is not entitled independently to undertake either medical treatment or minor surgery.
9. In considering whether to direct an RCVS listed veterinary nurse to carry out 'Schedule 3' procedures, a veterinary surgeon must consider how difficult the procedure is in the light of any associated risks, whether the nurse is qualified to treat the species concerned, understands the associated risks and has the necessary experience and good sense to react appropriately if any problem should arise. The veterinary surgeon must also be sure that he/she will be available to answer any call for assistance, and finally, should be satisfied that the nurse feels capable of carrying out the procedure competently and successfully.
10. When a veterinary nurse is negligent the liability is likely to rest with the directing veterinary surgeon.
11. Both veterinary surgeons and farriers are involved in the treatment of horses' feet. While veterinary surgeons are exempt from the restrictions in the Farriers Registration Acts 1975 and 1977, farriers are not exempt from the restrictions in the Veterinary Surgeons Act 1966, and may not carry out procedures deemed to be acts of veterinary surgery.
12. There is no clear demarcation line between veterinary surgeons and farriers in the exercise of their professional responsibilities, so that much depends on individuals and the relationship between them. Decisions as to whether a particular procedure should be performed by one or the other is a matter for consultation and co-operation. Veterinary surgeons should make every effort personally to discuss cases with farriers.
13. Farriery consists of trimming and balancing the equine hoof prior to and the fitting of conventional or surgical shoes, and where a veterinary surgeon requires particular work from a farrier this should be specified in personal contact between them.
14. A farrier must not normally penetrate sensitive structures, cause unnatural stress to the animal, make a diagnosis or administer drugs. If he feels that either the veterinary surgeon is treating the animal incorrectly, or that a further condition is present requiring treatment, he should notify the veterinary surgeon or advise the owner to call in the veterinary surgeon. If a veterinary surgeon considers that a farrier's work is inadequate he should contact the farrier directly. Neither should make detrimental comments about the work of the other unless in the course of a formal complaint to their regulatory bodies, the Royal College of Veterinary Surgeons or the Farriers Registration Council.
15. The Veterinary Surgery (Exemptions) Order 1962 allows for the treatment of animals by physiotherapy, provided that the animal has first been seen by a veterinary surgeon who has diagnosed the condition and decided that it should be treated by physiotherapy under his/her direction.
16. 'Physiotherapy' is interpreted as including all kinds of manipulative therapy. It therefore includes osteopathy and chiropractic but would not, for example, include acupuncture or aromatherapy (see Part 1I, paragraph 2, Your responsibilities in relation to the treatment of animals by non-veterinary surgeons).
17. All other forms of complementary therapy in the treatment of animals, including homoeopathy, must be administered by veterinary surgeons. It is illegal, in terms of the Veterinary Surgeons Act 1966, for lay practitioners however qualified in the human field, to treat animals. At the same time it is incumbent on veterinary surgeons offering any complementary therapy to ensure that they are adequately trained in its application.
18. Faith healers are required in terms of the Code of Practice of the Confederation of Healing Organisations, to ensure that animals have been seen by a veterinary surgeon who is content for healing to be given by the laying on of hands.
19. Behavioural treatment that includes acts of veterinary surgery must be undertaken by a veterinary surgeon.
20. Diagnostic veterinary pathology is covered by the definition of veterinary surgery and is legally undertaken only by veterinary qualified pathologists. The generation of objective numerical clinical pathology data (for example blood biochemistry and haematology) is acceptable only if it excludes diagnostic interpretation. Surgical and post-mortem pathology is inherently diagnostic and is fully within the legal definition of veterinary surgery.
1) The simple act of signing their names on documents has a great potential for error for veterinary surgeons. A certificate is a "written statement of fact made with authority", the authority in this case coming from the veterinary surgeon's professional status.
2) Some documents (for example, forms, declarations, insurance claims, witness statements and self-certification documents) may involve the same level of responsibility even if they do not bear the name of "certificate". If the facts are incorrect or misleading, the professional integrity of the veterinary surgeon is called into question. Cases coming before the Disciplinary Committee may arise from allegations of false certification.
3) There are three hazards for the veterinary surgeon when "certifying" in the wider sense:
a) Negligence: A breach of the duty owed to a relevant party with consequent damage. Negligence may arise from a failure to disclose all of the material facts or supplying incorrect information. The consequence may be civil court proceedings.
b) Criminal Offences: Criminal offences may be committed under trade descriptions legislation, legislation controlling animal exports and by aiding and abetting a third party. They may include fraud or knowingly or recklessly supplying false information. Any conviction brought to the notice of the RCVS may be considered in relation to the fitness of the veterinary surgeon to practise.
c) Professional Misconduct: Even if no criminal charges are brought, an aggrieved party or enforcement authority may make a formal complaint to the RCVS. If the complaint is judged to be justified, penalties may follow.
4) The twelve principles of certification (see annexes) were drafted by RCVS, BVA and MAFF (now DEFRA) and adopted by the Federation of Veterinarians of Europe. Eight of the twelve principles are included in the EU Directive 96/93/EC). Their purpose is to provide the foundation of certification for all those who draft or prepare, use or sign veterinary certificates even though at the present time veterinary surgeons may be presented with certificates which do not conform to all of them.
5) In framing obligations which veterinary surgeons must fulfil under day-to -day working conditions, the RCVS has taken into account not only the Twelve Principles of Certification but also relevant UK law including the Trade Descriptions Act 1968 (as amended) which specifies the defences open to the signatory of a certificate or equivalent document if he or she is challenged and also the fact that veterinary surgeons may be presented with certificates which do not conform to all of the Twelve Principles.
6) Given that veterinary surgeons' professional reputations and livelihoods may be at stake if their signatures on certificates are open to challenge and that they may be presented with certificates that do not conform to all of the Twelve Principles of Certification, the RCVS strongly advises veterinary surgeons as follows:
7) CAUTION Before signing any certificate veterinary surgeons must:
(a) scrutinise the document whatever its title
(b) be clear as to whom they are responsible in exercising their authority when they sign the document
8) CLARITY Scrutinising the document includes:
(a) reading and understanding any explanatory supporting material
(b) checking carefully for any ambiguity which should be clarified with whoever has issued the certificate
(c) in the case of certificates relating to international or European Economic Area trade, veterinary surgeons may need to ask DEFRA's assistance. They should record in writing the information received, the date and time it is received and the name of the DEFRA official giving the advice. They should expect their own queries to be similarly recorded. They may request and expect to receive written confirmation of the guidance given to them
9) CERTAINTY In considering what they will attest in order to satisfy the obligation of certainty, veterinary surgeons:
(a) must be sure that they attest only to what to the best of their knowledge and belief is true
(b) do not attest to future events
(c) do not recklessly attest to what others have declared or asserted
(d) they may attest to what another veterinary surgeon has certified. They may also attest to the fact that a declaration or assertion has been made by another person without attesting to its validity
10) CHALLENGE If they have gone further in what they have attested, they must consider what their defence would be if challenged and keep appropriate written records made at the time of the decision to sign.
For example, if challenged under the Animal Health Act 1981 (as amended) with false certification could they show (in the words of that Act):
that he did not know of that falsity and that he could not with reasonable diligence have obtained knowledge of it
or if challenged under the Trade Descriptions Act 1968 (as amended) could they show (in the words of that Act):
(a) that the commission of the offence was due to a mistake or to reliance on information supplied to him or to the act or default of another person, an accident or some other cause beyond his control; and
(b) that he took all reasonable precautions and exercised all due diligence to avoid the commission of such an offence by himself or any person under his control
11) All parts of a certificate or its equivalent should bear the date of the examination or test carried out, vaccination or sample taken, the date of signing the certificate and the name and address of the signatory veterinary surgeon.
12) A veterinary surgeon who is an LVI should use the LVI stamp only on official certificates issued or approved by DEFRA.
13) Self-certification of practices for the purpose of securing particular entries in the RCVS Directory of Practices, Practice Standards Scheme and Veterinary Nursing Scheme is subject to the obligations of this Guide in the same way as any other certification procedure.
14) If an alleged identification mark is not legible at the time of inspection, no certificate should be issued until the animal has been re marked or otherwise adequately identified.
15) When there is no identification mark the use of the animal's name alone is inadequate. If possible the identification should be made more certain by the owner inserting a declaration identifying the animal, so that the veterinary surgeon can refer to it as 'as described'.
16) Age, colour, sex, marking and breed may also be used.
17) The owner's name must always be inserted. (In the case for example of litters of unsold puppies this will be the name of the breeder or the seller.)
18) Where microchipping or tattooing has been applied it should be referred to in any certificate of identification.
19) Guidance is issued by DEFRA for the completion of these certificates and should be scrupulously followed. When problems are identified the DVM should be consulted, and if not then resolved, the advice of the RCVS should be sought.
November 2004
1. This guidance is based on current EU and UK law and published guidelines & Codes of Practice (see below)
2. The responsible use of veterinary medicines for therapeutic and prophylactic purposes is one of the major skills of a veterinary surgeon and crucial to animal welfare and to the maintenance of public health.
3. Under the Veterinary Medicines Regulations, veterinary surgeons may prescribe POM-V veterinary medicinal products only following a clinical assessment of animals under their care.
4. Failure by the profession to observe these requirements could result in the removal of the exemption for the supply of medicines by veterinary surgeons.
5. The Veterinary Medicines Regulations do not define the phrase 'under his care' and the RCVS has interpreted it as meaning that:
a. the veterinary surgeon must have been given the responsibility for the health of the animal or herd by the owner or the owner's agent
b. that responsibility must be real and not nominal
c. the animal or herd must have been seen immediately before prescription or,
d. recently enough or often enough for the veterinary surgeon to have personal knowledge of the condition of the animal or current health status of the herd or flock to make a diagnosis and prescribe.
e. the veterinary surgeon must maintain clinical records of that herd/flock/individualWhat amounts to 'recent enough' must be a matter for the professional judgement of the veterinary surgeon in the individual case.
6. The Veterinary Medicines Regulations do not define "clinical assessment", and the RCVS has interpreted this as meaning an assessment of relevant clinical information, which may include an examination of the animal under the veterinary surgeon's care.
7. Veterinary surgeons may prescribe POM-VPS veterinary medicinal products in circumstances where there has been no prior clinical assessment of the animals and the animals are not under his or her care. In these circumstances veterinary surgeons should prescribe responsibly and with due regard to the health and welfare of the animals.
8. Diagnosis for the purpose of prescription should be based on professional judgement following clinical examination and/or post mortem findings supported if necessary by laboratory or other diagnostic tests.
9. A veterinary surgeon must be satisfied that the animal would benefit from medication, particularly in the case of antibiotics or hormones.
10. The selected product must be authorised for use in the UK in the target species for the condition being treated and used at the manufacturer's recommended dosage.
11. If there is no suitable authorised veterinary medicinal product in the United Kingdom for a condition in a particular species, in order to avoid unacceptable suffering veterinary surgeons may exercise their clinical judgement according to the 'Cascade', whereby they select in the following order
a. a veterinary medicinal product authorised in the United Kingdom for use with another animal species, or for another condition in the same species (off-label use); or
b. if, and only if, there is no such product that is suitable, either:i. a medicinal product authorised in the United Kingdom for human use; or
ii. a veterinary medicinal product not authorised in the United Kingdom but authorised in another European Member State for use with any animal species (in the case of a food-producing animal, it must be a food-producing species); or
c. if, and only if, there is no such product that is suitable, a veterinary medicinal product prepared extemporaneously by a pharmacist, a veterinary surgeon or a person holding a manufacturing authorisation authorising the manufacture of that type of product.
12. A decision to use a medicine which is not authorised for the condition in the species being treated where one is available should not be taken lightly or without justification. In such cases clients should be made aware of the intended use of unauthorised medicines and given a clear indication of potential side effects. Their consent should be obtained in writing. In the case of exotic species most of the medicines used are unlikely to be authorised for use in the UK and owners should be made aware of and consent to this from the outset.
13. A veterinary surgeon who prescribes a POM-V or POM-VPS veterinary medicinal product, or supplies a NFA-VPS veterinary medicinal product, must:
a. before he does so, be satisfied that the person who will use the product is competent to use it safely and intends to use it for a use for which it is authorised;
b. when he does so, advise on the safe administration of the veterinary medicinal product;
c. when he does so, advise as necessary on any warnings or contra-indications on the label or package leaflet; and
d. not prescribe (or in the case of a NFA-VPS product, supply) more than the minimum quantity required for the treatment.
14. The Veterinary Medicines Regulations do not define 'minimum amount' and the RCVS considers this must be a matter for the professional judgement of the veterinary surgeon in the individual case.
15. Veterinary medicinal products must be supplied in appropriate containers and with appropriate labelling.
16. Veterinary surgeons may make retail supplies of POM-V veterinary medicinal products on the prescription of another veterinary surgeon (i.e. for animals that are not under the care of the supplying veterinary surgeon).
17. From 1 April 2009, practice premises from which veterinary surgeons supply veterinary medicinal products must be registered with the RCVS as ‘veterinary practice premises’, in accordance with the Veterinary Medicines Regulations; this Regulation (Regulation 8 of Schedule 3) does not apply to Authorised Veterinary Medicines – General Sales List (AVM-GSL).
18. Premises likely to be considered as ‘veterinary practice premises’ are those:
a. from which the veterinary surgeons of a practice provide veterinary services; and/or,
b. advertised or promoted as premises of a veterinary practice; and/or,
c. open to members of the public to bring animals for veterinary treatment and care; and/or,
d. not open to the public, but which are the base from which a veterinary surgeon practises or provides veterinary services to more than one client; and/or,
e. to which medicines are delivered wholesale, on the authority of one or more veterinary surgeons in practice.
19. Main and branch practice premises from which medicines are supplied are veterinary practice premises that must be registered with the RCVS.
20. Veterinary surgeons should keep a record of premises and other places where they store or keep medicinal products, for example, homes where medicinal products may be kept for on-call purposes and practice vehicles; the record should be held at the practice’s main ‘veterinary practice premises’ in accessible form.
21. Veterinary surgeons should keep a full record of all incoming and outgoing medicinal products and at least once a year carry out a detailed audit reconciling these with stock, recording any discrepancies. For further information please see the Veterinary Medicines Directorate's Clarification Note on record keeping.
22. Ketamine may be the subject of misuse and, therefore, should be stored in the controlled drugs cabinet and its use recorded in an informal register.
23. The act of dispensing, including quantity and batch numbers should be recorded in the animal's/farm's clinical records.
24. Farm clients should be advised specifically about withdrawal periods and on the recording of medicine use in their Medicines Record Book.
25. The Suspected Adverse Reaction Surveillance Scheme (SARSS) for veterinary medicines is operated by the VMD (telephone number for SARSS 01932/338427, fax 336618). All suspected adverse reactions should be reported using the yellow form (MLA 252A Rev. 8/01). Supplies should be held in the practice and may be obtained by return of post using the tel/fax number. Serious reactions (death or prolonged severe clinical signs) are mentioned specifically in the European Directives and companies marketing products are required to report them to the SARSS. Further information is available from the VMD.
1. The RCVS is required by statute to investigate any complaint against a member which may give rise to an allegation of professional misconduct. The RCVS receives complaints on a wide variety of issues all of which have to be investigated initially in order to establish whether or not they contain issues within its jurisdiction, and also in order to fulfil the public's legitimate expectations of a regulatory body.
2. RCVS disciplinary powers are exercised through the Preliminary Investigation and Disciplinary Committees, established in accordance with Schedule 2 of the Veterinary Surgeons Act 1966.
The Preliminary Investigation Committee
Distinction between Unethical Conduct and Conduct Disgraceful in a Professional Respect
Distinction between Professional Negligence and Conduct Disgraceful in a Professional Respect
3. The Preliminary Investigation Committee consists of the President and Vice Presidents of the RCVS and three elected members of Council. In the interests of transparency two lay observers sit with the committee.
4. Its duty is to investigate complaints against veterinary surgeons which contain allegations of disgraceful professional conduct (i.e. those which may be capable of leading to the removal of the veterinarian's name from the Register or their registration being suspended), fraudulent registration or conviction of an offence rendering him or her unfit to practise veterinary surgery. The Preliminary Investigation Committee must decide whether a case should be referred to the RCVS's solicitors for investigation, and if appropriate for charges to be drafted for consideration by the Disciplinary Committee.
5. The Disciplinary Committee consists of a Chairman elected by Council and eleven other members of Council, similarly elected, at least one of whom must be a Privy Council appointee. No member of the Preliminary Investigation Committee may serve on the Disciplinary Committee, nor may they do so subsequently in respect of any case considered during their membership of the P I Committee.
6. The Disciplinary Committee is a properly constituted judicial tribunal and must comply with the Veterinary Surgeons and Veterinary Practitioners (Disciplinary Committee) (Procedure and Evidence) Rules 2004 which provides that 'any charge which may result in a direction by the Committee that a respondent be removed from the register, shall be proved so that the Committee is satisfied to the highest civil standard of proof, so that it is sure,' which is tantamount to the criminal standard of proof.
7. If the Disciplinary Committee finds the charges against the Respondent proven it may order the Respondent's name to be removed from the Register of Veterinary Surgeons or his/her registration to be suspended for a specified period.
8. Alternatively judgement may be postponed for a period of up to two years or the Committee may make no order but warn the Respondent as to future conduct. Sometimes judgement may be postponed subject to specified undertakings given by the veterinary surgeon to the Committee.
9. Any Respondent against whom an order has been made has a right of appeal to the Judicial Committee of the Privy Council. The appeal must be lodged within 28 days after receiving notification of the Committee's order. The order itself will not take effect until after the 28-day period or until any appeal has been heard and determined.
10. When a veterinary surgeon's name is removed from the Register (striking off) they may not be involved in any form of veterinary practice. They may apply to have their name restored to the Register after 10 months have elapsed and will be required to reappear before the Committee to satisfy it that they are fit to return to practice.
11. In the case of a suspension the veterinary surgeon is similarly debarred from any direct form of veterinary activity until the period of suspension has expired, at which time their name will be automatically restored and they may resume practice.
12. Under the Veterinary Surgeons Act 1966 the RCVS has authority to deal with three types of case:
a. fraudulent registration
b. criminal convictions
c. allegations of disgraceful professional conduct
13. This would arise if someone were to gain admission to membership of the RCVS by falsely claiming to have the appropriate qualifications or by assuming a false identity.
14. The RCVS is required to consider any conviction against a veterinary surgeon in the criminal courts in the United Kingdom or elsewhere which may 'render him unfit to practise veterinary surgery'. It looks only at the fact and the nature of the conviction. Any defence put forward at the trial can only be introduced in mitigation before the Disciplinary Committee.
15. Not every criminal offence will necessarily be notified to the RCVS or referred to the Disciplinary Committee, but rather only those which are likely to affect the veterinary surgeon's ability or fitness to practise, call their honesty into question or endanger the public.
16. On admission to membership of the RCVS every veterinary surgeon makes a declaration of loyalty to the College, amounting in essence to entering into an agreement under which they promise to follow the College's ethical guidance in its entirety. (Such a contract is an essential feature of any self regulating profession.)
17. It is important to distinguish between unethical behaviour and disgraceful professional conduct.
18. Unethical behaviour is essentially a departure from that standard of behaviour accepted as the norm among members of the profession.
19. A series of substantiated allegations of unethical behaviour may lead to a charge of disgraceful professional conduct.
20. Disgraceful professional conduct - for example false certification or seriously deficient professional care for an animal - is serious in itself, and as such is likely to bring the profession into disrepute, and is likely to lead to referral to the Disciplinary Committee.
21. Professional negligence arises when the veterinary surgeon has failed to exercise the normal level of skill and judgement which would be expected of the average veterinary surgeon and as a result of which damage has been suffered. All harm is not necessarily actionable. It should be remembered that in the case of those with higher or specialist qualifications, or claimed specialist status, a correspondingly higher standard will be expected.
22. The RCVS has no power under the Veterinary Surgeons Act or other legislation to award compensation or damages which are the normal remedies when negligence is proven. Thus allegations of negligence which cannot be resolved directly as between veterinary surgeon and client are matters for adjudication by the civil courts. The RCVS has no power to usurp the court's jurisdiction.
23. It is accepted that in some cases negligence and disgraceful conduct may overlap, where, for example, the negligence has been so gross to amount to serious professional misconduct (seriously deficient professional care). Where this appears to be a real possibility the RCVS will investigate a complaint. If no issues of professional conduct are identified a complaint will not be pursued.
24. RCVS jurisdiction applies to all veterinary surgeons, whether EU, foreign or UK graduates practising in the United Kingdom, and to all UK veterinary surgeons practising in any part of the world who, although practising abroad have retained RCVS membership. Where there is a local veterinarian's board or regulatory body, however, the RCVS will usually work with that body rather than intervene itself. Similarly it will take into account any local circumstances in considering allegations of disgraceful conduct made against members practising abroad.
25. The RCVS must investigate all complaints made against its members, which fall within its jurisdiction (i.e. complaints that raise an issue of professional conduct), however trivial they may appear, in accordance with the following procedure (much simplified in the interest of clarity).
26. In the majority of cases the member's response will reveal that a misunderstanding has arisen and enable the RCVS to resolve the complaint by correspondence. It is however incumbent upon members to respond constructively to the allegations. Persistent failure to do so will in itself raise a misconduct issue. Members may indicate that they choose to exercise their 'right to silence' and the complaint may then go forward unrebutted.
27. Similar procedures are followed when a conviction is reported to the RCVS. Usually, the Preliminary Investigation Committee considers convictions.
N.B. This is a general description of the procedures. More detailed information is available on request from the RCVS Professional Conduct Department; this includes a complaints form, information for complainants and information for veterinary surgeons asked to respond to complaints.
1. The animal-owning public may not appreciate the difference between the meaning of '24-hour service' and '24-hour cover'. The position is complicated by advertisements in 'Yellow Pages' and other directories, some of which include the information that a practice provides '24-hour emergency cover'. It is often assumed, wrongly, that ONLY these practices provide this cover. The RCVS makes the following distinction:
2. This implies the provision of normal facilities throughout the 24 hours. The RCVS does not impose this requirement on a practice. Certain large practices and Veterinary Hospitals may be able and prepared to provide such a service, and may do so on behalf of other practices in their area.
3. This means the provision of immediate first aid and pain relief to deal promptly with emergencies, at all times. A veterinary surgeon may decide that non-emergency treatment should be delayed until normal working hours.
4. The RCVS requires a veterinary surgeon to take steps to provide 24-hour emergency cover. The RCVS does not require that a veterinary surgeon in practice provide the 24-hour emergency cover him or herself.
5. Veterinary surgeons are encouraged to cooperate with each other in the provision of 24-hour emergency cover. Such co-operation may be between groups of local practices. Alternatively, 24-hour emergency cover may be provided for a veterinary surgeon or practice by a dedicated 24-hour emergency service clinic. Arrangements must be made before an emergency arises, and normally confirmed in writing.
6. Clients should be provided with written information on the nature of the 24-hour emergency cover provided, including all relevant telephone numbers, location details and likely initial costs for an out-of-hours emergency consultation.
7. If an owner of an animal, who is not a client of the practice, requests an emergency out-of-hours consultation, the veterinary surgeon may reasonably direct the owner to his or her usual veterinary surgeon and decline to carry out the consultation. However, immediate first aid and pain relief must be provided to the animal if, for whatever reason, the owner cannot contact his or her usual veterinary surgeon. The veterinary surgeon should be aware that holiday-makers, new owners and other categories of animal owner may not have a 'usual veterinary surgeon' in the locality.
8. Veterinary practices should provide protocols for on-duty veterinary surgeons. Such protocols could include advice on:
a. risk assessments
b. information on the locality
c. contingency planning
d. telephone answering machines
e. any veterinary back-up
f. the veterinary services offered by local practices
g. the information on the provision of other 24-hour emergency services in the locality
h. clinical protocols
i. details of relevant equipment and local contacts
9. The responsibility for the welfare of an animal rests primarily with the owner, keeper or carer of the animal. When the owner, keeper or carer contacts a veterinary surgeon in the belief that the animal is suffering or requires attention, they place the onus of decision-making onto the veterinary surgeon. With the benefit of prior knowledge of the animal, or from relevant enquiry of the owner, the veterinary surgeon must decide whether attention is required immediately or can reasonably be delayed.
10. Veterinary surgeons must be aware of the difficulties created by:
a. making clinical judgements without examining the animal, and
b. having no immediate access to the animal's clinical records
and must be able to justify a decision that the needs of the animal will not be adversely affected should treatment be delayed. The responsibility for conveying the animal to the practice premises remains with the owner. Veterinary surgeons may be in a position to advise on the availability of an animal ambulance or a taxi service willing to transport sick animals to the practice premises.
11. Any veterinary surgeon asked to attend an animal away from the practice premises, particularly at night, may need to consider the safety implications of making the visit. Practice policies to exclude domiciliary visits are not acceptable and a veterinary surgeon should assess each individual situation.
12. In such circumstances, and generally, the RCVS does not expect a veterinary surgeon to risk 'life or limb', or that of anyone else. All the RCVS asks is that a veterinary surgeon acts reasonably, taking into account all the circumstances of any particular case, along with the guidance in Part 2D of the RCVS Guide to Professional Conduct (see 'Attendance away from practice premises' below).
13. A veterinary surgeon deciding whether to attend an animal away from the practice premises should also give consideration to the following non-exhaustive list of factors:
a. location and state of the animal
b. likely treatment needed
c. possibility of the animal being safely conveyed to the veterinary surgery
d. local availability of an animal ambulance service or something similar
e. health status of the animal and ability of owner to manage the animal's pain until veterinary attention can be sought during normal hours
f. travelling time for the veterinary surgeon
g. ability of the veterinary surgeon to make the visit in safety
h. possibility of another person attending with the veterinary surgeon
i. local weather conditions
14. If any complaint is made to the RCVS and a veterinary surgeon is able to explain his or her reasons for not attending and the RCVS can see that proper consideration was given to the circumstances and that a reasonable decision was taken and explained to the animal owner or client, that is likely to be an end of the matter.
15. The above obligations apply to neutering and vaccination clinics, and other limited service providers.
16. The cost of providing professional attention outside 'routine hours' is high and the RCVS accepts that clients may be required to pay a premium for emergency veterinary attention out of hours.
17. A veterinary surgeon or a lay member of staff accepting telephone calls must not refuse veterinary attention because the caller is unable to make immediate payment for the treatment. Arrangements for payment should be discussed at an early stage, but immediate first aid and pain relief should not be delayed while financial arrangements are agreed.
18. The RCVS is aware that it may be appropriate to advise euthanasia to relieve suffering, if the owner is unable to afford the fees and is ineligible for charitable treatment.
19. The RCVS has no power to set the fees that a practice charges.
20. Practices accepting referrals must make arrangements, in advance, to provide advice to referring veterinary surgeons or practices on a 24-hour basis for the care of that patient (see Part 2D, 'Referral practices' below).
21. Merely answering the telephone on a 24-hour basis is not in itself sufficient to satisfy the requirement to provide 24-hour emergency cover. Upon receiving a telephone call 'out of hours', it is the veterinary surgeon's responsibility to assess the needs of the animal and the degree of urgency and to respond accordingly.
22. It is quite appropriate for callers telephoning the practice numbers to hear a pre-recorded message, and/or to be invited to leave a message of their own. However, they must always be provided with a means to request urgent assistance, to which there should be a response, normally within 15 minutes.
23. Before leaving an animal at a practice, the owner, keeper or carer must be made aware of the level of supervision that will be provided to the animal, including the level of supervision during an overnight stay. Different levels of care required arise in differing circumstances:
a. Intensive Care
b. Post-operative recovery
c. RTAs and some orthopaedic procedures
d. Whelping and kittening
e. Stabilising procedures, e.g. for diabetics
f. Pending laboratory or other test results
g. Refuge - awaiting re-homing or abandoned
24. Clients are entitled to have their animals housed in a comfortable environment, monitored and treated by day and night, as appropriate to the animal's condition, by persons with the requisite knowledge and expertise. The RCVS is aware that inevitably in-patient treatment is expensive. Clients should also be made aware of the cost of providing care that is labour intensive. There are circumstances in which it may be appropriate for an experienced owner to provide nursing attention at home.
25. The above guidance applies to all veterinary surgeons and practices.
For the animal owner
26. With the introduction of more specialised emergency clinics, there may be a requirement for some animal owners, keepers or carers to travel greater distances to reach the service provider. The RCVS does not specify a distance or time that is acceptable, as each will be influenced by local conditions. Veterinary surgeons, when making arrangements for the provision of 24-hour emergency cover, should give consideration to these factors
For the veterinary surgeon
27. Changes in agriculture and veterinary practice mean that veterinary surgeons often need to travel further to visit clients than has previously been the case. The RCVS does not specify limits on time or distance, but veterinary surgeons must be able to demonstrate that they have made arrangements, in advance, to provide 24-hour emergency cover for all their clients. Those veterinary surgeons taking steps to provide 24-hour emergency cover (see Part 1C, para 1b, below), including dedicated providers of emergency services and those practices sharing in the provision of 24-hour emergency cover, must:
a. ensure that clients of the practice or other practices are expected to travel only reasonable distances
b. ensure that information regarding the arrangements for 24-hour emergency cover (also see Part 1D, para 1a, and see Part 2C, para 1a, below) (subject to (c)) is available to clients.
c. when entering into arrangements to provide 24-hour emergency cover for another practice, have confirmation (from the appropriate veterinary surgeon) that clients of that other practice will be informed of the agreed arrangements for 24-hour emergency cover (also see Part 1D, para 1a, and see Part 2C, para 1a, below).
28. Farm practices are accustomed to dealing with experienced stockmen, but many farm animals, equidae and more exotic species are also kept by inexperienced owners, whose various levels of skill must be taken account of, in providing 'large-animal' services.
29. In isolated communities there may be a need for a pragmatic approach to the provision of 24-hour emergency cover, provided that clients and the nearest veterinary practice are fully informed of the arrangements.
30. A remote region of the UK is considered to be a geographical area where, for logistical reasons, travelling may be difficult and may be influenced by inclement weather, ferries or other factors.
31. In remote regions of the UK, the RCVS accepts that there may be insufficient veterinary manpower for a veterinary surgeon 'in practice, to take steps to provide 24-hour emergency cover for the care of animals of those species treated by the practice during normal working hours'.
32. In addition, the RCVS accepts that in such remote regions a veterinary surgeon 'on duty providing 24-hour emergency cover' may not be able to provide immediate first aid or pain relief to all animals.
33. When considering whether a veterinary surgeon's steps to provide 24-hour emergency cover are reasonable and whether a veterinary surgeon is acting reasonably when on duty providing 24-hour emergency cover, the following non-exhaustive list of factors should be considered:
a) stock/animal density in the region;
(The lower the stock/animal density of the relevant species, the less likely that a region can support the veterinary manpower necessary to provide 24-hour emergency cover.)
b. remoteness of the region
(The more remote or inaccessible the region, the more impracticable it may be to provide comprehensive 24-hour emergency cover.)
c. proximity of other veterinary surgeons in practice in the region providing 24-hour emergency cover;
(In a remote region, where there is a veterinary practice providing 24-hour emergency cover, the RCVS is likely to expect other veterinary surgeons in practice in the region to provide similar 24-hour emergency cover.)
d. co-operation between veterinary surgeons in practice to provide 24-hour emergency cover in the region;
(While such cooperation between veterinary surgeons is encouraged by the RCVS, it is not mandatory between what may be competitor practices. See paragraph 5 above which states:
'Veterinary surgeons are encouraged to cooperate with each other in the provision of 24-hour emergency cover. Such co-operation may be between groups of local practices. Alternatively, 24-hour emergency cover may be provided for a veterinary surgeon or practice by a dedicated 24-hour emergency service clinic. Arrangements must be made before an emergency arises, and normally confirmed in writing.')
e. veterinary services in the region are for a particular species
(In a remote area, if there are no or limited veterinary services for a particular species, the provision of veterinary services to that species without the provision of 24-hour emergency cover is more likely to be acceptable.)
f. whether animals are owned as part of a business
(It is more likely that a business will be able to consider alternative sources of veterinary services than a member of the public and be able to consider the risks and problems associated with the absence of a full veterinary service. The use of contracts specifying the terms of business is likely to avoid ambiguity about the extent of those veterinary services, including how 24-hour emergency cover will be provided.)
g. the business client's knowledge and experience of handling and caring for the animals
(The more knowledgeable and experienced the business client in handling and caring for the animals the more reasonable will be the provision of a limited 24-hour emergency cover in a remote area. In addition, the more likely that a veterinary surgeon will be able to leave veterinary medicines (not controlled drugs) with the business client for administration to animals under the prescribing veterinary surgeon's care and after his or her clinical assessment (see Part 2H - The use of veterinary medicinal products)
h. compliance with the Working Time Regulations and Health and Safety legislation
(Veterinary surgeons are expected to comply with the Working Time Regulations and Health and Safety legislation and therefore, for example, it may be impracticable for those in single-handed or small practices in remote regions of the UK to provide comprehensive 24-hour emergency cover at all times.)
i. distance between the veterinary surgeon in practice and the client/patient
(The greater the distance between the veterinary surgeon in practice and the client/patient, the more impracticable may be the provision of comprehensive 24-hour emergency cover, and the more difficult it may be for a veterinary surgeon on duty providing that cover to respond to the needs of an animal that may require immediate first aid or pain relief.)
34 When considering complaints on 24-hour emergency cover, the RCVS will consider all relevant factors before deciding whether a veterinary surgeon has acted reasonably.
1. A veterinary surgeon must:
b. if in practice, take steps to provide 24-hour emergency cover for the care of animals of those species treated by the practice during normal working hours.
This applies equally to veterinary surgeons working in:
i charities providing veterinary services;
ii neutering and vaccination clinics and other limited service providers (see Part 2E, below); and,
iii referral practices (see Part 2D, below), including those in universities,
Emergency cover means, at least, immediate first aid and pain relief.
With prior arrangement, preferably confirmed in writing, 24-hour emergency cover may be provided by, or in conjunction with, one or more other veterinary practices.
c when on duty providing 24-hour emergency cover:
i not unreasonably refuse to provide first aid and pain relief for any animal of a species treated by the practice during normal working hours
ii not unreasonably refuse to provide first aid and facilitate the provision of pain relief for all other species until such time as a more appropriate emergency veterinary service accepts responsibility for the animal
iii not unreasonably refuse to accept responsibility for an animal from a colleague, in order to provide first aid and facilitate the provision of pain relief for that animal
Clients of another practice may be directed to their own practice, at least in the first instance.
Whether attendance away from the practice premises is essential, or not, is the decision of the on-duty veterinary surgeon taking into account the needs of the animal and the relevant health and safety issues.
1. The provision of veterinary services creates a contractual relationship under which the veterinary surgeon should:
a. ensure that clear written information is provided about practice arrangements, including the provision, initial cost and location of the out-of-hours emergency service, and information on the care of in-patients
1. Veterinary surgeons should be sufficiently familiar with and comply with relevant legislation including:
c. Health and Safety at Work (including the Working Time Regulations), Radiation Protection, Control of Substances Hazardous to Health and other similar legislation as it applies to veterinary practice.
Practice information
1. Veterinary practices should provide clients, particularly those new to the practice, with comprehensive written information on the nature and scope of the practice's services, including:
a. the provision, initial cost and location of the out-of-hours emergency service
b. information on the care of in-patients
c. the practice's complaints handling policy
and could also provide full terms and conditions of business, to include for example:
d. surgery opening times
e. whether open or by appointment
f. fee or charging structures
g. procedures for second opinions and referrals
h. use of client data
i. access to and ownership of records
Referral Practices
7. Referral practices must provide twenty-four hour availability in all their specialities, or they must, by prior arrangement, direct referring veterinary surgeons to an alternative source of appropriate assistance. Appropriate post-operative or in-patient care must be provided by the referral veterinary surgeon, or by another veterinary surgeon with similar expertise (and at a practice with similar facilities); unless agreed otherwise with the client and provided that the welfare of the patient is not compromised.
Attendance Away from the Practice Premises
15. Clients often request attendance on a sick or injured animal away from the practice premises. It must be recognised that in some circumstances it may be desirable to do so. On rare occasions, it may actually be necessary on clinical or welfare grounds.
16. The decision as to whether attendance away from the practice is essential or not, is solely for the veterinary surgeon concerned, having carefully balanced the needs of the animal against the relevant health and safety issues for the practice personnel.
Neutering Clinics
7. Animal welfare must always be the first consideration and veterinary surgeons working in such practices must:
a. have the appropriate facilities required for any small animal practice providing a similar service
b. ensure that a full pre-operative examination is carried out to establish fitness for surgery and freedom from intercurrent disease. If a disease is identified the animal must be re-directed to its regular veterinary surgeon, or to an appropriate animal charity for treatment BEFORE surgery
c. make provision for 24-hour emergency cover for the entire post-operative period during which complications arising from the surgery may develop
Vaccination Clinics
8. Vaccination clinics must similarly:
a. have the appropriate facilities required for these services in small animal practice
b. carry out a full health check, and contact the animal's regular veterinary surgeon if it is already under treatment
c. give advice on feeding and worming as part of the vaccination programme
d. make provision for 24-hour emergency cover for the period in which adverse reactions might arise
The working party was set up by the RCVS Advisory Committee with terms of reference adopted by Council on 6 November 1997. Dr Lydia Brown was appointed as chair with Mr Walter Beswick (Chair, Advisory Committee), Dr Jerry Lucke and Professor David Noakes as members.
TERMS OF REFERENCE
1. The working party was asked to formulate guidelines on
What constitutes recognised veterinary practice under the terms of A(SP)A
The use of animals in clinical teaching and research at undergraduate and postgraduate level.
The point at which a test moves from the conceptual stage under A(SP)A to be governed by the Veterinary Surgeons Act as a diagnostic test.
BACKGROUND
2. The working party has held a number of meetings, including meetings with Home Office representatives, and has considered the following papers:
Home Office guidance on the performance of procedures by veterinary surgeons (August 1988).
RCVS Newsletter article, 'Scientific procedure — or recognised practice?' by Jeremy Roberts based on the Home Office guidance (March 1991).
Report of the RCVS working party, 'The use of animals in clinical teaching and research' (June 1994).
RCVS Guide to Professional Conduct (1996, Paragraph 3.8 on pages 49 and 50).
Guidelines for the use of normal animals in veterinary clinical teaching prepared by Professor David Noakes based on material provided at the RCVS visitation to Atlantic College, University of Prince Edward Island, Canada (September 1994).
3. A draft report was circulated as the basis of a consultation exercise to the Veterinary Schools, the Animal Health Trust, MAFF (now DEFRA) and members of the 1994 RCVS working party, Mr James Allcock, Dr Peter Holt, Dr Polly Taylor and Dr Jeremy Roberts.
4. An amended draft report, incorporating suggestions from those consulted, was referred to the Home Office and discussed at meetings with representatives of the inspectorate and officials.
5. Constructive comments and suggestions were received from all those who replied. A useful dialogue has been established with Home Office representatives. It is accepted that it is for the RCVS to provide guidance to its members on what is recognised veterinary practice. RCVS advice is intended to assist veterinary surgeons, veterinary students, teachers in veterinary schools and in extra mural practices and Home Office inspectors and officials. It is accepted however that the Courts interpret the law and that RCVS guidance is no more than advice from the professional regulatory body. Moreover it is also recognised that RCVS guidance cannot cover all current situations and that new questions will have to be answered in the future.
RECOGNISED VETERINARY PRACTICE
6. Interpretation of the term 'recognised veterinary practice' is the key underlying all 3 elements in the terms of reference.
7. It is proposed that the term 'recognised veterinary practice in section 2(8) of A(SP)A should be interpreted as — procedures and techniques performed on animals by veterinary surgeons in the course of their professional duties which ensure the health and welfare of animals committed to their care.
8. The following definitions are used to clarify the terms:
Procedure and techniques are terms used for a veterinary investigation, diagnosis or treatment including any prophylactic measures taken to prevent or control disease.
A veterinary surgeon is a registered member of the RCVS. Some delegation must be permitted consistent with the criteria for delegating acts of veterinary surgery set out in the report of the RCVS deregulation working party 1996.
Professional duties are those carried out by, or under the responsibility of, a veterinary surgeon when his or her normal work (including, private and academic clinical practice and professional duties in animal welfare organisations, government service and commerce) involves techniques and procedures applied to animals committed to their care.
9. In all circumstances, the individual has to consider the primary purpose and whether he or she is acting in a professional capacity as a veterinary surgeon or as a research scientist. Although the procedures and techniques may be identical, analysis of the purpose for which they are applied should help the veterinary surgeon to determine if the intervention is of direct benefit to the animal or its immediate group (i.e. others of the same species) and therefore recognised veterinary practice, or if the intervention is for an experimental or other scientific purpose and controlled by A(SP)A.
10. Recognised veterinary practice does NOT include:
Experiments using animals primarily for research where the procedure is not part of normal veterinary clinical practice or a veterinary clinical investigation.
Deliberately exposing animals, including those used in unprotected control groups, to trauma or infectious agents where there is a risk to health and wellbeing.
Use of an animal in teaching, if the procedure would not normally be used to teach acts of veterinary surgery as defined in VSA 1966, section 27
Clinical investigations which would not be for the benefit of that animal or its immediate group.
11. When animals are used for experimental or other scientific purposes, veterinary surgeons are no different from non veterinarians which means that Home Office authorities under A(SP)A must be sought. Failure to comply with Home Office regulations by deliberately misinterpreting the recognised veterinary practice exemption under section 2(8), will be treated as infringements of A(SP)A and may be regarded as professional misconduct subject to full RCVS disciplinary action.
THE USE OF ANIMALS IN CLINICAL TEACHING
12. Under the terms of the VSA, the RCVS is responsible for monitoring veterinary education and professional training and is well placed to give guidance to the profession on ways in which animals are used in clinical teaching and clinical investigation. The responsibility for the animal's welfare lies with the supervising veterinary surgeon and any 'cruelty' would be in breach of the Protection of Animals Act 1911 (1912 Scotland) and subject to possible prosecution.
13. Veterinary graduates will have been properly trained at the time of registration and continual professional development is a professional obligation for veterinary surgeons throughout their careers. The training will, in most instances, be achieved using clinical cases where there will be an individual veterinary surgeon responsible to the animal and the owner.
14. The teaching of skills to veterinary students is controlled by the Veterinary Surgeons (Practice by Students) (Amendment) Regulation 1993 made under the Veterinary Surgeons Act 1966. Such use of animals applies to all veterinary students in their clinical years and is the responsibility of the clinicians in charge. The procedures and techniques are limited to those that would be undertaken by the supervising veterinary surgeon in the course of his/her professional duties. The purpose is not experimental or scientific but the student may acquire competence in those techniques that he/she will use as a qualified veterinarian.
15. Animals used for training and teaching purposes would normally be those presented to veterinary surgeons in the course of their professional activities.
16. Open discussions with colleagues at the local level should be encouraged. The ethical review process in the veterinary schools required under A(SP)A would be a suitable forum for considering the ethical issues on the appropriate use of animals in clinical teaching.
17. It is recommended that the RCVS should be the focus for professional advice in the UK and that a mechanism should be set up for collating information and identifying precedents. Based on this evidence, RCVS guidance should be under constant review.
18. The use of cadavers for teaching and investigation is encouraged. If having obtained the owner's informed consent, the animal is euthanased by overdose of an anaesthetic agent and confirmed as dead by the cessation of the circulation, the cadaver can be used for teaching purposes. This preparation would be recognised veterinary practice.
19. Perfusion of animals before death to obtain fixed anatomical specimens is not considered recognised veterinary practice and should be regulated under A(SP)A.
20. Acts of veterinary surgery may be carried out on animals by veterinary surgeons to train non-veterinarians in certain procedures covered by Schedule 3 or Orders made under the Veterinary Surgeons Act.
For example — veterinary nurses, and technicians employed in cattle embryo transfer teams.
CLINICAL INVESTIGATION ACCEPTED AS RECOGNISED VETERINARY PRACTICE
21. When conducting clinical investigation (without A(SP)A authorities) care must be taken to ensure that appropriate veterinary treatment and care is provided for all animals used in the study. The use of untreated 'control' groups needs careful consideration, to ensure that no avoidable suffering results as a consequence of withholding treatments. The inclusion of placebo treated 'control' groups will require A(SP)A authority if likely to cause pain, suffering, distress or lasting harm to the animal.
22. The use of any novel treatments must reasonably be expected to result in a similar or better outcome than that following conventional treatment. The veterinary surgeon must have some background knowledge of the treatment in order to make a professional judgement. When what is to be done has an experimental component, authority under A(SP)A may be necessary.
23. When there is a desire to pursue scientific investigation on clinical cases and with the owner's informed consent, it may be possible to bring the animals into A(SP)A authority and discharge them at the end of the investigation.
24. Veterinary surgeons conducting clinical trials within the terms of an Animal Test Certificate (ATC) issued by the Veterinary Medicines Directorate do not generally require A(SP)A authority.
25. The circumstances described above highlight the interface between VSA and A(SP)A with respect to clinical investigation. In these and similar circumstances veterinary surgeons are invited to approach the RCVS and a Home Office inspector at a preliminary stage to determine whether A (SP)A authority is needed.
DIAGNOSTIC TESTS AND APPLICATION OF NEW THERAPIES
26. The working party was asked to consider drawing up criteria that could be used to determine the point at which a veterinary diagnostic test moved from the conceptual stage, when it should be regulated under A(SP)A, to the point at which there was a clinical application and it might be regarded as recognised veterinary practice. During the course of discussion it was decided to examine the same criteria as they might apply to the introduction and application of new therapies into recognised veterinary practice.
27. There are many examples where veterinary surgeons apply diagnostic tests and techniques to clinical cases that have already been developed for use in other species or human patients. Similarly, treatments used in human medicine may be introduced for use in animals where potential benefits might be expected for the individual animal or its immediate group, for veterinary public health or environmental protection. This is legitimate.
28. Unless regulated under A(SP)A it would NOT be acceptable, and may bring the profession into disrepute, for a veterinary surgeon to use an animal in the development of a diagnostic test or a new form of treatment where:
The test or treatment has not previously been made available to the veterinary profession and there is no background evidence to predict a clinical application in the species or other veterinary benefit,
There is deliberate deception that would enable a veterinary surgeon or a non veterinarian to avoid regulation under A(SP)A.
Mr Walter Beswick
Dr Lydia Brown
Dr Jerry Lucke
Professor David Noakes
16 September 1999
Sections of the Guide to which this Annex applies:
Your responsibilities under the law and
Maintaining practice standards, communication and consent
Please also see VSA/A(SP)A additional guidance and examples
2. When a veterinary surgeon is presented with an injured animal whose clinical signs cannot be attributed to the history provided by the client, s/he should include non-accidental injury in their differential diagnosis.
3. If there is suspicion of animal abuse, as a result of examining an animal, a veterinary surgeon should consider whether the circumstances are sufficiently serious to justify breaching the usual obligations of client confidentiality. In the first instance, in appropriate cases, the veterinary surgeon should attempt to discuss his/her concerns with the client. In cases where this would not be appropriate or where the client's reaction increases rather than allays concerns, the veterinary surgeon should contact the relevant authorities, for example the RSPCA (Tel: 0300 1234 999 - 24-hour line covering England and Wales); SSPCA (03000 999 999 covering Scotland); USPCA (028 9081 4242 - 24-hour line covering Northern Ireland) to report alleged cruelty to an animal.
4. Such action should only be taken when the veterinary surgeon considers on reasonable grounds that either animals show signs of abuse or are at real and immediate risk of abuse - in effect where the public interest in protecting an animal overrides the professional obligation to maintain client confidentiality. A veterinary surgeon may contact the RCVS for advice before any confidential information is divulged.
5. Given the links between animal and child abuse and domestic violence, a veterinary surgeon reporting suspected animal abuse to the relevant authority should consider whether a child might be at risk. A veterinary surgeon may also consider a child to be at risk in the absence of any animal abuse.
6. Where a veterinary surgeon is concerned about child abuse or domestic violence, he/she should consider reporting the matter to the relevant authorities. The following authorities can be contacted, the local authority social services department, the NSPCC for England, Wales and Northern Ireland (Tel. 0808 800 5000 - 24 hour line cover); CHILDREN FIRST for Scotland 0131 446 2300) or local police Child Protection Unit. A veterinary surgeon may contact the RCVS for advice before any confidential information is divulged.
7. The NSPCC leaflet Understanding the links: child abuse, animal abuse and family violence - information for professionals provides further information, including information on domestic violence and telephone numbers for the relevant authorities throughout the UK.
Professional Conduct Department 28 January 2003
(Drafted by RCVS Certification Working Party, BVA and MAFF (now DEFRA) )
A veterinarian should be asked to certify only those matters which are within his own knowledge, can be ascertained by him personally or are the subject of a supporting certificate from another veterinarian who does have personal knowledge of the matters in question and is authorised to provide such a supporting document. Matters not within the knowledge of a veterinarian and not the subject of such a supporting certificate but known to other persons, e.g. the farmer, the breeder or the truck driver, should be the subject of a declaration by those persons only.
Neither a veterinarian nor any person described in 1. above should be requested or required to sign anything relating to matters which cannot be verified by the signatory.
Veterinarians should not issue a certificate which might raise questions of a possible conflict of interest e.g. in relation to their own animals.
All certificates should be written in terms which are as simple and easy to understand as possible.
Certificates should not use words or phrases which are capable of more than one interpretation.
Certificates should be:-
a. produced on one sheet of paper or, where more than one page is required, in such a form that any two or more pages are part of an integrated whole and indivisible;
b. given a unique number, with records being retained by the issuing authority of the persons to whom certificates bearing particular numbers were supplied.
Certificates should be written in the language of the veterinarian signing them, and accompanied by an official translation of the certificate into a language of the country of ultimate destination.
Certificates should identify animals individually except in cases where this is impractical e.g. day old chicks.
Certificates should not require a veterinarian to certify that there has been compliance with the law of the European Union or a third country unless the provisions of the law are set out clearly on the certificate or have been provided to him by the issuing authority.
Where appropriate, notes for guidance should be provided to the certifying veterinarian by the issuing authority indicating the extent of the enquiries he is expected to make, the examinations he is required to carry out, or to clarify any details of the certificate which may require further interpretation.
Certificates should always be issued and presented in the original. Photocopies are not acceptable.
Provided that:-
a. a copy of the certificate (clearly marked 'COPY') should always be provided to the authority by whom the certificates were issued - see 6. above; and
b. where, for any good and sufficient reason (such as damage in transit) a duplicate certificate is authorised and supplied by the issuing authority, this must be clearly marked 'duplicate' before issue.
When signing a certificate, a veterinarian should ensure that:-
a. he signs, stamps and completes any manuscript portions in a colour of ink which does not readily photocopy ie a colour other than black;
b. the certificate contains no deletions or alterations, other than those which are indicated on the face of the certificate to be permissible, and subject to such changes being initialled and stamped by the certifying veterinarian;
c. the certificate bears not only his signature but also, in clear lettering, his name, qualifications and address and (where appropriate) his official or practice stamps;
d. the certificate bears the date on which the certificate was signed and issued and (where appropriate) the time for which the certificate will remain valid;
e. no portion of the certificate is left blank, so that it could subsequently be completed by some person other than the certifying veterinarian.
Relates to the following areas of the Main Guide:
Specimen consent forms are available below
1. The purpose of this advice note is to provide guidance on communication difficulties that can arise when providing veterinary services. Communication issues have arisen in a number of complaints considered by the RCVS Preliminary Investigation Committee (PIC). While the intention is for the advice note to address the concerns expressed by the Lay Observers that sit with the PIC, the RCVS believes by and large most practices do a satisfactory job, based on the fact that the number of complaints is low in comparison with the number of consultations that take place in veterinary practice every day.
2. Three Lay Observers sit with the PIC, which considers whether to refer complaints against veterinary surgeons to the RCVS Disciplinary Committee. Each year the Lay Observers provide a report to the RCVS Council and in 2007, they raised the issues of communication and consent suggesting that additional advice to veterinary surgeons might reduce the number of such complaints received by the RCVS. They stated that:
‘Poor Communication continues to be a major area of concern as is informed consent for procedures undertaken as well as the failure to provide estimates before treatment begins and when costs escalate. It would be beneficial to all parties if more focus were given to these critical areas by practices, as it would significantly decrease the dissatisfaction being expressed by members of the public.’
3. The advice on communication and consent in the RCVS Guide to Professional Conduct is as follows:
1.‘The provision of veterinary services creates a contractual relationship under which veterinary surgeons should …
f. Ensure that a range of reasonable treatment options is offered and explained, including prognoses and possible side effects;
g. Give realistic fee estimates based on treatment options;
h. Keep the client informed of progress, and of any escalation in costs once treatment has started;
i. Obtain the client’s informed consent to treatment unless delay would adversely affect the animal’ welfare (to give informed consent, clients must be aware of risks)…’.
RCVS Guide to Professional Conduct Part 1-D ‘Your responsibilities to your clients’
’19. Good communication skills in professional and support staff are essential to good veterinary practice.
20. Veterinary surgeons must endeavour to ensure that what both they and their clients are saying is heard and understood on both sides, and encourage clients to take a full part in any discussion. Explanations should be given wherever possible in non technical language and if there is any doubt as to whether the client has understood, this should be recorded.
21. Informed consent, which is an essential part of any contract, can only be given by a client who has had the opportunity to consider the options for treatment, and had the significance and risks explained to them. Cost may also be relevant to the client's decision. If it is anticipated that any procedure will be performed by a veterinary student, a listed veterinary nurse or other member of the support staff the client should be made aware of the fact.
22 . If the client's consent is in any way limited or qualified or specifically withheld, veterinary surgeons must accept that their own preference for a certain course of action cannot override the client's specific wishes other than on exceptional welfare grounds.
23. When arrangements have been made to bring an animal under the Animals (Scientific Procedures) Act 1986 for experimental investigation, the client should be made aware of the general provisions of the Act so that informed consent can be given, (see Annex 3B, A(SP)A and VSA interface)
4. Consent can be expressed orally or in writing or by implication. Obtaining consent is a process. The signature of the client on a consent form is the culmination of discussions that should have gone before. Clients should be encouraged to ask questions and given time to consider the information provided during the process of obtaining consent. Obtaining consent is the responsibility of the veterinary surgeon with the animal under his or her care. Obtaining consent may also be delegated to the veterinary nurses or other competent staff at the practice.
5. The importance of communicating effectively with clients throughout a case on continuing treatment options, as well as any escalation of fees, is an essential part of maintaining consent. If a client’s consent is in any way limited or qualified (see Part 1 D of the Guide, paragraph 22 above), contemporaneous notes of this should be made on the clinical records.
6. For a contract to be valid and legally enforceable there must be (i) capacity to contract; (ii) intention to contract; (iii) consensus ad idem (agreement as to the same thing); (iv) valuable consideration (eg payment); (v) legality of purpose; (vi) sufficient certainty of terms.
7. In the context of the provision of veterinary services, ‘consent’ can be described as the agreement to carrying out specific actions, based on information of what the actions involve and the likely consequences. Effective communication between veterinary surgeon and client is essential. Clients should have an opportunity to consent to the services offered, and accept the costs of those services as estimated and agreed.
8. The existence or otherwise of a contract is relevant, for example, to recover non-payment of fees. Regardless of whether a fee is charged or not, the professional responsibilities remain the same towards the patient and client. For the purposes of determining to whom a veterinary surgeon’s professional responsibilities are owed, the ‘the client’ is the person who requests professional services for an animal.’ (Part 1 D of the Guide).
9. Consent forms may be used to record agreement to carry out specific procedures. They form part of the clinical records. A copy of the form should be provided to the person signing the form unless the circumstances render this impractical.* If any amendments are made subsequently, these should be made in ink, initialled and dated and a note of subsequent conversations recorded on the clinical records.
10. Provision should be made for uncertain or unexpected outcomes. Clients should be asked to provide contact telephone numbers to ensure discussions can take place at short notice. Provision for the veterinary surgeon to act without the client’s consent if necessary in the interests of the animal should be considered.
11. For routine procedures, information leaflets can be useful to explain to clients what is involved with a specific procedure, anaesthesia, expected outcome, after care etc. Clients should be given an opportunity to consider this information before being asked to provide consent. Use of information sheets should be encouraged but should not be used as a substitute for discussions with individual clients.
12. While responsibility for ensuring a client has provided consent rests with the veterinary surgeon, it should be recognised that veterinary practice staff may be the first to become aware of any misunderstanding concerning the procedure or treatment. Staff should be advised to communicate concerns to senior colleagues. The veterinary practice team should be encouraged to work together to ensure effective communication with clients and with each other.
13. The client may be the owner of the animal, someone acting with the authority of the owner, or someone with statutory or other appropriate authority. Care should be taken when consent is given by a client who is not the owner of the animal. Practice staff should ensure they are satisfied that the person providing consent has both the authority and capacity to provide consent. For example, if the person providing consent is not the owner and has not confirmed his/her authority of the owner to act, ,only in exceptional circumstances, for example if the request is by the police, should the procedure be carried out.
14. Problems can arise identifying who the client is. Occasionally, more than one owner will come forward and while it is not for the veterinary surgeon to determine ownership, it will be important to identify who the client is so it is clear to whom the professional responsibilities are owed. This should be made clear on the clinical records.
15. Veterinary surgeons should consider their clients’ language and communication needs. Clinical or technical terminology may need to be explained and clients may not wish to admit to a lack of understanding.
16. Misunderstandings can arise when using ambiguous terms and veterinary surgeons should be alert to the possibility of misunderstandings concerning terminology used by the practice.
17. A person’s understanding of the issues may be affected by a number of factors, such as impaired hearing or sight; mental incapacity; learning difficulties; difficulties with reading or language.
18. A person may be competent to sign a consent form, but for reasons of physical disability is unable to provide a signature. An independent witness may be asked to confirm the client has given consent orally. If this is not practicable, then a suitable member of the practice staff could be asked to confirm consent.
19. Persons under the age of 18 are generally considered to lack the capacity to make binding contracts. They should not be made liable for any veterinary or associated fees.
20. Children under the age of 16 should not be asked to sign a consent form. Where they have provided a signature, the parents or guardians should be asked to countersign.
21. Where the person seeking veterinary services is 16 or 17, veterinary surgeons should, depending on the extent of the treatment, the likely costs involved and the welfare implications for the animal, consider whether consent should be sought from parents or guardians before the work is undertaken.
22. Particular care should be taken when the treatment involves issues of health and safety, as for supplying Controlled Drugs (within the meaning of the Misuse of Drugs Act 1971) to anyone under 18.
23. Where the client’s ability to understand is called into question, veterinary surgeons will need to consider whether any practical steps can be taken to assist the client’s understanding. For example, consider whether it would be useful for a family member or friend to be present during the consultation. Additional time may be needed to ensure the client has understood everything and had an opportunity to ask questions.
24. The Mental Capacity Act 2005 (England and Wales) states: ‘A person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. It does not matter whether the impairment or disturbance is permanent or temporary. …’.
See Adults with Incapacity (Scotland) Act 2000
[There is no primary legislation dealing with mental incapacity in Northern Ireland as yet]
25. Where it appears a client lacks the mental capacity to consent, veterinary surgeons should try to determine whether someone is legally entitled to act on that person’s behalf, such as someone who may act under an enduring power of attorney. If not, veterinary surgeons should act in the best interests of the animal and seek to obtain consent from someone close to the client, such as a family member who is willing to provide consent on behalf of the person.
*[The RCVS Practice Standards Scheme Manual provides that for ‘General Practice’ (Tier 2 practices), signed consent forms are required for all procedures including diagnostics, medical treatments, surgery, euthanasia and when a patient is admitted to the care of a veterinary surgeon.]
Specimen Form of Consent for Anaesthesia and Surgical Procedures (WORD 84Kb)
Specimen Form of Request for Euthanasia (WORD 72Kb)
Subject to specified exemptions, only a veterinary surgeon may carry out acts of veterinary surgery. If a veterinary surgeon provides veterinary services on behalf of an organisation or individual, for example as an employee, the RCVS strongly recommends that the organisation or individual adhere to this Code of Practice.
The organisation or individual will:
1. recognise the professional responsibilities of veterinary surgeons, in particular the responsibilities set out in the RCVS Guide to Professional Conduct and additional guidance issued by the RCVS;
2. appoint a Chief Veterinary Surgeon to director or equivalent status within the business or an appropriate status within a charity [to be in effect a practice principal];
3. agree with the Chief Veterinary Surgeon that he or she has overall responsibility for professional matters within the business or charity, including:
clinical policy guidelines;
procedures by which medicines are obtained, stored, used and disposed*; and,
procedures for addressing clients' complaints on veterinary issues.
[* The Home Office, which has responsibility for drugs controlled by the Misuse of Drugs Act 1971 has indicated that (1) where it is clear employee veterinary surgeons are responsible for the purchase and supply of these drugs in the company's name, Home Office licences for the possession and supply of controlled drugs are not required and (2) it is desirable for a Chief Veterinary Surgeon to be responsible for company procedures by which these drugs are obtained, stored, used and disposed of by employee (and locum) veterinary surgeons.]
Professional Conduct Department 17 January 2003
Veterinary surgeons are reminded of the following professional conduct and legal issues, which may arise out of the provision of veterinary services via the Internet.
A veterinary surgeon who communicates with clients via the Internet about animals that he/she has already examined and which are his/her patients should remember that the professional conduct and legal position is essentially no different to communication with clients by telephone or letter. It should be clear in each case whether an animal is under the care of a veterinary surgeon and a clinical assessment has been carried out, as required by the Veterinary Medicines Regulations, such that a minimum amount of Prescription Only Medicines, Veterinarian, (POM-V) may be supplied for the treatment of that animal.
The Veterinary Medicines Regulations do not define the phrase 'under his care' and the RCVS has interpreted it as meaning that:
a. the veterinary surgeon must have been given the responsibility for the health of the
animal or herd by the owner or the owner's agentb. that responsibility must be real and not nominal
c. the animal or herd must have been seen immediately before prescription or
d. recently enough or often enough for the veterinary surgeon to have personal knowledge of the condition of the animal or current health status of the herd or flock to make a diagnosis and prescribe
e. the veterinary surgeon must maintain clinical records of that herd/flock/individual.
What amounts to 'recent enough' must be a matter for the professional judgement of the veterinary surgeon according to the circumstances of each case.
In addition the current RCVS Guide to Professional Conduct provides that:-
"Diagnosis for the purpose of prescription should be based on professional judgement following clinical examination and/or post mortem findings supported if necessary by laboratory or other diagnostic tests" [ref Use of Veterinary Medicinal Products - Diagnosis].
Other issues that are of particular relevance are:-
Supersession issues may arise if a member of the public moves from one practice to another.
As with any practice there must be provision of 24-hour emergency cover, as provided in the current RCVS Guide to Professional Conduct (ref Your Responsibilities to Your Patients and Provision of 24-hour Emergency Cover).
The current RCVS Guide to Professional Conduct states that:-
"Case records should include details of examination, treatment administered, medication prescribed and/or supplied, radiographs, the results of any diagnostic or laboratory tests and advice given to the client. It is prudent to include notes of telephone conversations, fee estimates or quotations, consents given or withheld and contact details".
It is therefore prudent to keep records of emails.
General information taken from standard texts or articles (source acknowledged) may be disseminated via the internet, either by way of a distance learning CPD project for veterinary surgeons, or for the general public who are seeking information about a particular condition, treatment or medication. [Subject to copyright law.]
General advice may be given in response to an enquiry.
Specific advice should only be given to the extent that is possible without a physical examination of the animal. The more specific the advice the more likely that the animal's owner should be advised to consult their own veterinary surgeon, in which case the animal owner should be asked to provide their veterinary surgeon with a copy of that advice.
Veterinary surgeons should ensure that the provision of specific advice does not compromise welfare since the patient has not been examined and there is no ability to monitor the animal.
A veterinary surgeon cannot usually have an animal under his/her care if there has been no physical examination. Consequently a veterinary surgeon may not treat an animal via the Internet alone and may not prescribe POM-V medicines in this context.
No professional conduct issues are likely to arise out of such advice provided that medication is not recommended for behavioural problems.
A veterinary surgeon who prescribes a POM-V or POM-VPS veterinary medicinal product, or supplies a NFA-VPS veterinary medicinal product, must:
a. before he does so, be satisfied that the person who will use the product is competent to use it safely and intends to use it for a use for which it is authorised;
b. when he does so, always advise on the safe administration of the veterinary medicinal product;
c. when he does so, advise as necessary on any warnings or contra-indications on the label or package leaflet; and
d. not prescribe (or in the case of a NFA-VPS product, supply) more than the minimum quantity required for the treatment.
The Veterinary Medicines Regulations do not define 'minimum amount' and the RCVS considers this must be a matter for the professional judgement of the veterinary surgeon in the individual case.
Veterinary medicinal products must be supplied in appropriate containers and with appropriate labelling.
Veterinary surgeons may make retail supplies of POM-V veterinary medicinal products on the prescription of another veterinary surgeon (i.e. for animals that are not under his or her care), should ensure that those to whom the medicines are supplied, or may be supplied, are informed that such supplies are made without a clinical assessment of the animal and that the animal is not under his or her care.
A veterinary surgeon who is associated with retail supplies of POM-VPS, NFA-VPS or AVM-GSL veterinary medicinal products (or makes such supplies), should ensure that those to whom the medicines are supplied, or may be supplied, are informed of:
a. the name and qualification (veterinary surgeon, pharmacist or SQP) of any prescriber;
b. the name and qualification (veterinary surgeon, pharmacist or SQP) of the supplier; and
c. the nature of the duty of care for the animals.
Similar safeguards should be put in place by a veterinary surgeon who is associated with retail supplies of POM-V veterinary medicinal products by pharmacists.
March 2006, Professional Conduct Department, Royal College of Veterinary Surgeons
When veterinary surgeons receive requests to prescribe medicinal compounds for use in dart guns they should consider carefully every aspect of the request. The medicines supplied for use in dart guns, such as Large Animal Immobilon are very potent. If they are not fully confident of their grounds in prescribing, they should refer the request to a more knowledgeable colleague.
Veterinary surgeons should take great care to ensure that any Large Animal Immobilon they prescribe or use is not administered to deer, or any other animals, which may subsequently be killed or slaughtered for meat production. The same position applies to the use of any other medicine not licensed for use in food-producing animals.
Veterinary surgeons administering Large Animal Immobilon, or any other immobilising medicine not licensed for use in a food-producing animal, must mark permanently, with an appropriate tag (see 1 below) in each ear, any deer (farmed or wild), or if relevant dispose of the carcass, to ensure, so far as practicable, that such animals will not enter the human food chain.
Before any supply is made a written agreement to supply should be signed by both the dart gun licence holder and veterinary surgeon. This should include the following points, which as appropriate should be adhered to by both parties to the agreement:
Notes
1. The tags are Ketchum tags stating 'EAT NOT' and are available from the Veterinary Deer Society by contacting Mr J Peters MRCVS at julian@arthurlodge.co.uk.
2. Section 8 of the Firearms (Amendment) Act 1997 states: -
"The authority of the Secretary of State[or the Scottish Ministers (by virtue of the provision made under Section 63 of the Scotland Act 1998] is not required by virtue of subsection (1)(a), (b) or (c) of Section 5 of the 1968 Act for a person to have in his possession, or to purchase or acquire, or to sell or transfer, any firearm, weapon or ammunition designed or adapted for the purpose of tranquillising or otherwise treating any animal, if he is authorised by a firearm certificate to possess, or to purchase or acquire, the firearm, weapon or ammunition subject to a condition restricting its use to use in connection with the treatment of animals."
3. The Veterinary Medicines Regulations 2005 requires that a veterinary surgeon who prescribes and supplies a POM-V, must:
a. prescribe for animals under his or her care;
b. prescribe after having carried out a clinical assessment of the animals;
c. prescribe the minimum amount for the treatment;
d. on supply, always advise on the safe administration of the veterinary medicinal product;
e. on supply, advise as necessary on any warnings or contra-indications on the label or package leaflet; and,
f. on supply, be satisfied that the person who will use the product is competent to use it safely, and intends to use it for which it is authorised.
4. SIR - The Food Standards Agency issued a warning in October against consuming venison from deer potentially exposed to Immobilon. This resulted from an incident in which deer, confined in a park, were tranquillised with etorphine (Large Animal Immobilon; Novartis Animal Health
A number of ethical issues arise. However, the Agency's concern was the very real risk that meat containing residues of the active ingredients contained in Immobilon could have found their way into the food chain. It would appear from this incident that the legal position with regard to the prescription and use of medicines not authorised for food animal species, such as Immobilon, needs clarifying. The Royal College of Veterinary Surgeons' Guide to Professional Conduct, in its Annex on Prescribing of Medicines, paragraph 24, advises that anaesthetics and analgesics should not be administered to food animals unless it is necessary for the health and welfare of the animals in circumstances where there is no viable alternative authorised product and where the imposition of the statutory withdrawal period would protect consumers. This is to conform with the Medicines (Restrictions on the Administration of Veterinary Medicinal Products) Regulations 1994 (SI 1994 No 2987).
[NB: SI 1994 2987 revoked by the Veterinary Medicines Regulations 2005 - See VMD Guidance Note No 15 Controls on the Administration of Veterinary Medicines]
Immobilon is authorised for use in deer, but is not authorised for use in food animals. No maximum residue limit (MRL) has been established for the active ingredients of Immobilon and, thus, an appropriate withdrawal period cannot be set. Immobilon cannot, therefore, be authorised for use in food-producing animals and the legislation prohibits its administration to such animals. Immobilon must not, therefore, be administered to animals which might enter the food chain at any time in the future.
Veterinary surgeons should take great care to ensure that any Immobilon they prescribe or use is not administered to deer, or any animals, which may subsequently be killed or slaughtered for meat production. The same position applies to the use of any other medicine not licenced for use in food animal species.
Veterinary Director, Food Standards Agency, Aviation House, 125 Kingsway, London WC2B 6NH (6 December 2003)
5. If the owner of the holding is not the owner of the animal, the owner of the animal should also be specified.
Professional Conduct Department, 18 May 2005 revised February 2006
View the Veterinary Medicines Directorate's guidance note on Controls on the Administration of Veterinary Medicines (Guidance Note 15).
If you experience any difficulty accessing this document, please contact the VMD at postmaster@vmd.defra.gsi.gov.uk.
1. Microchips are implanted in companion animals to assist with their return if lost or stolen and veterinary surgeons are frequently the first point of contact for those owners whose animals are missing.
2. A microchip may be scanned in circumstances where, for example:
the animal has been lost or is a stray,
it is suspected that the animal has been stolen, or
where a client is unaware that the animal has been microchipped.
3. Veterinary surgeons are encouraged to take appropriate steps to reunite the animal with the owner and if necessary contact the relevant database, for example, the PetLog Reunification Service (Tel 0844 4633 999 e-mail petlogadmin@the-kennel-club.org.uk).
4. If it is suspected that the animal is stolen, veterinary surgeons or the owner may involve the police.
5. An ownership dispute may arise where a client presents an animal with a microchip registered in another person's name. With their consent, both parties to the dispute can be put in touch with each other.
6. If a client declines to consent to the release of his or her name and contact details and details of the animal and microchip, a veterinary surgeon should breach client confidentiality to pass the necessary information to the PetLog Reunification Service. * [If the registered owner declines to consent to the release of his or her name and contact details these should be known to the Petlog Reunification Service.]
7. PetLog Reunification Service will then seek to reunite the animal with the registered owner or update the relevant database.
*The Petlog Reunification Service provides a standard form for veterinary surgeons to provide information to the service.
The Petlog Reunification Service indicates: 'In the unlikely event that the Carer [client] is not willing for their details to be released or refuses to agree to return the animal they will be informed that the Registered Owner will be advised to seek legal advice. On instruction from a Solicitor or the Police PetLog can release details.'
Professional Conduct Department 13 Feb 2003
(Issued November 2004)
1) The Guidance sets out the role of 'Named Veterinary Surgeon' ["the NVS"] under the Animals (Scientific Procedures) Act 1986 ["the 1986 Act"] and provides advice to veterinary surgeons deputising for the NVS. The 1986 Act is a UK wide Act, administered by the Home Office in Great Britain and the Department of Health, Social Services and Public Safety (DHSSPS) in Northern Ireland. The Guidance is issued after consultation with the Home Office and the Laboratory Animals Veterinary Association and taking into account the 1986 Act and associated statutory guidance.
2) Scientific procedure establishments and breeding and supplying establishments are required to have a veterinary surgeon who accepts responsibility under the 1986 Act to provide advice on the health and welfare of animals within these establishments. The name of the NVS is recorded on the establishment's certificate of designation.
3) Scientific procedure establishments are places at which project licences are held and include universities (university departments and medical schools), colleges of further education, government research establishments, pharmaceutical and other industrial research and development laboratories, and contract research laboratories. No regulated procedures may be carried out unless there is a project licence covering the work to be carried out and detailing the procedures, and a personal licence holder with authority to carry out those procedures. A breeding establishment is one where the common laboratory species, as listed in Schedule 2 to the 1986 Act are bred for use in regulatedprocedures. A supplying establishment is one from which Schedule 2 animals which have not been bred on the premises are kept and supplied for use in regulated procedures. Some establishments may fall into more than one of these categories.
4) Veterinary surgeons are expected to undergo specific training for the role of NVS (see paragraph18 and 19).
5) The NVS should:-
a) Ensure there are adequate arrangements for the provision of veterinary cover and services at all times (see paragraph 21);
b) provide advice on animal health and welfare to the certificate holder, project and personal licence holders, and animal care staff;
c) notify the personal licence holder of animals whose condition gives cause for concern and, if necessary, arrange for or carry out humane killing if this is required (see also paragraph 39);
d) determine whether an animal remains alive at the end of regulated procedures when this is an option (see also paragraph 41);
e) certify, as necessary, fitness of animals to leave the establishment (see also paragraph 42);
f) participate in the establishment's ethical review process; and,
g) ensure that appropriate records are maintained.6) The NVS is appointed by the certificate holder and named on the certificate of designation of an establishment. He or she has responsibilities associated with the 1986 Act (including paragraphs 5b-g). By application to the Home Office, the certificate holder may seek to appoint additional NVSs, each having separate areas of responsibility and usually specified project work or locations.
7) Under this Guidance the NVS has veterinary care responsibilities to the RCVS (paragraph 5a).
8) A veterinary surgeon may be contracted as the NVS on a full-time or part-time basis depending upon, for example, the size of the establishment and the nature and complexity of the research programmes. The contractual hours and resources (e.g. the assistance given by other veterinary surgeons) should be adequate to enable the NVS to have sufficient time to fulfil his or her role. Whether full-time or part-time the responsibilities and statutory duties of the NVS are the same.
9) Whether the appointment is full-time or part-time, the NVS must arrange to visit the facilities on a regular basis for both advisory and veterinary care roles, rather than waiting to be called out in an emergency. In this way the NVS should become familiar with the animals, the research workers and their areas of scientific interest, as well as the procedures carried out on animals within the establishment. The frequency of these visits should be determined by the NVS according to the number and species of animals involved and the nature and severity of procedures performed. An appropriate schedule of visits should be agreed in advance in consultation with the responsible staff of the establishment, in particular with the Named Animal Care and Welfare Officer(s) ("the NACWO") and the certificate holder. The visiting schedule should be regularly reviewed and amended as necessary.
10) The job description and/or contract of the NVS should define the responsibilities involved and provide a reporting structure that gives the NVS direct access to the certificate holder at the establishment.
11) The names of the veterinary surgeons deputising for the NVS are not included on the certificate of designation. Therefore, they should be recorded at the establishment and made known to the certificate holder, the NACWO, licensees and other relevant staff in the establishment. The means of contacting an appropriate veterinary surgeon at any time should be clearly defined and available.
12) The NVS and deputising veterinary surgeons are required to have professional indemnity insurance or equivalent arrangements. Such cover may be held individually or through an employer. The chosen level of indemnity related to NVS duties should be discussed with the Insurance providers, for example the Veterinary Defence Society. The level of cover can then be confirmed.
13) The certificate holder is ultimately responsible for ensuring that the facilities, animal welfare and care, staffing levels and expertise in the establishment meet the requirements of the 1986 Act and the Codes of Practice. The NVS is answerable to the certificate holder in an advisory role and for providing the contracted service. Therefore the NVS should make reports (it is suggested at least annually) directly to the certificate holder.
14) Periodic meetings with the Home Office Inspector are desirable and may assist the NVS to fulfil the statutory role. The NVS should be available for discussion with the Home Office Inspector if the latter makes a request.
15) The NVS at a scientific procedure establishment should liaise closely with his/her colleagues at other associated establishments (e.g. where a research project involves collaboration between two or more establishments) and, especially if animal health problems arise in recently acquired animals, with colleagues at supplying and breeding establishments.
16) Where the NVS also holds a project licence, another veterinary surgeon must be agreed with the Home Office as responsible for providing independent veterinary advice regarding the health and welfare of the animals involved. If there is any other significant conflict of interest, the NVS should consider the need for independent veterinary advice.
17) The NVS and veterinary surgeons deputising for the NVS must maintain client confidentiality as set out in the Guide to Professional Conduct. Contracts and client records, together with project and personal licences, should be stored securely to prevent any unauthorised access.
18) The Home Office requires that a new NVS attend a course, approved by the RCVS, specifically on the role of the NVS, either before or within one year of accepting appointment. In any event a new NVS should undertake training on the needs of the laboratory animals on which he or she will provide advice.
19) The NVS and veterinary surgeons assisting or deputising for the NVS are expected to participate in continuing professional development relevant to the species held and used and the type of scientific work carried out at the establishment.
20) The NVS should be familiar with the range of scientific procedures carried out under project licences and may take part in the training of technicians and personal licence holders on animal welfare and health. In particular the NVS may be involved in the training of minor procedures, surgical methods, anaesthetic regimens, peri-operative care and assessment of competence.
21) The NVS should ensure there are appropriate arrangements for the provision of veterinary services, including 24-hour emergency cover (see RCVS Guide to Professional Conduct for details). The NVS may delegate these duties to suitably competent deputies. The certificate holder is responsible for providing the necessary resources for the provision of such cover and services. Staff at the designated establishment are expected to contact the NVS or delegated deputy, to seek veterinary advice or assistance, as appropriate; but the RCVS Guide does not stipulate that staff of the designated establishment must be on site 24 hours a day.
22) The delivery of veterinary treatment and services should take into consideration the experimental procedures which the protected animals are being or will be subjected to, and that data, or other products, being collected as part of the programme of work may be compromised as a result of the veterinary intervention.
23) As a minimum the NVS should: -
a) advise on the health and welfare of protected animals in the establishment;
b) advise on suitable preventive medicine and health screening programmes;
c) advise on the provision of appropriate facilities, environmental conditions and trained staff for the care of sick or injured animals;
d) provide for diagnosis and treatment of disease, and advise on the control of any disease outbreaks;
e) arrange for the provision of an appropriate veterinary diagnostic laboratory service, advise on interpretation of results, and conduct or arrange post mortem examinations for diagnostic purposes as appropriate;
f) advise on the evaluation of the breeding performance of colonies, in conjunction with the NACWO (see paragraph 56); and,
g) direct the use of all prescription only medicines and controlled drugs for use on protected animals in the establishment (as set out e.g. in the Medicines Act 1968; the Misuse of Drugs Act 1971 and subordinate legislation). (See paragraphs 28-31).
24) Where colleagues provide some of the veterinary services and/or deputise for duties associated with the Act, the NVS should make appropriate arrangements to ensure that delegated services are delivered. The NVS should make clear which duties and tasks are being delegated, how these should be fulfilled and how the delivery of such services should be documented. The NVS should liaise with the colleagues involved to ensure they are appropriately briefed on the scientific objectives of projects at the establishment and on the constraints and humane end-points in these projects.
25) When procedures regulated under the 1986 Act are conducted at places other than designated establishments, such as on farms or at fisheries, a local veterinary practitioner will often provide veterinary services. Good liaison between the NVS, the local practitioner, and the licence holders involved is strongly recommended to ensure neither welfare nor science is compromised. At the end of the regulated procedures the local veterinary surgeon may be able to provide any certification needed (see paragraphs 44-46).
26) The NVS may delegate some veterinary procedures or treatment to animal care staff, within the provisions of the Veterinary Surgeons Act 1966. Special instructions should be given and these must adequately inform animal care staff on the appropriate and responsible use of minor medical treatments, for example, dealing with and recording minor injuries or topical lesions in group-housed animals. Where written instructions are not provided the NVS must ensure staff are adequately informed verbally.
27) Periodically, the NVS should check that delegated procedures or treatments and preventive medicine programmes have been carried out to a satisfactory standard and appropriate records kept. Where minor medical treatments are initiated, varied or discontinued by animal care staff, the action taken, the justification for the action, and the outcome should be recorded and the records regularly reviewed by the NVS.
28) The NVS is responsible for the appropriate storage, administration and safe disposal of prescription only medicines and controlled drugs obtained by him or her (including by prescription) for therapeutic purposes.
29) The Veterinary Medicines Regulations 2009 do not apply in relation to a product intended for administration in the course of a procedure licensed under the Animals (Scientific Procedure) Act 1986, except that, if the animals are to be put into the human food chain, the only products that may be administered to the animals are—
a) authorised veterinary medicinal products administered in accordance with their marketing authorisation, or
b) products administered in accordance with an animal test certificate granted under paragraph 9 of Schedule 4.
30) The NVS is expected to give guidance on the use of anaesthesia and analgesia.
31) Where carcasses of treated animals may be destined for the food chain, due regard must be paid to laws relating to tissue residues. If substances with no Maximum Residue Limit (MRL) have been used, at any stage in the procedures, the animal should not be allowed to enter the food chain.
32) European Parliament Directive 2001/82, as amended, provides that no animal may enter the food chain if it has been administered a substance that is not listed in the Table of allowed substances in Commission Regulation 37/2010 (this table replaces Annexes I, II or III of Council Regulation (EEC) 2377/90). Where a Maximum Residue Limit (MRL) has been set, any residue must be at concentrations lower than or equal to the MRL.
32) Under the 1986 Act the prime responsibility of the NVS is to advise the certificate holder on veterinary matters. The following should be considered the minimum areas for which advice should be given:
a) maintenance of health status and suitable preventive medicine protocols, and an appropriate programme for monitoring the health and welfare and quality of animals, and their environment;
b) provision of care, e.g. suitable environmental controls, development and monitoring of social and environmental enrichment programmes, or where there are concerns that staffing levels may compromise animal welfare;
c) maintenance of animals needing special attention, for example immuno-compromised mice ;
d) provision of specialist veterinary facilities, in particular for aseptic surgery and post-operative care, quarantine, acclimatisation and other special animal welfare needs (usually, the NVS will be involved in the design and planning of new facilities for such purposes);
e) appropriate methods of euthanasia and means of assessing competence;
f) appropriate humane methods of identification; and,
g) whether animals are fit to go to a non-designated establishment (see paragraphs 42-43).The NVS should also be asked to direct the use of all prescription only medicines and controlled drugs for use on protected animals in the establishment (as set out e.g. in the Medicines Act 1968; the Misuse of Drugs Act 1971 and subordinate legislation).
33) The NVS should advise on:-
a) strategies to minimise the severity of regulated procedures, and how particular adverse effects may be controlled, e.g. refinements to methods of dosing and sampling; clinical monitoring; use of anaesthesia and analgesia; appropriate humane end-points;
b) the health status needed and suitability of animals for planned studies;
c) the impact of the procedures proposed on the animals, and any specific husbandry and care needs during the procedures; and,
d) the fate of animals at the end of regulated procedures or at the end of use at that establishment (see paragraphs 41-46).34) To provide suitable up to date advice, it is essential to hold (and hold securely) copies of, or have ready access to, all project licences and any conditions attached. The NVS should expect that his or her advice on these issues would be sought, normally at an early stage of drafting a project licence and for any subsequent substantive amendments.
35) For research workers using animals the NVS should provide:-
a) practical advice on techniques, particularly surgical approaches and suitable anaesthetic regimens and peri-operative care;
b) advice on the recognition of pain, suffering distress and lasting harm , and ill-health, and physiological and behavioural disturbances in animals (such as arise from fear or boredom);
c) advice on the recognition and assessment of severity and any potential breach of the severity limit; and,
d) advice on the recognition of humane end-points.36) Advice may involve consultation with other named persons and experts.
37) Commonly a senior animal technician holds the position of NACWO and is the main point of contact on matters relating to the general care and husbandry of animals in the establishment. He or she is likely to be the person who contacts the NVS in cases where the health or welfare of an animal gives rise to concern. The NVS should foster a good working relationship with the NACWO(s) and other animal care staff.
38) The NVS should provide advice on maintaining health status and animal welfare issues, including socialisation and enrichment.
39) Under the 1986 Act, if the NVS considers that the health or welfare of any protected animal gives rise to concern, he or she must notify the personal licence holder. If there is no personal licence holder (as when the animal has not undergone a regulated procedure), or if one is not available, the NVS must take steps to ensure that the animal is cared for and, if necessary, that it is humanely killed using an appropriate method. Normally problems should be resolved through discussion with the personal licence holder or project licence holder involved. There may be occasions when it is advisable to consult the certificate holder or consult or notify the Home Office Inspector.
40) The NVS should be familiar with relevant methods of humane killing listed in Schedule 1 to the 1986 Act, and with the associated Code of Practice, together with any additional approved methods set out in the conditions of the certificate of designation.
41) At the end of a series of regulated procedures for a particular purpose (typically a project licence protocol) which does not specify that the animal will be killed, the 1986 Act requires that the relevant personal licence holder must, in the first instance, decide whether the animal should be killed or not. In the great majority of instances this decision is made at a designated establishment (if not see paragraphs 44-46), and if the personal licence holder's decision is that the animal need not be killed then the project licence holder is obliged to pass the matter to a veterinary surgeon, normally the NVS. If the (N)VS determines that the animal is not suffering and is not likely to suffer adverse effects from the procedures done, then the animal may be discharged into the care of the (N)VS within the designated establishment. No certificate is necessary and the principle of veterinary direction can be applied. The decision of whether an animal may remain alive can be taken by a person the NVS considers able to do so and according to specific criteria, which the NVS has defined. These criteria would normally be specified in the project licence. Should the animal subsequently move off the designated establishment veterinary certification (see paragraphs 42-43) will be needed.
42) When a protected animal, which has undergone and completed the regulated procedures, is to move off the designated establishment to a non-designated place such as a slaughterhouse, a family home or a farm, the certificate holder is obliged to request a veterinary surgeon, normally the NVS, to certify that the animal is not likely to suffer adverse effects from those regulated procedures. Guidance is given in the LAVA Guidance on the Discharge of Animals from the Animals (Scientific Procedures) Act 1986 (reference 6).
43) The NVS may also be involved in meeting other regulatory requirements for the transport, import or export of protected animals, including certifying fitness of animals for transport, where appropriate.
44) The NVS may be called upon to advise project licence holders about the fate of animals that have undergone procedures at non-designated establishments (referred to as "places other than designated establishments" or PODEs), such as at a farm or in the wild.
45) Similar certification to that given to animals leaving a designated place (see paragraphs 42-43) should be provided for animals which come to the end of a protocol at a place which is not designated, but the NVS may be in no position to carry out the certification (because the facts are not within his/her knowledge, e.g. wildlife, farmed fish or farm animals which may be under the care of another veterinary surgeon). If no veterinary surgeon is available at the place another "suitably qualified person" may provide this certification. The project licence holder with advice from the NVS should designate such a "suitably qualified person", who should have proven expertise at judging the health and welfare of the particular type of animals concerned. The NVS should advise on suitable training for such persons. (See reference 6).
46) Particular criteria apply for release to the wild and a distinction has to be made between release at the end of regulated procedures and release with the expectation of gathering further data (e.g. from transmitters). (See reference 6 for further details).
47) Under a condition placed on the certificate of designation an establishment must have an ethical review process ["ERP"]. The aims of the process are:
"To provide independent ethical advice to the certificate holder, particularly with respect to project licence applications and standards of animal care and welfare.
To provide support to named people and advice to licensees regarding animal welfare and ethical issues arising from their work.
To promote the use of ethical analysis to increase awareness of animal welfare issues and develop initiatives leading to the widest possible application of the 3Rs (replacement, reduction and refinement)."
['Home Office Guidance on the Operation of the 1986 Act' Appendix J March 2000] (reference 1).
48) The NVS is an obligatory participant in the process. In general terms, the NVS should only advise on matters within his/her professional competence, but may in addition contribute to the ERP in a lay capacity. He or she should advise the ethical review process on: -
a) accommodation and care, particularly for animals with special welfare requirements;
b) the refinement of studies, and choice of species;
c) the health and welfare status of animals;
d) the appropriateness of the procedures proposed;
e) general strategies to minimise the severity of protocols;
f) how particular adverse effects may be controlled; and,
g) appropriate humane end-points.49) Within the ERP, the NVS should assist in promoting high standards of care and welfare, and a culture of care within the designated establishment.
50) It is important to appreciate the full implications of advice given by the NVS in the light of the statutory responsibility to advise on animal health and welfare. Considerable care must be taken to avoid ambiguity and undue delay and sometimes it may be necessary to give advice in writing.
51) The NVS should maintain a written record or copy of formal advice given, which should be readily available for review. This applies whether the advice is given in writing or verbally.
52) The NVS should supervise the maintenance of appropriate animal health records relating to the protected animals. The format of the records should be agreed with the Home Office Inspector and with the certificate holder (see reference 2).
53) Records should be at least sufficient to show any treatments given to animals or groups of animals and, together with records maintained by other named persons, identify and monitor incidence of disease in the colonies, so that control or corrective action can be taken. As well as a written record of advice or treatment given, there should normally be an indication of the result. Results of required microbiological surveillance programmes should also be recorded.
54) Health records should be regularly reviewed by the NVS and any subsequent action record ed.
55) Records should be kept safely and be readily available to the animal care staff and the Home Office Inspector.
56) In breeding colonies, the recording of colony data (see reference 3, paragraph 3.45) is the certificate holder's responsibility. However, the NVS should agree acceptable performance targets with the care staff and should review the records on a regular basis, to provide assurances that problems are not going unnoticed.
Breeding ("Breeder") Establishments are designated establishments where the common laboratory species, as listed in Schedule 2 of the 1986 Act are bred for use in regulated procedures. The same establishment can be a user and/or supplying establishment.
A Certificate of Designation is the document providing official approval for use of an establishment for activities controlled by the 1986 Act, and is held by a senior person, the Certificate Holder, representing the establishment. At issue, conditions are placed on the certificate, and the Holder is responsible for ensuring compliance with these.
Designated Establishment is the term given to the place to which a Certificate of Designation issued under the 1986 Act applies.
Named Animal Care and Welfare Officer is the term given to the person named on the certificate as responsible for the day-to-day care of the protected animals in specified designated areas.
A Named Veterinary Surgeon is the veterinary surgeon specified on the certificate of designation. While it is accepted that veterinary surgeons may deputise for the NVS, no deputies may be specified on the certificate.
A Personal Licence is issued to an individual (the "personal licence holder"/licensee) to permit him/her to apply specified regulated procedures that are also authorised by a project licence to specified types of protected animal at a specified place(s). The personal licensee is the person primarily responsible for the care of the protected animals.
A Project Licence authorises a programme of scientific work detailed on the schedule to the licence on specified types of protected animal at a specified place(s), and is issued to an individual (the project licence holder/project licensee).
Protected animals are those covered by the 1986 Act, which briefly is all vertebrates, including immature forms from mid-gestation/incubation or capacity for independent feeding onwards, and Octopus vulgaris.
Regulated procedures (under the 1986 Act) are interventions or omissions applied to protected animals for a scientific purpose, which may cause pain suffering distress or lasting harm.
Schedule 1 (of the 1986 Act) gives a list of methods of humane killing that do not require project and personal licence authority. It was revised in 1997 and has an accompanying Code of Practice.
Schedule 2 (of the 1986 Act) gives a list of types of animals that must be bred or supplied from a designated breeder or supplier if intended for use in regulated procedures.
Scientific Procedure ("User") Establishmentsare designated establishments at which project licences are held and include universities (university departments and medical schools), colleges of further education, government research establishments, pharmaceutical and other industrial research and development laboratories, and contract research laboratories. The same establishment can be a breeding and/or supplying establishment.
Supplying Establishments are designated establishments from which Schedule 2 animals that have not been bred on the premises are kept and supplied for use in regulated procedures. The same establishment can be a breeding and/or user establishment.
User/Breeder Codes of Practice provide guidance on minimum standards for facilities, housing and care at the respective designated establishment.
Veterinary direction (from reference 7) means instructions from a veterinary surgeon who is not necessarily present.
Veterinary supervision (from reference 7) means the veterinary surgeon is on the premises and able to respond to a request for assistance if needed.
Veterinary supervision that is direct and continuous(from reference 7) means that the veterinary surgeon is present and giving his or her undivided personal attention.
1) Home Office Guidance on the Operation of the Animals (Scientific Procedures) Act 1986 [particularly the NVS Section, paragraphs 4.59 - 4.64]. HMSO; London March 2000.
2) Home Office Code of Practice for the Housing and Care of Animals Used in Scientific Procedures. HMSO: London Feb. 1989
3) Home Office Code of Practice for the Housing and Care of Animals in Designated Breeding and Supplying Establishments. HMSO: London Jan.1995
4) The Humane Killing of Animals under Schedule 1 of the Animals (Scientific Procedures) Act 1986. Home Office Code of Practice. HMSO: London Jan. 1997
5) Guidance Notes on the Role of the Named Animal Care and Welfare Officer in the Establishments Designated under the Animal (Scientific Procedures) Act 1986
6) Guidance on the Discharge of Animals from the Animals (Scientific Procedures) Act 1986, LAVA, March 2001
7) RCVS Guide to Professional Conduct (current edition)
This annex was updated in June 2010 and has been replaced by Advice Note 32 on the use and reuse of samples, post mortems and disposal (PDF file - 70Kb).
This annex was updated in January 2009 and the document 'Guidance for giving evidence in Court' may be downloaded as a pdf document (109Kb)
This annex is referred to in Part 1G - Your Responsibilities under the Law
The RCVS Practice Standards Manual is now available to download as a PDF file (202 KB).
The Rules of the Scheme are also available to download as a PDF document (70 KB).
All information and further documentation relating to the Practice Standards Scheme is now available to download from the Practice Standards section of the RCVS website.
For further information on using PDFs, please follow the link in the Web Tool Box (botttom left of this page).
For any further information or questions, please email Eleanor Ferguson.
Everyone is familiar with the traditional figure of the veterinary surgeon treating all kinds of animals and he is expected to be expert in everything from kidney disease in kittens to colic surgery on a carthorse. However, faced with an ever-increasing fund of veterinary knowledge, it has become impossible for any individual vet to remain up-to-date and expert at everything. In order to anticipate and meet the needs of patients and clients, the UK veterinary profession has evolved a system of 'veterinary referral'. By considering a referral of your animal to a colleague, your vet is ensuring that the patient can benefit from the best of diagnosis and treatment that the profession has to offer.
To maintain consistency and ensure predictable high standards the Royal College of Veterinary Surgeons (the veterinary profession's governing body) oversees a system of clinical training, further examinations and Specialist recognition.
Some cases are referred for diagnostic tests or treatments which are not available at your own practice. This enables efficient use of expensive complex equipment and allows the patient to be seen by a veterinary surgeon with particular interest, experience and expertise in that type of case. This is a well known procedure in human medicine where family doctors regularly refer, for example, heart cases to expert cardiologists, skin problems to dermatologists and so on.
Whether or not a case is referred is agreed by discussion between the client and his usual veterinary surgeon. There is still considerable overlap between the work done by a referral practice and by your local practice. Your own veterinary surgeon will give you all the information you need to decide whether or not you want a referral Whilst a 'Specialist' might reasonably be expected to perform, for instance, a surgical procedure more expertly and with a better prospect of success, the higher fee and the need to travel to a distant referral centre may bee seen as a disadvantage. Your own veterinary surgeon has a responsibility to provide you with all the information needed to make a proper and fully informed decision about referral.
Referral services do tend to be more costly than other veterinary work. This largely because the cases treated are usually more complex and time consuming, often requiring the use of expensive equipment. Additionally, the extra time and cost of acquiring specialised clinical training and qualifications is reflected in the fees charged by most referral centres. All veterinary surgeons, including referral clinicians, are happy to discuss costs and provide an estimate of the fees involved before any treatment is commenced.
Formerly the clinical departments of the six UK university veterinary schools and the Animal Health Trust in Newmarket provided most of the referral services in the United Kingdom. However, in recent years an increasing number of RCVS Diplomates and Specialists are working in private practice across the country. Whilst any veterinary surgeon is free to accept referral cases most practices choose to refer where possible to colleagues who are Diplomates of the RCVS, or are RCVS Recognised Specialists in the knowledge that these colleagues are trained and qualified to an appropriate standard.
Your own veterinary surgeon will contact the referral centre to arrange an appointment and communicate any relevant case note and other clinical information. Afterwards your animal will be returned, as quickly as possible, to the care of your own veterinary surgeon.
The referral centre will provide your own practice with a report of the patient's treatment and any necessary information and instructions relating to ongoing care.
When referral works well, everyone benefits, the patient, the owner and both veterinary practices. However, on rare occasions problems may arise, leaving the client dissatisfied. Most often this down to misunderstanding and is best resolved by talking it over with either your own veterinary surgeon or the referral practice. If this does not resolve the matter and you consider it to be sufficiently serious you may make a complaint to the Royal College of Veterinary Surgeons which is responsible for regulating the conduct of all veterinary surgeons, including those in referral practices.
The Royal College of Veterinary Surgeons maintains a list of recognised specialists in a large number of specialities including:
Veterinary:
AnaesthesiaSmall Animal MedicineCardiology
Dentistry
Dermatology
Epidemiology
Neurology
Nutrition
Ophthalmology
Diagnostic Pathology
Public Health
Radiology
Reproduction
Small Animal Surgery
Equine Internal Medicine
Equine Surgery
Equine Stud Medicine
Exotic Animal Medicine
Zoo & Wildlife Medicine
Deer Health & Production
Fish Health & Production
Goat Heath & Production
Poultry Health & Production
Sheep Health & Production
Pig Medicine
All veterinary surgeons have a string of letters after their name, which are sometimes difficult to understand. Here we try to explain the relevance of the various clinical qualifications which practising veterinary surgeons might achieve:
Membership of the Royal College of Veterinary Surgeons. This is the entry qualification without which no one is permitted to practise veterinary in the United Kingdom. It is awarded after five years' successful study at an approved university veterinary school.
A certificate is an indication of a competent clinician and is obtained by examination not less than 2 years after qualification as a veterinary surgeon.
A diploma is an indication a high standard of academic and professional expertise gained by examination.
Recognition as a specialist by the RCVS is an indication of an expert who usually after obtaining a diploma, has satisfied a number of other stringent criteria. Uniquely specialist status is reviewed and re-assessed every five years. These clinicians are identified by the title 'RCVS recognised specialist in'
Whilst the majority of referrals will be made to clinicians with a diploma or specialist recognition, there are occasions when other, less formally qualified, will accept referral cases. Your veterinary surgeon will be happy to answer any questions which you may have.
This advice is should be considered in relation to the following sections of the Guide to Professional Conduct:
Part 1 F; Your Responsibilities to Your Professional Colleagues
Part 2 D; Referrals and Second Opinions
1. The purpose of these Guidelines is to safeguard the position of source and recipient animals involved in transplant procedures. It is the involvement of source animals which makes transplant procedures uniquely different in ethical terms from any other procedures.
2. These Guidelines are intended to apply in the first instance only to kidney transplants in cats, as this is the only procedure likely to be seriously contemplated in the United Kingdom in the immediate future, and will be reviewed regularly.
3. The College takes the view that the transplantation of kidneys in cats should be regarded as ethically acceptable in the United Kingdom, but only if carried out in accordance with the Guidelines set out below. In devising the Guidelines below, it has deliberately set high standards which must be attained before transplants can be undertaken in the United Kingdom.
4. The College accepts that only a few Members may choose to carry out this procedure.
5. The Home Office has accepted that kidney transplants in cats can be 'recognised veterinary practice' and, as such, exempt from the need for a Home Office licence under the Animals (Scientific Procedures) Act 1986. This is supported by Counsel's opinion sought jointly by the RCVS, the British Small Animal Veterinary Association and the Royal Society for the Prevention of Cruelty to Animals (RSPCA), (the "Legal Opinion").
6. The RSPCA has indicated that the removal of a major organ from a living source animal might constitute an offence under the Protection of Animals Act 1911 and this possibility is supported by the Legal Opinion. However, the RSPCA has indicated that the degree to which this RCVS advice is followed will "influence any decision the RSPCA might take in considering the likelihood of a prosecution relating to organ transplantation between animals."
PART A: ETHICAL SOURCING
7. All source animals must be treated with compassion and respect.
8. Organs for transplantation should not be commercially produced for the purpose; source animals should not be bred or bought for the purpose of transplantation.
9. The responsibility to provide a suitable source animal should normally be for the transplantation centre.
PART B: BALANCING THE INTERESTS OF THE SOURCE AND RECIPIENT ANIMALS
10. Transplantation centres must give equal consideration to the interests of the source and recipient animals in deciding whether it is appropriate to proceed.
11. Source animals should be assessed for adequate renal function. In every case there must be the necessary compatibility between the source animal and the potential recipient animal. The level of distress caused to the source animal should be kept to a minimum. Source animals should be used on only one occasion.
12. In the event that the source animal is to be adopted or is already owned, then the owner or future owner needs to be fully informed of the procedure and any possible long term implications to the source animal. The owner of the recipient animal must be informed of the potential outcomes for the recipient animal. Owners must give informed consent to all procedures, which should be confirmed in writing.
13. Source animals should only be euthanased when there is no reasonable alternative.
PART C: TRANSPLANT CENTRES
14. Centres intending to carry out transplantation procedures must meet the following requirements:
15. To safeguard both the source and recipient animals, there must be a suitably qualified team of veterinary surgeons to remove and implant the organ and to provide the necessary post-operative support, both to the source and recipient animals. The team should include veterinary surgeons with Diplomate or Board Certified Level qualifications in Medicine, Soft Tissue Surgery and Anaesthesia and qualifications or experience in microvascular surgery and critical care. Ideally, at least one member of the team should have first hand experience of transplant surgery at another centre over a period of time.
16. To safeguard the ongoing care of the recipient and source animals, the centre must ensure satisfactory arrangements for long-term care, as determined by the group specified in paragraph 15. In particular, before carrying out transplantation procedures the centre must a) provide the recipient's primary practice with aftercare guidelines, and b) ensure that the veterinary surgeon(s) from the primary practice are willing and able to undertake this aftercare.
17. Approved centres will be expected to be up to date with current developments that significantly improve outcomes, keep appropriate records of the transplantations carried out and undertake regular audit of clinical outcomes.
18. The centre must have an Ethics Committee to ensure that all procedures are subject to rigorous and critical review. This Committee should include lay representation and must represent the health and welfare interests of both source and recipient animals and the views of staff involved.
INSPECTION
19. Centres seeking formal confirmation that they meet the requirements above may ask RCVS to appoint an Inspector for the purpose. The costs of the inspection are to be borne by the Centre seeking approval.
From time to time, Animal Health (formerly the State Veterinary Service) comes across instances where the actions of individual veterinary surgeons may be criticised. In some instances, these actions may be such that Animal Health feels obliged to report the facts of the case to the RCVS for possible disciplinary action. In the past, problems with certification of animals or animal products have been the commonest cause of such referrals. However, the increasing scrutiny and audit of activities in other areas of work means that other problems cannot be ruled out.
The number of cases warranting referral to the RCVS has been, and is expected to remain, small. This note sets out the arrangements which have been agreed between Animal Health and the RCVS for dealing with such cases.
1. The following situations warrant formal referral to the RCVS for consideration of possible disciplinary action:
a) a serious failure on the part of a certifying veterinary surgeon to abide by the RCVS guidance on certification;
b) the conviction of a veterinary surgeon for an offence under animal health, welfare or medicines legislation;
c) the conviction of a veterinary surgeon for any other offence which leads to suspension of the LVI designation of that veterinary surgeon.
The referral will be in the form of a letter from the Director of the Veterinary Field Service (DVFS) to the Assistant Registrar at the RCVS, setting out the facts of the case as they appear to Animal Health. A copy of the letter will be sent to the veterinary surgeon concerned.
2. If other circumstances arise which lead the DVFS to consider that a referral to the RCVS might be warranted, he may discuss the case with the Assistant Registrar on a without prejudice basis. Any subsequent referral will be in the form of a letter to the Assistant Registrar, setting out the facts of the case as they appear to Animal Health. A copy of the letter will be sent to the veterinary surgeon concerned.
1. The current law is set out in section 6 of the Animal Welfare Act 2006, and in the Docking of Working Dogs' Tails (England) Regulations 2007 (SI 2007/1120).
2. In brief, the Act makes it an offence to remove the whole of part of a dog's tail other than for the purpose of medical treatment, subject to the exemption for docking the tails of certain working dogs. In particular, the legislation states:
a. that any veterinary surgeon who docks a tail must certify that s/he has seen specified evidence that the dog is likely to work in specified areas (the form of words for the docking certificate can be found on the DEFRA website);
b. the dog must be no older than five days and will need to be microchipped;
c. the types of dog that may be docked (types specified in the Docking of Working Dogs' Tails (England) Regulations 2007 are (1) hunt point retrieve breeds of any type of combination of types, (2) spaniels of any type of combination of types or (3) terriers of any type of combination of types. A copy of these regulations can be found on the OPSI website); and
d. the types of evidence which the veterinary surgeon will need to see.
3. Veterinary surgeons practising in England should also be aware of the provisions which apply in other parts of the United Kingdom, as they might be asked to undertake docking that could be illegal in the client's normal country of residence.
4. The current law is set out in section 6 of the Animal Welfare Act 2006, and in the Docking of Working Dogs' Tails (Wales) Regulations 2007 (SI 2007/1028 (W.95)). The regulations are similar to those which apply in England but not identical. In particular:
a. the types of dog which may be docked are more narrowly defined (types specified in the Docking of Working Dogs' tails regulations 2007 are (1) certain hunt point retrieve breeds, (2) certain breeds of spaniels and (3) certain breeds of terriers. There is a detailed list of the breeds which can be docked in Schedule 2 Part 1 of the Regulations and this is available on the OPSI website;
b. the certificate which must be completed by both veterinary surgeon and client requires the client to specify the breed of the dog and its dam, and the veterinary surgeon must be satisfied that the dog and its dam are of the stated type (information about the certification required is available on the Welsh Assembly website;
c. the certificate must specify the purpose for which the dog is likely to be used and confirm that evidence relevant to the particular case has been produced.
5. Veterinary surgeons practising in Wales should also be aware of the provisions which apply in other parts of the United Kingdom, as they might be asked to undertake docking that could be illegal in the client's normal country of residence.
6. The current law is set out in section 20 of the Animal Health and Welfare (Scotland) Act 2006. This prohibits the mutilation of animals, apart from procedures specified in regulations, and the regulations which have been made do not include an exemption for non-therapeutic tail- docking of dogs. It will also be an offence to take a dog from Scotland for the purpose of having its tail docked.
7. There has been no change in the law in Northern Ireland. Thus the legal advice obtained by the RCVS in 1996, set out below, still applies:
Leading Counsel has advised:
1. Docking, which may be defined as the amputation of the whole or part of a dog's tail has, since July 1993, been illegal under UK law, if performed by a lay person.
2. The Royal College has for many years been firmly opposed to the docking of dogs' tails, whatever the age of the dog, by anyone, unless it can be shown truly to be required for therapeutic or truly prophylactic reasons.
3. Docking cannot be defined as prophylactic unless it is undertaken for the necessary protection of the given dog from risks to that dog of disease or of injury which is likely to arise in the future from the retention of an entire tail. The test of likelihood is whether or not such outcome will probably arise in the case of that dog if it is not docked. Faecal soiling in the dog is not for this purpose a disease or injury, and its purported prevention by surgical means cannot be justified.
4. Similarly, docking cannot be described as prophylactic if it is undertaken merely on request, or just because the dog is of a particular breed, type or conformation. Council considers that such docking is unethical.
5. Docking a dog's tail for reasons which are other than truly therapeutic or prophylactic is capable of amounting to conduct disgraceful in a professional respect. In the event of disciplinary proceedings being brought in respect of tail docking, it shall be open to the RCVS by evidence to prove, and to the Disciplinary Committee on such evidence to find, that any therapeutic or prophylactic justification advanced for the docking in question is without substance. If such a finding is made, the Disciplinary Committee may proceed to consider and to decide whether in the circumstances the veterinary surgeon who undertook that docking knew, or ought to have known, that such purported justification is without substance.6. For the avoidance of any doubt, any instance of tail docking which is found to have been undertaken for reasons which were not truly therapeutic or prophylactic will necessarily constitute an unacceptable mutilation of the dog, which, if carried out by a veterinary surgeon who knew or ought to have known of the lack of true justification, would almost certainly be considered to be conduct disgraceful in a professional respect.
RCVS Council, June 2007
Professional Conduct Department 17 January 2003
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Date:2/9/2010 |
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