3. Part 1: Embracing the vet-led team
22. The RCVS is the regulator of both veterinary surgeons and veterinary nurses. Under Schedule 3 of the existing VSA, veterinary nurses are able to undertake medical treatment and minor surgery, not involving entry into a body cavity.
Recommendation 1.1: Statutory regulation of the vet-led team
23. The LWP reaffirms the recommendations found in the 2019 RCVS report to Defra on the Review of Minor Procedures Regime (RMPR report). Among the recommendations was a two-fold approach to veterinary paraprofessionals:
24. First, legislation should be amended to underpin the work of those paraprofessions who are currently working in a legal ‘grey area’ as their work amounts to acts of veterinary surgery too substantial to be underpinned by an exemption order: in particular equine dental technicians, musculoskeletal therapists, and cattle foot trimmers.
25. Second, the RCVS should seek to bring the vet-led team under its regulatory umbrella in order to be able to assure standards and protect animal health and welfare – this is particularly necessary for those paraprofessionals who carry out acts of veterinary surgery.
26. The RMPR report attempted to address the issue of paraprofessionals by making proposals that could potentially be achieved by reform of the existing VSA. However, the legal advice on whether this could be achieved in practice is inconclusive – it is possible that it would ‘stretch’ the VSA too far from its original purpose to be acceptable to legislators. Further, it would be a somewhat inflexible measure that does not provide for futureproofing. Any new paraprofession requiring legislative underpinning (such as the proposed formal vet tech role) would require significant further legislation to achieve. This contrasts with regulatory regimes such as the General Dental Council (GDC), who are able to add new paraprofessions to their regulatory remit via Section 60 Orders under the Health and Social Care Act.
27. The LWP therefore recommends that new legislation should provide flexibility to allow the RCVS to give legal and regulatory underpinning to new paraprofessions whose work amounts to veterinary surgery without recourse to new legislation. This should be full statutory regulation, and may include measures to allow ‘grandfathering’ to ensure that no-one is denied the right to a livelihood, much as existing practitioners were grandfathered by the early Veterinary Surgeons Acts.
Recommendation 1.2: Flexible delegation powers
28. The LWP reiterates that, by default, acts of veterinary surgery should be reserved to veterinary surgeons. At present, new legislation is required if Council determines that additional acts of veterinary surgery can be undertaken by a properly regulated and supervised paraprofession. The LWP concludes that this is too restrictive, and, in accordance with Principle 4 and modern regulatory regimes such as those for social workers under the Social Workers Regulations 2018, recommends that the RCVS should be able to determine which tasks should be eligible for delegation by a veterinary surgeon where such delegation can be fully justified and evidenced, subject to rules concerning consultation requirements and approval by the Secretary of State.
Recommendation 1.3: Separating employment and delegation
29. The LWP notes that some paraprofessionals could be part of the vet-led team without necessarily being employed by a veterinary surgeon. While the legal underpinning for their activities is not yet in place, this is already the case with some paraprofessions such as equine dental technicians whose work can consist of veterinary surgery requiring delegation by a veterinary surgeon.
30. At present, Schedule 3 of the VSA restricts such delegation to allied professionals (currently only veterinary nurses) who are in the employ of the delegating veterinary surgeon. The LWP recommends that this restriction is removed. In practice, this would allow a ‘district veterinary nurse’ model, in which VNs could help clients to administer treatment to their pets at home under the direction of a veterinary surgeon who was not their employer. The veterinary nurse would be working ‘with but not for’ a veterinary practice. Decoupling direction from employment would avoid a potential double-standard relative to other paraprofessions, and help to better use VNs to their full potential in the interests of animal health and welfare.
Recommendation 1.4: Statutory protection for professional titles
31. The RCVS already has a longstanding recommendation that the title ‘veterinary nurse’ should be protected to prevent its use by unqualified, unregulated individuals. The protection of professional titles gives clarity and assurance to the public. The LWP reaffirms this recommendation, and recommends that protection of title be extended to any new paraprofessions who fall under the RCVS’s regulatory umbrella.