DOI
https://doi.org/10.18849/ve.v11i2.752Abstract
One-sentence summary:
This paper reports on the perceived barriers to the delivery of contextualised care in UK small animal veterinary practice.
Abstract:
Objective: To identify the main barriers to the delivery of contextualised care in UK small animal veterinary practice, and to understand how these are experienced in practice.
Background: The term contextualised care was introduced in the veterinary context in a published article by members of Veterinary Humanities UK. Although the term has been widely adopted there has been no explicit research into contextualised care in practice.
Evidentiary value: This paper presents the first empirical evidence using quantitative and qualitative data on the barriers to contextualised care as perceived by over 400 veterinary professionals and over 700 dog and cat owners. This evidence should help veterinary teams to identify potential barriers to the delivery of contextualised care.
Methods: The study used a mixed methods approach analysing data from questionnaires, interviews, and focus groups.
Results: The most frequently reported barriers related to lack of continuity of care and financial constraints, but the research also found that fear of regulatory scrutiny, missed or incorrect diagnoses, and client complaints could act as a barrier to adapting care to the individual animal, owner, and context. The study found some variation in the barriers encountered based on experience, role, and practice type.
Conclusion: Overcoming the barriers to contextualised care will require support at all levels, including from professional bodies, educators, and those with leadership positions in veterinary practice.
Application: This research should help veterinary teams to overcome potential barriers to the delivery of contextualised care.
References
Armitage-Chan, E. & May, S.A. (2018). Identity, environment and mental wellbeing in the veterinary profession. Veterinary Record. 183(2), 68. DOI: https://doi.org/10.1136/vr.104724
Assing Hvidt, E., Lykkegaard, J., Pedersen, L.B., Pedersen, K.M., Munck, A. & Andersen, M.K. (2017). How is defensive medicine understood and experienced in a primary care setting? A qualitative focus group study among Danish general practitioners. BMJ Open. 7(12), e019851. DOI: https://doi.org/10.1136/bmjopen-2017-019851
Belshaw, Z., Brand, C.L., O’Neill, D.G. & Packer, R.M.A. (2025). More than just one man and his dog: The many impacts of puppy acquisition on the mental health of families including children in the UK. PLOS One. 20(9), e0331179. DOI: https://doi.org/10.1371/journal.pone.0331179
Brown, B.R. (2018). The Dimensions of Pet-Owner Loyalty and the Relationship with Communication, Trust, Commitment and Perceived Value. Veterinary Sciences. 5(4), 95. DOI: https://doi.org/10.3390/vetsci5040095
Bruch, J.D., Foot, C., Singh, Y., Song, Z., Polsky, D. & Zhu, J.M. (2023). Workforce Composition In Private Equity–Acquired Versus Non–Private Equity–Acquired Physician Practices. Health Affairs. 42(1), 121–129. DOI: https://doi.org/10.1377/hlthaff.2022.00308
Cabana, M.D. & Jee, S.H. (2004). Does continuity of care improve patient outcomes?. The Journal of Family Practice.
CMA. (2024). Veterinary Services for Household Pets in the UK: Consultation on proposed market investigation reference, [online]. Available at: https://assets.publishing.service.gov.uk/media/65eee4015b6524420bf21a93/Veterinary_Services_for_Household_Pets_in_the_UK_-_Consultation_on_proposed_market_investigation_reference.pdf [Accessed: 20 January 2026].
Coe, J.B., Adams, C.L. & Bonnett, B.N. (2007). A focus group study of veterinarians’ and pet owners’ perceptions of the monetary aspects of veterinary care. Journal of the American Veterinary Medical Association. 231(10), 1510–1518. DOI: https://doi.org/10.2460/javma.231.10.1510
Coe, J.B., Adams, C.L. & Bonnett, B.N. (2009). Prevalence and nature of cost discussions during clinical appointments in companion animal practice. Journal of the American Veterinary Medical Association. 234(11), 1418–1424. DOI: https://doi.org/10.2460/javma.234.11.1418
Corr, S.A., Lund, T.B. & Springer, S.. (2024). Cat and dog owners’ expectations and attitudes towards advanced veterinary care (AVC) in the UK, Austria and Denmark. PLOS ONE. 19(3), e0299315. DOI: https://doi.org/10.1371/journal.pone.0299315
Croney, C., Appelbaum, J.W., Delgado, M. & Stella, J. (2025). How Does Access to Veterinary Care Relate to Animal Welfare? Advances in Small Animal Care. 6(1), 209–221. DOI: https://doi.org/10.1016/j.yasa.2025.06.014
Egenvall, A., Höglund, O.V., Hoffman, R., Valle, P.S., Andersen, P.H., Lönnell, C., Byström, A. & Bonnett, B.N. (2024). Prices for veterinary care of dogs, cats and horses in selected countries in Europe. Frontiers in Veterinary Science. 11, 1403483. DOI: https://doi.org/10.3389/fvets.2024.1403483
Englar, R.E. (2023). Recasting the gold standard – part I of II: delineating healthcare options across a continuum of care. Journal of Feline Medicine and Surgery. 25(12). DOI: https://doi.org/10.1177/1098612X231209855
Fedesco, H.N., Brodsky, J.E., Warman, S.M. & Khosa, D.K. (2025). The American Association of Veterinary Medical Colleges Spectrum of Care Initiative: supporting spectrum of care preparation in veterinary education programs. Journal of the American Veterinary Medical Association. 263(S3), S85–S91. DOI: https://doi.org/10.2460/javma.25.05.0358
Freeman, G. & Hughes, J. (2010). Continuity of care and the patient experience, [online]. Available at: https://assets.kingsfund.org.uk/f/256914/x/c22b0594f7/gp_inquiry_continuity_care_2010.pdf [Accessed: 11 February 2026].
Gibson, J., White, K., Oxtoby, C. & Brennan, M. (2022). ‘We’re gonna end up scared to do anything’: A qualitative exploration of how client complaints are experienced by UK veterinary practitioners. Veterinary Record. 191(4), e1737. DOI: https://doi.org/10.1002/vetr.1737
Glasspool, B.M., Blackwood, L. & Bowlt Blacklock, K.L. (2025). Effect of Changes in Canine Thyroid Cancer Terminology on Caregiver Anxiety Levels and Treatment Preferences in a Scenario‐Based Study. Veterinary and Comparative Oncology. 23(2), 187–196. DOI: https://doi.org/10.1111/vco.13044
Grimm, H., Bergadano, A., Musk, G.C., Otto, K., Taylor, P.M. & Duncan, J.C. (2018). Drawing the line in clinical treatment of companion animals: recommendations from an ethics working party. Veterinary Record. 182(23), 664. DOI: https://doi.org/10.1136/vr.104559
Groves, C.N.H., Janke, N., Stroyev, A., Tayce, J.D. & Coe, J.B. (2022). Discussion of cost continues to be uncommon in companion animal veterinary practice. Journal of the American Veterinary Medical Association. 260(14), 1844–1852. DOI: https://doi.org/10.2460/javma.22.06.0268
Hickey, K., Smith, D. & Shields, E. (2024). Qualitative Research on Pet Owners’ Experiences of Buying Veterinary Services in the UK, [online]. Available at: https://assets.publishing.service.gov.uk/media/65eedd9d62ff4898bf87b261/Qualitative_Research_on_Pet_Owners__Experiences_of_Buying_Veterinary_Services_in_the_UK.pdf [Accessed: 11 February 2026].
Kinnison, T., May, S.A. & Guile, D. (2014). Inter-Professional Practice: From Veterinarian to the Veterinary Team. Journal of Veterinary Medical Education. 41(2), 172–178. DOI: https://doi.org/10.3138/jvme.0713-095R2
Kipperman, B.S., Kass, P.H. & Rishniw, M. (2017). Factors that influence small animal veterinarians’ opinions and actions regarding cost of care and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout. Journal of the American Veterinary Medical Association. 250(7), 785–794. DOI: https://doi.org/10.2460/javma.250.7.785
Kunze, A.J. & Seals, C. (2020). Exploring fourth-year students’ perceptions of the hidden curriculum of a Doctor of Veterinary Medicine program through written reflections. Education in the Health Professions. 3(3), 121–128. DOI: https://doi.org/10.4103/EHP.EHP_23_20
May, S. (2015). Towards a scholarship of primary health care. Veterinary Record. 176(26), 677–682. DOI: https://doi.org/10.1136/vr.h2521
O’Connor, A., Totton, S.C., Hernandez, M., Meyers, E., Meyers, K., Abreu, H.M., Spofford, N. & Morrison, J. (2025). Risk factors for, metrics of, and consequences of access to veterinary care for companion animals: A scoping review. PLOS One. 20(5), e0325455. DOI: https://doi.org/10.1371/journal.pone.0325455
Office for National Statistics. (2025). CPI IndexVeterinary and other services for pets. Available at: https://www.ons.gov.uk/economy/inflationandpriceindices/timeseries/l7hh/mm23 [Accessed: 11 February 2026].
O’Neill, D.G., McMillan, K.M., Church, D.B. & Brodbelt, D.C. (2023). Dog breeds and conformations in the UK in 2019: VetCompass canine demography and some consequent welfare implications. PLOS ONE. 18(7), e0288081. DOI: https://doi.org/10.1371/journal.pone.0288081
Pyatt, A.Z., Walley, K., Wright, G.H. & Bleach, E.C.L. (2020). Co-Produced Care in Veterinary Services: A Qualitative Study of UK Stakeholders’ Perspectives. Veterinary Sciences. 7(4), 149. DOI: https://doi.org/10.3390/vetsci7040149
Quain, A., Ward, M.P. & Mullan, S. (2021). Ethical Challenges Posed by Advanced Veterinary Care in Companion Animal Veterinary Practice. Animals. 11(11), 3010. DOI: https://doi.org/10.3390/ani11113010
RCVS. (2023). RCVS Standards and Guidance for the Accreditation of Veterinary Degree Programmes 2023, [online]. Available at: https://www.rcvs.org.uk/sites/default/files/2025-12/1rcvs-standards-and-guidance-updated-dec2025.pdf [Accessed: January 23, 2026].
RCVS. (2024). 2024 Facts and Figures from The Royal College of Veterinary Surgeons RCVS Facts. Available at: https://www.rcvs.org.uk/sites/default/files/2026-02/rcvs-facts-2024.pdf [Accessed: 11 February 2026].
RCVS. (2025). Code of Professional Conduct - supporting guidance - 2. Veterinary Care, [online]. Available: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/veterinary-care/ [Accessed: 11 February 2026].
RCVS Knowledge. (2025a). Contextualised care: a roadmap, [online]. Available at: https://www.rcvsknowledge.org/resource/contextualised-care-a-roadmap/ [Accessed: 11 February 2026].
RCVS Knowledge. (2025b). How to achieve contextualised care: insights from the veterinary sector and pet owners, [online]. Available at: https://www.rcvsknowledge.org/cc-report [Accessed: 11 February 2026].
Roder, C.A. & May, S.A. (2017). The Hidden Curriculum of Veterinary Education: Mediators and Moderators of Its Effects. Journal of Veterinary Medical Education. 44(3), 542–551. DOI: https://doi.org/10.3138/jvme.0416-082
Rollin, B.E. (2020). Integrating Science and Well-Being. Veterinary Clinics of North America: Small Animal Practice. 50(4), 899–904. DOI: https://doi.org/10.1016/j.cvsm.2020.03.009
Rosolin, B., Roberts, C.P. & Robinson, D. (2024). The 2024 Survey of the Veterinary Profession: A report for the Royal College of Veterinary Surgeons, [online]. Available at: https://www.employment-studies.co.uk/wp-content/uploads/2024/12/SotP-2024-VS-report-619-A.pdf [Accessed: 11 February 2026].
Sánchez-Vizcaíno, F., Noble, P-J.M., Jones, P.H., Menacere, Buchan, I., Reynolds, S., Dawson, S., Gaskell, R.M., Everitt, S. & Radford, A.D. (2017). Demographics of dogs, cats, and rabbits attending veterinary practices in Great Britain as recorded in their electronic health records. BMC Veterinary Research. 13(1), 218. DOI: https://doi.org/10.1186/s12917-017-1138-9
Skipper, A., Gray, C., Serlin, R., O’Neill, D., Elwood, C., Davidson, J. (2021). ‘Gold standard care’ is an unhelpful term. Veterinary Record. 189(8), 331. DOI: https://doi.org/10.1002/vetr.1113
Skipper, A., O’Neill, D., Serlin, R., Davidson, J., Elwood, C. & Gray, C. (2024). Contextualised care faddish or foundational. Veterinary Record. 195 (3), 117. DOI: https://doi.org/10.1002/vetr.4567
Singh, Y., Song, Z. & Polsky, D. (2022). Association of Private Equity Acquisition of Physician Practices With Changes in Health Care Spending and Utilization. JAMA Health Forum. 3(9), e222886. DOI: https://doi.org/10.1001/jamahealthforum.2022.2886
Strand, E.B., Scoresby, K., Walker, H., Hernandez, A., Accornero, V., Messinger, L., Linden, P., Ward, C., Knight, M.P., Engelman, H., Moore, K. & Slater, M.R. (2024). Life with pets study: lower income veterinary clients’ perception of pets’ quality of life. Frontiers in Veterinary Science. 11, 1422359. DOI: https://doi.org/10.3389/fvets.2024.1422359
Summerton, N. (2000). Trends in negative defensive medicine within general practice. The British Journal of General Practice. 50(456), 565–566.
Van Walraven, C., Oake, N., Jennings, A. & Foster, A.J. (2010). The association between continuity of care and outcomes: a systematic and critical review. Journal of Evaluation in Clinical Practice. 16(5), 947–956. DOI: https://doi.org/10.1111/j.1365-2753.2009.01235.x
Williams, R. (2025). How the cost of veterinary care impacts the wellbeing, learning and practice of early career vets. Veterinary Record. 196(2), e4597. DOI: https://doi.org/10.1002/vetr.4597
Zhu, J.M., Zeveney, A., Read, S. & Crowley, R. (2024). Physician Perspectives on Private Equity Investment in Health Care. JAMA Internal Medicine. 184(5), 579–580. DOI: https://doi.org/10.1001/jamainternmed.2024.0062
License
Copyright (c) 2026 Sally Everitt, Andréa Taylor, Ashley Doorly, Katherine Cropley, Allison Osterberg, Katie Mantell

This work is licensed under a Creative Commons Attribution 4.0 International License.
Veterinary Evidence uses the Creative Commons copyright Creative Commons Attribution 4.0 International License. That means users are free to copy and redistribute the material in any medium or format. Remix, transform, and build upon the material for any purpose, even commercially - with the appropriate citation.