Standards & Advice update: Consumer choice and professional autonomy

Following a recent review, the RCVS Standards Committee has agreed to consolidate the our existing guidance on consumer care and freedom of choice. The Committee also agreed to update our guidance on professional autonomy to encompass some of the key principles of contextualised care and ensure that the commercial interests of businesses do not unduly influence the clinical decision making of individual vets and veterinary nurses.

Consumer rights and freedom of choice

Chapter 10. Consumer rights and freedom of choice

In order to make the obligations in relation to consumer rights and freedom of choice more accessible and easier to navigate for the profession, the Committee agreed to consolidate the existing guidance on this topic from the 30 chapters of the supporting guidance into Chapter 10 of the supporting guidance to the Code of Professional Conduct. Where applicable, a link has been added at the end of each section to signpost to the chapter the guidance was taken from.

Chapter 10 now provides general guidance around consumer rights and freedom of choice, as well as more specific guidance focusing on how this topic applies to veterinary medicines, fees, referrals and incentives, advertising and recommendations, and informed consent.

While there are some minor updates to the wording, the consolidated guidance in this chapter serves only to clarify the current guidance and does not introduce any new requirements. For example, in paragraph 10.22 ‘the option to monitor the animal without further tests or treatment’ has been added as an example of the range of reasonable treatment options that may be discussed with the client.

Please note that once the Competition & Markets Authority has completed its market investigation, a more substantial review of this guidance will take place.

Chapter 17. Veterinary teams and leaders

Under the current regulatory framework, the RCVS does not regulate practices, although practices may choose to be accredited through the RCVS Practice Standards Scheme. However, as outlined in Chapter 17 of the supporting guidance, practices are expected to have an appointed senior veterinary surgeon who has overall responsibility for professional matters within practice such as clinical policy guidelines, complaints policies, and procedures relating to medicines.

The Committee therefore agreed that new guidance be added to this chapter to set out that the appointed senior veterinary surgeon should also ‘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’ (paragraph 17.15(e)).

The full details of the role of the appointed senior veterinary surgeon can be found in paragraphs 17.14-17.16 within Chapter 17.

Contextualised care and professional autonomy

Chapter 2. Veterinary Care

The Committee agreed to provide more information on contextualised care and exercising professional judgement within the supporting guidance at Chapter 2. This guidance aims to clarify the position on contextualised care and address situations where veterinary surgeons may feel under pressure to treat animals in a particular way under their practice policy.

Further, the Committee hopes that veterinary surgeons will feel supported to exercise their autonomy in deciding appropriate care, particularly in settings where they may be encouraged to follow organisation protocols which prescribe testing and treatment routes.

The guidance is as follows:

2.2  Veterinary surgeons and veterinary nurses are personally accountable for their professional practice and must always be prepared to justify their decisions and actions. When providing care, veterinary surgeons and veterinary nurses should:

[…]

c. make decisions on treatment regimes based first and foremost on animal health and welfare considerations, whilst providing contextualised care and exercising professional judgement about what is best for the animal in each individual case, taking into account the needs and circumstances of the client. For more information please see the RCVS Knowledge’s guidance on contextualised care;

d. where organisational protocols are in place, consider whether applying these in each individual case is appropriate;

Chapter 17. Veterinary teams and leaders

As stated above, we do not currently have jurisdiction over practices, beyond accreditation under the Practice Standards Scheme. However, the Committee felt it was already an implicit responsibility of those in the role of the appointed senior veterinary surgeon is to make sure that professional obligations, including clinical freedom and professional autonomy, are not interrupted without a legitimate reason.

The Committee felt this should be made explicit and agreed a further addition to the guidance as a result. The amendment states that the appointed senior veterinary surgeon should ‘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’ (paragraph 17.15(f)).