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Standards & advice update: November 2020

While much of our Standards & Advice Team’s work since the last update in June this year has been dominated by the increasing complexity of the coronavirus-related restrictions across the four nations of the UK, the team and our Standards Committee has still been busy looking at how we can improve, refine and update the supporting guidance to the Code, and advice to the profession, both on an ongoing basis, and in response to particular circumstances.

This month we will update you on our work to improve the language and readability of the Health Protocol guidance, and a reminder around using human-licenced paracetamol in veterinary practice.

Health Protocol 

At its meeting in September 2020, the Standards Committee agreed to amend the Health Protocol to put it into plainer English, reduce ‘legalese’ and therefore make it easier to navigate. The purpose of the Health Protocol is to recognise that referring a veterinary surgeon or veterinary nurse who is suffering from a health condition that is impairing their fitness to practise to a formal and public Disciplinary Committee, and potentially stopping them from practising, is not always in the public interest, and therefore allows for a more supportive approach. Additionally, where concerns have been raised about an individual veterinary surgeon or veterinary nurse that are directly related to their health, the Health Protocol allows for medical management as an appropriate alternative to disciplinary proceedings.

The amendments have not changed the substance of the Health Protocol, but instead the language has been changed to make the supporting guidance easier for the profession to understand. The changes do not impact how the guidance should be used in practice but rather the amendments are to clarify the scope and reach of the protocol, and the circumstances in which it may be relevant.

In addition, a number of case studies have been produced to give the professions a better idea of how the Health Protocol applies in practice and when a referral to the College may be appropriate. These case studies can be found within the guidance at para 15.6.

Any questions relating to the Health Protocol should be address to the Standards and Advice Team: advice@rcvs.org.uk

Prescribing human-licensed paracetamol

Veterinary professionals should be mindful that advising a client to administer human-licensed paracetamol to their animal is considered to be a veterinary prescription, and therefore the prescribing cascade should be followed as is clearly set out as a requirement in the Code of Professional Conduct.

The only authorised veterinary form of paracetamol for companion animals is Pardale-V (Oral Tablets). This authorisation is only for use in dogs.

Pardale-V can also be prescribed for other species under step (a) of the prescribing cascade, however this would only be appropriate and justifiable where there is no medicine authorised in the UK to treat the condition (ie pain) in that species. Vets should also be mindful that the cost of the medication cannot be taken as justification for prescribing under the cascade, and instead the decision should be made only to avoid unacceptable suffering.

Human-licensed paracetamol could be prescribed under step (b)(i) of the prescribing cascade, however, the justification in this case would also need to account for why a veterinary medicine (authorised for that species and condition, or for another species or condition) could not be used.

The Veterinary Medicines Directorate has confirmed that, in an emergency, a vet may consider that it is in the best interest of the animal for the owner to administer paracetamol that they already have at home, until such time that the animal can be assessed by a vet and a more appropriate prescription given.

Currently, under the temporary Covid-19 guidance, a vet may instead be able to assess and prescribe for an animal remotely (subject to the guidelines in FAQ 4), and may therefore avoid a prescription for human-licensed paracetamol.

Chapter 4 of the supporting guidance to the Code of Professional Conduct provides further detail on using the prescribing cascade.

 

November 2020