Providing a first-class pet emergency service: how your fees are spent

Mandisa Greene, our professional standards director, reveals the true cost of delivering outstanding out-of-hours pet care

Why does out-of-hours veterinary care cost as much as it does? 

It’s a question emergency and critical care vets like me are asked all the time. And, in my experience, it’s occasionally followed by angry accusations of profiteering and ripping off customers. 

“You’re only in it for the money. If you loved animals you wouldn’t charge so much,” is something all vets and nurses – at least once in their careers – have been shouted at by a frustrated pet owner. 

The issue creates an extreme set of emotions in both pet owners as well as clinicians – and it’s easy to see why. There’s not a consumer on earth who enjoys feeling as though they’re being ripped off. 

Vets and nurses, on the other hand, find few things more difficult than being accused of caring more about money than helping pets. It’s like a dagger to a vet or nurse’s heart, and I know some who have left the profession altogether because they feel so demoralised by it. 

The sad reality is pet emergencies are inevitable – an estimated 92% of all pets will experience some type of severe emergency situation over the course of their lifetime. 

However, judging by some of the debates on online forums and social media, it seems there are many misconceptions around vets’ fees in general, particularly for out-of-hours pet emergency services, and why they cost what they do. 

So I’m going to try to explain. 

Clinical staff costs

Out-of-hours veterinary treatment provided by companies like Vets Now typically costs more than care offered by daytime veterinary surgeries due to a dedicated emergency team working unsociable hours and a need for extensive state of the art equipment available around the clock. 

To be frank, it costs a lot of money to provide an out-of-hours pet emergency service. 

Perhaps unsurprisingly, the highest proportion (61%) of the hard-earned cash pet owners pay in fees to Vets Now goes towards paying, and training, our veterinary surgeons, registered veterinary nurses, and other clinic staff. 

There are several reasons why staff costs are proportionately so high. For a start, every one of our 60 out-of-hours pet emergency clinics and 24/7 hospitals have a dedicated emergency team – at least one vet and one vet nurse (more at busy times) – on site at all times, regardless of whether any cases come through the doors. 

That’s just the unpredictable nature of emergency medicine. 

Daytime vets who do their own out of hours typically rely on income from their routine general practice appointments to subsidise the cost of running it.  

We do not offer routine appointments and, at night and on weekends, we simply cannot guarantee whether we’ll be busy or not.  Emergency vets don’t know how many cases, if any, we will see in a night because they are not planned appointments. 

However, by operating solely as emergency vets, our training, wealth of experience and expertise is completely dedicated to accidents and emergencies.   

Vets and vet nurses salaries

It’s no secret that basic salaries for vets and vet nurses are rising and, in turn, becoming an increasingly big part of overall expenditure – particularly for out-of-hours emergency businesses. 

There are lots of factors behind this, but the main one is people who work unsociable hours tend to want higher pay than those who work Monday to Friday. One analogy that comes to mind is that of emergency plumbers. Anyone who’s had to call a plumber in the middle of the night will know that you pay a hefty premium for their expertise during unsociable hours, and veterinary medicine is no different. 

On top of that, there is also a recruitment crisis in the veterinary profession right now and practices and hospitals are competing against each other for an ever-dwindling pool of talent. 

Despite all of this, however, vets are still being paid far less than their counterparts in comparable professions such as human medicine (even though they have studied and trained for the same amount of time and often racked up equally huge student loans). 

In more than 15 years as a vet, I’ve never worked alongside anyone who is primarily motivated by money. The bottom line is vets and vet nurses enter the profession because of their innate sense of wanting to care for animals and help their owners, not because they want to get rich. 

Investing in clinical excellence

In addition to wages, there is also a significant amount of money invested in staff training and development.  At Vets Now, all of our permanent vets and vet nurses receive comprehensive inductions, so they have all the medical and surgical expertise at their fingertips in the most demanding circumstances. 

It’s perhaps not common knowledge among pet owners, but all practising vets are also duty bound to complete at least 35 hours of training and development a year, while vet nurses must do a minimum of 15 hours. This is regardless of whether they are working full-time or part-time, at night or during the day. 

The vast majority of our clinical staff do much more than this and, as an organisation, we pride ourselves on supporting them financially. 

That’s because our mission is to provide pet owners with the highest levels of emergency veterinary care.  We also reinvest in our people and we make sure we offer competitive salaries and other benefits to ensure our people are valued and rewarded appropriately. 

Vets Now also invests a lot in research and evidence-based medicine, to optimise our survival rates for critically ill patients.   

For example, a team of researchers from Vets Now published a case study following a quality improvement project which we hope will be significant in helping outcomes for maternal and neonatal care in dogs not just for Vets Now, but for the whole profession.  

As emergency vets, we see a high number of dystocia cases (the difficulty in passing the foetus through the pelvic canal) at our clinics and hospitals throughout the UK and as such, we recognise that managing canine dystocia cases can be challenging.  We therefore identified room for improvement in the care of these cases, ultimately improving our maternal and neonatal care. 

Support office costs

Across the UK, Vets Now employs over 1700 people, including vets, vet nurses, animal care assistants and receptionists, and our support office helps them to do their jobs. 

It plays host to our customer hub, HR, health and safety, recruitment, learning and development, technology, marketing and finance departments among others. 

Our contact centre team, who are the first point of contact for worried pet owners during their time of need, are also based here. They deal with more than 11,000 emergency calls a week – freeing up our clinic staff to focus on caring for sick and injured pets. 

This is the pet emergency equivalent of 999 – and on a typical weekend day up to 90 call handlers answer the phones with the support of veterinary nurses.

Each of these departments is a vital cog in the Vets Now wheel and every member of the support team is there to ensure customers and their pets receive the care and support they deserve, at the time they need it most, in addition to supporting the staff who provide it for them. 

Just like our vets and vet nurses, they are guided by a commitment to compassion, integrity, honesty and dependability. Around 6% of our income pays for the overheads and salaries associated with our support office team. 

Cost of running our clinics

Around 11% of the money our customers pay in fees goes towards fixed costs such as rent, heating, lighting and equipment. At Vets Now, our services are run from “host practices” which have the space and facilities to enable us to provide the highest standard of out-of-hours care. 

In simple terms, we take over these practices when the daytime vets close – paying the host practice rent. 

But there’s more to it than just ensuring there are adequate levels of clinical staff on hand to treat any pet emergencies that may occur. Because of the potentially complex nature of emergency veterinary work, all of our clinics must have a minimum level of medical equipment. 

This includes ultrasound machines, incubators and oxygen cages, as well as endoscopes, blood analysers, and syringe drivers. Also on the list of equipment our clinics must be equipped with are stretchers, microscopes and ECG monitors. 

In total, there are 32 pieces of technology on this list, some of which cost upwards of £8500. 

Our pet emergency hospitals, which deal with specialist referrals as well as out-of-hours emergency cases, have additional specialised equipment. In Manchester, for example, there is a hugely expensive CT scanner, used to provide very detailed images of within the body. 

It almost goes without saying that this equipment does not come cheap. But it does provide our vets and vet nurses with state-of-the-art diagnostic tools that allow them to assess a pet’s medical problems as quickly as possible. 

Drugs and consumables

Another 7% of the fees paid by pet owners goes towards medication and medical supplies. Many veterinary drugs are hugely expensive. Owners sometimes raise that they can buy them cheaper online, but this masks the true reality of the situation. 

The cost of running an online drugs warehouse is significantly cheaper than a pharmacy in an emergency veterinary clinic. Our clinics stock drugs for almost every eventuality and, as a result, waste is inevitable. 

The reason for this is simple – as a pet emergency service we just never know what will come through our doors. 

Anti-venom, which is used to treat adder bites in dogs, is a good example. It’s held in case of emergencies and has been used to treat countless dogs with severe bites, but it has a use-by date and isn’t always needed, meaning it must be discarded. This is also one of the most expensive drugs to purchase, with one dose costing more than £280. 

Profit

Around 15% of our income is profit. Vets Now was set up by a vet and is still run by vets.  I’ve been a vet for 15 years, and as Medical Director, I sit on the Operational Board of Vets Now with other vets, including our CEO, Tricia Colville who was a vet for many years before she moved into leadership roles. Every business decision we take is taken for the long-term benefit of the customers, staff and veterinary practices that use our service. 

For example, a vast chunk of our profits were reinvested in the upgrade and extension of our pet emergency hospital in Glasgow, which previously treated up to 10,000 pets a year but was working at capacity. 

To be sustainable, every business must generate a profit in order to re-invest in growth and diversification and to ensure we’re around for years to come. As I said, Vets Now was set up by a vet who was determined to provide an essential, emergency service that benefited both pets and the veterinary teams who care for them. 

Why Vets Now was set up

It’s also important to provide context on why dedicated out-of-hours emergency and critical care services such as Vets Now actually exist. 

In days gone by, most vets covered their out-of-hours shifts themselves. This meant being “on-call” at nights and weekends – usually after a busy day shift. I did it myself, and sometimes it involved nothing more than answering a few phone calls, while on other occasions I’d end up working all night and the following day, or all weekend. 

This working pattern inevitably results in fatigue and can leave vets predisposed to making errors of judgement. This isn’t good for pets or the vets who are treating them. 

Our founder, Richard Dixon, who is a vet, understood those challenges. His solution was Vets Now, and today, over two decades on, we work in partnership with more than 1700 local veterinary practices to ensure their clients and their pets receive the best care at the time they need it most. 

This benefits owners because it means their sick or injured pets can now be treated urgently by a highly-trained emergency vet and veterinary nurse who are already on duty and awake and alert. But it also helps the veterinary team as they no longer have to work every minute of every day. 

Why do I sometimes have to wait a long time to see a vet? I’m paying a lot of money to be seen.

In terms of patient triage and resourcing at our clinics, we operate much like the NHS A&E service; we see patients in order of urgency based on their clinical need rather than through booked appointments, ensuring sick and injured pets are prioritised to receive the urgent care they need.  

Similar to a human A&E, the nature of emergency medicine in general is very unpredictable and can often result in longer wait times for some patients.  But if you have a longer wait, it means that your pet is less sick than others that we are tending to more urgently.  

Importance of communication

Our staff understand that paying for veterinary treatment, especially for an unplanned emergency, can be a real struggle for many pet owners and we aim to be upfront and transparent about our costs – and we always provide detailed estimates. 

We will always take the time to explain the diagnostic and treatment options available, and together with the pet owner, come up with a plan to provide the most appropriate level of care. Pet owners who can’t afford the full range of treatment should speak to their vet as soon as possible to see if they’re able to tailor the treatment options. 

They will be able to fully discuss the risks and benefits associated with any alternative plans so they can support pet owners to make an informed decision. 

Financial planning

Almost all pets will require urgent emergency care at some point during their lifetime. Some, particularly those with chronic health problems, will need it several times. As such, we’d urge all pet owners to plan for the worst case scenario. 

The latest research shows the minimum average overall cost of owning a dog is between £5,200 and £15,700 depending on size and breed (but this doesn’t include the initial cost of getting a dog, or vet fees if your dog becomes ill). Cat owners should expect their pet to cost at least £11,100 over their lifetime. 

Given these huge sums, pet insurance should be seriously considered. 

Daytime vets can usually offer advice on policies, although it’s important to be aware not everything will be covered. For those in financial need, we work alongside numerous charities who may be able to provide assistance. 

For non-emergencies, Vets Now also offers an online consultation where you can video chat online with an experienced vet.  A 10-minute online vet consult costs just £24 which you can pay online using a credit or debit card.  We will refund your online video vet consultation if we recommend an in-person follow up within 48 hours. 

But whatever your circumstances and whatever decisions you make about your pet’s care, please be reassured that your pet’s welfare will always be our number one priority.