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‘Radical’ changes ahead for the profession?

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By Josh Loeb

RCVS council has kickstarted a process that could see the existing Veterinary Surgeons Act swept away and replaced with new legislation that would revolutionise oversight of the profession.

At last week’s council meeting, members gave the green light to a consultation with the profession about plans for the biggest veterinary legislative reboot for more than 50 years.

Under the proposals, the RCVS would gain new powers, including a new legal ‘power of entry’ to inspect veterinary businesses, rights to regulate paraprofessionals and the ability to force disclosure of material in investigations.

Suggested measures also include:

  • Compulsory regulation of vet practices to replace the current system of voluntary regulation through the Practice Standards Scheme, underpinned by powers to enable Care Quality Commission-style inspections of practices.

  • An overhaul of the disciplinary system to introduce a lower standard of proof, alongside more flexible and ‘compassionate’ approaches towards misconduct.

  • Modernisation of the registration system to allow for regular revalidation, with the revalidation period yet to be determined, and new measures that could enable limited licensure.

  • Protection of the title ‘veterinary nurse’ and expansion of the role of vet nurses to let them carry out cat castrations, extend their role in anaesthesia and set the scene for the introduction of some prescribing powers.

The blueprint was drawn up by the college’s Legislation Working Party (LWP), led by former RCVS president Stephen May. Some aspects of the masterplan were public knowledge already but others were confidential until last week, when the totality was revealed to council in a 39-page document called ‘Report of the RCVS Legislation Working Party’.

Presenting the report, May said he wished to ‘lay down the proverbial gauntlet’ and called on council members to debate the issues.

He also admitted the proposed changes were ‘radical’ but he challenged any critics of reform to justify their stance: ‘Now that we’ve come out of the confidential stage, I am determined to educate those within our profession. I accept they may not have understood because they’ve not seen all the detail or explored it.’

Now that the proposals have been agreed upon ‘in principle’ by the council, the college plans to consult with the profession before making a further decision about how to proceed.

A replacement for the existing Veterinary Surgeons Act could be up and running within three years

The final vision for a new Act of Parliament would need to be considered by Defra and MPs – a potentially lengthy process. However, in a best-case scenario it is understood that a replacement for the existing Veterinary Surgeons Act could be up and running within three years.

What’s being proposed?

• New powers for the RCVS to regulate, on a statutory basis, all paraprofessionals identified as being part of the ‘vet-led team’. This is expected to include equine dental technicians, musculoskeletal therapists and cattle foot trimmers, but there is as yet no full list of paraprofessionals.

• The legal status of delegation by a vet to a paraprofessional would be separated off from the issue of employment, allowing a vet nurse or paraprofessional to work under the direction of a vet who is not their employer.

• Statutory protection of professional titles, including the title of ‘veterinary nurse’ (VN).

• Paving the way for a VN prescriber role, something that would ultimately require further work, including changes to separate legislation governing veterinary medicines.

• Enhancing the role of veterinary nurses (VNs) – allowing VNs to carry out cat castrations, extending their role in anaesthesia and creating a ‘district veterinary nurse’ model, mirroring the situation in human healthcare.

• Empowering the RCVS to introduce regular revalidation for veterinary professionals; underpinning continuing professional development on a mandatory basis.

• Introducing a modern, compassionate ‘fitness to practise’ regime. Rewiring the disciplinary system to focus on issues of current capability and impairment of fitness to practise, rather than past misconduct. Introducing powers of interim suspension for veterinary professionals under investigation, meaning vets could in some cases be temporarily suspended pending the outcome of a disciplinary case. Introducing a wider range of sanctions for the disciplinary committee.

• New powers to order vets to pay costs in some RCVS hearings – this could help ‘discourage repeated applications for restoration where circumstances have not changed or [act] as an incentive to engage in proper and timely case management’.

• Modernising RCVS registration – introducing provisions to allow limited licensure, including for those who, because of disability, are unable to carry out some types of veterinary tasks.

• Compulsory regulation of vet practices, with inspectors given powers of entry and the RCVS handed powers to issue improvement notices.

The project is not without risks. ‘In principle’ approval by the council followed a lively debate in which one council member went as far as to warn that any move to so comprehensively reform the profession could unintentionally backfire and end up threatening the RCVS’ very existence.

What is the earliest timetable for change?

2020 – RCVS consultation with profession later this year.

2021 –Finalised proposals could go to Defra.

2022 – Consultations with government could complete.

2022/3 – Bill could go before parliament to start the process of ratification.

  • (Note: The RCVS has emphasised that it does not have a specific timetable in mind since much would depend on decisions made by the government)

Council member Tim Walker, a lay member with a background in human healthcare regulation, said: ‘I think it’s right that we pursue a new and comprehensive Act of Parliament, but we have to be alive to the risks. It’s not something that would just be agreed by Defra – a new Act would require input from the Treasury, the Cabinet Office, devolved country governments, all sorts.

There’s considerable risk that this process might open up the whole question of whether it remains appropriate for the professional body and regulator to remain as one single entity

‘There’s considerable risk that this process might open up the whole question of whether it remains appropriate for the professional body and regulator to remain as one single entity.

‘That is not something that we would get to choose – it’s something that the government would decide.’

Walker suggested that amending the existing Act, rather than completely overhauling it, could be a safer way to proceed as it might ‘expose the RCVS to a lower degree of existential risk’.

However, May said that the changes the LWP proposed were ‘not possible within the confines of the Veterinary Surgeons Act 1966, which has served the profession well for 50 years but is really not fit for the 21st century’.

RCVS registrar Eleanor Ferguson described the Veterinary Surgeons Act 1966 as ‘a creature of its time’, saying it was increasingly not fit for purpose. She told council members that the profession would be ‘kidding ourselves’ to think that the changes being proposed would be possible within the confines of the existing Act.

‘Going forward I think it’s going to be hard to see how we could potentially make these changes without some form of fundamental new legislation,’ she said. ‘I agree that nothing is risk free but it’s also not risk free to stay where you are, and I think there may come a point when the nettle has to be grasped and we have to move forward to getting more modern wholesale legislation.’

At the RCVS council meeting on 4 June, council members voted 26 for and five against accepting the LWP report’s content ‘in principle’. There were two abstentions.

During the same meeting, members also voted to hold a separate consultation about related proposals to change aspects of the disciplinary process, including standard of proof – a move Vet Record has reported on previously (VR, 22 February 2020, vol 186, p 199). ●

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