Royal College of

Veterinary Surgeons
Recommendations for future
veterinary legislation
 2 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Executive summary

1. This report presents recommendations from the RCVS The RCVS set up the Legislation Working Party (LWP) in
on the future of veterinary legislation. It concludes that 2017 with a mission to examine the Veterinary Surgeons
new legislation will be required to replace the Veterinary Act 1966 (VSA) and make recommendations for reform.
Surgeons Act 1966 and presents a new and exciting The LWP was tasked to establish principles on which
vision for future regulation of the veterinary professions. any future reform would be based, and to produce a
coherent and comprehensive vision of a modern, future-
2. As the regulator, the RCVS maintains and upholds the proofed legislative framework underpinning the veterinary
educational, ethical and clinical standards of veterinary professions. The LWP was specifically tasked with
surgeons and veterinary nurses, with animal welfare and ensuring that consideration was given to the regulation of
public protection at the core of all it does. Implementing allied paraprofessionals and veterinary practices.
the recommendations outlined within this report will
ensure a fairer, more efficient, proportionate and flexible 6. The LWP consisted of a membership drawn from
regulator, and in turn enable the veterinary professions to across RCVS Council and staff, including veterinary
better serve the public interest surgeons, veterinary nurses and lay members, as
well as representation from both the British Veterinary
3. The recommendations outlined within this report pave Association (BVA) and British Veterinary Nursing
the way for veterinary professions to foster a professional Association (BVNA). Over the course of three years and
environment that is inclusive and attractive to those 12 meetings, the LWP explored over 56 reform proposals,
wishing to pursue a veterinary career. It outlines how from fundamental questions on how the professions are
members of the professions can adapt to future governed, to relatively minor changes.
challenges by encouraging professional growth and
development. By increasing opportunities for veterinary 7. The LWP were also keen that any replacement for the
nurses and other allied professionals, the vision set out VSA should be modern, principle-based and future-
will create a more robust and flexible workforce and at proofed legislation without the excessive and archaic
the same time, increase efficiency within clinical practice. levels of detail present in the current Act. This would
This in turn will provide the public and their animals with a provide greater flexibility, allowing more agile adaption to
quality of care they expect to receive. future demands and removing the burden of additional
Parliamentary time or other burdensome processes
4. Public protection is central to the recommendations, being required in future in order to make amendments.
which show how new legislation would provide the public
with further assurances that professionals on the RCVS 8. In November 2020, the LWP recommendations were
register are trusted and competent. Through regulation put out for public consultation. In total, the consultation
of practices and a renewed, more forward-looking received 1,330 responses, of which 714 (54%) were
disciplinary process with the welfare of animals and from veterinary surgeons, 335 (25%) from veterinary
the public at its heart, the public will be confident that nurses, 93 (7%) from veterinary paraprofessionals,
practitioners are working to high professional standard. 73 (5%) from student veterinary nurses, 58 (4%) from
members of the public, 40 (3%) from veterinary and
5. These recommendations are the culmination of four industry organisations, including representative bodies,
years of extensive review of current legislation, followed and the remainder from veterinary students and
by public consultation on the report published by the veterinary practice managers. Following this extensive
RCVS Legislation Working Party (LWP) in 2020. They can consultation, in June 2021 RCVS Council voted that all
only be realised in full by a new Veterinary Surgeons Act. recommendations should be adopted.
 3 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Key messages: Key recommendations:

The principles for the new legislation proposed by the RCVS 9. Embracing the vet-led team. The vet-led team can
be defined as ‘appropriately-regulated professionals,
The RCVS believe that reform should be based on the including veterinary nurses, working under the direction
following principles: of a veterinary surgeon, to protect animal health and
welfare’. The RCVS is proud of its regulation of veterinary
Principle 1: nurses, who play an essential part in the vet-led team,
Legislation should not be unduly burdensome or and their role should be expanded to allow them to fulfil
complicated; it should provide clarity to the public and their potential and encourage growth in the profession.
enhance public confidence in the professions, eg protection The RCVS also believes that additional paraprofessions
of veterinary titles, statutory underpinning for continuing should be brought under the RCVS’s umbrella –
professional development (CPD). becoming ‘allied professions’ - to underpin their
standards. The adoption of a model of paraprofessional
Principle 2: regulation similar to that of the General Dental Council,
The RCVS disciplinary process should be ‘forward looking’, which the RCVS is proposing allows the it to regulate
with public protection at its heart. all members of the vet-led team, and to create greater
evidence-led flexibility over what can be delegated to
Principle 3: these allied professionals. Statutory protection must be
The vet-led team should fall under a single regulatory given to the professional titles of all allied professions
umbrella. regulated by the RCVS, including veterinary nurses.

Principle 4: 10. Assuring practice standards. The RCVS Practice

By default, acts of veterinary surgery should continue to Standards Scheme (PSS) has been very successful in
be restricted to veterinary surgeons. However, in order promoting high standards within veterinary practice.
to allow for future-proofing, there should be flexibility to However, it is a voluntary scheme and as a result
reflect and review the procedures that may be delegated to there is no mechanism to ensure standards across all
appropriately qualified and supervised members of the vet- practices through assessments. At present the RCVS
led team. Additional tasks may be delegated where this can only regulates individual veterinary surgeons and nurses,
be fully justified and evidenced. Such evidence may include unlike modern regulatory regimes such as that recently
comparison with other health professions. established for the General Pharmaceutical Council.
Nor does the veterinary sector have an equivalent to
Principle 5: the Care Quality Commission. The RCVS recommends
Delegation rights to different paraprofessions should be that it should be granted statutory authority to regulate
variable without impacting each other. For instance, the rights all veterinary practices. For practice regulation to be
of veterinary nurses to undertake minor acts of veterinary meaningful and enforceable across the board, the RCVS
surgery should be amendable without impacting the rights of would need powers of entry similar to those regulators.
farmers, as is the situation at present.
11. Introducing a ‘Fitness to Practise’ regime. The
RCVS’s existing disciplinary processes do not reflect
modern best practice. The RCVS recommends that a
forward-looking ‘Fitness to Practise’ regime should be
introduced, with less focus on past misconduct, but
instead introducing the concept of ‘current impairment’.
This model would include the following: introducing a
wider range of sanctions, including conditions of practice
orders which would restrict an individual’s ability to
practise, short of suspension; introducing interim orders
to allow vets and veterinary nurses to be restricted from
practising whilst cases are investigated where there is
a significant risk of harm; and underpinning the Health
 4 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

and Performance Protocols in legislation. The RCVS to take a holistic approach to public assurance. It also
also recommends reforming the appeal processes ensures that the Royal College functions are properly
so that they become the responsibility of the High funded; some RCVS activities might well not be carried
Court rather than the Privy Council and introducing out at all if the RCVS did not take responsibility for them.
the power to require disclosure of information. A These includes some Charter-based activities carried
further recommendation is to reduce the Disciplinary out as part of the proactive and supportive approach to
Committee quorum to three, with flexibility to use a regulation such as initiatives in the area of mental health
larger number of Committee members for longer or and leadership.
more complex cases.
15. A new Act. Many of the proposed recommendations
12. Modernising RCVS registration. The RCVS require primary legislation. The number and scale of
recommendations include a number of reforms to proposed changes, and in particular the proposal to
improve the RCVS’s registration processes that are not embrace paraprofessionals by regulating the whole
possible under the VSA. This includes the separation veterinary team, mean that it is unlikely that the RCVS
of registration and licence to practise, in line with other coherent vision for reform can be achieved in its entirety,
regulators; to underpin mandatory CPD; and to enable or even substantially, via amendments to the Veterinary
the RCVS to introduce a revalidation regime (as found Surgeons Act 1966. While some recommendations
in other health professions such as the General Medical could perhaps be implemented piecemeal via secondary
Council) if this was judged to be appropriate in future. legislation, any combination of these may well be too
substantial a reform for this method of legislative change.
13. Improving access to the profession for those The RCVS has done the best it can within the limits of
with disabilities. The RCVS recommends the the VSA since its creation in 1966, but the process of
introduction of provisions for limited licensure in specific using creative solutions to mitigate the limitations of the
circumstances, where disability would limit the ability to VSA, such as the Health and Performance Protocols,
work in all areas of practice. may now be nearing its limit. The VSA is in many ways an
old-fashioned piece of legislation, overly restrictive and
14. Retaining a Royal College that regulates. The RCVS prescriptive, burdensome rather than principles-based,
recommends that it continue to be a ‘Royal College that and unfit to underpin the work of a modern regulator or a
regulates’. This unique arrangement allows the RCVS modern profession.
 5 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Introduction

16. The Veterinary Surgeons Act has been under regular 19. The report indicated numerous areas in which the RCVS
review since it became law in 1966, and while it has was out-of-step with best practice, and that would
served both public and the veterinary profession well require legislative reform to remedy. Some of these
in many ways, various reviews over the years have areas, including the separation of the Disciplinary and
highlighted its inadequacies. It has been amended Preliminary Investigation Committees from Council, and
numerous times, and sometimes substantially – notably the reform of Council’s composition, were achieved via
in 1991 when veterinary nurses were named and Legislative Reform Orders in 2013 and 2018 respectively.
empowered by the reform of Schedule 3 of the Act.
20. In addition to the VSA, the RCVS is also underpinned by
17. In 2008, the Environment, Food and Rural Affairs Royal Charter. A new Charter was granted as recently
Committee (EfraCom) published a report on the as 2015. This Charter established the objectives of the
Veterinary Surgeons Act and its possible replacement. RCVS as a Royal College that regulates, and which
Much progress has been made since then on therefore go beyond that of a narrow regulator: "to
various issues raised in the report, including reform set, uphold and advance veterinary standards, and to
to modernise RCVS governance and to make promote, encourage and advance the study and practice
its disciplinary processes independent of RCVS of the art and science of veterinary surgery and medicine,
Council. There is now much more consensus across in the interests of the health and welfare of animals
the profession on the ‘veterinary-led team model’, and in the wider public interest" . The new Charter also
potentially enabling Defra’s ambition that “any underpins the regulation of veterinary nurses, and
successor to the VSA would need to encompass contains provisions for new allied professions to be
providers of wider veterinary services.” The EfraCom regulated by the RCVS. However, it made no provisions
report, and Defra’s response to it, included agreement for delegation to these allied professions, as this requires
that the RCVS’s disciplinary measures should include primary legislation.
a wider range of sanctions. The EfraCom report also
stressed that further consensus should be sought 21. In 2016, the RCVS submitted a petition to Defra containing
across the profession for further reforms. The RCVS has over 10,000 signatures calling for statutory protection of
taken this on board and consulted with the public and the title ‘veterinary nurse’. While Defra was not prepared
the professions as part of this process. to legislate for this at that time, it suggested a review of
Schedule 3 of the VSA to explore whether the veterinary
18. In more recent years, the 2013 First Rate Regulator report nursing role should be expanded. This led to the RCVS
highlighted several trends in regulatory reform reflecting establishing a working party that undertook a survey
shifts in public expectations in professionals and the of both the veterinary surgeon and veterinary nurse
organisations charged with regulating them, noting that professions, which confirmed an appetite for veterinary
“Regulatory reform has been underpinned by a need to nurses to be able to undertake more tasks than at present,
sustain or boost public confidence in the way professions ensuring increased utilisation of existing skills.
are regulated”. This can be seen in the shift towards
risk-based approaches to regulation by a number 22. Between 2016 and 2018 the RCVS also undertook a
of regulators, with “a stronger focus on consumer review of the VSA’s ‘Exemption Orders’, which allow
expectations and outcomes”. The importance of the certain minor acts of veterinary surgery to be undertaken
agility and flexibility of regulation was also highlighted. by non-veterinarians. The subsequent report was
 6 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

published in January 2019, and recommended historic 24. When considering these recommendations, at all
reforms to add the work of several paraprofessions to times, the LWP and subsequently RCVS Council
Schedule 3, while bringing those paraprofessions under the have sought to examine what other regulators do,
regulatory umbrella of the RCVS. both at home and abroad. This is not because others
always have it right and the RCVS does not. Each
23. Following the UK’s 2016 referendum on European Union recommendation has been made on its own merits.
membership, it was decided to broaden these reviews However, there is a reason why ‘best practice’ is
into a full analysis of the VSA in order to help ensure that regarded as such. While there may be a case for the
veterinary regulation could continue to be fit for purpose in a regulation of the veterinary profession to differ from
changing world. The LWP drew on reform suggestions from other professions, even in the healthcare sector, the
staff and Officers of the RCVS, as well as suggestions made RCVS has taken the view that such exceptions need to
by the British Veterinary Association and British Veterinary be carefully justified. On the whole this set of reforms
Nursing Association, who were represented on the Working would bring the RCVS more into line with current
Party. The main recommendations are presented below, regulatory standards, and ensure that this is done in
grouped by theme. A full list of recommendations is a way that allows regulation to be more responsive to
presented in Annex A. future changes.
 7 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Part 1.
Embracing the vet-led team

25. The RCVS is the regulator of both veterinary surgeons However, the legal advice on whether this could be
and veterinary nurses. Under Schedule 3 of the existing achieved in practice is inconclusive – it is likely that it
VSA, veterinary nurses are able to undertake medical would ‘stretch’ the VSA too far from its original purpose
treatment and minor surgery, not involving entry into a to be acceptable to legislators. Further, it would be a
body cavity. somewhat inflexible measure that does not provide
for future-proofing. Any new paraprofession requiring
Recommendation 1.1: legislative underpinning (such as the proposed formal vet
Statutory regulation of the vet-led team tech role) would require significant further legislation to
26. The RCVS reaffirms the recommendations found achieve. This contrasts with regulatory regimes such as
in the 2019 RCVS report to Defra on the Review of that of the General Dental Council (GDC), who are able
Minor Procedures Regime (RMPR report). Among the to add new paraprofessions to their regulatory remit via
recommendations was a two-fold approach to veterinary Section 60 Orders under the Health and Social Care Act.
paraprofessionals:
30. As part of this, paraprofessionals would only be
27. First, legislation should be amended to underpin the considered for regulation by the RCVS if they met the
work of those paraprofessions who are currently working criteria previously approved by RCVS Council, which are:
in a legal ‘grey area’ as their work amounts to acts of
veterinary surgery too substantial to be underpinned • that their work would have to be underpinned by
by an exemption order: in particular equine dental evidence
technicians, musculoskeletal therapists, and cattle foot • that they would not be a reputational risk to the RCVS
trimmers. • that they would need to be self-funding

28. Second, the RCVS should seek to bring the vet-led team 31. These paraprofessionals would be governed in a similar
under its regulatory umbrella in order to be able to assure way to veterinary nurses. This means that they would
standards and protect animal health and welfare – this is have a voice on the relevant decision-making bodies,
particularly necessary for those paraprofessionals who and that standards of qualifications and conduct would
carry out acts of veterinary surgery, and would enable the also be similarly assured.
veterinary professions and the public to identify suitable
practitioners. 32. The RCVS therefore recommends that new legislation
should provide flexibility to allow the RCVS to give legal
29. The RMPR report attempted to address the issue of and regulatory underpinning to new paraprofessions
paraprofessionals by making proposals that could whose work amounts to veterinary surgery without
potentially be achieved by reform of the existing VSA. recourse to further additional legislation in the future.
 8 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

This should be full statutory regulation, and may include 35. At present, Schedule 3 of the VSA restricts such
measures to allow ‘grandfathering’ to ensure that no- delegation to allied professionals (currently only
one is denied the right to a livelihood, much as existing veterinary nurses) who are in the employ of the
practitioners were grandfathered by the early Veterinary delegating veterinary surgeon. The RCVS believes
Surgeons Acts. that this restriction should be removed. In practice,
this would allow a ‘district veterinary nurse’ model, in
Recommendation 1.2: which VNs could help clients to administer treatment
Flexible delegation powers to their pets at home under the direction of a veterinary
33. The RCVS reiterates that, by default, acts of veterinary surgeon who was not their employer. The veterinary
surgery should be reserved to veterinary surgeons. nurse would be working ‘with but not for’ a veterinary
At present, new legislation is required if Council practice. Decoupling direction from employment
determines that additional acts of veterinary surgery would avoid a potential double-standard relative to
can be undertaken by a properly regulated and other paraprofessions, and help to better use VNs to
supervised paraprofession. The RCVS feels that this their full potential in the interests of animal health and
is too restrictive, and, in accordance with Principle welfare. The RCVS Code of Professional Conduct and
4 and modern regulatory regimes such as those for Supporting Guidance is in place to ensure that the
social workers under the Social Workers Regulations relationship and communication with the veterinary
2018, recommends that the RCVS should be able to surgeon in instances where tasks are delegated are
determine which tasks should be eligible for delegation robust. An example of this can be seen in new guidance
by a veterinary surgeon where such delegation can be which was added to the Code of Professional Conduct
fully justified and evidenced, subject to rules concerning in November 2020 for musculoskeletal therapists.
consultation requirements and approval by the Secretary
of State. Recommendation 1.4:
Statutory protection for professional titles
Recommendation 1.3: 36. The RCVS already has a longstanding
Separating employment and delegation recommendation that the title ‘veterinary nurse’
34. The RCVS believes that some paraprofessionals could be should be protected to prevent its use by unqualified,
part of the vet-led team without necessarily being employed unregulated individuals. The protection of professional
by a veterinary surgeon. While the legal underpinning for titles gives clarity and assurance to the public. The
their activities is not yet in place, this is already the case with RCVS recommend that protection of the VN title should
some paraprofessions such as equine dental technicians be part of new legislation and should be extended to
whose work can consist of veterinary surgery requiring any new paraprofessions that fall under the RCVS’s
delegation by a veterinary surgeon. regulatory umbrella.
 9 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Part 2.
Enhancing the VN role

37. In addition to separating employment from delegation veterinary nurses, Animal Nursing Auxiliaries) under both
rights, and giving statutory protection to the title ‘veterinary the 1948 and 1966 Acts.
nurse’, the RCVS also recommends a number of specific
expansions of the VN role: 40. When the 1988 Statutory Instrument (SI) was introduced
the term ‘veterinary nurse’ had only been in use for
Recommendation 2.1: four years, and the reforms to Schedule 3 to formally
Extending the VN role in anaesthesia recognise their role and allow them to undertake minor
38. In 2015, following extensive consultation and discussion, acts of veterinary surgery was still three years away. The
RCVS Council approved a recommendation to increase non-statutory Register of VNs would not be introduced
the role of veterinary nurses in the induction and for another 19 years. Since then, things have moved on
maintenance of anaesthesia via reform of Schedule considerably. Veterinary nurses are now a fully-fledged
3. These proposals would allow the veterinary allied profession, associates of and regulated by the
nurse to “assist in all aspects of anaesthesia under RCVS under its Royal Charter powers. They are not the
supervision” - meaning a vet must be on the premises. ‘laypeople’ whom the SI targeted in 1988. Notwithstanding
This recommendation would increase the utilisation the debatable question of whether castration is ‘entry into
of veterinary nurses while freeing up veterinary a body cavity’, the RCVS recommends that veterinary
surgeons’ time. The RCVS supports the retention of this nurses should be able to undertake this task under
recommendation, which could be linked to an advanced veterinary direction and supervision.
qualification.
Future recommendations
Recommendation 2.2: 41. The RCVS is also exploring additional options for
Allowing VNs to undertake cat castrations enhancing the VN role that do not require changes to
39. At present, Schedule 3 explicitly prohibits veterinary the Veterinary Surgeons Act. Research is currently being
nurses from carrying out cat castrations. Having reviewed carried out into the risks and opportunities of a potential
the history of the VSA, it is clear that this provision was ‘VN prescriber’ role that could allow VNs to prescribe
introduced in 1988, as the last in a series of Statutory certain routine medicines that are currently restricted to
Instruments that prohibited untrained lay people, veterinary surgeons. Recommendations may be brought
including farmers, from carrying out numerous acts that to Council for decision in due course, based on the results
should be reserved to veterinarians for animal welfare of this research. Implementation of any recommendation
reasons. Prior to this, cat castrations had been carried would involve legislation to amend the Veterinary
out legally by laypeople (including the precursor to Medicines Regulations.
 10 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Part 3.
Assuring practice regulation

Recommendation 3.1: However, where there are allegations that a veterinary

Mandatory practice regulation surgeon has breached paragraph 4.3 of the RCVS Code
42. Unlike other sectors, there is no body responsible for of Professional Conduct, which states that ‘veterinary
regulating veterinary practices. In human healthcare the surgeons must maintain minimum practice standards
Care Quality Commission fulfils this role, and some overseas equivalent to the Core Standards of the RCVS Practice
veterinary regulators such as the Veterinary Council of Standards Scheme [PSS]’, powers of entry would be
Ireland have this responsibility. At present, the RCVS has useful. At present, if a veterinary surgeon refuses entry,
no mandatory powers to regulate veterinary practices. This it is extremely difficult, if not impossible, for the RCVS to
is increasingly at odds with a world in which practices may investigate allegations of this nature.
not be owned by the individual veterinary surgeons whom
the RCVS does regulate. It is reasonable for the public to 46. While it is rare for other regulators to have powers of entry
expect that all practices are assessed to ensure that they (one exception being the General Pharmaceutical Council),
meet at least the minimum requirements, and at present this human healthcare premises, for example, hospitals, GP
assurance is not in place for all practices. surgeries and care homes, are regulated by the Care Quality
Commission (CQC) which has powers of entry and may carry
43. The RCVS Practice Standards Scheme (PSS) has been very out unannounced inspections. The RCVS recommends that
successful in assuring standards, and a recent ‘reboot’ of it be given powers of entry in order to remedy this omission
the Scheme has increased membership to 68% of veterinary in the veterinary sector, and to ensure that regulation of
practices. Whilst non-PSS practices might be meeting practices can be underpinned and enforced. If a mandatory
core standards, there is no guarantee or assurance that practice standards scheme (as outlined in 3.1) is to be
this is the case – this is not consistent with our aims with implemented, the public would expect the regulator that
regards to animal welfare and public protection. The RCVS upholds these standards would have the appropriate and
has sought to address this via the Code of Professional requisite powers to support it. It is important however to
Conduct. However, as the Code only applies to individual reiterate that the RCVS would only use powers of entry if there
veterinary surgeons, this does not necessarily sit easy with was a failure to comply with reasonable requests in a timely
responsibilities at practice level where individuals will have fashion, and as a last resort.
varying degrees of control over practice decisions and
policies, and therefore creates a greater responsibility for Recommendation 3.3:
more junior members of staff than might be considered Power to issue improvement notices
reasonable. 47. The RCVS recommends that it be granted the power to issue
improvement notices when a person or a business is failing
44. The RCVS therefore recommends that it be given the power to fulfil a legal duty, and where improvement is required to
to implement mandatory practice regulation, including ensure future compliance. Improvement notices would be
powers of entry (see below). subject to a robust appeals process. The RCVS Strategic
Plan 2020 – 2024 committed to greater clarity on appeals
Recommendation 3.2: across all the areas where the RCVS make decisions, this
Powers of entry for the RCVS would be the case with improvement notices. This power to
45 The RCVS has no power of entry, meaning it does not have issue them would provide better protection for the public,
the right to enter a veterinary practice without consent. while being a more proportionate response than pursuing a
In most cases, this does not pose a problem in terms of disciplinary case. Improvement notices provide practices with
investigating allegations of serious professional misconduct. a clear and concrete action plan to remedy any deficiencies.
 11 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Part 4.
Introduce a modern ‘Fitness to
Practise’ regime

48. Under the VSA, the RCVS may only take action where b. An enhanced suite of powers available to enable
there has been ‘serious professional misconduct’ (SPMC). more effective investigations and case management
The definition of SPMC is widely accepted as conduct c. A reduction in the length and cost of investigations/
which falls far below the standard expected of a veterinary proceedings wherever possible
surgeon. As such, the RCVS can only deal with the most d. The ability to amend/update legislation more easily in
serious of allegations, and negligence (ie conduct falling the future as systems and thinking develops.
below the standard expected) falls outside the scope of
the RCVS’ powers. 52. In addition to these broad objectives, there are also a
number of specific matters that require attention. All of
49. Almost all human healthcare regulators operate a these matters, broad and specific, are explored in more
variant of the ‘Fitness to Practise’ (‘FTP’) model . The detail below.
key characteristic of the FTP model is that it focuses on
whether or not a registrant’s fitness to practise is ‘currently 53. A ‘forward-looking’ process with the protection of animals
impaired’, rather than whether they have been guilty of and the public at its heart: Legislative changes in a
SPMC in the past. Prior to FTP, the prevailing model for number of areas would assist the RCVS in achieving this
regulation was the ‘unacceptable professional conduct’ objective:
(‘UPC’) model (a concept very similar to disgraceful
conduct/SPMC); however, this model is now considered a. Recommendation 4.1:
to be outdated as it is backward-looking, ie focusing on Introducing the concept of ‘current impairment’
past misconduct. By way of contrast, the emphasis of FTP Under the current system, if a veterinary surgeon or veterinary
is forward-looking, ie focusing on whether there is any risk nurse is found guilty of serious professional misconduct
to the public or the public interest. Moving the focus away the Disciplinary Committee (DC) proceeds straight to the
from SPMC would also allow the RCVS to consider matters sanction stage, and the sanction is determined on the basis
where a practitioner’s fitness to practise is impaired for of that past misconduct. The RCVS recommends that this is
other reasons (such as those currently addressed by the changed in line with the fitness to practise model. Under this
existing RCVS Health and Performance Protocols) which in system, DC would need to be satisfied that the veterinary
turn would better protect animals and the public. surgeon’s or nurse’s fitness to practise is currently impaired
before it could proceed to the sanction stage. This means that
50. In a recent paper , the Professional Standards Authority in circumstances where the veterinary surgeon or nurse has
(PSA) called for a number of reforms of the FTP model, taken steps to remediate their failings and shown significant
and the RCVS recommendations take these latest insight into what has gone wrong, the DC may conclude that
proposals into account. there is no (or very low) risk of repetition of similar behaviour
and as such, the veterinary surgeon’s or nurse’s fitness to
51. It is recommended that any new legislation should include practise is not currently impaired. If the DC comes to this
measures with a view to achieving the following: conclusion, it must dismiss the case without proceeding to
sanction, even though the veterinary surgeon or nurse has
a. A ‘forward-looking’ process with the protection of been guilty of misconduct in the past. It should be highlighted
animals and the public at its heart that the purpose of sanctions is to protect the public rather
 12 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

than to punish the individual, however it is understood that surgeon’s or nurse’s right to practise pending a final decision
sanctions may have a punitive effect. This approach is more by DC where a veterinary surgeon or nurse poses a significant
consistent with the aims of regulation, because it focuses on risk to the public or to animals. The current lack of power
whether the veterinary surgeon or nurse currently poses a risk to to impose interim orders is not only problematic during the
animals and the public, rather than whether he or she has posed investigation stage, it is also an issue in cases that have been
a risk in the past. The power to impose conditional or restricted through the full hearing process and DC have decided to
registration (also known as ‘conditions of practice orders’), a suspend or remove a practitioner’s registration. In such cases,
power almost all other regulators have, would allow the DC to there is a statutory appeal period of 28 days and, as such, the
adequately protect animals and the public by imposing a less sanction does not take effect until that time has elapsed (and
onerous sanction. However, the most serious of cases would if an appeal is lodged, not until that the appeal is dismissed or
almost always proceed to the sanction stage. withdrawn). The result of this is an illogical situation where DC
have determined that a practitioner is not fit to practise and yet
b. Recommendation 4.2: they are permitted to practise for 28 days or significantly longer
Widening the grounds for investigation (sometimes up to a year) depending on whether or not an
At present, the RCVS may only investigate where there is an appeal has been lodged.
allegation that could amount to serious professional misconduct.
This means that the RCVS may not intervene in cases where a d. Recommendation 4.4:
practitioner might pose a risk to animals, the public or the public Introduce reviews of suspension orders
interest for other reasons. For cases involving allegations of At present, DC has no power to review the suspension orders
poor performance or ill-health affecting a veterinary surgeon’s it imposes; in other words, if a practitioner is suspended for
or nurse’s ability to practise safely, the RCVS has devised the six months they are automatically restored to the Register
Health and Performance Protocols, which provide a framework once that time has elapsed, whether or not they are fit to be
for the RCVS to work with an individual towards the common restored. The practical effect of this is that where DC has
aim of becoming fit to practise, however these can only be concerns regarding a respondent’s fitness to practise, it has
engaged with the consent of the individual concerned. Where no choice but to remove them from the Register completely
there is no consent, the Preliminary Investigation Committee as it is the only way to retain any control over that person’s
(PIC) has no option but to refer the matter to the DC. A more restoration to the Register. The RCVS recommends that DC be
satisfactory situation might be the option to refer such cases empowered to review suspensions and, if necessary, extend
to dedicated ‘Health’ or ‘Performance’ Committees that have the suspension or impose conditional registration as part
a range of appropriate and proportionate powers designed of that review; they would then be able to ensure protection
to support the veterinary surgeon or nurse in regaining their of animals and the public and, at the same time, impose a
fitness to practise. Members of the Health and Performance less onerous sanction on the veterinary surgeon or nurse.
Committees would be selected in the same, independent Ensuring the individual is no longer impaired, and therefore fit
way as the current Disciplinary Committee. The Health and to practise, before they are restored to the Register is essential
Performance Committees would have a range of appropriate for protecting the public and ensuring the reputation of the
and proportionate powers designed to support the veterinary profession is upheld.
surgeon or nurse in regaining their fitness to practise.
e. Recommendation 4.5:
Where there have been allegations that a veterinary surgeon Introduce a wider range of sanctions
or nurse might pose a risk to animals, the public or the The range of sanctions available to DC is very limited, in
public interest for reasons other than serious professional that it may only issue a reprimand or warning, suspend
misconduct, all grounds for investigation would be subject to or indefinitely remove an individual from the Register . The
the same, robust process, based on breaches of the Code RCVS recommends that DC be given the power to impose
and Supporting Guidance and subject to the same burden and conditional or restricted registration (also known as ‘conditions
standard of proof. of practice orders’), a power almost all other regulators
have. This recommendation intends to broaden the range
c. Recommendation 4.3: of sanctions available when a person’s fitness to practise
Introducing powers to impose interim orders is found to be impaired. This proposal would not result in a
The RCVS recommends that it should have the power to larger number of hearings as the threshold for referral to the
impose interim orders, ie a temporary restriction on a veterinary Disciplinary Committee would remain the same. Again, the
 13 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

power to impose conditions of practice orders would allow DC, to consensual case conclusion. The CE model may be
in suitable cases, to adequately protect animals and the public particularly useful in health and performance cases where
by imposing a less onerous sanction. undertakings or conditions are used (similar to the result
achieved by the RCVS Health and Performance Protocols).
54. An enhanced suite of powers available to enable more
effective investigations and case management: There 56. The RCVS has also made recommendations in relation
are a number of additional powers that would enable the to restoration periods, the appeal process and case
RCVS to better achieve this objective. These are outlined management conferences: see Annex A for details.
below:
Recommendation 4.8:
a. Recommendation 4.6: Future-proofing of the disciplinary process
Introduce the power to require disclosure of information 57. The RCVS’ disciplinary process derives directly from the
Other regulators, including the healthcare regulators, have VSA, which is a piece of primary legislation. As a general
statutory power to require disclosure of information where principle, primary legislation is not easy to amend and
that information may be relevant to a fitness to practise doing so usually requires a lengthy, drawn-out process.
investigation. By way of contrast, the RCVS has no such In recent years, the RCVS has twice amended the VSA
power and instead must rely on the cooperation of the by Legislative Reform Order (LRO), however the scope of
relevant parties, which is not always forthcoming. In recent amendment that can be achieved by LRO is limited and
times, the RCVS has had particular difficulty in obtaining so it is unlikely to be the correct instrument for achieving
information from a number of organisations, which has the degree of disciplinary reform recommended in this
resulted in difficulties with investigations. This situation is report.
unsatisfactory as it hinders the RCVS from effectively carrying
out its investigative duties; it is recommended that this is 58. New primary legislation via an Act of Parliament is
remedied. likely to be required to achieve the disciplinary reforms
proposed above (and in this report in general). The
55. A reduction in the length and cost of investigations/ RCVS therefore recommends that disciplinary reform
proceedings wherever possible: There are a number of is implemented predominantly through secondary
areas where legislative change could reduce the length legislation, with primary legislation serving only to enable
and cost of investigations and disciplinary hearings: that secondary legislation. An example of how this could
work is the Health and Care Act 1999 (HCA) which, at
a. Recommendation 4.7: section 60, enables the named healthcare regulators
Formalise role of Case Examiners and allow them to to modify their regulatory processes in any way ‘that is
conclude cases consensually expedient for the purpose of securing or improving the
At present the RCVS does have a ‘case examination’ stage, regulation of the profession or the services which the
but it does not operate a true Case Examiner (CE) model. profession provides or to which it contributes’ through an
In the case of other regulators that use the CE model (eg Order in Council.
the General Medical Council (GMC), General Dental Council
(GDC), Nursing and Midwifery Council (NMC) and General 59. However, even an Order in Council in not necessarily a
Optical Council (GOC)), CEs make decisions in pairs (one straightforward process and may still take a significant
registrant and one lay) and, in some cases, one or both amount of time (for example, it took the GDC just
are employees of the regulator. CEs also have powers that over two years to obtain an order in relation to case
allow them to dispose of suitable cases consensually where examiners). As such, the RCVS recommends that if
the threshold for referral is met (so long as the wider public other legislative mechanisms exist that would allow more
interest can be satisfied by disposing of the case in this flexibility and enable the RCVS to amend legislative
way). This model is more cost effective than convening the provisions more quickly as time moves on and attitudes
PIC for all decisions (for example, the NMC has recently change, then these should be considered. These could
reported a year-on-year decrease in FTP spending and has include a mechanism similar to those in the new Social
attributed this, in part, to the introduction of CEs). It also Workers Regulations 2018, allowing reform subject to
allows for quicker and more consistent decision making, rules concerning consultation requirements and approval
and is less stressful for the respondent if the case is subject by the Secretary of State.
 14 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Standard of proof in England, ‘it is not acceptable that a registrant who is

The RCVS is in a small minority of regulators – and the only more likely than not to be a danger to the public should
major regulator – that still applies the criminal standard of be allowed to continue practising because a panel is not
proof (ie beyond all reasonable doubt/so as to be sure), certain that he or she is such a danger’. The standard
when deciding the facts of a case. The majority of other of proof is set out in the 2004 rules and, as such, can
regulators have now moved to the civil standard, ie on be amended without the need for a change in primary
the balance of probabilities/more likely than not. In light legislation. However, RCVS Council concluded that it
of the primary purpose of regulation, the civil standard is would not be appropriate to change the standard in
considered to be the more appropriate standard of proof. isolation, and instead agreed that it should be introduced
As the Law Commission explained in its 2014 report on as part of a full fitness to practise system in any future
the regulation of health and social care professionals legislation.
 15 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Part 5.
Modernising RCVS registration

Recommendation 5.1: ‘veterinary surgeon’. It is pertinent to point out that is distinct

Introduce provisions to allow limited licensure in from how a veterinary surgeon might continue to hold full
principle, including for those with a disability registration if they develop a disability after qualification
60. In the context of the veterinary profession, ‘limited licensure’ and initial registration, as they can choose to restrict their
refers to the concept whereby a suitably-qualified individual own practice as required without pursuing formal limited/
would be licensed to undertake less than the full range of restricted licensure.
activities that could be considered to be acts of veterinary
surgery, or work that would otherwise require someone 63. There is no provision for UK-qualified veterinary surgeons
to be registered as a veterinary surgeon. In principle to operate under limited licensure. The general licence for
such limitations could range from being restricted from veterinary surgery is considered an international standard
undertaking a specified act or area of practice, through to (particularly for the purposes of certification, for instance in
only being licensed to undertake a specific procedure or international trade of animal and animal products) therefore
area of employment. at the present time there is limited appetite for a general
introduction of limited licensure for domestic graduates,
61. Where a disability prevents a person from being able to but this may change in future. Further, in future there may
undertake all aspects of a veterinary degree and veterinary be an appetite for RCVS Council, after due consultation, to
practice, limited licensure could permit such candidates to introduce limited licensure for overseas veterinary graduates
complete the relevant education for a branch of veterinary whose degree does not qualify them for a general UK
surgery, and allow them to join the Register of Veterinary licence. This could allow the RCVS to help to address
Surgeons and become Members of the RCVS. For workforce shortages without undermining the assurance of
instance, if an individual may not be able to work in practice standards.
due to a disability, they may still be able to teach, undertake
research, work in pathology, veterinary regulation, politics Recommendation 5.2:
or policy. This would widen access to the profession and Empower the RCVS to introduce revalidation
ensure that it would foster an inclusive and supportive 64. The First Rate Regulator report noted that “Most regulators
culture within the profession. At present individuals in this already have a role in ensuring that, once registered,
situation are unable to undertake the veterinary degree as registrants remain up-to-date with evolving practices
any ‘reasonable adjustment’ would not meet the RCVS and continue to develop as professionals”. In 2007,
Day One Competencies; this cannot be remedied without a Department of Health report proposed that all the
legislative reform to allow limited/restrictive licensure, which statutorily-regulated health professions should have
in turn would allow the Day One Competencies to be arrangements in place for ‘revalidation’, to ensure that
adapted for a limited/restricted licence to practice. health professionals remain up-to-date and demonstrate
that they continue to meet the requirements of their
62. This recommendation would mean that a veterinary surgeon professional regulator as they are now, rather than when
with a restricted/limited licence to practice could still be a they first registered. The professional standard against
vet in every meaningful sense, and with the same ‘status’. It which each is judged is the contemporary standard
is worth highlighting that veterinary surgeons already tend required to be on the Register, and not the standard at the
not to practise in every area of veterinary medicine they point at which the individual may have first registered.
have trained for; the distinction would be that, by necessity,
they were formally restricted from practising in one or more 65. The GMC became the first UK health regulator to implement
areas so as to be able to join the Register and hold the title a system of revalidation; the five-year revalidation cycle
 16 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

takes into account a local evaluation of a doctor’s practice are satisfied, a person may continue to be registered for
through annual appraisal. The appraisal is carried out by the whole of their life (providing they pay their fees and are
an experienced independent doctor, and then referred to not removed by DC or for lack of response); there is no
a ‘responsible officer’ who has a statutory responsibility requirement to revalidate as there is with other professions.
for making a revalidation recommendation to the GMC. The RCVS should be empowered to introduce a system of
The responsible officer makes a recommendation about revalidation in future, should RCVS Council decide to do so.
the doctor’s fitness to practise to the GMC based on the
outcome of the doctor’s annual appraisals over the course Recommendation 5.3:
of the five years, a portfolio of supporting information that Underpin mandatory continuing professional
meets the GMC requirements, and whether there are any development (CPD)
outstanding concerns for any part of the doctor’s scope of 67. The First Rate Regulator report noted that “CPD is a
work. Following the responsible officer’s recommendation, requirement for all professionals wishing to register with the
the GMC decides whether to renew the doctor’s licence to health professional and legal services regulators.” However,
practise. Revalidation aims to give assurance that individual the VSA does not give the RCVS the power to enforce
doctors are not just qualified, but safe. It also aims to help this requirement, except through the disciplinary process.
identify concerns about a doctor’s practice at an earlier Members of the RCVS are asked to certify that they have
stage and to raise the quality of care for patients by making satisfied the CPD requirement as part of the annual renewal
sure all licensed doctors engage in continuing professional process. However, if they do not, there is no power to refuse
development and reflective practice. renewal of registration. Therefore, the RCVS should be
empowered to refuse renewal of registration if a veterinary
66. Under the VSA, providing that conditions of registration surgeon fails to meet their minimum CPD requirement.
 17 Royal College of Veterinary Surgeons (RCVS) recommendations for future veterinary legislation

Conclusions

68. This historic report and the consultation that was

undertaken before its publication is the end result of the
most comprehensive review of the Veterinary Surgeons
Act since its inception in 1966. It sets out a coherent set
of principle-based reforms which, if enacted, would allow
the RCVS to function as a modern, flexible regulator fit for
the 21st century. Many of the key reforms require primary
legislation, and it is difficult to avoid the conclusion that
the time for piecemeal change is over, and that a new
Veterinary Surgeons Act is now required, one that is itself
sufficiently future-proof to one day beat the current VSA’s
half-century on the statute book.
Royal College of
Veterinary Surgeons
Recommendations for future
veterinary legislation

Royal College of Veterinary Surgeons

Belgravia House, 62-64 Horseferry Road, London SW1P 2AF
T 020 7222 2001 F 020 7222 2004 E [email protected] | www.rcvs.org.uk
 RCVS Legislation Review Report Annex A: Table of Recommendations

Recommendation for legislative reform Reasons for reform

Part 1: Embracing the vet-led team

1. Recommendation 1.1: Statutory regulation of the vet-led team Ensure that all paraprofessionals are working legally

Legislation should underpin the work of those paraprofessionals who Assure the standards of conduct and education of all
are carrying out acts of veterinary surgery. members of the vet-led team.

Empower the RCVS to bring additional paraprofessions under its

regulatory umbrella without additional legislation; this should be a
requirement for those carrying out acts of veterinary surgery.

These paraprofessionals would be governed in a similar way to

veterinary nurses. This means that they would be represented on the
relevant decision-making bodies, and that standards of qualifications
and conduct would also be similarly assured.

May include measures to allow ‘grandfathering’ to ensure that no-one

is denied the right to a livelihood, much as existing practitioners were
grandfathered by the early Veterinary Surgeons Act.

2. Recommendation 1.2: Flexible delegation powers Potential to free up veterinary surgeons to do work that only
they can do, with lower-risk tasks being undertaken by
By default, acts of veterinary surgery should be reserved to veterinary
paraprofessionals under veterinary direction.
surgeons
Future-proofs delegation regulation.
The RCVS should be able to determine which tasks should be eligible
for delegation by a veterinary surgeon where such delegation can be
fully justified and evidenced.

3. Recommendation 1.3: Separating employment and delegation This is already a reality for many paraprofessions.
 RCVS Legislation Review Report Annex A: Table of Recommendations

Recommend that direction by a veterinary surgeon to a Would empower veterinary nurses and potentially increase
paraprofessional (including veterinary nurses) should no longer their reach, benefitting animal health and welfare as well as
require the paraprofessional to be employed by the veterinary clients.
surgeon.

This would enable, for instance, a ‘VN practitioner’ role to develop.

4. Recommendation 1.4: Statutory protection for professional titles Ensures that unregulated individuals are not carrying out
acts of veterinary surgery.
Protection of paraprofessional titles including ‘veterinary nurse’ and
any new paraprofessions who fall under the RCVS’s regulatory Better clarity for the public.
umbrella.

Part 2: Enhancing the VN role

5. Recommendation 2.1: Extending the VN role in anaesthesia Increasing utilisation of veterinary nurses while freeing up
veterinary surgeons’ time.
Allow veterinary nurses to “assist in all aspects of anaesthesia under
supervision”, pursuant to an animal-specific protocol.

6. Recommendation 2.2: Allowing VNs to undertake cat castrations Increasing utilisation of veterinary nurses while freeing up
veterinary surgeons’ time.
Veterinary nurses should be able to undertake this task under
veterinary direction and supervision.

Part 3: Assuring practice regulation

7. Recommendation 3.1: Mandatory practice regulation Ensure that all practices meet at least the basic minimum
legal requirements.
The RCVS be given the power to implement mandatory practice
regulation, should RCVS Council decide to replace or underpin the
PSS with a more comprehensive scheme.
 RCVS Legislation Review Report Annex A: Table of Recommendations

8. Recommendation 3.2: Powers of entry for the RCVS Makes evidence gathering easier and more efficient.

The RCVS be given powers of entry into order to remedy this Better protects the public.
omission in the veterinary sector, and to ensure that mandatory
regulation of practices (see Recommendation 3A) can be underpinned
and enforced.

9. Recommendation 3.3: Power to issue improvement notices Better protection of the public.

Introduce a power to issue improvement notices when a person or a More proportionate response than pursuing a disciplinary case.
business is failing to fulfil a legal duty and improvement is required to
ensure future compliance. Provides practice with a clear action plan.

Part 4: Introduce a modern ‘Fitness to Practise’ regime

10. Recommendation 4.1: Introducing the concept of ‘current More consistent with the primary purpose of regulation
impairment’
Using current impairment as the gateway to sanction means
that the test becomes forward-looking and more in line with
Change the trigger for considering sanction to whether the
the primary purpose of regulation (i.e. protecting the public).
practitioner’s fitness to practise is ‘currently impaired’. By way of contrast, disgraceful conduct is a backward-
looking concept that may skew the emphasis away from
public protection/current risk of hard to punish for past
wrongdoing.

11. Recommendation 4.2: Widening the grounds for investigation Better protection of the public/animal welfare

Would allow the RCVS to intervene earlier when issues

involving health and performance are raised and take action
 RCVS Legislation Review Report Annex A: Table of Recommendations

Allow the RCVS to investigate for reasons other than serious that may prevent the issues from escalating – benefitting
professional misconduct, e.g. poor health, knowledge of English or both the practitioner, the public and animal welfare.
sustained poor performance.

Recommendation 4.3: Introducing powers to impose interim Better protection of the public/animal welfare where there is
orders a significant risk of harm.

Introduce a temporary restriction on a veterinary surgeon or nurse’s Remedies the appeal period anomaly when DC impose
right to practise pending a final decision by DC where a veterinary suspension or removal.
surgeon or nurse poses a significant risk of harm to the public or to
animals.

12. Recommendation 4.4: Introduce reviews of suspension orders More proportionate sanctions with more robust safeguards.

Introduce the power to review a suspension order to ensure that the

practitioner is in fact fit to practise before they are restored to the
Register (would also apply to conditions of practice orders, see
Recommendation 4.5).

13. Recommendation 4.5: Introduce a wider range of sanctions More powers to deal with matters appropriately.

Introduce conditions of practice orders (or otherwise restrict a

practitioner’s practice short of suspension).

14. Recommendation 4.6: Introduce the power to require disclosure Speed up investigative process.
of information
May allow RCVS to bring cases where previously it would
have been restricted by lack of cooperation

Bolster public confidence in the RCVS’ processes.

 RCVS Legislation Review Report Annex A: Table of Recommendations

Introduce the power to require the disclosure of information where that Members of the public and organisations may feel more
information might assist in carrying out the RCVS’s regulatory comfortable providing information if there is a statutory
functions. basis.

15. Recommendation 4.7: Formalise role of Case Examiners and In-line with other healthcare regulators.
allow them to conclude cases consensually
More cost effective than convening PIC for all decisions
(NMC has recently reported a year-on-year decrease in FTP
Introduce the power to dispose of suitable cases consensually where
spending and has attributed this, in part, to the introduction
the threshold for referral is met (so long as the wider public interest
of CEs).
can be satisfied by disposing of the case in this way).
Quicker decision making.
See also Recommendation 3.3: Improvement notices.
More consistent decision making.

Less stressful for respondent if case is subject to

consensual disposal.

More flexibility in terms of CE powers.

May be particularly useful in health and performance cases

using undertakings/conditions (similar to the result achieved
by the RCVS Health and Performance Protocols.

16. Recommendation 4.8: Futureproofing of the disciplinary process

In line with the Health & Care Act 1999, allow future reform of the DC
process via Ministerial Order or a less onerous mechanism.

17. Recommendation 4.9: Statutory underpinning for the RCVS

Health and Performance Protocols
 RCVS Legislation Review Report Annex A: Table of Recommendations

Introduce a formal procedure for dealing with health and performance

cases.

18. Recommendation 4.10: Reduce the DC Quorum to three Speed up proceedings.

Reduce the quorum in line with other regulators. Reduce costs.

Easier to list hearings as fewer diaries to manage.

Less intimidating for respondents.

19. Recommendation 4.11: Reformed restoration periods Currently the VSA sets restoration application limit to 10
months. For other regulators, length of time is much longer
Extend range of options for minimum period before which a veterinary (e.g. the Nursing and Midwifery Council (NMC) has five
surgeon or nurse can apply can apply to be restored to the register years).
following removal.
Longer restoration periods would increase public confidence
Enable restoration to be subject to conditions or restrictions of in the RCVS as a regulator.
practice (see also Recommendation 4.5).

20. Recommendation 4.12: Allow voluntary removal Currently, the practitioner must remain on the Register so
that the disciplinary processes can be completed.
Allow voluntary removal of practitioners under investigation for
disgraceful conduct in certain circumstances Other regulators, e.g. the GMC, have the power to grant
applications for voluntary removal even where fitness to
practise concerns have been raised. Applications of this
nature would be considered by the Case Examiners (or
equivalent) and may only be granted in circumstances
where public protection and wider public interest can be
satisfied by this disposal. It is a form of consensual disposal.

At present, a similar effect is achieved by the practitioner

giving undertakings to DC that they will voluntarily remove
 RCVS Legislation Review Report Annex A: Table of Recommendations

themselves from the Register and, in some circumstances,

not apply to re-join. However, this requires a hearing to be
convened.

21. Recommendation 4.13: Case Management Conferences Identifies issues that may hinder the progress of a hearing at
an early stage and allows time to resolve those issues.
Formalising the role of Case Management Conferences (CMCs)
More accurate time estimates/less wasted time and cost.

Avoids unnecessary witness attendance by identifying and

narrowing issues in dispute in advance.

Directions made at the CMC would be enforceable by DC.

22. Recommendation 4.14: Recommend that DC should be given Other regulators have this power but use it sparingly, only
power order costs. where absolutely necessary

Provision to allow DC to make costs orders, for instance for Examples of where the power might be useful are to
unsuccessful restoration applications, as per other healthcare discourage repeated applications for restoration where
regulators. circumstances have not changed or as an incentive to
engage in proper and timely case management.

23. Recommendation 4.15: Appeals against DC decisions to be More in-keeping with other regulators.
heard by the High Court instead of the Privy Council
Regulatory processes are more familiar to the High Court
DC appeals to the Privy Council against suspension or removal and therefore appeals likely to result in predictable
should be moved to the High Court. decisions.

High Court process more familiar to those representing the

parties.

Likely to speed up process.

24. Recommendation 4.16: Appeals mechanism for reprimands and At present, the only way to challenge these decisions is by
findings of misconduct way of judicial review.
 RCVS Legislation Review Report Annex A: Table of Recommendations

Introduce a right of appeal against a decision to reprimand or a finding A more proportionate remedy for those wishing to challenge
of disgraceful conduct. DC decisions.

25. Recommendation 4.17: Automatic removal offences Swift conclusion, with no hearing, to cases with (usually)
one inevitable outcome. Can be appealed.
Introduce a presumption in favour of removal from the register if a vet
or veterinary nurse is convicted of certain extremely serious criminal Bolster public confidence in the profession and in the RCVS.
offences, e.g. rape and murder.
Social Work England has this power. Also supported by
GMC consultation, Law Commissions, and PSA.

26. Recommendation 4.18: Power to appeal unduly lenient decisions Provides an addition safeguard to animals, the public and
wider public interest.
Right of appeal if RCVS believes the DC has made a decision that is
too lenient. The PSA hold this power. There is no equivalent of the PSA
for veterinary practice and so we are the only body that
would be in a position to appeal where a sanction (or lack
of) was unduly lenient.

Part 5: Modernising RCVS registration

27. Recommendation 5.1: Introduce powers to create limited Increasing access to the profession.
licensure provisions, including for those with a disability
Ensuring compliance with human rights legislation.
Limited licensure should be permitted for UK graduates where
disability prevents them from being able to undertake all aspects of a Ability to address workforce shortages with greater
veterinary degree and veterinary practice. Other provisions could be assurance of standards.
used for overseas graduates.

28. Recommendation 5.2: Empower the RCVS to introduce Ensure that veterinary surgeons and nurses remain up to
revalidation date and continue to demonstrate that they continue to meet
the requirements of their professional regulator as they are
now, rather than when they first registered.
 RCVS Legislation Review Report Annex A: Table of Recommendations

Empower the RCVS to introduce a system of revalidation in future,

should RCVS Council decide to do so.

29. Recommendation 5.3: Underpin Mandatory Continued Ensure that veterinary surgeons and nurses cannot practice
Professional Development (CPD) if they are not keeping their knowledge and skills up to date.

Empower the RCVS to refuse registration if a veterinary surgeon fails

to meet their minimum CPD requirement.

Part 5A: Further registration issues

NB: These are mainly technical issues requiring relatively minor legislative change to the existing VSA. The RCVS recommends that
these be remedied via legislative change. The spirit of these recommendations would need to be reflected in any new Act.

30. Recommendation 5.4: UK graduates

The VSA stipulates that any person who passes ‘examinations in

veterinary surgery’ from a UK university with a recognition order in
place ‘shall be entitled to be registered in the register [of Veterinary
Surgeons] and shall on being so registered become a member of the
College’.

This leaves no discretion for the Registrar to refuse registration in any

circumstances (e.g. if the individual has a previous conviction or if
there is any other issue that might call into question his or her fitness
to practise), as so long as person passes their exams (they do not
even have to graduate) they are entitled to be registered.

31. Recommendation 5.5: EU nationals

If a person is a ‘European Union rights entitled person’ and they are

an ‘eligible veterinary surgeon’ according to Schedule, they are
entitled to be registered and become a MRCVS. The Registrar does
 RCVS Legislation Review Report Annex A: Table of Recommendations

have some discretion in that they may refuse registration where the
applicant has been convicted of a criminal offence, if an ‘alert’ has
been received under Article 56a of Directive 2005/36/EC1 or there are
‘serious and concrete doubts’ regarding English language ability.

However, this discretion is limited and does not, for example, enable
them to refuse Registration if the applicant is subject to a conditional
discharge. This limitation has caused problems in the past (e.g. RCVS
v Lown).

No reference to restoration following further proceedings, suspensions

running their course, etc.

32. Recommendation 5.6: Non-EU qualifications: Lack of formal

route in the Act for registration by individuals with ‘acquired
rights’

This relates to non-EU applicants with non-EU qualifications who have

the right to register under the MRPQ by virtue of their ‘acquired rights’.

The lack of right to appeal negative decisions under S.6 of the VSA is
inconsistent with the provisions relating to European Union Rights
Entitled Persons (EUREPs) in that there is a right of appeal for those
refused registration under s.5A (EUREPs with European
qualifications) and s.5B (EUREPs with acquired knowledge and skill)
and a right of appeal against decisions under S.5BA (decision to
remove a person who ceases to be a EUREP).

1 This is where one member state issues an alert concerning a particular individual that can be viewed by all other member states, the alert will usually be to notify others that
the individual has been found not fit to practise by the relevant competent authority.
 RCVS Legislation Review Report Annex A: Table of Recommendations

33. Recommendation 5.7: Recognition of qualification and

registration

The recognition of qualification and registration is currently one

process. This is problematic for the purposes of complying with the
English language provisions that came into force in January 2016.
Where a competent authority has ‘serious and concrete doubts’ about
a person’s English language ability, it is required to recognise the
individual’s qualification (if it meets the requirements set out in the
MRPQ) before refusing registration on language grounds. Due to the
way the VSA is drafted, if the RCVS recognises a qualification, it
technically means that person is automatically entitled to be
registered.

The RCVS recommends underpinning this separation in legislation.

34. Recommendation 5.8: Separation of registration and licence to Recommendation to separate registration and licence to
practise practise.

Once an individual is registered by the RCVS, they are automatically This could replace the existing ‘period of supervised
allowed to practise. In other professions, registration and a licence to practice’ and VN temporary student enrolment status.
practise are distinct.

Separating these two stages would be essential if, for example, the
RCVS wished to introduce revalidation. It would also mean that the
‘non-practising’ register was no longer necessary as individuals could
be registered but not have a licence to practise.

This issue applies to all registrants regardless of their registration

route (i.e. whether they were UK graduates, EU nationals, statutory
examination).

The RCVS recommends underpinning this separation in legislation.

 RCVS Legislation Review Report Annex A: Table of Recommendations

35. Recommendation 5.9: Temporary registration - nomenclature

The heading of S.7 is “Temporary registration” is misleading in that it

suggests that the section relates to registration that is limited in
duration. In fact, S.7 has a much wider application in that it allows
RCVS Council to restrict registration in a number of ways, e.g. the
place a person may work, the “circumstances” in which a person may
practice veterinary surgery.

Further, “Temporary registration” suggests registration under S.7 must

be for a limited period of time but in fact, the section permits a person
to be registered indefinitely (albeit with restrictions upon their
practice).

Internal policy currently limits temporary registration to five years.

The RCVS recommends that legislation need to underpin both

temporary and limited registration. Provisions should be clearer than
at present.

See also recommendation 5.1: limited licensure.

36. Recommendation 5.10: Restoration following voluntary

removal/removal for non-contact

Where a person voluntarily removes themselves from the register or is

removed by the registrar following six months without response that
person is entitled to be restored to the register if they apply to do so
(unless the original entry was incorrect or fraudulent).

There is no requirement for the applicant to show that they are in

good standing/of good character and given that a number of years
may have passed since their removal this is unsatisfactory.
 RCVS Legislation Review Report Annex A: Table of Recommendations

The RCVS recommends that this discrepancy is remedied.

See also Recommendation 5.8

37. Recommendation 5.11: Restoration following voluntary

removal/removal for non-contact

Where a person wishes to restore in these circumstances but there is

a concern about them, for example another competent authority have
raised an issue or they have disclosed a conviction, the RCVS has no
power to refuse restoration, or any formal power to delay until the
issue is resolved/investigated.

In practice, registration is delayed as long as possible whilst the

matter is investigated, but there is no formal power to do this.

The RCVS recommends that it should have the power to suspend

restoration in these cases.

38. Recommendation 5.12: Annual renewal – declared convictions

If someone discloses a conviction as part of their annual renewal, the

RCVS cannot refuse to renew their registration even where the
conviction is very serious. Instead, the RCVS must register the
individual and then initiate disciplinary proceedings so that action may
be taken. It should be noted that as the RCVS has no power to issue
interim orders, the individual is permitted to practise while the
disciplinary investigation takes place.
 RCVS Legislation Review Report Annex A: Table of Recommendations

The RCVS recommends that it should have the power to allow

suspension of registration where a conviction has been declared
during annual renewal.

Part 6: Education issues

39. Recommendation 6.1: Powers to revise the Statutory

Examination

The RCVS Statutory Membership Examination provides a route for

overseas-qualified veterinary surgeons whose degrees are not
recognised by the RCVS to register in the UK.

At present amendments to the content of the exam, and the fee that
can be charged for it, are contained within a schedule to the VSA and
therefore require parliamentary time to amend.

The RCVS recommends that powers to amend the examination fees

and format are delegated to the RCVS.

40. Recommendation 6.2: Ability to charge UK vet schools for

accreditation visits

At present, the cost of accreditation visits is born by the RCVS

membership fee. There is an argument that the RCVS should have
the power to charge the veterinary schools for these visits, should
RCVS Council decide to do so in future. This power would also guard
against the possibility that future models of delivery of veterinary
education would be onerously expensive to assess.

Part 7: Governance issues

 RCVS Legislation Review Report Annex A: Table of Recommendations

41. Recommendation 7.1: Power for the Minister to make further Would provide future-proofing by reducing the administrative
changes to size/composition via Ministerial Order burden and Parliamentary time required should the decision be
made to reform RCVS governance again in future.
This measure was originally intended to be part of the 2018
Legislative Reform Order which modernised RCVS governance, but
was considered too substantial a delegation of power to be achieved
by that mechanism.

Part 8: Miscellaneous measures

42. Recommendation 8.1: Revised Exemption Orders (EOs) as

recommended by the Exemption Orders and Associates (EO&A)
Working Party.

As per RCVS RMPR Report of January 2019.

If measures are taken via primary legislation then the RCVS should
be empowered to more easily amend EOs to allow for flexibility and
future-proofing.

43. Recommendation 8.3: Empower the RCVS to set the annual

renewal fee

At present the RCVS requires Privy Council approval to amend the

annual renewal fee. Other regulators are not required to do this. The
requirement is burdensome and makes budgeting uncertain.

The RCVS recommends that powers to amend the annual renewal

fee and format are delegated to the RCVS.
 RCVS Legislation Review Report Annex A: Table of Recommendations

44. Recommendation 8.4: Preserve the Royal College/Regulator Allows a holistic approach from a public assurance
relationship perspective

The RCVS Recommends that ‘Royal College that regulates’ model Ensures that Royal College functions are properly funded
continues.
Allowing a more proactive and supportive approach to
regulation through Charter-based activities such as mental
health, leadership etc