The evolution of the veterinary profession in the UK – and Ireland

I’ve been writing about the changing veterinary profession for a long time: here is an article I wrote nine years ago for the Telegraph which predicted many of the changes we are now seeing.

This week, the UK veterinary profession is under the spotlight, following the Competition and Merger Authority’s (CMA) final review which was published yesterday. The audio track at the foot of this page is from an interview that I did on this review with Radio Scotland, but before listening to it, here’s the background information.

The CMA veterinary Review – a final report

After two years, interviewing many pet owners and vets, the Competition and Markets Authority concluded that a lack of information that helps people make informed decisions has led to weak competition and higher prices for veterinary care for pets. They have launched a package of measures that they hope will make the market more competitive, easier to navigate and more responsive to pet owners’ needs. The CMA had 56,000 responses to their call for feedback on vets – including 45,000 from the general public and 11,000 responses from those working in the veterinary industry, which equates to around a fifth of UK vets and veterinary nurses.

The changes in the veterinary clinic ownership model

The underlying story here is that forty years ago when I became a vet, all clinics were owned by individual vets, James Herriot style. But in the past twenty years, younger vets are not joining up as “partners” in the old way. Instead, they stay as employee vets, doing the job they love (being vets) and so when older vets get to retirement age, they need to sell the business to someone else, or close it down. So large vet groups started to buy up vet clinics, creating chains of vet clinics which are not always very clearly identifiable. There are six LVGs (Large Vet Groups): CVS, Medivet, Pets at Home, IVC, Linnaeus, and VetPartners. The latter three groups also have very extensive clinic ownership in Ireland, although this has not been widely publicised to date.

Corporate groups now own over 60% of UK veterinary practices, as well as nearly 75% of specialty clinics. These percentages are unknown for Ireland, but they are moving in the same direction.This has been driven by increased investment from private equity firms.This trend has completely changed the way the vet profession operates. There are no longer individual vets/owners making the business decisions in each clinic, as it was in the past. Now decisions and strategies are done in a more central, systematic, organised way. Concerns have been raised by some suggesting that sometimes there may be prioritisation of profits in corporate models, compared to the traditional independent, personalized care.

The CMA found that vet prices had risen at twice the rate of inflation (63% between 2016 and 2023). Rather than a price freeze, their response is a “transparency blitz”, focussing on forcing vet businesses to be much more up front about their prices .

Prescription Fee Caps

This is the headline-grabber. Pet owners can often buy prescription only medications for their pets cheaper online than at the local vet clinic, but they need a prescription from their local vet to be able to order this. Up till now, there has been no price control on the provision of a written prescription and some vets have charged £30 or more. The CMA has capped the fee for a written prescription at £21 for the first medicine and £12.50 for any additional ones. Over 70% of pet owners purchase long-term medication from their vet practice even though many could save £200 a year or more if they bought online. In Ireland, there are no widely available online pet pharmacies in the same way as the UK, so this is less relevant at the moment, but people do ask for written prescriptions, and each clinic charges for these according to their own choice: there are no rules and no cap.

Mandatory Price Lists

Practices must now publish “comprehensive” price lists online and in-surgery for standard services (consultations, diagnostics, etc.). Some vets already do this but the CMA found that less than 40% of practices had prices on their websites – and these tended to cover few services and are sometimes hard to find.

In Ireland, similar percentages probably apply to the publication of price lists, and there are no rules about whether or not vets have to do this.

Estimates

The CMA found that less than half of people received pricing information in advance of recent non-routine treatment. Only 29% of these were given price information in writing. Now, for any treatment expected to exceed £500, vets must provide a written estimate in advance and a fully itemised bill afterward. Again, many vets already do this, in the UK and in Ireland but it is not universal practice, and when a vet is under time and work pressure, it can be difficult to fit in the extra work involved in generating the estimate.

Ownership Disclosure

The CMA found that less than half of people using a large veterinary group knew that their practice was part of a chain. Now large groups will have to clearly state their ownership on signage and websites. No more “stealth” corporatisation; the public needs to know if they are in an independent or a chain. For me as a vet, this is the most welcome move: it has felt like some of the larger corporates have been deliberately disguising themselves, as if they are trying to hide their ownership from the public. They will no longer be able to do this, so people will know exactly who they are dealing with.

BBC Radio Scotland interview

In a recent interview, I shared my insights on the evolving veterinary profession in the UK, and you can listen below

The Evolution of Pet Care: From Limited Options to Human-Level Standards

One of the most striking changes in the veterinary field is the sheer breadth of care now available. Decades ago, treatment options for seriously ill pets were relatively limited. Today, we can offer medical and surgical interventions that rival human healthcare, including:

Advanced Diagnostics: Referrals for CT scans and complex imaging are now commonplace.

Specialized Surgery: Procedures like brain surgery are increasingly accessible for pets.

Family-Centric Care: Our relationship with pets has deepened, with many now considered integral family members. This shift in attitude drives the demand for the highest standard of care, regardless of the cost.

Understanding Rising Costs and Contextual Care

While these advancements are undeniably positive for animal welfare, they also contribute to the rising cost of veterinary services. As more sophisticated treatments become available, vet bills naturally increase. In response to this, the veterinary profession is increasingly embracing contextual veterinary care. This individualized approach involves:

• Active Listening: Vets work closely with owners to understand their specific needs and goals.
• Tailored Treatment Plans: Together, we develop plans that consider the animal’s condition, the owner’s financial situation, and their vision for their pet’s end-of-life care.
• Collaborative Decision-Making: Instead of a one-size-fits-all approach, we offer a range of options, empowering owners to make the best decision for their unique circumstances.

Transparency and the Changing Business Model

The interview also touched upon significant shifts in the business side of veterinary medicine. The traditional model of vet-owned practices is being replaced by corporate groups, which now own:

• Over 60% of UK veterinary practices.
• Nearly 75% of specialty referral clinics.

The CMA is addressing the need for greater transparency regarding this ownership. New regulations will require practices to clearly disclose if they are part of a larger group, ensuring pet owners are fully informed about who is providing their animal’s care.

The veterinary profession is at a crossroads, balancing incredible technological progress with the need for accessibility and transparency. By focusing on contextual care and clear communication, we can ensure that pets continue to receive the best possible care while supporting the owners who love them.