Definition of a Veterinary Practice / Veterinary Business (working document)

transparency statement this document was prepared with the assistance of ai tools to support drafting and refinement all content has been reviewed, edited, and is subject to vet council staff verification and approval before publication part 1 proposed glossary definition veterinary practice (also referred to as veterinary business) a veterinary practice is a business or enterprise through which one or more veterinarians provide veterinary services to clients it may be operated as a sole trader, partnership, limited liability company, or other business structure a veterinary practice includes any physical premises, mobile service, or digital/remote service delivery model through which veterinary services are offered the terms “veterinarian” and “veterinary” are protected under the veterinarians act 2005 and must only be used in association with practising veterinarians a veterinary practice must have veterinarians working there to use the title the obligations of a veterinary practice are carried by the veterinarians who own, operate, or provide services through it where a practice is owned or operated by a non veterinarian, the veterinarians providing services through that practice retain their individual professional obligations under the code in full, and those obligations are not diminished by the structure of the business or by any contractual or employment arrangement the default position the obligations of a general veterinary practitioner apply by default to all veterinarians in clinical practice these include the obligation to make 24 hour emergency care available for clients’ animals a practice remains a general practice regardless of the species or type of animal it treats, the geographic area it serves, the hours during which it operates, or the range of conditions it manages the specific and limited range of veterinary services framework sections 5 10–5 13 of the code establish the specific and limited range of veterinary services framework this framework permits a practice to restrict the scope of services it offers to clients and to limit its emergency care obligations proportionately it is important to understand what this framework is and what it is not the framework grants a defined dispensation — a restricted range of services and a corresponding restriction on emergency care obligations — in exchange for a defined and inseparable compensating obligation ensuring that each client has access to continuing and comprehensive primary veterinary care, including 24 hour emergency care, through a general veterinary practitioner this privilege cannot be claimed without the compensating obligation being fully discharged the framework is available only where the totality of services offered to clients through the practice meets all conditions set out in sections 5 10–5 13 a practice that offers general veterinary services to any of its clients does not meet those conditions and is a general practice the determining question is not the number of veterinarians in the practice, the individual veterinarian’s particular role within the practice, or the hours it operates, but whether all services offered to clients through the business fall within the defined scope how the framework applies the critical distinction the specific and limited framework applies at the level of the service the practice offers to clients it does not apply at the level of an individual veterinarian’s clinical role or skills within a practice this distinction is fundamental • where a practice offers only a specific and limited range of veterinary services — and all conditions in sections 5 10–5 13 are met — the practice and all veterinarians within it may limit their emergency care obligations to those proportionate to the services provided, as set out in those sections a practice may only operate under the advanced services framework if they offer a single recognised service across their client base a practice that offers more than one type of advanced service — whether to the same clients or to different clients — does not meet this requirement, and gvp rules apply to the full scope of their practice • where a practice offers general veterinary services alongside specific or advanced veterinary services — whether through the same or different veterinarians — the practice is a general practice the full obligations of a general veterinary practitioner apply to the practice as a whole a veterinarian within that practice whose individual clinical work is focused or advanced does not, on that basis, operate outside the general veterinary practitioner framework such a veterinarian may describe themselves as having a particular interest or area of clinical focus, consistent with the vet council’s policy on use of titles (or as a specialist if they are a registered specialist), but that description does not affect emergency care and other general veterinary practitioner obligations • where a practice provides gvp services to some clients and specific and limited services to others — a combined service offering — the practice is a general practice in respect of its gvp clients and must meet the full gvp obligations for those clients and includes the provision of 24/7 emergency care the specific and limited framework applies only to the clients receiving that defined service, subject to all conditions of sections 5 10–5 13 being met this arrangement is permitted but carries the following additional obligations ◦ there must be explicit written terms of service with each client that clearly identifies whether they are being provided with gvp services or advanced services ◦ for advanced services clients the veterinarian must confirm, before providing the service, that the client has a gvp and by implication access to 24/7 emergency care, and obtain consent to share records ◦ for gvp clients the veterinarian must be able to demonstrate that adequate emergency care is available for those clients at all times, including when the veterinarian is unavailable because they are providing advanced services to remote clients this distinction reflects the purpose of the framework the restricted emergency obligations available under sections 5 10–5 13 are justified only because the practice has ensured that its clients have access to comprehensive primary care elsewhere where a practice is also a general practice for some or all of its clients, those clients already have that comprehensive care through the practice itself the justification for restricted emergency obligations does not arise annual practising certificate declaration veterinarians with skills that meet the advanced services criteria in section 5 12 will be required to declare this when completing their annual practising certificate only if they intend to work in a practice that restricts its services to a specific and limited range of veterinary services the declaration is triggered by the intended practice model, not by the possession of advanced skills alone a veterinarian with equivalent skills working within a general practice has no obligation to make this declaration practice categories for the purposes of these standards, veterinary practices are understood to fall into one of the following categories, based on the services they offer to clients as a whole • general practice — a practice in which one or more veterinarians act as general veterinary practitioners, providing continuing and comprehensive primary veterinary care for animals under their care this includes any practice that provides a mix of general and specific or advanced veterinary services, or that restricts its services by species or type of animal while providing the full range of veterinary care for those animals it also includes practices that operate during non standard hours — such as urgent care clinics such practices are general practices for regulatory purposes and must have formal, documented arrangements to ensure their clients can access emergency care during the hours they are not open • specific and limited practice — a practice in which the veterinarian(s) in that practice provide a specific and limited range of veterinary services within the framework set out in sections 5 10–5 13 of the code the three sub categories within this framework — unique services, advanced services, and consultancy services — carry distinct obligations regarding rvm authorisation, gvp communication, and emergency care registered specialists providing specialist referral services fall within the advanced services sub category (section 5 12) ³ • dedicated after hours emergency clinic — a practice that provides emergency care services continuously throughout the after hours period, operating on behalf of general veterinary practices so that their clients can access emergency care when their gvp practice is closed unlike urgent care clinics that operate for only part of the after hours period, a dedicated after hours emergency clinic maintains continuous coverage throughout its operating period and must have documented protocols for continuity of care, gvp communication, and handover when it closes a single business entity may operate across more than one of these categories where this is the case, the obligations attaching to each category of service apply to the relevant services delivered part 1a veterinarian roles and their regulatory significance veterinarians practise in a variety of roles and with varying levels of clinical specialisation understanding how these roles relate to the regulatory framework — particularly in relation to emergency care obligations and the specific and limited range of veterinary services framework — is important for both veterinarians and their practices the following categories describe the principal roles relevant to these standards general veterinary practitioner (gvp) a general veterinary practitioner is the predominant veterinarian who a client chooses to provide the continuing and comprehensive primary veterinary care requirements for an animal or group of animals ⁴ this is the default role for all veterinarians in clinical practice, regardless of the species or type of animal they treat, the geographic area they serve, or the hours during which they practise all gvp obligations under the code apply, including the obligation to make 24 hour emergency care available for clients’ animals veterinarian with a special interest a veterinarian with a special interest is a veterinarian practising in general practice who has developed advanced skills, knowledge, or experience in a focused area of veterinary medicine or surgery — through postgraduate study, extended clinical experience, or both — at a level that may not meet the requirements for registration as a specialist but that is recognised by peers as being above the standard expected of a general practitioner a veterinarian with a special interest continues to practise as a general veterinary practitioner and may deliver those advanced services within that context their advanced skills do not in themselves alter their emergency care obligations or those of their practice, and do not require any declaration at annual practising certificate a veterinarian with advanced skills is not required to operate within the specific and limited range of veterinary services framework they may continue as a gvp and deliver advanced services without restriction it is only where the practice chooses to access the dispensation of restricted emergency obligations under the specific and limited framework that the conditions and compensating obligations of that framework arise a veterinarian with a special interest may describe themselves as having a particular interest or area of clinical focus, consistent with the vet council’s policy on use of titles ⁵ they must not describe themselves as or imply they are a specialist unless they hold registration in the relevant veterinary specialty veterinarian providing a specific and limited range of veterinary services a veterinarian providing a specific and limited range of veterinary services works within a practice where the totality of services offered to clients through that business falls within the specific and limited range of veterinary services framework in accordance with sections 5 10–5 13 of the code the framework is available to any veterinarian with the qualifying skills — it is not a restriction but a dispensation, available by choice a veterinarian or practice that meets the conditions may access the corresponding limitation on emergency care obligations one that does not, or chooses not to, continues as a general practice with all associated obligations the determining question is whether the totality of services offered to clients through the business falls within the defined scope of the framework this applies equally to a sole practitioner practice and a multi veterinarian practice a sole practitioner who offers only specific and limited services to all clients meets the conditions; a sole practitioner who also provides general veterinary services to some clients does not, and remains a gvp for all purposes where all conditions of the framework are met, the practice may limit its emergency care obligations to those proportionate to the services provided, provided the inseparable compensating obligation is fully discharged ensuring each client has access to continuing and comprehensive primary veterinary care, including 24 hour emergency care, through a general veterinary practitioner specialist a specialist is a veterinarian who holds registration in a veterinary specialty under the veterinarians act 2005 ⁶ registration requires qualifications assessed by the vet council as meeting the requirements for specialist registration in the relevant specialty it is an offence to use the title “specialist” or imply specialist status if you are not a registered specialist specialists providing specialist referral services typically operate in a way that naturally satisfies the conditions of the specific and limited range of veterinary services framework — and in particular its central compensating obligation this is because specialist practice is ordinarily conducted on a gvp to specialist referral basis the referring gvp retains primary responsibility for the client’s animal, including responsibility for continuity of care and emergency cover outside the specialist’s scope the compensating obligation — that clients have access to continuing and comprehensive primary veterinary care through a gvp — is therefore met through the referral relationship itself where specialists operate a shared care model with referring practices, the same principle applies this alignment between specialist practice and the advanced services sub category of the framework (section 5 12) reflects the purpose of both advanced, focused clinical services delivered on a referral basis, with the continuity of primary care responsibility retained by the referring gvp where a registered specialist is employed within a general practice — for example, as a specialist surgeon or internist within a mixed referral and general practice — the practice remains a general practice the full obligations of a general veterinary practitioner apply to that practice, including 24 hour emergency care obligations the specialist’s registration does not modify the practice’s category or obligations part 2 species and type restriction a veterinary practice may, by choice, restrict its services to particular species this is a legitimate and common feature of veterinary practice in new zealand — for example, a practice that sees only companion animals, or one that works exclusively with horses or production animals a species restriction of this kind reflects the competence of the veterinarians within the practice and is consistent with the code’s requirement that veterinarians practise within their sphere of competence ¹ restricting services to particular species does not, however, alter the category of practice or reduce the obligations attached to it a practice that provides continuing and comprehensive primary veterinary care for animals of a particular species — including accepting animals into its care and taking responsibility for their ongoing health and welfare — is a general practice in respect of those species the full obligations of a general veterinary practitioner apply, including the obligation to make emergency care available at all times for animals under the practice’s care the same principle applies where a practice restricts its services to a particular type or class of animal within a species a practice that sees only greyhounds, or only sport horses, is restricting by animal type — not by the nature or scope of the veterinary services it offers provided it is providing continuing and comprehensive primary veterinary care for those animals, it remains a general practice with the full obligations that flow from that the defining question is not which animals a practice treats, but what it does for them a practice that acts as the primary veterinary care provider for its clients’ animals — regardless of species or type — is a general practice a species or type restriction does not in itself constitute a specific and limited range of veterinary services as defined in sections 5 10–5 13 of the code a practice that restricts to companion animals, or to greyhounds, but provides the full range of veterinary services to those animals, remains a general practice where a practice’s species or type restriction is relevant to emergency care, the practice must ensure that its emergency service arrangements are adequate and appropriate for the animals it treats and the clients it serves practices should communicate clearly to clients any species or types they do not treat, so that clients whose animals fall outside that scope can establish a relationship with an appropriate practice when a veterinary emergency arises involving a species or type outside a veterinarian’s competence or usual scope, the veterinarian is expected to assist the caller to access an appropriate service ² part 3 accompanying context note for inclusion in the statement on veterinary emergency care or associated guidance documents the professional obligations described in the statement on veterinary emergency care attach to veterinarians as individual registrants however, in practice, many of these obligations — in particular those relating to emergency care arrangements, client communication, record keeping, and staffing — are most effectively discharged at the level of the veterinary practice as an organised business entity where the statement refers to obligations of a “practice” or “veterinary business”, this means the obligation is one that must be satisfied by the veterinarians who carry professional responsibility within that practice in a sole practice, this is the sole veterinarian in a multi veterinarian practice, all veterinarians carrying clinical responsibility share accountability for ensuring that the practice meets its obligations, with veterinarians in ownership or management roles bearing particular responsibility for the systems and arrangements in place the default position is that a practice is a general practice, with the full obligations that flow from that this is so regardless of the species or type of animal treated, the geographic area served, the range of conditions managed, or the hours during which the practice operates a practice that provides services only during certain hours — such as an urgent care clinic that closes at midnight — is a general practice and must have formal, documented arrangements in place to ensure its clients can access emergency care during the hours it is not open the code recognises only one framework that permits a departure from those default obligations the specific and limited range of veterinary services framework in sections 5 10–5 13 that framework is available only where the totality of services offered to clients through the business falls within the defined scope, and it carries an inseparable compensating obligation to ensure each client has access to continuing and comprehensive primary veterinary care elsewhere a practice that does not fall clearly and fully within that framework should proceed on the basis that the obligations of a general veterinary practitioner apply in full a practice may restrict its services by species or by type or class of animal this reflects competence and is entirely appropriate, provided clients are informed and emergency care obligations are met in respect of the animals the practice does treat a species or type restriction does not alter the category of the practice or the obligations that attach to it the relationship between individual obligations and practice level behaviour the veterinarians act 2005 regulates individual veterinarians the vet council’s jurisdiction attaches to registered individuals, not to veterinary businesses or the corporate entities through which veterinary services may be delivered where these standards speak of obligations on a “practice” or “veterinary business”, this reflects the practical reality that many professional obligations are most effectively discharged through organised business systems — but the legal obligation itself rests on the veterinarians within that practice this means that the professional standards set by the vet council reach practice level behaviour through the individual veterinarian a veterinarian who owns or manages a practice carries a particular responsibility for ensuring that the systems, agreements, and policies of that practice enable compliance with professional standards an employed veterinarian who has limited influence over business decisions is not absolved of professional responsibility, but the vet council recognises that the degree of responsibility is not uniform across all roles within a practice the expectation is that veterinarians will use whatever capacity they have to ensure the practices in which they work meet the required standards, and will raise concerns through appropriate channels — including with the vet council — where they believe a practice is not doing so where a practice is owned or controlled by a person or entity that is not a registered veterinarian, the veterinarians providing services through that practice must not allow commercial or organisational pressures to compromise their individual professional obligations the structure of the business does not alter those obligations footnotes 1 code of professional conduct, section 5 3 (competence); see also guidance emergency services and competence (vet council, 2021) 2 code of professional conduct, ss 5 7, 5 8; guidance emergency services and competence (vet council, 2021) 3 veterinarians act 2005, s 14 (specialist registration) the operative obligations for how a registered specialist practises in a specific and limited context flow from section 5 12 of the code of professional conduct (advanced services) 4 code of professional conduct, glossary general veterinary practitioner 5 vet council policy on use of titles veterinarians must not describe themselves as or imply they are a specialist unless they are registered in the veterinary specialty concerned veterinarians act 2005, as reflected in code s 7 1 1(b)(iv) 6 veterinarians act 2005, s 14 the vet council’s policy on qualifications and post nominal titles sets out requirements for use of specialist designations