It seems poignant to discuss in this editorial the Royal College of Veterinary Surgeons' council decision to approve new ‘under care’ and out-of-hours service guidance in January (RCVS, 2023). There has been much discussion surrounding the potential impact of such decisions in the veterinary media and communications from organisations. The British Veterinary Association (BVA, 2023) have issued statements raising concerns about the impact that remote prescribing may have on the vet–client–patient relationship.
The total impact of the RCVS council's decision will take months, if not years, to fully come to visibility. However, I find myself asking what impact this will have on responsible use of antimicrobials, the one-health relationship with medical colleagues and the profession's strong efforts to combat growing levels of antimicrobial resistance.
To an extent, some vets may already undertake some remote prescribing. However, this comes with significant knowledge of that client's animals' needs, likely follows an extensive annual (or more frequent in some cases) health plan, and involves close communication and follow up with the client.
The RCVS note that they made amendments following the consultations to create a number of safeguards, with claims that practices ‘…should have the facility to physically examine the animal and/or visit the premises…’ (RCVS, 2023) and that vets are required to undertake a physical exam in a number of defined criteria including ‘…prescribing antimicrobials and controlled drugs unless there are exceptional circumstances.’ (RCVS, 2023).
Linked to this, it is promising to see the launch of the first RUMA Companion Animal and Equine report (RUMA CAE, 2022) last year, and some companies releasing small animal antibiotic usage reports (RUMA CAE, 2023) to increase the visibility and accountability of antimicrobial prescribing in other sectors, and I would like to see all the veterinary corporates following suit.
However, with the Secretary of State for Health and Social Care publicly detailing actions and outlining proposals that fly in the face of responsible antimicrobial usage in humans (Antibiotic Research UK, 2022), it is not surprising that colleagues often face frustration from clients when they do not or will not prescribe antimicrobials.
As public awareness of ‘under care’ guidance and remote prescribing rises, after what many have called our profession's ‘watershed moment’ (BVA, 2023), I hope that the new RCVS guidance does not lead to increased public pressure for remote prescription of antibiotics and undermine the work done to date.