17. Veterinary teams and leaders

Veterinary surgeons and veterinary nurses in the veterinary team

17.1  Veterinary surgeons and veterinary nurses working for an organisation or practice have shared responsibilities relating to the provision of veterinary services by the team and business. Veterinary surgeons and veterinary nurses have a personal professional responsibility to comply with the RCVS Codes of Professional Conduct.

17.2  Veterinary surgeons and veterinary nurses should fully understand the scope and any limitations of their role and ensure that they work within these.

17.3  Veterinary surgeons and veterinary nurses should communicate with colleagues and others within the organisation or practice, to coordinate the care of patients and the delivery of veterinary services.

17.4  Veterinary surgeons and veterinary nurses who have concerns about the professional conduct (including health and performance) of a colleague are encouraged to discuss the matter with the appropriate senior person, for example, the appointed senior veterinary surgeon of the practice. If the matter cannot be resolved with such an approach, any concerns should be brought to the attention of the RCVS Professional Conduct Department.

17.5  Veterinary surgeons and veterinary nurses should be aware of and adhere to all of their responsibilities as set out in the relevant equalities legislation* and should take steps to challenge unlawful discrimination, harassment and victimisation where it arises.

(*For further information see the Equality and Human Rights Commission website)

17.6  Veterinary surgeons and veterinary nurses must understand and comply with practice policy regarding data protection. 

Veterinary surgeons and veterinary nurses in leadership roles

17.7  Some veterinary surgeons and veterinary nurses are responsible for leading or managing other members of the veterinary team or running the practice in full or in part. Veterinary surgeons and veterinary nurses in such roles have additional responsibilities. Veterinary surgeons and veterinary nurses continue to have responsibility for animal health and welfare when they perform non-clinical duties and they remain accountable to the RCVS for their decisions and actions.

17.8  Veterinary surgeons and veterinary nurses in leadership roles should ensure that any working systems, practices or protocols allow veterinary surgeons and veterinary nurses to practise in accordance with the RCVS Codes of Professional Conduct. If in the course of an RCVS investigation into a concern it appears that a veterinary surgeon or veterinary nurse has followed working systems, practices or protocols which contravene the RCVS Codes of Professional Conduct, the veterinary surgeon or veterinary nurse responsible for the working systems, practices or protocols will be at least as accountable as the veterinary surgeon or veterinary nurse who has followed them.

17.13  Veterinary surgeons and veterinary nurses should regularly review work within the team, to ensure the health and welfare of patients; and, ensure that processes are in place to enable changes in practice when indicated. Veterinary surgeons and veterinary nurses in leadership roles should lead on clinical governance. They should enable and encourage staff to raise concerns and should act on concerns brought to their attention.

The appointed senior veterinary surgeon

17.14  Veterinary surgeons provide veterinary services through a variety of entities such as limited companies, charities, partnerships or sole practitioners and may be managed by non-veterinary surgeons. At all times, veterinary surgeons remain subject to their professional responsibilities and the RCVS Code of Professional Conduct. To provide appropriate professional direction, the RCVS expects the organisation to appoint a senior veterinary surgeon.

17.15  The appointed senior veterinary surgeon should:

a. Have an appropriate level of seniority, for example, director, head of clinical services or other equivalent status within the organisation.

b. Have overall responsibility within the organisation for professional matters; for example, this includes ensuring that clinical policy guidelines and procedures for addressing clients’ complaints about the provision of veterinary services are in line with the RCVS Codes of Professional Conduct.

(See Chapter 2 for references to professional autonomy and contextualised care)

c. Have overall responsibility within the organisation for the procedures by which  medicines are obtained, stored, administered, sold or supplied, and disposed. Veterinary medicinal products, including POM-Vs and veterinary medicinal products prescribed under the cascade may only be obtained by a veterinary surgeon (even though they may be paid for by a business entity) and may only be sold or supplied from veterinary practice premises registered with the RCVS. It should also be noted that in England, Wales, and Scotland, wholesale supply may only be delivered to a registered veterinary practice premises (RVPP). (see further guidance on the registration of veterinary practice premises).

d. Ensure that their colleagues within the organisation, especially those who are not veterinary surgeons or veterinary nurses, recognise the professional responsibilities of veterinary surgeons and veterinary nurses, in particular those set out in the RCVS Codes of Professional Conduct and supporting guidance issued by the RCVS.

e. Have overall responsibility within the organisation for ensuring that the RCVS supporting guidance and legislation relating to consumer obligations, such as consumer choice, are being adhered to.

(See Chapter 10 for more information on consumer rights and freedom of choice)

f. Have overall responsibility within the organisation for ensuring that the clinical freedom and professional autonomy of veterinary surgeons and veterinary nurses is not impeded or eroded by external factors, such as the commercial interests of the practice.

17.16 Where the senior veterinary surgeon works at an RCVS-Approved Graduate Development Practice/Workplace*, the senior veterinary surgeon must:

a. Sign a declaration agreeing that the practice will provide any graduate employed at the practice with regular support as defined by the VetGDP guidance.

b. Engage positively with feedback on the delivery of the programme and any quality assurance activity.

*Please refer to the VetGDP guidance for timescales and deadlines for becoming an RCVS-Approved Graduate Development Practice/Workplace.

Professional indemnity insurance and equivalent arrangements

17.17  Veterinary surgeons and veterinary nurses must ensure that all their professional activities are covered by professional indemnity insurance or equivalent arrangements. The purpose of professional indemnity insurance is to cover compensation claims in the event an allegation of negligence is made against you.

17.18 In addition to professional indemnity insurance, veterinary surgeons and veterinary nurses may also decide to take out insurance to provide cover in the event a concern is raised with the RCVS (although this is not required). Many policies will include both types of cover, however it should not be presumed this is the case. Veterinary surgeons and veterinary nurses should have particular regard to this issue when carrying out locum work, as although the practice’s insurance is likely to provide cover for negligence claims, it may not provide any other type of cover.

17.19 For ‘equivalent arrangements’ to be satisfactory, they must cover four key areas:

a. There must be sufficient funds available to cover potential future claims;

b. Those funds must be readily available in the event that losses need to be compensated – funds are not readily available where use affects significantly the work of the business or life of an individual;

c. There must be an established procedure in place for dealing with claims and accessing those funds, so that all parties have clarity about the process; and

d. There must be arrangements in place to ensure claims are dealt with by those who are independent of those who are the subject of the claim, so that decision-making is not based on personal interest. 

17.20  Veterinary surgeons and veterinary nurses seeking to rely on the equivalent arrangements provision should seek professional advice (e.g. from a solicitor or accountant) to ensure equivalence with professional indemnity insurance. 

Controlled drugs

17.21  The Home Office, which has responsibility for drugs controlled by the Misuse of Drugs Act 1971 has indicated that (1) where it is clear employee veterinary surgeons are responsible for the purchase and supply of these drugs in the company's name and these are to be used directly by a veterinary surgeon acting in their professional capacity treating individual patients, Home Office licences for the possession and supply of controlled drugs are not required and (2) it is desirable for the appointed senior veterinary surgeon to be responsible for company procedures by which these drugs are obtained, stored, administered, sold or supplied, and disposed of by employee (and locum) veterinary surgeons.