The current position
Under care
"The terms 'under care' and 'clinical assessment' are not defined by legislation, so it is left to the RCVS to interpret what they mean."
- Before a veterinary surgeon can prescribe prescription-only veterinary medicines (POM-Vs), according to Schedule 3, paragraph 4 of the Veterinary Medicines Regulations 2013 (VMRs) they must first carry out a ‘clinical assessment’ and have the animal ‘under their care’. These terms are not defined by the VMRs and so it is left to the RCVS to interpret what they mean.
- It is important to note that, under the VMRs, the requirements to carry out a clinical assessment and have the animal under one’s care only apply to the prescription of POM-Vs. This means that when prescribing other classes of medicines or treatment not involving the prescription of POM-Vs, veterinary surgeons do not need to satisfy these requirements (although there are more general obligations relating to the provision of veterinary care, 24-hour emergency first-aid and pain relief, and responsible prescribing that must be met).
- Our current guidance on prescribing POM-Vs effectively requires a physical examination to be carried out before a veterinary surgeon can establish that an animal is under their care. The guidance states that animals should be ‘seen’ immediately prior to prescribing or ‘recently or often enough for the veterinary surgeon to have personal knowledge’ of the animal or herd. It goes on to say that a veterinary surgeon cannot usually have an animal under their care if there has been no physical examination and that they should not prescribe POM-Vs via the internet alone. Remote prescribing is therefore allowed under our current guidance, but only where the animal is already under the veterinary surgeon’s care.
We recognise, however, that there are some situations where the precise requirements of the VMRs are not practical, for example, when prescribing for herds, shoals and flocks, or issuing repeat prescriptions as a locum. In addition, the current guidance was written at a time before good quality video calls were widely accessible and physiological data could, in some cases, be gathered at a distance.
24-hour emergency first aid and pain relief
- The RCVS Code of Professional Conduct requires all veterinary surgeons in practice to ‘take steps to provide 24-hour emergency first aid and pain relief to all animals according to their skills and the specific situation’. Veterinary surgeons are not obliged to provide the service personally or expected to remain constantly on duty. They are, however, required to ensure clients are directed to another appropriate service when they are off duty or otherwise unable to provide the service. The current guidance is set out in full in Chapter 3: 24-hour emergency first aid and pain relief.
- The out-of-hours obligations for veterinary surgeons working for limited service providers (LSPs), or based in referral practices, are slightly different to the general position described above and this is discussed more below.