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‘Temporary remote prescribing should end’

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By Josh Loeb

The RCVS should end temporary remote prescribing, the BVA has said.

James Russell, the BVA’s president, said the association could not see any reason why now a new client would be unable to access in-person veterinary care in the first instance.

The association is therefore asking RCVS council to reconsider the temporary measure, which was first brought in because of the Covid-19 pandemic.

The RCVS gave the green light in March for vets to prescribe prescription-only veterinary medicines (POM-Vs) remotely without first having physically examined the animal. In June this emergency measure was extended for a further eight weeks. It was then extended a second time at the end of July.

On 30 September the RCVS wrote to all vets and vet nurses to extend the period for a third time, until the end of October, but with the additional requirement for the prescribing vet to consider whether the animal can first be brought under their care.

While the BVA says it supported the initial March decision as a ‘pragmatic solution’ amid national restrictions surrounding Covid-19, the association is now ‘questioning the ongoing need’ for the measure.

‘We understand that allowing remote prescription of POM-Vs was a necessary measure at the height of the lockdown, as practices struggled to assess patients in person,’ Russell said. ‘However, the veterinary professions have done a fantastic job in adapting to the restrictions and are now able to work safely and see patients.

We cannot currently see any reason why a new client would be unable to access in-person veterinary care in the first instance

‘Whilst we recognise the RCVS has provided additional guidance for the remote prescribing of POM-Vs, we cannot currently see any reason why a new client would be unable to access in-person veterinary care in the first instance and we are asking RCVS council to reconsider this measure when it meets in October. It makes sense to continue allowing vets to remotely prescribe for existing patients, for example if an owner is shielding, but we feel it is no longer appropriate to be remotely prescribing to animals that have never been physically examined by the vet.’

He added that, the longer that temporary measures stayed in place, ‘the greater the expectation from animal owners that they will always be in place, and the harder it will be to have the discussion about the best way forward.

‘As a profession, we are rightly concerned about antimicrobial resistance and we pride ourselves on the responsible use of medicines. Continually extending the temporary measures without a full analysis would risk undermining our position.’

The intervention follows concerns raised by some RCVS council members last month about the continuation of emergency pandemic powers used by the college (VR, 19/26 September 2020, vol 187, p 206).

The college says its temporary guidance allowing vets to prescribe POM-Vs remotely was always subject to appropriate safeguards.

Extensions had been approved in view of the ‘ongoing uncertainty caused by local lockdowns’, the fact that many practices had not returned to ‘business as usual’ and the need for some veterinary professionals and clients to continue to self isolate or shield.

According to an economic impact assessment seen by members of the college’s Covid-19 taskforce in September, 50 per cent of practices are still carrying out remote consulting, which includes remote prescribing under the temporary guidance.

Previously, surveying the profession’s experiences of remote prescribing ‘identified no immediate safety concerns around this’, the college said.

RCVS president Mandisa Greene said: ‘The reason for maintaining the possibility of remote prescribing without a physical examination was that we recognised that the current situation is unpredictable, and while the ability for the public to visit practices in person has improved over the last few months, we felt that situations might still arise where that would not be possible, and where access to remote prescribing would be necessary.

‘These could include further local lockdowns, ongoing quarantine arrangements, and the remaining fact that some members of both the veterinary team and the public continue to shield.

‘It remains our intention that this guidance will continue to be a temporary measure and may be subject to further extensions or updates given the uncertain nature of the Covid-19 pandemic.’

RCVS council will review the position at its meeting on 8 October, with any changes being effective by 1 November at the earliest.

In addition, the BVA has asked for a timeframe for the publication of the results of an RCVS survey of practices’ experiences of remote consulting and prescribing, which the college is known to have been working on in mid-June.

The RCVS has also confirmed that it will resume its review of ‘under care’ and 24/7 veterinary service provision, following the interruption caused by the pandemic. •

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