Comments OPINION
Introduction
The UK veterinary profession is at a pivotal point. Ongoing changes are being implemented to increase efficiency and there is a need for reinvigoration and for the maintenance of high-quality animal welfare and patient care. Also, at the time of writing, there is a Competition and Markets Authority( CMA) review underway.
Veterinary nurses( VNs) are crucial in every aspect but they are still underutilised. Introducing a veterinary nurse prescriber( VNP) role, divided into supplementary prescriber and independent prescriber, could be a muchneeded and transformative reform for the profession.
Taking inspiration from the successful implementation of nurse prescribers within the human healthcare profession [ 1 ] and adapting the role to fit within the veterinary profession could potentially increase practice efficiency, improve patient welfare, provide further career pathways for VNs and increase client satisfaction.
In this opinion piece, the author explores how a VNP role could be implemented, the differences between independent prescribers and supplementary prescribers, and how this collaborative approach between VNs and veterinary surgeons( VSs) could improve patient care and welfare while maintaining high clinical standards.
Background
The role of a prescribing nurse in human healthcare was first lobbied for in 1986 for a small list of community nurses [ 2 ]. The role has since evolved to include two types of prescribing nurses: independent prescribers( IPs) and supplementary prescribers( SPs).
An IP can perform a full clinical assessment, diagnose and prescribe any licensed medication as long as it is within their scope of competency, which allows the IP to work independently. To become an IP, a registered nurse must complete a master ' s-level post-registration certificate set out by the Nursing and Midwifery Council. As an example, an IP in general practice can diagnose and treat a chest infection. This may require further work-up or may simply require medication to be prescribed; an IP can do all of these tasks. However, they must make sure anything they do does not exceed their scope of practice [ 3 ]; for example, an IP nurse trained in diabetes may not diagnose a chest infection if they have not been trained appropriately.
An SP holds a role comparable to that of an IP, yet there are important distinctions; notably, an SP is not authorised to independently diagnose conditions or prescribe medication. SPs must follow a clinical management plan drawn up by the primary doctor. SPs can adjust and change medication if it is within the doctor ' s predetermined management plan.
Relevant legislation
A recent report by the CMA briefly mentioned the potential for a VNP role within the veterinary profession [ 4 ]. The CMA noted that a reform to legislation would need to be implemented for the introduction of this role.
Under the legislation currently governing the profession, the Veterinary Surgeons Act 1966( VSA) and the Veterinary Medicines Regulations 2013( VMR), VNs are not able to independently make diagnoses or prescribe medications.
Under Schedule 3 of the VSA( as amended in 2002), a VS can delegate some tasks to an RVN if certain conditions are complied with, such as minor surgery that does not involve entry to a body cavity. However, the diagnosis of a condition can be made only by a VS.
Under the VMR, RVNs cannot prescribe any form of medication; this task is reserved for VSs, pharmacists and suitably qualified persons( SQPs).
If a VNP role were to be introduced, it would be sensible to introduce a supplementary veterinary nurse prescriber( SVNP) role first, followed by an independent veterinary nurse prescriber( IVNP) role if the SVNP role proves successful. This two-stage approach would allow the gradual development of the role and enable data to be collected to assess the success of its implementation. It would also ensure that RVNs were eased into a prescribing role while still working under the direction of a VS as the primary caregiver.
The SVNP role would not include minor diagnoses, as the RVN would be able to prescribe only within the VS ' s care plan. This may require the amendment of the VMR only, initially, to allow RVNs who have completed formal training to prescribe POM-V medicines( prescription-only medicines – veterinarian). There would not necessarily need to be an immediate reform of the VSA or new legislation introduced until the IVNP role was proposed.
If an IVNP role were to be introduced, through a reform of the VSA or new legislation, IVNPs could also be allowed to perform minor diagnoses. Similar to human IPs, they could prescribe and diagnose within their scope of training and competency, as set out by regulatory bodies within the veterinary field.
Adapting IP and SP roles to the veterinary profession
It is important to note that every patient considered in this opinion piece would need to have undergone a clinical examination by a VS within the previous 6 – 12 months( depending on the condition) before a VNP could be utilised in their care. This would ensure that
Volume 40( 5) • October 2025
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