Towards Mandatory Practice Regulation (MPR)

We recently completed our first Mandatory Practice Regulation (MPR) Working Party meeting, in-person at the home of the Royal College of Nursing (RCN) in Cavendish Square, London. We would like to extend a huge thanks to the mix of veterinary professional stakeholders, legal experts and representatives of other regulators who attended the meeting and shared invaluable experience and ideas on the top line themes for what MPR in the veterinary sector should eventually look like.

So, what is MPR and why do we need it? The current Veterinary Surgeons Act 1966 (VSA) is an outdated piece of legislation which, as the title suggests, predates Neil Armstrong taking his “small step for man” on the moon. It was introduced at a time when all veterinary practices were owned by vets. Fast forward to 2024, over 50% of veterinary practices are now owned by the seven largest employers. Currently, the RCVS has no statutory powers directly to regulate veterinary practices to ensure that they meet the legal and regulatory minimum standards, reducing our ability to assure veterinary standards.

As part of its package of recommendations for legislative reform, the RCVS is asking for statutory powers to create an MPR scheme to ensure that all practices are assessed, similar to how human hospitals, GP practices and care settings are regulated by the Care Quality Commission. This would align us with our core mission to enhance society through improved animal health and welfare, while also shifting us into the 21st century alongside other healthcare profession regulators.

How are we managing at present? Our Practice Standards Scheme (PSS) is currently used under Royal Charter powers to assess and accredit practices, and almost 70% of UK practices are members of the scheme. However, the PSS is an entirely voluntary scheme and as a result is not the right mechanism to ensure standards across all practices.

With the above in mind, this will be the first in a series of updates to inform you on the progress of the working group as we put together details of how an MPR system would work in practice.

In our first session it was fascinating to engage with Duncan Rudkin from the General Pharmaceutical Council (GPhC) and Dr Simon Watson from Healthcare Improvement Scotland (HIS). Both outlined the respective approaches of their assessment regimes, which include risk-informed, risk-based and intelligence-led inspections, with patient safety at the heart of everything they do.

We also brainstormed on the following key elements in relation to a future MPR scheme: scope, standards, assessment, enforcement, governance, cost and acceptability. Examples of key considerations over the next couple of meetings will include:

• How do we measure outcomes?
• How will the scheme be resourced?
• How will the scheme be governed within the RCVS?

We want to make sure that we continue to communicate with the profession as plans for a MPR scheme are developed, so please do stay tuned to this blog.