The big news this month in the veterinary industry (and for a day or so in early September in the mainstream media, too) was the announcement that the Competition and Markets Authority (CMA) is launching a review of the veterinary sector. The CMA has become increasingly involved in the vet sector over the past few years, making several interventions to restrict the purchase of additional veterinary practices by some corporate groups in areas of the country where they already have a dominant hold on veterinary services. The CMA’s current review of how veterinary services are bought and sold has been launched amid concerns that pet owners may not be getting a good deal or receiving the information they need to make good choices.

From their website:  “The CMA is concerned that pet owners may not find it easy to access the information they need about prices and treatment options to make good choices about which vet to use and which services to purchase”.

As an independent referral clinic, we welcome the CMA’s review. When a pet needs more than routine care, we think it’s important the owner is fully aware of the options for their pet’s treatment, and they have all the information they need to make an informed choice of where their pet is treated and by whom, as per the RCVS’ Guide to Professional Conduct. There may be multiple options available -for example referral to a visiting (peripatetic) surgeon (who may be a Specialist or may be a Certificate holder/Advanced Practitioner), referral to a Specialist Centre such as ours, or referral to a multidisciplinary hospital. Owners often do not understand these distinctions and so they are reliant on their GP vet to explain the differences.

So what are the advantages of referral to a Specialist centre such as ours?

  1. Expertise and Experience. By seeking treatment from a Specialist, owners can be confident that their pet is being treated by a surgeon who has undergone three years of full-time postgraduate training in surgery and has been examined to the highest (Diploma) standard. This means that our surgical knowledge, our clinical decision-making and our surgical expertise have been assessed to a higher standard than certificate holders and Advanced Practitioners. 
  2. Specialist facilities. Our clinic has been designed for specialist surgery and has features you will not find in GP practice or many other referral centres. Our theatres have a HEPA-filtered ventilation system to ensure the air is ultra-clean, which is important to minimise the infection risk after orthopaedic surgery. We also have a CT scanner, intraoperative x-ray and calm and quiet wards.
  3. Advanced nursing and anaesthesia. Many of our nursing and tech team have come from some of the region’s biggest referral hospitals, and their expertise in managing referral patients compassionately and safely is second-to-none. Local nerve blocks are routine to ensure our patients wake up comfortably and we only use sevoflurane anaesthesia, which minimises airway irritation and ensures a quick recovery from anaesthesia. Ventilatory support with advanced anaesthetic monitoring is available.
  4. 24/7 availability. Our surgeons are always available in case an owner or a GP vet has a concern or a query with a case, whether this is at the weekend or at night. 
  5. Great value care. Because we are independent and only focused on orthopaedics, we are able to provide very competitive pricing. We know we are cheaper than the multidisciplinary centres and we do not think you will find a better value Specialist centre in the south east.

It’s important for GP vets to choose where they refer to carefully. GP vets tell me that a good referral can really bond an owner to their practice. If the owner and their pet have a good referral experience, then that owner will be incredibly grateful for the referral. Problems can arise, however, if the referral process is not transparent and I have sadly seen this lead to an erosion of trust between owners and their GP vets.

We do not know how broad the CMA review will be. They will certainly be looking at the influence of corporate groups on owner choice. From a referral perspective, they will be looking at whether corporate groups are promoting referrals to their own referral centres or to their own peripatetic (mobile) Certificate holders/Advanced Practitioners. Both are means of keeping revenue within the business and are not necessarily a problem as long as the process is transparent, prices are fair, and owners are made aware of all the options available, including those outside of the group. It will be interesting to see what the CMA can do if they do find an issue with the referral process, especially since this is an area in which the RCVS should be policing themselves. 

The CMA are encouraging pet owners, as well as those in the industry, to respond to their review. If you have any experiences you would like to share with the CMA there is a questionnaire that you can fill in here: https://www.gov.uk/cma-cases/veterinary-services-market-for-pets-review