Do you understand the distribution system for veterinary medicines in the United Kingdom? If you both care about animals and understand veterinary medicines then there’s a job out there for you to get involved in that needs doing right now!  It’s time to mobilise.

What is an “animal care business”?

As I write this blog the Competition and Markets Authority (CMA) is just finishing an enquiry into veterinary practices run by veterinary surgeons, or increasingly now by big, incorporated businesses. Some of the CMA findings on veterinary medicines echoed those of the investigation by the Competition Commission (CC) under the 1973 Fair Trading Act over two decades ago (and an inquiry by Sir John Marsh that preceded it). The interim findings of the CMA state that it may review the 2005 Order implementing some of the CC’s recommendations. ⁽¹⁾

In advance of receiving the final report from the CMA, DEFRA has just started a consultation on a review of the 1966 Veterinary Surgeons Act (1966 VSA), possibly at the request of the Royal College of Veterinary Surgeons (RCVS), although apparently considering other matters.  DEFRA has drawn the provisional findings of the CMA into this review, before waiting for its final conclusions, probably because the RCVS has said that it wants to be able to regulate “veterinary businesses”.  DEFRA’s consultation has extrapolated its review to include “animal care businesses”.  The DEFRA consultation talks of regulating “veterinary acts”, without specifying the limits of what those “acts” might be, or defining what it means by “veterinary”.   And it talks of “advice based on diagnosis”, but again without defining the limit of what it means by that word, e.g. by referring to diagnosis of disease.

Does anybody clearly understand yet what DEFRA and the CMA are trying to change?

Despite a CMA review that has now lasted several years I still encounter people who think they understand the UK veterinary medicines distribution system, but don’t.  In fact, given what the CMA just said, I’m not even sure at this stage that the CMA has yet understood the veterinary medicines distribution system because it has come out with an unqualified interim recommendation for more widespread purchasing by consumers of veterinary medicines via the internet:  This would significantly increase the risk of prescription fraud.  It’s not a bad time then to write a blog about it given that some of the people who might be able to e.g. distinguish the roles of the Royal College of Veterinary Surgeons from the Royal Veterinary College still don’t understand the veterinary medicines distribution system: Many of the people I have met across the veterinary pharmaceutical industry couldn’t do that. And yet some of these people are probably responding to DEFRA’s consultation on the review of the VSA with their very strongly held opinions right now.

To be fair to the people at the CMA just trying to do their job, they aren’t due to make their final recommendations until May 2026, over a month from now. If DEFRA wants to do something sooner than May 2026 we have to wonder why, and also whether anybody has taken the time to understand the UK veterinary medicines distribution system.

How the UK Veterinary Medicines Distribution System is Designed to Work

If for now we ignore feed additives being incorporated into animal feed by feed mills, sometimes called Zootechnical Feed Additives, Medicated Feedingstuffs, or Specified Feed Additives (abbreviated as SFAs – there’s a comment on these later), then there are four categories of veterinary medicines in the UK.  At first this appears complicated, but there’s a logic behind the system if you appreciate that veterinary medicines fall into two basic groups, distinguished by how they need to be supplied after careful consideration of whether a non-AI generated real human being is considered essential to help the unqualified consumer to use them safely.

1. AVM-GSL…“A is for anybody and any volume”

AVM-GSL stands for “authorised veterinary medicine – general sales list”.   This is the home for medicines that the UK government’s chosen competent authority, the Veterinary Medicines Directorate (VMD), has decided are so safe that they can be advertised without restriction, and supplied in any volume by any unqualified person with no safety information other than what is in the pack literature.  When the VMD together with the Veterinary Products Committee (VPC) place products in this category they must consider not just the data supplied by the marketing authorisation holder on what happens when the product is used as intended in the directions for use, but also the potential for misuse.  And in doing so these bodies also need to take account of the fact that the average reading age in the UK is probably between 9-11 years old:  This means that for the AVM-GSL category, product information and packaging literature should be written at a low level, typically key stage 2/3 i.e. primary school, in order to be understood by everyone likely to access the products. 

In the field of human healthcare, companies supplying medicines that are genuinely general retail medicinal products, i.e. those sold without the involvement of a qualified person, are also obliged to provide a high-level of 24/7 customer support, to design packs to reduce the quantities of medicines provided thereby reducing risk, whilst giving prompt access to further help and advice.

It is not always the case that consumers misuse products because they don’t understand the label, although of course some will be dyslexic, and English may not be their first language. Even without consideration of dyslexia, there are also other estimates on literacy rates in the UK and one site

https://www.calendar-uk.co.uk/frequently-asked-questions/how-many-people-in-the-uk-cannot-read-or-write

estimates that close to 20% of the UK adult population is functionally illiterate.

When we consider the need to understand specialised technical information, the potential for misunderstandings cannot be ignored by any competent body. But sometimes even ‘literate’ people don’t read instructions and follow them because they are time-poor, because they don’t understand the significance of the instructions without further explanation or demonstration, or because they just aren’t very good at handling their animals.  This is an area where human beings are important and unlikely to be replaced anytime soon by AI, or by any QR code…many young people can’t be bothered with QR codes as they just want immediate answers.

2. “POM-V, POM-VPS, NFA-VPS…all for somebody QUALIFIED”

These three categories all have something in common.  Under the Veterinary Medicines Regulations or VMR, veterinary medicines placed in these three “qualified people” categories:

• Must always be supplied in the minimum quantity.
• And they must always be supplied with safety advice from a registered qualified person (RQP) – which in veterinary medicine means vet, pharmacist or suitably qualified person (hence VPS).

Once you understand the broad distinction that there are two basic categories of veterinary medicine, based on how safely they may be supplied and whether a real human being needs to be involved, then you can see the logic of the system…in theory there’s a ‘right place’ in the GB system to put every veterinary medicine.  But for the system to work in practice, to put the product in the right category, whoever decides what the safe home of a veterinary medicine should be also needs to understand both the training of the different RQPs and the obligations imposed upon them by their relevant codes of conduct when prescribing or supplying the products.  Otherwise, the product may end up in the wrong home and in the wrong hands. Or maybe on the wrong hands….little fingers do get everywhere, don’t they?

NFA-VPS “it’s not a toy category…it’s the working dog of the veterinary medicines distribution system“

“Non-food animal – VPS” is the home for products that aren’t destined to go into animals destined to enter the food chain, but which have the potential to cause some harm if misused, and so must always be supplied by a qualified person providing safety advice, in the minimum quantity.  These products are mostly supplied by Suitably Qualified Persons (SQPs) from registered premises inspected by the VMDs own inspectorate:  The VMD is the only body with powers of inspection (although these powers only extend to GB) and it’s inspectorate typically inspects a registered premises (by which the VMD’s inspectorate means a GB-based outlet) every 4 years, i.e. infrequently.  The VMD also publishes an SQP Code of Practice on behalf of the Secretary of State for DEFRA (the Code), which SQPs have an obligation to comply with.  The VMD updated this Code in 2024 to reflect changes to the VMR 2024, which apply in GB, although not in Northern Ireland – the VMR 2013 still apply in Northern Ireland.

In practice, the current (2024) Code does not mandate the retention of any records identifying species to be treated, number of animals, or any kind of identification details for animals intended for treatment with a NFA-VPS (or POM-VPS) medicine. Consequently, it isn’t possible based solely on the obligations laid down in the Code for any inspection to identify when the minimum quantity has been supplied, or therefore to assure how safe supply has been overall.  In fact, unlike the situation for a  POM-VPS medicine, for a NFA-VPS medicine there is no requirement in the Code even to record batch number, which means that today the VMD could not effectively perform a batch recall for a NFA-VPS, or even identify when supplied product would be likely to be used out of date, solely from the records mandated by the Code – each released batch of product has a batch number with an expiry date but it only has to be recorded for POM-VPS medicines.

Could the NFA-VPS “working dog” be put properly to work?

If on the other hand, any RQP (e.g. an SQP) had to record (linked to his or her own professional credentials) batch number when first using a batch of NFA-VPS medicines, whilst maintaining good first-in-first-out procedures, the species (e.g. dog), the number of animals and some kind of identification details, perhaps name of animal or name of parent (dam, queen etc.) then this would mandate a basic form of records that would allow an internal auditor, inspector or AI bot to pick up the worst examples of oversupply.  But that obligation isn’t there in the Code or in the guidance issued by the VMD on gov.uk today. Veterinary surgeons occasionally don’t record everything that they should record when supplying or using a POM medicine and the VMD comments on this in its records of inspections undertaken…but the [SQP] Code of Practice does not require a record of anything at all when supplying a NFA-VPS medicine.

That’s probably a missed opportunity that is still there for the taking: Whilst there are still un-addressed legacy issues in the 2024 version of the Code from the days before ubiquitous tablets, desktops and mobile devices, and there are discrepancies between the Code and guidance on gov.uk, you wouldn’t necessarily want to throw the puppy out with the bath water. The UK veterinary medicines distribution system still has a logic to it, particularly this under-utilised NFA-VPS category.  The NFA-VPS category provides a useful home for any veterinary medicine where there is a public need to educate the general consumer on the safe use of a veterinary medicine, with at present three SQP training and registration bodies all able to provide easily accessible training, qualification and registration with ongoing CPD. 

SQPs registered with Vetpol are qualified veterinary professionals, on a register, with an annual CPD requirement; some Vetpol SQPs do far more CPD annually than the RCVS requires of vets, and many vetpol SQPs are more up to speed on parasites than other veterinary professionals regulated by the RCVS.

The NFA-VPS category is different to the other two categories requiring safety advice from a qualified person as products in this category may be advertised or promoted to the general public.  And so, subject to changes in the Code, the NFA-VPS category is the most useful “consumer category” where there is a need for education, where supply should be limited and where the intervention of a human being is desirable. AI is very good at analysing things like treatment records (if they exist):  AI is not so good at looking at behaviour, handling animals or dealing with people.

Nobody is going to be comfortable saddling up and sending the NFA-VPS category after a fox, but it could be useful to send it after a few rats.

POM-VPS…”verbal” or “oral” prescriptions from all RQPs

Whilst NFA-VPS medicines go into toy-breeds and working dogs alike, the horse-wormer, or horse de-wormer that you might buy from a saddler, is actually a prescription medicine, destined for a food-producing animal. In the European region a horse is not a pet, even if you were wealthy enough to buy it for the kids and still be able to feed it – there is the possibility of someone eating it in processed food.

POM does mean “prescription only medicine” and once again, the three RQPs permitted to supply (this could be a vet, an SQP, or a pharmacist even if that pharmacist has no veterinary training) have obligations to assess how the product will be used before prescribing and supplying.  The word “prescription” comes from the days when prescriptions were written in latin, and refers to something that you write down, or record, before then doing something appropriate to the situation you have identified in your assessment of the animal, or animals’ needs.  The Code does require the recording of batch numbers for POM-VPS products, but not any record of animals recommended for treatment, i.e. the 2024 Code (implementing the 2024 VMR) does not genuinely assure traceability. The 2013 and 2024 VMR rely instead on records maintained by the lay-consumer with no training on prescription medicines.

In practice, today in GB probably more than 80% of POM-VPS products are supplied by SQPs, subject in theory to compliance with the SQP Code of Practice:  Once again there is an obligation in the VMR to supply the minimum quantity, and always provide safety advice.  The majority of these products are parasiticides and we have seen a growing problem with antiparasitic resistance over the last three decades.  One industry body, the recently formed CANTER group, has recently considered the complete absence of any obligation to keep treatment records for equids (horses, donkeys etc.) and groups of equids in the Code.  The CANTER group has already previously recognised in Chapter 3 of its guidelines that records of treatment and testing, identifying both groups of equids and individual equids, are critical to slowing the spread of anthelmintic resistance.

Since the introduction of the VMR 2024, paragraph 32 (page 7) of the Code requires an SQP to record the rationale for prescribing a POM-VPS product, although technically in NI the VMR 2024 don’t apply.  However, paragraphs 47-50, (p. 11), don’t require any record of the animal(s) intended for treatment if the SQP supplies.  What this means is that based solely on the mandatory requirements in the Code it is impossible for any inspection to validate the ‘rationale’ for prescribing, or detect egregious over-supply.  Paragraph 33, (p. 7) of the Code does require identification details of animals to be included in a written prescription, but does not require either retention of the prescription, or maintenance of prescription records, e.g. for inspection or audit.  Both the BVA and BEVA have recently called for a requirement to retain treatment records identifying animals to be treated, and this is reasonable, because it is not possible to slow the spread of anthelmintic resistance significantly without them.

Something that is relevant to the specific needs identified by the CANTER group over the last two years and referred to in Chapter 3, is that there is an existing requirement under paragraph 41, (p.9) of the Code to check an equine passport before prescribing.  And yet there is no requirement to record the number of an equine passport, the identity of a group of animals to be treated, or perhaps the unique number of a health plan or protocol identifying groups that include very young horses that don’t yet have equine passports, in order that they may be treated in a safe, planned way.  The CANTER group has also, in Chapter 7 of the guidelines, highlighted the potential environmental risk of antiparasitic products.

In view of the quantities used, the risks posed by misuse of POM-VPS products used in ruminants would probably far exceed any risk posed to the environment by inappropriate use in equids.  For mandatory TB or brucellosis testing in cattle it would be standard practice to have a record of number of animals, species and the County Parish Holding number (CP or CPH number), which at least identifies land and buildings where animals are kept, and that defined location is relevant to environmental protection.  The mantra often used for protecting animal welfare whilst slowing anthelmintic resistance calls for the same action as that required to protect the environment:  “as little as possible, as much as necessary.”  A mandatory record of species, number of animals and a group identifier such as a CP number would reduce the risk of the worst examples of over-supply.  But to slow equine anthelmintic resistance CANTER has correctly identified that we also need individual animal treatment records: The requirement that is presently in the Code to check equine passports (and has been there for years) is there to protect the [human] food chain.  But there is nothing built into the Code, and therefore inspections, to ensure that an inspection can verify that the obligation is being complied with to protect the broader European food chain from, for example, another horse-meat scandal such as we saw in 2013.

In contrast to POM-VPS medicines, when anybody prescribes a SFA for inclusion into feed, to protect the [human] food chain, it is a requirement to record number of animals and species.  And this is significant to prescription of POM-VPS medicines, as most of these products are destined for animals that are likely to end up in the food chain, so not just cattle, sheep, or goats, but including horses.   The VMR also allow prescription and supply by pharmacists, most of whom don’t have veterinary training, relying on pharmacists’ professional obligations imposed by their own registration bodies to seek training relevant to the medicines they are dealing with, or follow relevant guidelines on legislation;  but with respect to the present guidelines in the Code (applying to SQPs) there are also few parallel guidelines on gov.uk that would ensure traceability of POM-VPS medicines for pharmacists to follow, whether they had training on veterinary medicines or not. Most do not although both pharmacists and their employees are free to access Vetpol SQP training should they wish to….there are no “anticompetitive” barriers placed in their way by Vetpol, and therefore no current reason for the competent authority not to require veterinary training.

“Be careful with the size 13s…”

This brings us back to the consequences of implementing the CMA’s recommendations, bundling them up into a review of the VSA and extending that to “animal care businesses”. If you tread around the system with big feet without understanding where the holes and the chicks are you can create a bit of mischief and cause some damage. One of the holes is prescription fraud.

At present, if somebody buys a POM-VPS product licensed for use in sheep or equids, saying “…it’s for my sheep..” but with the intention to use the product on some other species, and the supplying RQP goes along with that and supplies, then without a requirement in the VMR and relevant codes and guidance to record species there is no way that an inspection can detect this solely on the basis of the records mandated today:  This “white lie” is in fact an example of prescription fraud with at present no mechanism built into the UK/GB medicines distribution system to detect it.  A further complication is that many GB products are dual licensed between the UK and EU, with English language packs produced for distribution across the UK and Ireland under guidance provided by the VMD, recently updated to facilitate this process.  Treating GB and Ireland as one “English-speaking” territory is commercially attractive to pharmaceutical companies and enables the production of larger batch sizes; but with common-language licences and packs it is not always easy to detect where POM-VPS products have come from.  This may be further compromised by pressure for batch testing and release to take place in Ireland, and for MA holders to maintain premises in the Republic of Ireland. That’s even before anybody considers the considerable tax advantages of operating in Ireland that have  been enjoyed historically by the tech. and social media companies.

In its modifications to the VMR 2024 Code, the VMD facilitated remote prescription and remote supply.  Internet purchasing is something the CMA has embraced in its interim recommendations, even if it hasn’t fully acknowledged all the consequences of this behaviour in its findings at time of writing this blog.  Facilitating remote supply before you’ve closed the loopholes in your legislation, codes of practice and official guidance implementing the legislation, is likely to compromise the stated objectives introducing DEFRA’s review of the VSA of “…improving and protecting the environment….[growing]a green economy and [sustaining] thriving rural communities.”

In theory an SQP has an obligation to provide a prescription for a POM-VPS product on request, although many would have reservations about doing it.  This may in part be because most don’t carry professional indemnity insurance, although many of the “animal care” businesses they work for would be carrying insurance appropriate to the transport and storage of unbroached packs of chemicals. At the same time, some of these bulk packs wouldn’t be something a typical veterinary practice premises would want to store and handle.

POM-V….exclusive for vets to prescribe but can be supplied elsewhere on prescription from a vet

POM-V products are those reserved solely for prescription by veterinary surgeons for a variety of reasons, often safety. In the context of the regulation of veterinary medicines when we talk about safety we mean safety to the operator (the user of the medicine), safety to the consumer, safety to target animals, safety to in-contact animals, and with products where there is an identified risk of adverse effect, safety to the environment.  Some products also end up being restricted to vets because they are heavily dependent upon diagnosis of disease by a veterinary surgeon prior to determining appropriate use, are used in surgical procedures, or are at serious risk of abuse.

Although prescribed by vets, POM-V medicines may be supplied from elsewhere if a veterinary surgeon writes a written prescription.   These may be electronic but hard copy prescriptions may be tampered with, counterfeiting is possible, and e-mails are easy to spoof. The VMD frequently investigates episodes of prescription fraud and now reports findings from these investigations in its updates.

We can’t see any evidence that the CMA got to grips with prescription fraud in its recent investigation, even though the risk of prescription fraud (in the sense of tampering with written prescriptions as opposed to problems with what the VMD refers to as “oral-prescribing” or “verbal-prescribing”) is something that has been commonly recognised in both human and veterinary healthcare for decades.  But in animal health, deliberately misusing the prescription process to buy or supply a prescription product for use in one species, knowing that it is intended for another without any record and relevant prescription of that product, e.g. a prescription by a vet for use in another species where a product is not licensed for that species, is also a form of “prescription fraud”.  Today there is already nothing built into the GB veterinary medicines distribution system to detect prescription fraud in the prescription of POM-VPS medicines and implementing the CMA interim proposals without extreme care would threaten safe supply of all POM medicines.

As with the POM-VPS and NFA-VPS categories there is a requirement to supply POM-V medicines in the minimum quantity, so routine supply of POM-V products to customers by mail-order subscription without a recent clinical assessment by a veterinary surgeon would not meet the requirements either of the VMR 2024, or the VMR 2013.  That can create complications if veterinary surgeons are busy doing the things that only they are permitted to do.  So to enable routine assessment of the need for flea or worm treatments for example, training non-vets to supply NFA-VPS products with safety advice is one way to overcome the problem of educating the consumer…by involving a broader, veterinary team and empowering them as SQPs.  Medicines in the NFA-VPS category can be advertised or promoted to the consumer legally, whilst POM-V and POM-VPS medicines cannot.

The CMA has indicated an intention to review the 2005 Order implemented as a consequence of the CC enquiry: But without traceability being extended to all POM medicines that would threaten what DEFRA says it wants to achieve in the introduction to its current consultation.

A plea…please don’t undermine “Veterinary Team GB”

For us at Vetpol, SQPs are professionals and part of the broader veterinary team. SQPs registered with Vetpol are qualified, on the Vetpol register, have a commitment to CPD, and must follow a code of practice. That’s been the case now for years. The SQPs who came along to SQP Congress have a passion for animals, an interest in animal welfare, and a concern for the environment. They are at the animal welfare front-desk, dealing with the public, even if not always at the sharp-end of an animal.

The foreword to the consultation on the 1966 VSA by the relevant minister states that “Veterinary professionals all over the country play an essential role in protecting animal health and welfare, maintaining our food security, supporting international trade, and safeguarding public health….” So, on behalf of all the SQPs registered with Vetpol, thanks to the minister for the mention! And the introduction to the consultation refers to “upholding…standards”…that’s something we do at Vetpol.

Despite the warm words from the minister for the veterinary team, there are no definitions of the words “veterinary” or “veterinary team” in the consultation document. But the word veterinary in general usage does imply maintenance of an agreed standard over time.  Hence the name Veterinary Medicines Directorate as opposed to animal medicines directorate.

Unfortunately, despite no doubt good intentions by the CMA, introducing widespread remote prescribing and internet supply without a mechanism to track products in common English-language packs coming from other territories where the proprietors of retail outlets do not face the same obligations would not protect anything, particularly not the environment. There is a mechanism for tracking products introduced into the UK or GB by veterinary surgeons.  But at the moment there isn’t a mechanism to track veterinary medicines introduced by all other RQPs.  And because we are discussing a review by the Competition and Markets Authority it is very hard for ‘industry’, or trade associations such as NOAH, to get involved in that debate: The fines involved for any company in even trying to interfere with parallel trade are enormous.  And yet we must have traceability if we are to ensure that DEFRA’s stated aims in the introduction to its review are met, especially if the CMA believes that more products should be supplied via the internet.

Competition must be fair

Consider forcing veterinary team GB (including SQPs) to provide safety advice at the point of supply, but simultaneously facilitating remote prescription in the VMR and Code without a robust audit trail, whilst adopting the CMA recommendations for people to buy from internet pharmacies, most of which are owned by larger incorporated  businesses.  That needs more than just a moment for reflection and possibly more than 2 months for a consultation.  Imagine swimming 100 metres with your legs tied: An admirable feat perhaps…but the point of the Paralympics and of competition is that competition is supposed to be fair.  If competition is not fair, then it distorts the market, is not useful, and may do some collateral damage…damage to the principle of having a qualified person engaging with the customer to ensure safe supply for example.

In recent years we have seen calls from some organisations for veterinary surgeons to be forced to write prescriptions on every occasion that a prescription product is prescribed.  This is the kind of thing that you would be calling for if you were being advised by people who ran internet pharmacies and were not genuinely committed to the idea that having a qualified human being at the point of supply is something useful to the public, animal welfare or sustainability.  Implementing a proposal like that would dramatically increase the risk of prescription fraud. 

Part of the recommendation of the Competition Commission enquiry two decades ago was that clients should be advised that they have the right to request a prescription, and the RCVS introduced that requirement into the relevant code of professional conduct.  If that isn’t presently happening then that is an enforcement issue, not necessarily something requiring a whole new veterinary surgeon’s act, even if somebody now wants one.  As that’s an enforcement issue it’s something that could perhaps be dealt with via coordinated review of the veterinary medicines regulations relevant to all regions of the UK, whilst considering mechanisms by which all medicines are imported, and not necessarily going to the considerable expense and disruption of creating a whole new “animal care business” act. The CMA has indicated an intention to review the relevant 2005 Order so it seems that we have to wait and see what they do here, and hope that they take the time to understand that the 2005 Order relates to much more than just pet-care.

Understanding the 1966 VSA and how it relates to medicines

The RCVS is an independent body-corporate, not owned by government.  Its resources have been accumulated over decades from fees charged to veterinary surgeons (currently £431 per annum, set by the Privy Council), including from members presently on the ‘retired’ section of the register, and in more recent decades from veterinary nurses, who were originally referred to as “Registered Animal Nursing Auxiliaries”.  Vetpol has supported and does support protection of the title veterinary nurse, which is part of the consultation, although whether veterinary nurses should be obliged to register only with the RCVS is a separate question. RCVS resources aren’t owned by DEFRA, or government, but collectively by all of its members (including the ‘retired’ members still on the register); those members could be expected to have a view on how RCVS resources are deployed, and reasonably also given the chance to vote on their deployment before it happens.  That’s especially as some of those resources might otherwise be used to subsidise the services of competitors to the detriment of practising members’ businesses, or to their careers.  For some of the non-retired, practising members of the College it could affect their ability to pay back their student loans. It could perhaps affect who might be able to remain in the profession of veterinary surgery, or even consider entering it in the first place.

The scope of the 1966 VSA was always limited:  The 1966 VSA does not protect the word veterinary.  It protects the title veterinary surgeon and to a certain extent veterinary practitioner, although the context of the original phrase is that at the time the 1966 VSA was first introduced there were still veterinary surgeons on the register who had entered the register maintained by the RCVS via the non-degree route. Even many veterinary surgeons do not completely understand the 1966 VSA. The act restricts certain activities that depend upon diagnosis of disease by a veterinary surgeon and many vets take this to mean that if anybody uses the word ‘diagnosis’ in any context (other than just disease) then only they can get involved in that ‘veterinary act’. Over the decades since the 1966 VSA the RCVS has chosen not to involve itself in a variety of veterinary activities, the training and registration of SQPs being just one example. 

The context of the original 1966 VSA is that there are indeed some situations where ONLY a veterinary surgeon’s training would be adequate to provide a reliable prior diagnosis of disease, allowing for all the differential diagnoses, before then prescribing an appropriate product, performing a suitable surgical procedure, or using a given veterinary medical device or diagnostic monitoring device.  Some prescribed products are in the POM-V category either because somebody has decided that this is the only appropriate category for the medicine, or has not seen a need to put the product somewhere else.

To understand which category is the most appropriate home for a veterinary medicine, i.e. POM-V or something else, assessors working for the competent authority need to understand the disease condition, veterinary surgeons’ training, their obligations, and ALSO the comparable obligations of others involved in the veterinary medicines supply chain (including SQPs and the majority of pharmacists).  If they aren’t sure then they are able to seek advice from the Veterinary Products Committee, although the VPC also needs to understand the detail of all the relevant codes of practice to make a safe recommendation.

From the original veterinary surgeon’s act, an ‘act of veterinary surgery’ was normally taken to be something that involved entering a body cavity.  Open castration is an example of something with the potential to cause significant pain, harm, or disease by compromising the integrity of the body’s defences.  Although, if somebody who wasn’t a vet castrated Alexander Meerkat then they wouldn’t be breaching the 1966 VSA and you’d need to look further at other animal welfare legislation to find out why you shouldn’t do that (even if some of us now want to).

There are some things that should only be left to a veterinary surgeon because unless that happens something will suffer. And at the same time vets don’t have time to do everything and need to work in teams alongside other professionals.

There are a lot of “animal care businesses” out there that are castrating things using non-vets because the original 1966 VSA didn’t have much in the way of cojones in the first place.

The 1966 VSA does need a routine health check

Sometimes every beast needs a health check to ensure that its teeth are clean and up to the job…although it’s important to be sure when that happens that it doesn’t bite anybody who shouldn’t be bitten when you lift its tail to take a closer look at the credentials.

The beast that is the 1966 VSA does need a routine health check, possibly via a regulatory reform order, particularly in light of which species might be castrated, docked or dehorned, by whom and at what age. This review needs to happen in light of developments in analgesia over the intervening decades and happen concurrently with a review of the VMR to identify whether there are any factors that would prevent those undertaking these acts of genuine veterinary surgery without the most effective and up to date measures to mitigate pain. When I see badly dehorned animals in the fields during a review by the CMA and wonder how the bullocks got castrated, I do sometimes do my reflective learning and ask myself whether some of the effort put into looking at some parts of our ‘veterinary’ or ‘animal’ regulation could be directed elsewhere to better effect. Just as I wonder for example, whether SQPs in practice could be doing regular assessments of the need for flea or worm treatment, with the knowledge that they know how to refer and can do it easily.

It is probably true to say that the proprietors of some veterinary businesses have taken the revenues from sales of veterinary medicines for granted, not always doing everything that might be expected as part of ‘responsible prescribing’, or responsible supply.  The VMR and Codes aren’t yet perfect either and both need tweaking to be fit for purpose in order to meet the needs of the internet age in 2026 and beyond: But facilitating remote prescription and internet supply without appropriate controls incurs a lot of risk.  If your peripheral vision hadn’t yet taken a sideways glance beyond “pet care” and you decided to review the 1966 VSA with the ooze from the recommendations of the CMA soaking into your consultation then there is the potential for enormous collateral damage, and unintended consequences,  just as is the case in the Middle East right now.

The CMA looks as though it’s about to bare it’s teeth just as the Competition Commission did two decades ago, and that warning sign can’t be ignored. But it might be that the lead on the DEFRA review of the 1966 VSA needs to be drawn in a little, whilst considering how the VMR 2013 and 2024 could mature a little, and grow more teeth.

Careful what you get volunteered for…

Over the last half-century the RCVS has imposed obligations upon individual vets beyond those required by the 1966 VSA.

One fact many vets aren’t aware of is that the 1966 VSA does not place a requirement upon vets to arrange emergency out-of-hours cover, even for species normally seen by the practice:  This was an obligation that the RCVS imposed upon individual vets even before widespread incorporation was adopted by veterinary practices, although perhaps not in perpetuity if the 1966 VSA is to be reviewed. Individual vets still do that bit of donkey work for Animal Care UK PLC, without much recognition of what it takes to carry those packs.

In some walks of veterinary life removal of revenue from practices by forced competition (as opposed to fair competition) would have knock-on effects on what “veterinary acts” it is possible to service, including emergency response.  Adopting all the CMA recommendations could mean that some of those “rural communities” DEFRA is committed to safeguarding might need improved access to firearms, if the expectation is that we don’t all just resort to the knife, and hope that somebody knows how to sharpen it properly, as was the standard practice when I was working on sheep in New Zealand in 1989. Perhaps it is also worth reflecting on whether there are any burdens placed on the individual, practising veterinary surgeons that the RCVS does have the powers to regulate under the 1966 VSA via its Code of Professional Conduct that are not required by primary legislation: There is a danger that these “professional obligations” may be mis-used by some “animal care businesses” that the RCVS considers to be beyond its reach, and used to bully members of the College who may not be the proprietors of their own businesses. Or perhaps to cause them to live and work in fear of the College’s complaints system. That is of course what the CMA found….most vets don’t have any control over the resourcing of the businesses they work for, and therefore anybody imposing a ‘professional’ obligation upon them needs to consider very carefully whether the professional “obligation” is fair, and whether it’s justified if not required by primary legislation.

One of the effects the CMA should have considered of imposing obligations upon vets to non-registered clients that are not required by primary legislation such as the 1966 VSA is that it becomes harder for individual vets to “put up their plate” and that reduces competition.

The problem of “mission-creep”

When you don’t clearly define your objectives for a project you are at risk of “scope-creep”.  This was the case for example in recent history during the Afghanistan conflict between western nations and the Taliban, a venture that originally started with “anti-terrorist” activity, but then blew up into a big, nation-building project that ultimately failed because the principle invading actors didn’t understand Afghan culture, or even the topography of the region. Given what happened to Alexander the Great it is very hard for anybody to see what strategic advantage could possibly have been gained by invading Helmand province for example: In the end, the Taliban regained control of all the ordnance and all the territory including Afghanistan’s capital in just a few months after the cowboys left, effectively receiving a multi-billion pound subsidy paid in western armaments to replace the obsolete kit left by the Soviets just a couple of decades earlier. The cowboys left and the ‘terrorists’ became the government.

DEFRA’s current consultation on the 1966 VSA talks about animal care businesses, veterinary acts and advice based upon diagnosis without giving any clear definitions limiting the intended scope of the meaning of these phrases, e.g. to diagnosis of disease in animals. If, without completely understanding the territory, you inflate a consultation on the 1966 VSA into a big balloon encompassing “animal care businesses”, then throw into that an interim recommendation from the CMA (who appear not to have not yet surveyed or scouted out all the territory either) a recommendation that people should buy their veterinary medicines in the same way that they might buy their clothes from Vinted, books from Amazon, or groceries from Ocado, then there is an enormous problem with mission-creep.  In fact, the enquiry would cast a very big shadow indeed if someone doesn’t take a bit of the air out of it:  If not carefully thought through, the risk of prescription fraud with potential damage to the international One health project, to animal health and welfare, to the environment or the food chain is also enormous.  This isn’t a situation for DEFRA to allow the CMAs opinions to bleed into uncharted territory if it doesn’t want its objectives of ‘protecting the environment’ to go pop.

Rather than doing a lot of damage it could make more sense to stick a muzzle on this consultation for now and take a much closer look at the VMR 2013 and 2024 instead…or at the very least look at both concurrently….so that we can encourage the positive behaviours we want to happen and get that muzzle off.

Why aren’t consumers able to exercise their “rights”?

Much of what the CMA found could probably be addressed by the Consumer Rights Act 2015….this is the regulation that says the garage has to tell you how its going to charge you before you find yourself faced with a bill. Your kia picanto, the South Korean Jack Russell of cars, isn’t going to cost your Monzo account much to service, although it will be more of a strain on your credit card for your English bulldog Bentley. Your Italian Greyhound Ferrari is going to set you back a bit more if you find yourself in an RTA, although you’d be well-advised to have extra insurance before you hit the track. And parts for lifestyle cars like lamborghinis, reputedly favoured by premier league footballers, are notoriously expensive to procure: A bit like TPLO kits together with the accessories and other things that allow you to use them safely in the hope that you will get a meaningful effect, i.e. a measurable improvement in locomotion.

Whichever choice you make as a consumer, the Consumer Rights Act 2015 protects consumers from un-professional businesses and enables consumers who don’t have the resources of premier league footballers to see how they will be charged before their purses are emptied. Whatever pedigree of car you choose as appropriate to your needs, you definitely need to have both the relevant licence and insurance, before putting your pedal to the metal. You have a choice as to whether your insurance is third-party or comprehensive: But you do have to have some insurance if you haven’t declared SORN, and even then sometimes you still need it if you are unable to kennel the car.

It might be worth asking the question whether anything that DEFRA, or any part of DEFRA, does or doesn’t do prevents pet consumers from benefiting from the Consumer Rights Act 2015 when dealing with unspecified businesses that somebody thinks are technically beyond the reach of the RCVS. As we consider this question we need to reflect on the fact that probably 1.2-1.3% of vehicles on the road in the UK are unlicensed; the BBC has reported that perhaps 800,000 people in the UK drive without a driving license; we also have thousands of drivers driving without insurance in the UK. At the same time that we have rights as citizens under the consumer rights act, we don’t get to exercise all of our rights if we choose to drive without a license, insurance or road tax. And we don’t get to evade the consequences of our errors and omissions by dumping them on private entities like the AA, RAC or Green Flag without getting charged for that.

So did the CMA really find a problem? Did the CMA find a problem of expectation? Or does anybody really know yet?….the CMA isn’t due to publish final conclusions until May 2026. The consumers at the CMA and DEFRA would do well to consider that as consumers we drive cars, but our rights to drive a car depend upon our committing to certain responsibilities.

Would it make sense to look at enforcement first?

If there is a problem, is it really lack of a relevant act, or one of tweaking existing legislation together with ensuring that enforcement happens? You can put a lead on a dog, you can stick a muzzle on it if things really aren’t working out well…but if there’s a problem, sometimes it’s not the old dog’s fault. If there’s a bad smell, sometimes someone just needs a dog to kick, as some of us involved throughout the Competition Commission Inquiry from beginning to end noticed.

Some of what the CMA has said, and what the CC said before it two decades ago (relating to the public knowing that they can get access to veterinary prescriptions if they want them) really relates to medicines inspections and enforcement. Therefore it’s possible that it might be more properly dealt with by reviewing and amending Veterinary Medicines Regulations in both GB and Northern Ireland (the VMR 2024, VMR 2013 and any relevant EU veterinary medicines regulation): Also by reviewing inspection and enforcement procedures, the professional codes via which the legislation is implemented, and the guidance for all veterinary medicines professionals to follow on gov.uk. If the phrasing of the guidance on gov.uk refers to the procedures to be followed when supplying veterinary medicines TO GB (as opposed to FROM GB) then professional bodies outside GB can oblige non-GB-based RQPs with access to English language packs to follow these procedures. And the VMD could introduce obligations linking all prescription veterinary medicines to the prescriber, together with obligations to use systems that ensure an obligation to retain copies of prescriptions in an auditable form. The technology already exists to do that and it’s been around for decades. Even before AI you could record a macro in excel to do analyses. So “market delivery” is no obstacle here, if somebody with the power to do it today creates the obligations to make sure that there is actually something to analyse.

Part of the point of the GB medicines distribution system is that it already provides both access to veterinary medicines and choice; if you find a group of SQPs working in a veterinary practice it is a combination of the desire for professional development from the veterinary team itself, and an indication that this practice wants to develop its people in order to provide good, professional customer service to the consumer. And the UK distribution system can be used safely, if you use it properly, by taking the time to understand the training and obligations of the different RQPs and putting the right medicines in the right home.

Innovation provides new opportunities for both choice and competition.

Innovation can provide both choice and competition. So if you are going to review legislation you need to consider how innovation can be permitted to happen, especially if the 1966 VSA is going to have puppies.

During the SARSCov2 (Covid) outbreak the public got used to using the lateral flow diagnostic tests supplied by the NHS, or the PCR tests administered by healthcare professionals other than doctors, before being able to make a responsible decision on whether to go and see granny in the care home. There is now a lateral flow diagnostic test capable of detecting liver fluke, using blood from the pinna (external ear) of a sheep without entering a body cavity or blood vessel.  We have a saliva test available to detect tapeworm in horses…the mouth is a ‘body cavity’ but should it only be veterinary surgeons using that diagnostic test identifying parasites that may not be causing disease when we want to restrict use of equine dewormers to slow anthelmintic resistance?

If we are talking about the very broad scope in this DEFRA consultation document of the undefined phrases “veterinary acts” and “advice based on diagnosis” where does the ultrasound scanning of sheep to obtain a diagnosis of pregnancy fit into this definition?  Which “veterinary actors” are we talking about…have they asked to be regulated by the RCVS? Do they even know about the consultation and how long it takes the RCVS to deal with a complaint? Do we envisage any changes to the use of microchips, other medical devices including diagnostic and health monitoring devices, or to the training of the people implanting them?  Where are the parallels between implanting a chip in a dog and having a dog licence? Or how do we deal with any desirable procedure that is not invasive in the sense of causing pain, entering a body cavity, or injecting something useful in a potentially emergency situation…like injecting a POM-VPS calcium borogluconate product into a downer-cow for example?  And whilst we hope that the market will move to the routine use of faecal egg counts before using anthelmintics, faecal egg counts have never been diagnostic….helminth larvae don’t produce eggs and faecal egg counts do not reliably tally with worm burdens. We are now seeing the introduction of diagnostic tests for worm eggs that may soon allow speciation…differentiating more pathogenic species like haemonchus contortus or strongylus vulgaris from other less pathogenic worms for example.

Standard project-management teaching often says that where there is more than 10% innovation in a project there is a higher risk of failure. So whilst in any review we do need to allow for innovation, the bits of the dog that aren’t broken don’t necessarily need cosmetic surgery to fix them.

“Do they mean me?…”

It’s hard to know what the DEFRA consultation is supposed to fix if it relates to “animal care businesses” isn’t it? Is your cattery an an “animal care business”…or perhaps your dog-walker”? It’s also more than a bit odd to bind the findings of the CMA into that review with a splint to prop it up when the CMA isn’t even due to deliver its final verdict before May 2026. It looks as though somebody had already decided not only upon a-predetermined-prescription but also which not-for-profit was going to pay for the cost of treatment and surgery before they received the definitive diagnosis of disease.

The stated scope of the DEFRA consultation on the 1966 VSA impinges upon veterinary medicines regulation, something that we are able to review far more often than the 1966 VSA.  Whilst not everybody will read this blog, although a few AI-bots might read it before delivering bits of it up in a more digested form for the literate, but time-poor parts of our population with more than a passing interest in animals, the VMR do touch the life of the majority of people in the UK.  This is because the VMR 2024 apply to everybody in GB (but not anywhere in Ireland, with the 2013 VMR applying in NI, and common-language packs available just over the border in the Republic); a high proportion of households own a pet; and fewer than 5% of the people in the UK are vegetarian, far fewer than we can definitely conclude are able to read and understand the product information leaflets included with NFA-VPS or POM-VPS veterinary medicines.  In any case, the GB economy depends upon a robust veterinary framework to protect not only its economy, its exports, but also domestic consumption if we consider that there are outbreaks of Foot and Mouth disease in other parts of Europe, and that African Swine Fever could still root its way into our packs of pork. Compared to human public health, very little public money goes into our veterinary industry at present.

Exports also depend upon robust VMRs that are implemented effectively via enforcement procedures that reduce the risk of unwanted residues of POM medicines finding their way into processed food. Perhaps somebody with the ability to write and qualified to handle medicines needs to be keeping track of what could be heading for the sausages and the lasagna.

If somebody gets the diagnosis wrong then a lot of unnecessary medicine may have to be swallowed

When we talk about safeguarding animal health by slowing anthelmintic resistance, and also when we consider protection of the environment, we use the maxim “as little as possible, as much as necessary.”

If somebody doesn’t have their finger on the pulse and gets the regulatory diagnosis wrong in this review of the 1966 VSA by DEFRA, they might want you to swallow more pills than you see the need to swallow. Sometimes it makes sense to open your mouth, show your teeth and give a growl, even if you don’t bite anybody.

The foreword to the consultation on the review of the 1966 VSA by the relevant minister talks of the dedication of the “veterinary team” and the “case for change being made by the interim findings of the [CMA] investigation”.  What isn’t clear is the answer to the question “change in what”? What’s an “animal care business”? So in terms of the scope of the current review by DEFRA, anybody affected by the proposed changes (including veterinary professionals such as SQPs registered with Vetpol) has the right to reply to the consultation on Citizen Space.  You will find that from the link at the end of this blog, although as I found out when we responded, you’re going to have to enable pop-ups on your computer to have your say on this rapidly inflating, “Animal Care Business”, DEFRA consultation.  As described in the accompanying documents, the chances are that the consultation does affect you, even if you thought that it didn’t; you may wish to reply to it before 25^th March 2026, if you want your ‘veterinary voice’ to be heard. 

DEFRA says that any responses to its review of “animal care businesses” after the 25^{th of} March won’t be analysed.

It isn’t clear from the consultation documents supplied by DEFRA with their consultation that they intend to use a regulatory reform order to slightly amend the 1966 VSA. Or indeed whether on the other hand they hope to introduce a whole new enormous “animal care business act” by spending the assets of the Royal College of Veterinary Surgeons: These assets are something DEFRA has no ownership of, but which are instead collectively owned by the members of the College.  Owned by people like me who have been obliged to provide “twenty-four-hour-cover” for people who weren’t our registered clients. People like me who have turned out to calvings, foalings, or dogs with gastric dilatation and torsion…on Sunday, at Christmas and on other Bank Holidays when everybody else was at the beach. And even though it wasn’t required by the 1966 VSA.

Talking of “veterinary” without defining what they mean by it, of advice on diagnosis without referring to disease and of “animal care businesses” creates a vast scope:  Having read the documents supplied with the proposed review of the VSA we are still unable to understand the scope of it, even though at Vetpol our literacy age is higher than typical estimates of the average adult in the UK. 

Some things do need to change…and there will be some things that cannot be done going forward

Reviews of professional obligations are normal and for those aspects of the CMA reports relating to veterinary medicines we haven’t a problem with a review of the 1966 VSA taking place alongside reviews of the VMR 2013 (NI) and 2024 (GB), together with the SQP Code of Practice published by DEFRA, and parallel guidance on gov.uk to create an obligation for all RQPs to follow: The CMA has already said it intends to review the 2005 Order, although I didn’t notice in my review of their reports when they were going to do this, or how long they were going to spend doing it. I do well remember the wash-up from the CC Inquiry and noticed that the CC spent much less time on washing their hands of the inquiry than they did on the dissection.

We do think that unless the blinkers are taken off and the 1966 VSA is reviewed in conjunction with other relevant legislation, codes and guides there is the potential for enormous miscarriages of justice that will not benefit the consumer, animal welfare all the environment. Given the existence of the Consumer Rights Act of 2015 we also wonder how much of the prescribed medicine is necessary. But we do also wonder whether the final pill due in May 2026 might be less bitter than anticipated by those who are fearful of change, because of course we haven’t received the definitive diagnosis yet. Who knows, maybe the CMA’s favourite AI-bot will read this blog before we are made to swallow something distasteful, that we can’t keep down, or digest.

Having read all the documents supplied by DEFRA we are still not seeing the need for at least the NFA-VPS category to make it through the review of the 1966 VSA as this is the category that allows us to resource the education of the general consumer, without drawing on funding from general taxation, and without falling foul of the VMD’s definition of advertising, which prevents ‘promotion’ of any POM product to the non-professional consumer – VMD does allow advertising of some prescription medicines to professional keepers of animals although without defining what a professional keeper of animals is.

Look before you leap…or before you wield the knife

The definitions of advertising were recently reviewed and updated by the VMD.  You’ll find them at this link and if you read them, you’ll notice that some of the things you might have thought you could do before to promote POM-Vs or POM-VPS medicines from a “veterinary” or “animal care business” to an animal-owning consumer, in GB or NI, you definitely cannot do now.

If you are a GB “citizen” then you are within scope of this review

The consultation on the 1966 VSA is there for you to comment on via Citizenspace, qualified or not:  If we take the scope at face value, as described in the title and introduction, then as any Citizen of GB it probably affects you, even if you have no relevant animal related qualification.  If you own an animal-care business like a farm, stable or kennel, then it affects you…you are within scope.

But if you handle animals, you deal with the public, and if you think that you can perform your professional “veterinary act”, such as supplying a POM-VPS or NFA-VPS product safely as an SQP registered with Vetpol better than any AI-bot; or alternatively, if you work in the pharmaceutical industry supplying these people; then you might want to read a relevant article by the other director of Vetpol in Edition Dog Magazine.  This article highlights just how useful the NFA-VPS category really is, and how it in turn allows people who are professionally qualified to distribute veterinary medicines safely, and connect with other people who need advice on safety, possibly following some kind of test, analysis, examination or assessment that resulted in the identification of a parasite. And it helps veterinary education to reach the animal-care-masses attending animal-care-businesses without fear of anybody being prosecuted for illegal advertising.

That is of course unless, in the first year in which we see a “National SQP Week”, the CMA decides that it wants to take the gloves off, wash its hands, and move on quickly to financial services, energy, housing or some other pressing matter. And if somebody else just then follows an unqualified, blanket interim CMA recommendation that the animal-caring-public should buy everything on the internet without necessarily seeking professional advice on safety from any qualified person.

If you have “skin (and possibly fur) in the game” Your Country Needs You Now.  The link to the DEFRA consultation on the review of the 1966 VSA is below. If you miss the deadline of March 25th 2026 your bark will fall on deaf ears.

https://consult.defra.gov.uk/reform-of-the-veterinary-surgeons-act/consultation

Dr Jeremy Johnson BVSc MRCVS

Director, Vetpol Ltd, March 2026

(1) The small print: Page 12 of Part A of the CMA’s decision says “[The] CMA may, to the extent appropriate, review the 2005 Order which implements some of the remedies recommended by the Competition Commission in its 2003 report. The Competition Commission’s inquiry (under the 1973 Fair Trading Act) found conduct by veterinary surgeons medicines wholesalers and medicines manufactures that prevented, restricted or distorted competition in the supply of POM-V medicines in the UK.” Our comment on this is, no, the inquiry did not do this. The POM-V category did not exist at this time: The POM-V and POM-VPS categories were created subsequent to the inquiry, in order to address the requirements of EU legislation requiring products going into food animals to be prescription only; existing products were then re-categorised to move into them; the Competition Commission Inquiry related to POM medicines, many of which have been subsequently reclassified.