Prescribing from outside the UK

Scenario

Remote Vets 4U is an online-only company based in the United Kingdom. It provides a platform for animal owners to access veterinary care remotely 24/7 and employs veterinarians based outside the UK.

Stuart is employed by Remote Vets 4U and lives in Greece. Until recently, Stuart was registered both as an MRCVS and with the Greek veterinary regulator but has since let his RCVS registration lapse.

This morning, Stuart had a remote consultation with Parminder and her dog, Rex. Before beginning the consultation, Stuart confirmed with Parminder that Rex is registered at a veterinary practice locally and obtains the details so that he can pass on any relevant clinical information following this consultation.

Parminder explains that Rex is lame and that this has come on suddenly over the past couple of days. Stuart has seen a video of Rex in advance and asks a number of questions during the consultation.

Following this assessment, Stuart decides he has enough information to prescribe anti-inflammatories effectively and safely and says he will send Parminder a prescription via email.

He also tells Parminder that if Rex doesn’t improve over the next couple of days, she should attend her usual practice for further investigation.

Things to think about...

Veterinary surgeons who provide veterinary services to animals in the UK are considered to be practising in the UK regardless of where there are physically based. This means that they must be an MRCVS on the 'UK-practising' category of the RCVS register, keep up to date with continuing professional development (CPD) and have professional indemnity insurance (PII). Stuart does not satisfy these criteria and, as such, should not be providing any such service.

Even if Stuart was properly registered, had completed CPD and had PII in place, there are still a number of barriers before POM-Vs could be prescribed from outside the UK, as set out below.

According to the VMRs, veterinary surgeons must take the animal under their care and carry out a clinical assessment. The College's new guidance states having an animal 'under care' means that the veterinary surgeon has been given, and accepted, responsibility for the animal.

Stuart has clearly taken responsibility for Rex and, as such, according to the new guidance, must be able, on a 24/7 basis, to physically examine him and carry out any necessary investigations. This service should be provided within a reasonable timeframe, which could be immediately.

Stuart would not be able to fulfil this obligation himself from Greece and so he (or Remote Vets 4U on his behalf) would have to find a veterinary provider, based in the UK to provide this service.

It is Stuart’s responsibility to make any such arrangement (it is not enough that Rex is registered at another practice) and it must be made in advance before veterinary services are offered with the terms confirmed in writing.

Remote Vets 4U is an online-only business and, as such, clients would be able to contact them from anywhere in the UK. This means that if they, or Stuart, were going to go down the route of putting these arrangements in place, they would have to ensure that there was cover local to all clients who use their service which would be logistically challenging.

Finally, even if Stuart and Remote Vets 4U were able to fulfil their obligations in terms of 24/7 follow up care, they would not be able to supply any medicines prescribed as medicines may only be supplied from ‘Registered Veterinary Practice Premises’ (RVPPs) which, due to inspection requirements, can only be registered in the UK.