Statement
The BSAVA recommends that veterinary surgeons discuss clearly the relevant options for referral for each case on its individual merits, and clearly inform clients of the qualifications and level of expertise of the professionals, paraprofessionals, and their respective centres to whom they intend to refer. Veterinary surgeons should also be clear regarding any on-going case responsibility particularly where clients are directed to non-veterinary qualified individuals. In addition, transparency regarding ownership of the referral practice should be conveyed to the client, for example, if the referral centre is within the same business group as the first opinion practice or not.
Date
June 2025
Background information
Veterinary surgeons may advise referral for a number of reasons, including when a case or treatment option is outside their area of expertise, in order to access specific interventions not available to the individual, or to access a level of care not available in the clinic, for example ICU. These referrals may be to other colleagues within the veterinarian’s place of work or to an individual/centre external to the place of work. This process is bilateral with requirements for both the referring and receiving veterinarian to fulfil. Further guidance can be found here.
Veterinary surgeons sometimes have the need or desire to involve paraprofessionals in the care of their small animal patients. Most commonly this might be for behavioural issues or physiotherapy/rehabilitation. However, in these areas the range of qualifications and services on offer may be confusing. It is important to be clear about the qualifications and experience of the person accepting referrals.
When discussing and arranging referral (to veterinary professionals or para-professionals) the veterinary surgeon must take note of the RCVS Code of Professional Conduct to consider all the relevant factors, which might include:
- the ability and experience of the referral veterinary surgeon / para-professional
- the location of the service
- the urgency of treatment
- the circumstances of the owner, including the existence of and any limitations of insurance.
Once referral is agreed, the referring veterinary surgeon must ensure all relevant clinical information such as clinical history, diagnostic imaging, laboratory tests etc are promptly made available to the receiving veterinary surgeon.
Veterinary surgeons should be prepared to justify their referral decisions and should record the reasons for their decisions in the clinical notes.
Referral for behaviour or training
The management of behavioural problems in animals does not count as an act of veterinary surgery unless it involves diagnosis or the use of prescription only medicines. Whilst there is no formal requirement to insist upon the involvement of a veterinary surgeon before animal behaviour work is carried out, many clinical animal behaviourists (CAB) and all certified clinical animal behaviourists (CCAB) will work on referrals from veterinary surgeons in case an underlying disease or injury is causing the unwanted behaviour. There are a growing number of vets working in the field of animal behaviour. A list of RCVS recognised specialists in Veterinary Behavioural Medicine can be accessed through their website.
There are currently no legally defined standards for titles or qualifications commonly employed by those offering behaviour and training services. As a result, some individuals may be practising and calling themselves animal or canine behaviourists, psychologists or trainers, without having formal, recognised training, qualifications or relevant experience. This situation can prove confusing and challenging for owners and veterinary professionals.
In order to make an informed decision about the options for behavioural referral, it may be helpful to consult the lists of membership organisations in order to clarify training, experience requirements, and identify those whose members:
- must adhere to a code of conduct
- commit to ongoing CPD attendance
- hold appropriate professional indemnity and public liability insurance,
- and have a complaints procedure.
The Animal Behaviour and Training Council (ABTC) holds lists of practitioners from membership organisations who meet standards of knowledge, understanding and practice.
Physical Therapies
The Veterinary Surgeons (Exemptions) Orders 1962 and 2015 allow for the treatment of animals by physiotherapy, provided that the animal has first been seen by a veterinary surgeon who has diagnosed the condition and decided that it should be treated by physiotherapy under his/her direction. For the purpose of this legislation ‘physiotherapy’ has been interpreted as including all kinds of manipulative therapy including osteopathy and chiropractic (RCVS Supporting guidance 19.19-20).
The term physiotherapist, physical therapist, chiropractor and osteopath are protected titles only in the field of human treatment. It is therefore important to check the qualifications, training, regulation and professional indemnity insurance of individuals advertising themselves as animal/canine/veterinary physiotherapists, physical therapists, chiropractors and osteopaths. Pet insurance providers may also make stipulations about the qualifications of paraprofessionals if they are asked to pay for treatment.
Referral for physiotherapy, Osteopathic Therapy and Chiropractic Therapy
Referral to individuals for musculoskeletal therapies (broadly termed physiotherapy) is often required or requested. In this instance the animal must have been examined by a veterinary surgeon and they have prescribed physiotherapy. This delegation should be to an individual who is believed to be suitably qualified and registered with an appropriate governing body. As the RCVS does not regulate musculoskeletal therapists, it cannot recommend specific voluntary registers.
Related statements
Further Information
RCVS Treatment of animals by unqualified persons
There are a number of paraprofessional membership bodies and associations for behaviour, training and physical therapies. The following information is intended to provide a summary and does not imply endorsement. Veterinary professionals should satisfy themselves in respect of the qualifications and professional status of a practitioner before referring.
Behaviour & Training
The following organisations meet the role criteria for trainers and behaviourists set by the Animal Behaviour and Training Council (ABTC):
- Association of Pet Behaviour Counsellors (APBC)
- The Association for the Study of Animal Behaviour (ASAB)
- Fellowship of Animal Behaviour Clinicians (FABC)
- Association of Pet Dog Trainers (APDT), UK
- The British and Irish Association of Zoos and Aquariums (BIAZA)
- Gundog Trainers Academy
- International Association of Animal Behaviour Consultants (IAABC)
- Karen Pryor Academy
- National Institute for Canine Ethics
- Professional Association of Canine Trainers (PACT)
- Puppy School
- The Canine Behaviour and Training Society (TCBTS)
In addition, the British Veterinary Behaviour Association (BVBA) is a membership organisation for those wishing to learn more about veterinary behavioural medicine.
Physiotherapy
- Association of Chartered Physiotherapists in Animal Therapy (ACPAT)
- National Association of Veterinary Physiotherapists (NAVP)
- Institute of Registered Veterinary and Animal Physiotherapists (IRVAP)
- International Association of Animal Therapists (IAAT)
- Register of Animal Musculoskeletal Practitioners (RAMP)
Hydrotherapy
- Canine Hydrotherapy Association (CHA)
- National Association of Registered Canine Hydrotherapists (NARCH)
Rehabilitation
Chiropractic
- Royal College of Chiropractors Animal Faculty
- McTimoney Animal Association (MAA)
- British Veterinary Chiropractic Association
- International Veterinary Chiropractic Association
Osteopathy
Advanced practitioners and specialists can also be searched for on the RCVS registration list:
Provenance
Reviewed by members of BSAVA Scientific Committee (Rachel Casey, Gillian Diesel, Ben Garland, Macauly Gatenby, Melanie Hezzell, Michael Rampersad, James Warland) 2025