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Welcome to the Royal College of Veterinary Surgeons

1. Referrals and second opinions

Updated 15 June 2016


1.1  Veterinary surgeons should facilitate a client’s request for a referral or second opinion.

1.2  A referral may be for a diagnosis, procedure and/or possible treatment, after which the case is returned to the referring veterinary surgeon, whereas a second opinion is only for the purpose of seeking the views of another veterinary surgeon. Neither a second-opinion veterinary surgeon nor a referral practice should ever seek to take over the case, unless the client chooses to change practices.


When to refer

1.3  Veterinary surgeons should recognise when a case or a treatment option is outside their area of competence and be prepared to refer it to a colleague, organisation or institution, whom they are satisfied is competent to carry out the investigations or treatment involved.

1.4 The veterinary surgeon should make a referral appropriate to the case.  When considering what is appropriate the veterinary surgeon should consider all relevant factors.  These might include the ability and experience of the referral veterinary surgeon, the location of the service, the urgency of treatment and the circumstances of the owner, including the availability and any limitations of insurance.  Veterinary surgeons should be prepared to justify their referral decisions and should record the reasons for their decisions.

1.5 In cases where the client does not accept the veterinary surgeon’s advice regarding referral and would instead prefer referral to a colleague, organisation or institution of which the referring veterinary surgeon has insufficient knowledge to determine appropriateness, they may need to advise their client accordingly.  In some such cases, the veterinary surgeon may consider that they cannot be party to such a referral relationship.

1.6  The referring veterinary surgeon has a responsibility to ensure that the client is made aware of the level of expertise of appropriate and reasonably available referral veterinary surgeons, for example, whether they are veterinary specialists or advanced practitioners. They must not describe a referral veterinary surgeon as a specialist, or as an advanced practitioner, unless they are on the respective list.  

1.7  Both the referring veterinary surgeon and the referral veterinary surgeon have a responsibility to ensure that the client has an understanding of the likely cost arising from the referral.



1.8 Veterinary surgeons’ and veterinary nurses’ first consideration is animal health and welfare. Veterinary surgeons and veterinary nurses considering offering or accepting any form of incentive, whether in a referral setting or otherwise, should consider whether the existence of the incentive gives rise to a real or perceived conflict of interest.  An incentive should not distract a veterinary surgeon or veterinary nurse from their professional responsibilities towards animals and clients and, in some cases, should be declined, for example where a veterinary surgeon or veterinary nurse would not otherwise enter into that arrangement. 


Referring a case

1.9  The initial contact should be made by the referring veterinary surgeon, and the referral veterinary surgeon should be asked to arrange the appointment. 

1.10  The referring veterinary surgeon should provide the referral veterinary surgeon with the case history and any relevant laboratory results, radiographs, scans etc. Any further information that may be requested should be supplied promptly.   

1.11  The referral veterinary surgeon should discuss the case with the client including the likely costs of the referral work and promptly report back on the case to the primary veterinary surgeon. When reporting back to the referring veterinary surgeon, there should be transparency as to who dealt with the case.


Second opinions

1.12  Veterinary surgeons may follow similar procedures for second opinions and should ensure that any differences of opinion between the veterinary surgeons are discussed and explained constructively.

See also the supporting guidance on ‘Providing the service – referrals’, 3.5-3.7

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