Standards & advice update: January 2019

At its last meeting on 30 January 2019, our Standards Committee approved a number of changes to the supporting guidance to the Code of Professional Conduct covering areas such as equine pre-purchase examinations (PPE), euthanasia, clinical records and surgical artificial insemination in dogs.

Some of these changes were to keep our guidance in line with legislative changes and some based on feedback we have received from our other Committees and subcommittees.

A summary of the changes that is set out below. New guidance is in bold text and removed guidance is struck out. In each case, we have also explained why we have made these changes.

Chapter 7 – Equine pre-purchase examinations

7.9 Ideally, veterinary surgeons should not carry out PPEs where the vendor is an existing client and/or has a personal relationship with the veterinary surgeon, because of the conflict of interest. However, if, for practical or other reasons, veterinary surgeons do, they should follow additional safeguards to ensure the examination is not only fair, but perceived to be fair, by the client requesting the PPE.

7.10 These additional safeguards are:

a)   the veterinary surgeon makes the purchaser aware that the vendor is also a client and/or has a personal relationship with the veterinary surgeon, and the potential purchaser has no objection. If there is an objection, the vendor's veterinary surgeon must not act;

b)   the vendor agrees to permit disclosure of relevant clinical/case records. If permission cannot be obtained then the vendor's veterinary surgeon should not act. If the records reveal a factor which is likely to be prejudicial to the purchaser’s intended use, the purchaser should be informed with the vendor’s permission in advance of the examination; and,
c)   it is made clear to both parties that in this instance the veterinary surgeon is acting on behalf of the purchaser.

Explainer

The guidance was amended following consideration by Standards Committee of feedback received via PIC/DC Liaison Committee. It was agreed that, for clarity and the avoidance of doubt, there should be a specific requirement that a veterinary surgeon conducting a pre-purchase examination on behalf of a prospective purchaser should disclose to the prospective purchaser any personal relationship with the vendor, in addition to any client relationship.

Chapter 8 – Euthanasia of animals

8.2 Euthanasia is not, in law, an act of veterinary surgery, and in most circumstances may be carried out by anyone provided that it is carried out humanely. No veterinary surgeon is obliged to kill a healthy animal unless required to do so under statutory powers as part of their conditions of employment. Veterinary surgeons do, however, have the privilege of being able to relieve an animal's suffering in this way in appropriate cases.

8.3 In England, animals which are kept under a licence granted under the Animal Welfare (Licensing of Activities Involving Animals) (England) Regulations 2018 must either be euthanased by a veterinary surgeon, or by a person who has been authorised to do so by a veterinary surgeon. These animals may include animals sold as pets, boarded cats and dogs, and animals trained for exhibition. Horses held under a licence granted by the regulations may be euthanased by a person who is competent and holds a licence or certificate to do so. Veterinary surgeons are expected to use their clinical judgment when authorising a non-veterinary surgeon to euthanase an animal, however, the following factors may be considered:

a. the experience of the person

b. whether the method of euthanasia is humane and effective

Explainer

In October 2018, the Animal Welfare (Licensing of Activities Involving Animals) (England) Regulations 2018 was enacted. The purpose of this legislation is to promote the welfare of animals by licensing the following activities: selling animals as pets, providing or arranging for the provision of boarding for cats or dogs, hiring out horses, dog breeding and keeping or training animals for exhibition.

The legislation imposes several conditions on the licence holder including providing protection from pain, suffering, injury and disease and, for this, suggests that euthanasia can only be performed by a veterinary surgeon or a person who has been authorised by a veterinary surgeon as competent.

However, no guidance is given on what ‘a person who has been authorised as competent’ might mean and what qualifications might be required.

Therefore, veterinary surgeons will be required to use their clinical judgement to establish whether the non-vet is competent in each particular case, taking into account the whole circumstance including the experience of the person and whether the method of euthanasia is humane and effective.

Chapter 13 – Clinical and client records

13.2 The utmost care is essential in writing records or recording a client's personal details to ensure that they are clear, legible, accurate, and appropriately detailed. Clinical and client records should be objective and factual, and veterinary surgeons and veterinary nurses should avoid making personal observations or assumptions about a client’s motivation, financial circumstances or other matters.

Explainer

This guidance was amended following consideration by Standards Committee of feedback received via PIC/DC Liaison Committee about a case that involved the clarity and legibility of clinical records. This change brings our supporting guidance into line with other overseas veterinary and healthcare regulators.

Chapter 14 – Client confidentiality

14.6 In circumstances where the client has not given permission for disclosure and the veterinary surgeon or veterinary nurse considers that animal welfare or the public interest is compromised, client confidentiality may be breached and appropriate information reported to the relevant authorities. Some examples may include situations where:

a. an animal shows signs of abuse

b. a dangerous dog poses a risk to safety

c. child or domestic abuse is suspected

d. where a breeder in England has presented litters without possessing a licence to breed, or has breached the licence conditions (where applicable)

e. where the information is likely to help in the prevention, detection or prosecution of a crime

f. there is some other significant threat to public health or safety or to the health or safety of an individual.

Explainer

This change is also based on the Animal Welfare (Licensing of Activities Involving Animals) (England) Regulations 2018 which, in part, was enacted in order to tighten regulations around the sale of puppies and to combat ‘puppy farms’.

It is foreseeable that veterinary surgeons and veterinary nurses may examine animals, primarily puppies, which have been bred without a licence, in excess of the licence conditions, or in conditions which are in breach of a licence.

Therefore, it is considered timely to amend the guidance to support veterinary professionals in making decisions about disclosing such circumstances to the relevant authorities. The relevant authority in this case is the local authority that has issued the licence.

There is no obligation for veterinary surgeons and veterinary nurses to request to see proof of a breeder’s licence. However, where there are animal welfare concerns arising from a breeder client, a veterinary surgeon or veterinary nurse may ask to see proof of a licence, and/or use their discretion to report the circumstances to the local authority. A veterinary surgeon or veterinary nurse would either be reporting a breeder client for breach of licence conditions, or reporting the breeder client for not having a licence.

Chapter 27 – Miscellaneous procedures: legal and ethical considerations

27.30 Surgical Artificial Insemination (AI) is prohibited by UK animal welfare legislation which legally restricts mutilations to animals, ie procedures which interfere with sensitive tissue or bone structure, as it is not a procedure exempt within the relevant regulations for the UK jurisdictions set out in paragraph 27.2 (a-d).

27.30 Surgical Artificial Insemination (AI) carries many disadvantages for the bitch and is unlikely to be carried out in the best interests of any particular dog, but a veterinary surgeon may carry out surgical AI:

·        in the rare circumstances where Transcervical Insemination (TCI) has been demonstrated not to be a practical option

AND

·        the invasive nature of surgical AI is justified* and accompanied by an appropriate regime of post-operative pain relief.

* Veterinary surgeons are advised that on the information available to the Advisory Committee, surgical AI is justified only for exceptional reasons, for example, the incorporation of new genetic traits into a line or breed when the sire is not easily available or unable to mate naturally for reasons other than inherited disease.

27.31 When carrying out surgical AI, a veterinary surgeon should record in the bitch’s clinical records why TCI is not a practical option and the justification for the invasive procedure.

Explainer

Changes to this chapter of the supporting guidance, specifically in regards to surgical artificial insemination in dogs, were discussed at Standards Committee.

The proposed changes to the guidance were to clarify that surgical artificial insemination (AI) in dogs is prohibited by animal welfare legislation – specifically the Animal Welfare Act 2006, which prohibits mutilations. Prohibited procedures are defined as those which interfere with sensitive tissue or bone structure. Surgical AI in dogs is not one of the exemptions permitted within the Mutilations (Permitted Procedures) (England) Regulations 2007.

This prohibition replaced outdated guidance which only permitted surgical AI of dogs under extremely limited circumstances.