Dr. Sue Paterson

Royal College of Veterinary Surgeons photo

Royal College of Veterinary Surgeons Junior Vice President Dr. Sue Paterson chaired the regulatory body's Environment & Sustainability Working Party and represents it on the U.K. Health Alliance on Climate Change, a coalition of British health organizations.

The United Kingdom's veterinary regulator is introducing sustainability requirements to its code of conduct and accreditation schemes as it takes a more active stance on environmental issues than many of its counterparts overseas.

Starting June 1, the Royal College of Veterinary Surgeons will enact a raft of environmental sustainability measures — most of them voluntary, some of them mandatory.

The changes are being made through the RCVS's Professional Standards Scheme (PSS), an accreditation program for veterinary practices that offers levels ranging from basic "core" standards to more rigorous "general practice" and "hospital" standards.

Although participating in the PSS itself is optional, the RCVS's code of professional conduct requires that all veterinarians in the U.K. must practice to at least the "core" standards of the PSS.

The new sustainability measures include two such core requirements: One is that veterinary practices must have their own written sustainability policy. The other is that they must be able to demonstrate that they are using parasiticides, such as spot-on flea and tick treatments, responsibly.

The latter requirement comes in the wake of research in the U.K. and elsewhere that indicates spot-on products are polluting waterways after being washed down drains when pets are bathed, when owners wash their hands and when pets swim in nature.

Eight requirements pertaining to sustainability have been added to the voluntary "general practice" level of PSS accreditation. These include appointing a "sustainability champion or sustainability team" in the practice, establishing a travel policy to reduce staff and client mileage, undertaking regular waste surveys, and employing techniques to minimize use of anesthetic gases.

Around two-thirds of practices in the U.K. are members of the PSS, which the RCVS says "aims to promote and maintain the highest standards of veterinary care." Practices can use PSS accreditation to distinguish themselves from the competition. Official RCVS-branded badges and certificates proving various levels of PSS accreditation, for instance, can be displayed in marketing materials or physically in buildings.

"As a profession, among both nurses and vets, there's already been a huge drive to be sustainable," Dr. Sue Paterson, the RCVS's junior vice president, said in an interview. "What we needed was more guidance as to how people could actually do it. So, for me, this is about providing the guidance, the resource and the impetus for vets and vet nurses to work in a more sustainable way."

RCVS taking a 'collaborative' approach to assessment

Adherence to PSS requirements is assessed upon joining and then once every four years. Assessors are either veterinarians or registered veterinary nurses who have been RCVS members for at least five years and approved as having suitable experience for undertaking assessments.

Veterinary practices that aren't PSS members are subject to inspections no more than every four years by the U.K. government's Veterinary Medicines Directorate to ensure they comply with rules around the prescribing, labeling, storage and supply of medicines. Membership of the PSS is recognized by the VMD, so practices that have joined the PSS don't require VMD inspections.

Although the two "core" sustainability requirements — having a sustainability policy and using parasiticides responsibly — will be mandatory for all veterinary practices in the U.K., failure to meet them is unlikely to result in harsh consquences.

"If there was a serious fault in meeting the core PSS standards, which are part of our code, then we'd expect them to put that right pretty quickly," Paterson said. "But I can't ever see anyone ever losing their right to practice. You'd have to be pretty dreadful for that to happen."

Practices undergoing PSS assessments get a report handed back four to six weeks later and, if there is a fault, are given time to make amends. "It's very much a partnership between the practice and the standards assessors," Paterson said. "This is all about working collaboratively so they can improve. We're not there to fail people. We're there to work with them."

Moreover, the two core requirements aren't especially prescriptive in nature. In order to have a valid written sustainability policy, for instance, the practice must "show senior commitment," such as having it signed by a practice manager; make it available to view, such as on a website; and share it with all team members. Exactly what must be in the sustainability policy isn't specified.

Similarly, the parasiticide requirement states a practice must be able to demonstrate that when using such products, "it does so responsibly, and is accountable for the choices made in such use." To achieve that, the RCVS advises, assessors will want to see evidence such as a parasiticides policy, waiting-room poster and meeting notes where parasiticides have been discussed by staff. What level of parasiticide use would be considered irresponsible isn't spelled out.

"There has to be latitude because we're looking at different parts of the country; we're looking at different species," Paterson said, noting the PSS applies to companion animals, production animals and equine medicine. "And practices are different in the way they work, the way that they are populated, the clients that they serve — and also the challenges they face from an environmental perspective."

Offering an example, Paterson notes that lungworm — a nematode worm that infects the lungs — is abundant in southern England but absent in the north of Scotland. "We're being hugely flexible with all these things," she said.

Sustainability requirements mostly absent in US, Canada, Australia

Still, veterinarians in the U.K. are obliged to pursue sustainability goals more vigorously than their colleagues in many other countries.

In the U.S. and Canada, sustainability requirements mandated by state or provincial veterinary boards are limited at most. For instance, the College of Veterinarians of Ontario's facility accreditation standards, which are mandatory in the Canadian province, require scavenging systems for waste anesthetic gas, and expectations for the appropriate disposal of expired drugs only.

Sustainability requirements aren't mentioned in the American Veterinary Medical Association's or the Canadian Veterinary Medical Association's respective principles of veterinary medical ethics. The AVMA and CVMA publish policy positions on sustainability issues, such as climate change, though these provide guidance only and tend to be broad and conceptual.

"The AVMA's principles of veterinary medical ethics focuses on interactions among veterinarians, patients, and clients, and expectations thereof, and isn’t really where we would address sustainability/green practices," AVMA spokesperson Michael San Filippo said. The AVMA, he added, has policy positions on a range of topics related to sustainability, also including regulation of veterinary medical waste, lead, wildlife conservation, integrated pest management and extractive industries such as mining. The association also offers advice for practices that want to become more sustainable.

"In addition, one of the Veterinary Information Forum topics to be discussed during the AVMA House of Delegates summer session at this year’s AVMA Convention is 'Sustainability in veterinary medicine: the greening of veterinary workplaces,' " San Filippo said.

The CVMA, for its part, told the VIN News Service that it is developing a Green Practice Initiative that will offer guidance to Canadian veterinarians on sustainability, pending CVMA Council approval. A working group formed to develop the initiative is doing a training course — Carbon Literacy for Veterinarians — offered by Vet Sustain, a U.K.-based volunteer group founded by veterinarians, CVMA communications manager Lori Ahronson said. Participation in the Green Practice Initiative is expected to be voluntary, she added.

Jan Robinson, the College of Veterinarians of Ontario's chief executive, said its leadership council's strategic plan includes promoting the importance of One Health — the understanding that the health of humans, other animals and the environment are interconnected. "Although there aren't strategic priorities focused on the environment this year, our current work in this area supports a healthy environment, with focus on drug stewardship, identification of One Health opportunities with our partners and support for animal welfare during emergency situations," Robinson said.

In Australia, sustainability requirements aren't mandated or encouraged by state veterinary boards or the Australian Veterinary Association's code of conduct. The AVA, though, also has overriding policy positions on various environmental issues, including climate change. A voluntary program in Australia, the Accredited Veterinary Hospital Scheme, doesn't include sustainability measures.

The AVA is developing a new policy "in the area of sustainablity," AVA spokesperson Dr. Cristy Secomb told VIN News, without elaborating. "The policy is in the final stages of consultation before it goes to a vote as per our internal processes. The outcome of that will then dictate how quickly it will be ratified by the board."

Attitudes in the veterinary profession on the importance of pursuing sustainability goals can vary from practitioner to practitioner. On discussion boards of the Veterinary Information Network, an online community for the profession and parent of VIN News, some veterinarians endorse being mindful of environmental stewardship. Others note that the veterinary sector's impact on the environment is relatively small compared with that of other sectors, such as human medicine or energy.

Still, as the potential effects of climate change become more apparent, greater attention is being paid to how practitioners can reduce their carbon footprints. For instance, Mars Inc., the world's largest employer of veterinarians, has introduced moves encouraging staff to limit their use of inhaled anesthetics, which are disproportionately potent greenhouse gases.

For her part, the RCVS's Paterson said the vast majority of veterinarians in the U.K. appear to back sustainability measures. She cited a survey of 430 practitioners conducted in 2021 by the British Veterinary Association that found 97% considered environmental sustainability to be "quite important" or "very important."

"This is all about helping the profession to be sustainable rather than beating them to be sustainable," she said. "We're pushing at an open door. People want to do this."