Responsible medicine use: but who is responsible?

There is good reason why many medicines are prescription only (POM-V); in the case of antibiotics this is to ensure they are not misused resulting in the rapid development of antimicrobial resistance (AMR). The increasing awareness of AMR in recent years and high-profile reports such as the O'Neill Report (2016) have increased focus on veterinary prescribing, dispensing and administration of antibiotics. The RCVS Code of Professional Conduct for Veterinary Surgeons is very clear: ‘POM-V medicines must be prescribed by a veterinary surgeon, who must first carry out a clinical assessment of the animal under his or her care’. The phrase ‘under his care’ is not defined in the Medicine Regulations, but the RCVS has interpreted it to mean: ‘The veterinary surgeon must have been given the responsibility for the health of the animal or herd by the owner or the owner's agent’, ‘that responsibility must be real and not nominal’, ‘the animal or herd must have been seen immediately before prescription or recently enough or often enough for the veterinary surgeon to have personal knowledge of the condition of the animal or current health status of the herd or flock to make a diagnosis and prescribe’. It therefore follows that any veterinary surgeon can only prescribe to animals he or she has recently seen or that are on a farm they regularly visit.