This, says the company, will make vaccination easier for vets and clients.
Eravac is an injectable emulsion ready for administration without the need for reconstitution beforehand.
Each box contains 10 individual doses which can be given to pet rabbits from 30 days of age.
The company is now inviting practices to sign up for the free Beta trial and shape the development of the new platform and how video consultations can be integrated into traditional ways of working.
The platform, which can be branded with the practice logo, uses an app which clients download onto their mobile devices and use to book appointments. The system has its own appointment booking system, but also integrates with Vetstoria. When an appointment is booked via video, practitioners see it in their PMS. They then visit their online account, select the relevant appointment and click ‘start video call’. Payment can be collected from the owner prior to the consultation.
Susie Samuel, Managing Director of VetHelpDirect said: "While developing this product, we have been mindful that the use of telemedicine in our industry has been hugely controversial. We believe that inviting local vets to trial and refine this technology, using their team to work with their own clients removes many of the risks and dangers otherwise inherent in the proposition."
I agree wholeheartedly. The controversy over telemedicine has been about the idea of allowing the prescription of drugs to animals that have not been seen in person. Using a service like this (or the one launched by the Virtual Vet Group last year) to offer video consultations to patients that are already under your care strikes me as an altogether different kettle of fish. I think it will help improve engagement with existing clients, by reducing unnecessary trips to the practice for follow-up or post-operative consultations, saving time, money and the planet.
Susie added: "In our fast-moving world pet owners are increasingly reliant on technology and expect to be able to access services easily. The results of our recent VetHelpDirect research of 419 owners showed 38% of survey respondents said they would like to have the option of a video consultation if it was offered by their own vet. If we are to keep up with this demand, we need to embrace new ways of working."
VetHelpDirect says that whilst it believes that the growth in the use of this technology will change the way veterinary medicine is practiced, video consultations will always work alongside in-person consultations, as just one tool in an overall strategy of care, and certainly will not replace face to face diagnosis.
Let's hope so.
Susie added: "What is clear from our research is that whilst clients would like to be able to have video consultations with a vet their strong preference is for this to be with their own vet; whilst 38% of people would use video consultations with their own vet this falls to only 7% if it is provided by a vet not known to them.
"Of course, telemedicine is by no means the answer in every case, what the new service does offer is flexibility for practitioners and the ability to work in new ways that will benefit the animals and owners. For example, giving free telephone advice has become common place in many practices but is very hard to monetise. Video consultations provide a commercial solution to this problem.”
For more information, or to join the trial, contact Susie Samuel susie@vethelpdirect.com
The specific qualifications affected will be as follows:
Level 3 Diploma in Veterinary Nursing (Small Animals) (7457-03) Ofqual Accreditation No: 600/6052/9
Level 3 Diploma in Veterinary Nursing (Equine) (7457-13) Ofqual Accreditation No: 600/6052/9
Level 3 Diploma in Small Animal Veterinary Nursing (7457-33) Ofqual Accreditation No: 603/5101/9
Level 3 Diploma in Equine Veterinary Nursing (7457-43) Ofqual Accreditation No: 603/5102/0
According to the College, City & Guilds has also said it does not intend to apply to become an End-point Assessment Organisation for the veterinary nursing apprenticeship end-point assessment.
The College also says that City & Guilds has not provided any reason for its decision, other than to say it is 'based on several factors'.
Susan Howarth RVN, Chair of the RCVS Veterinary Nurse Education Committee said: "We fully recognise this will be worrying news for many VN students, so our immediate priority is to provide as much information and reassurance as possible to those currently enrolled with City & Guilds-approved centres, or those who might be intending to enrol soon.
"We have published a list of frequently asked questions on our website to help address what are likely to be the most immediate concerns (www.rcvs.org.uk/cityandguilds), which we will add to as more information becomes available.
"Anyone with additional questions or concerns at this stage should speak to their Centre in the first instance, or contact the RCVS VN team at vetnursing@rcvs.org.uk or 020 7202 0788."
During the next days and weeks, the College will be liaising closely with City & Guilds to ensure the needs of their VN learners continue to be met and all commitments to them honoured up to September 2023. It will continue to audit and monitor the City & Guilds programme and affiliated Centres until 31 August 2023.
In the meantime, the College will also work closely with the two other awarding organisations – Central Qualifications and VetSkill – and with the Higher Education establishments that offer alternative routes to VN qualifications, to consider how best to prevent a shortfall in VN training places arising from City & Guilds’ decision to withdraw these qualifications.
The speakers include Aldo Vezzoni, a European Specialist in Small Animal Surgery, Peter Southerden, a European and RCVS Specialist in Veterinary Dentistry, orthopaedic specialist Daniel Lewis, veterinary physiotherapist Barbara Houlding, neurosurgeon Fred Wininger, Gary England, Professor of Comparative Veterinary Reproduction at Nottingham University, Rob Lowe, the ophthalmologist, Nick Bacon, Specialist in Small Animal Surgery, and Rachel Lumbis, a lecturer in Veterinary Nursing at the Royal Veterinary College, and, of course, Noel Fitzpatrick himself.
Dermatology, dentistry, ophthalmology, endoscopy and hepatobiliary disease have all been added to this year's education streams, together with a new ‘Top Tips’ stream, offering practical advice for immediate use in clinical practice.
In total, Vet Festival will have 18 separate education streams covering small animal clinical topics with dedicated nursing and rehabilitation content a key component of the programme.
The integration of veterinary professionals is a fundamental theme of the festival so, in the rehabilitation stream, surgeons, physiotherapists, rehabilitation specialists and hydrotherapists will offer perspectives in tandem.
Over the weekend, 135 lectures will be offered to suit those at every level of clinical practice. Delegates will collect 14 hours of CPD over the two days.
Also new in 2020 is the introduction of a ‘Wellness and development for you and your practice’ theatre, with speakers from both within and outside the profession, including paralympic champion Rachel Morris MBE, psychotherapist Di Gammage and mindfulness leadership specialist, Natalie Pennicotte-Collier. Various wellbeing activities, such as yoga, movement, fitness and mindfulness, will take place alongside the lectures.
Professor Noel Fitzpatrick, Clinical Chair at Fitzpatrick Referrals, who launched Vet Festival in 2015, said: "Outdoor festivals bring joy to the soul and I have always wanted education and continuing professional development to feel uplifting, inclusive and life-enhancing, both professionally and from a personal wellness perspective. That’s what VetFest is all about – food for the mind, body and soul."
Nicole Cooper, VET Festival Event Director, added: “For veterinary professionals keen to learn about the latest thinking and developments in small animal veterinary medicine, Vet Festival is simply unmissable. The breadth of content on offer and the quality of our speakers increases every year but what really sets VET Festival apart is the opportunity it offers for delegates to learn in a relaxed, fun environment.
Tickets for VET Festival can be purchased here: https://www.vetfestival.co.uk/delegate-info/ticket-information
In the first episode of the series, BCVSp Trustee James Swann speaks to Dr Rosanne Jepson about dialysis in dogs and cats. A specialist in internal medicine in dogs and cats, Dr Jepson explains why dialysis might be needed in pets for treatment of kidney disease and whether it's ethical to do this treatment in animals.
In episode two BCVSp trustee Celia Marr speaks to James Wood, Professor of Equine and Farm Animal Science at the University of Cambridge about zoonotic diseases and their importance for animal and human health in Africa.
BCVSp trustee Myra Forster-van Hijfte, who is responsible for Your Vet Specialist’s public outreach programme, said: "Podcasts are a great addition to our website, giving animal owners a convenient and highly engaging way to learn more about the Veterinary Specialist’s role. The advantage of audible platforms is that they enable content to be accessed more or less wherever you are or what you are doing. We hope our listeners will enjoy our first series as much as the team did making them."
The BCVSp says the podcasts are also designed to be a useful resource for practices to direct their clients to for more information on specific topics.
As part of an increasing focus on wellbeing at Congress, Jenny will be sharing her thoughts on balancing a successful career with family commitments. Prior to becoming a dragon, Jenny worked in banking for 30 years. She became CEO of cash machine company Hanco, bought out the business, turned it round and sold it for £50 million.
The expanded 2020 Congress programme offers 450 hours of CPD delivered by more than 100 globally recognised speakers. The Association says this year's highlights include more 'open to all' streams, a new range of practical workshops, small group sessions, wetlabs and nurse case reports. There will also be an increased number of AVP streams, an infectious disease stream as well as a popular favourites stream, which will include endocrinology, critical care and trauma medicine, ophthalmology and cardiology.
New wet labs are being introduced, with a chicken anatomy refresher focussing on linking this knowledge to clinical presentations and common procedures. There's a similar session for rabbit anatomy along with a new dermatology practical and surgery of the small intestine.
BSAVA Congress Programme Committee Chair Sue Murphy said: "Our ethos with the 2020 programme is to deliver unrivalled education, designed to tackle the current needs of the profession, with topical, clinically relevant and evidence-based content. Each stream is devised by our committee of volunteer vets, nurses and practice managers, ensuring our entire programme is created by the profession, for the profession."
BSAVA President, Sue Paterson said: "We are extremely proud to be hosting such an impressive programme of education at our 63rd annual Congress and 30th year in Birmingham. With our prestigious keynote speaker, the small animal focussed exhibition, the BSAVA Awards and a packed social programme including a DJ, band, Bongo’s Bingo and Silent Disco at the V20 Party Night, Congress 2020 celebrates the very best of the profession; a not to be missed date in this year’s veterinary calendar!"
To register for BSAVA Congress visit www.bsavaevents.com. If you book before the 29th January, you'll get 20% off.
Krka says the new pack, available for cats and for toy, small, medium and large dogs, is designed to offer practices greater dispensing flexibility and to encourage quarterly visits and compliance with healthcare plans.
Selehold is presented in a pipette with a colour-coded cap and transparent tube to enable the owner to check when the full dose has been given. Each pipette is individually wrapped for ease of use and dispensing.
Ms Sabrina Jordan, Country Brand Manager for Krka, said: "We aim to optimise the value we give to our customers by offering them highly effective, tried and trusted, affordable generic medicines with added value.
"Selehold has proved a popular addition to our parasite control range because of its ease of use and cost-effectiveness.
"With many of our customers focusing on encouraging owners to visit the practice quarterly and to sign up to a healthcare plan for their pet, the 3-pack version of Selehold works well as it enables the practice to offer clients a high quality, good value solution that supports this compliance framework."
The proposal seems to have its roots in the First Rate Regulator initiative announced by Nick Stace in November 2012. As part of the initiative, the College commissioned Sally Williams and Associates to conduct research amongst stakeholders and report back with recommendations for being a first rate regulator.
One of those recommendations was to move to the civil standard of proof (page 33/34 here). There is no stated rationale for this recommendation, other than: "The majority of other professional regulators have moved to the civil standard of proof".
Nevertheless, the recommendation then found its way into the RCVS 2017-2019 Strategic Plan.
The proposal was then mentioned in the published summary of the Legislation Working Party's meeting in December 2017:
"In considering reform to the disciplinary process, the Registrar noted that the RCVS is one of the only regulators (and the only healthcare-based regulator) still using the criminal standard of proof (‘beyond all reasonable doubt’) when determining the facts of a case. Most other regulators used the civil standard of proof (‘on the balance of probabilities’) when making their determinations. Consideration of moving to the civil standard has also been carried over from the College’s previous Strategic Plan and the Registrar agreed to review the last six months’ cases to assess what the likely outcome of those cases would have been under the civil standard, and the cost of change. The Working Party also decided to contact other regulators about their disciplinary processes, in order to gather information about their experiences of what does and does not work, both for long-standing issues and new reforms."
The proposal then resurfaced last week in the Veterinary Record, which reported that the College is in 'advanced discussions' about adopting the lower standard (Standard of Proof for disciplinaries could change).
The College has now issued a statement to VetNurse.co.uk as follows:
"The Royal College of Veterinary Surgeons (RCVS) is currently very much in the minority of regulators still using the criminal standard of proof ('beyond all reasonable doubt') in its disciplinary proceedings, rather than the civil standard of proof ('on the balance of probabilities').
"By comparison, all nine of the healthcare regulators in the human field (as overseen by the Professional Standards Authority) have moved to the civil standard, as have other regulators such as the Bar Standards Board and the Solicitors Regulation Authority.
"In our last two strategic plans we have committed to considering whether or not the RCVS should change the standard of proof in line with other regulators and these discussions have been taking place as part of the ongoing deliberations around legislative reform.
"A change to the standard of proof would require an amendment of our 2004 Procedure and Evidence Rules via the Privy Council rather than new primary legislation, but we would consult with the profession before any such changes were made and, at present, this matter has not been put before RCVS Council for a decision."
So, as it stands now, no evidence has yet been presented to the profession which supports the need for - or benefits of - a change to the standard of proof required in disciplinaries. The idea that it should be done simply because 'that's what the other regulators are doing' does not hold water. The veterinary profession is unique. According to the College's own research, it enjoys a remarkably high level of trust amongst the public. But at the same time, it also suffers one of the highest suicide rates.
Clearly Council will need to reflect extremely carefully on whether the members of such a widely trusted profession should face an even greater threat of losing their career, particularly when they seem to be at such a risk of vexatious complaints, fear of a disciplinary is already so high, and the consequences of this change on mental health in the profession could be so profound.
It may even be true to say that lives could depend on this decision.
Part of the VN Futures project, the lunchtime webinars will be delivered between February and June 2020 via the Webinar Vet, and the College is encouraging all nurses, veterinary surgeons, practice managers and owners to attend, as it says the webinars will benefit the whole practice team.
All three webinars take place at 12.30pm and last one hour. They are as follows:
Tuesday 4 February 2020 – ‘Maximising the potential of the veterinary nurse’ presented by Louise Northway RVN, BVNA Council member and recipient of the RCVS Inspiration Award. The webinar will give an overview of the role of veterinary nurses under Schedule 3 of the Veterinary Surgeons Act, how VNs can develop their role in practice and take on extra responsibilities and how VNs can approach these conversations in practice through the creation of learning and development plans. This webinar will illustrate how fully utilising the nursing team not only hugely boosts the morale of the work force, but also enhances patient care and increases the efficiency of the business.
Tuesday 10 March 2020 – ‘Veterinary nurses’ time is valuable: How and why to charge for it’ presented by Stephanie Writer-Davies MRCVS, Career Progression Working Group member, and Jane Davidson RVN, VN Council member and regular blogger on veterinary nursing issues. This webinar will provide examples and case studies of how veterinary nurses contribute to practice finances, how practice pricing structures can be developed so that the financial value of veterinary nurses’ time and effort can be better highlighted, and how veterinary nurses can demonstrate their value to clients.
Tuesday 23 June 2020 – ‘Lead or Head RVN: What’s in a name?’ presented by Gillian Page RVN, President of the Veterinary Management Group. This webinar will look at the role of the traditional Head RVN and how development of ‘Lead RVNs’ in different areas of practice can help to allow for growth of other talented team members and provide increased and shared responsibility and progression. This webinar will explore how this enhances practice efficiency alongside development of team members, thus increasing job satisfaction and, ultimately, retention.
Racheal Marshall, Chair of RCVS Veterinary Nurses Council and the VN Futures Board, said: "We hope that veterinary nurses will engage with these webinars in order to gain some inspiration about how they can truly show their value to their team, their clients and the wider public.
"The VN Futures research clearly demonstrated that there was a desire from the veterinary nursing profession to find ways in which VNs could gain greater recognition for the work they do and progress in their careers. These webinars, and our talented presenters, will provide many practical examples and case studies on how this can be done, help build confidence and highlight opportunities for further learning and development."
To sign up to the free webinars visit https://www.thewebinarvet.com/sponsors/VN%20Futures.
The annual renewal fee for veterinary nurses is due for payment on 1 November every year, although you have up to midnight on 31 December to pay before you're removed from the Register. The 409 veterinary nurses who failed to meet this payment deadline for last year were removed from the Register on 1 January 2020.
Of the 409 veterinary nurses who were removed for non-payment this year, 70 or so have subsequently applied for restoration to the Register, paying a £58 restoration fee, in addition to the standard renewal fee of £69.
The 409 removals represent 2.2% of the profession as a whole, which is down from the 2.7% removed last year.
A list of individuals removed from the Register on 1 January 2020, and who hadn’t been restored prior to 2 January at 11.30AM, has been published to help practices check their veterinary nursing staff are still on the Register.
Those with questions about how to restore to the Register should contact the RCVS Registration Department on 020 7202 0707 or registration@rcvs.org.uk.
For questions about paying the annual renewal fee or setting up a Direct Debit contact the RCVS Finance Department on 020 7202 0723 or finance@rcvs.org.uk.
Sam and Dick will be joint Clinical Directors of the hospital and co-owners of the business alongside the Pets at Home Vet Group, their Shared Venture Partner.
They say the vision is to create a world-class facility with a team of highly motivated veterinary specialists, nurses and support colleagues providing outstanding levels of service to meet the needs of referring veterinary surgeons, their clients and patients.
The purpose-built facility will offer specialist referral services across a range of disciplines, including anaesthesia, diagnostic imaging, internal medicine, orthopaedics, neurology and soft tissue surgery. Emergency referrals will be accepted seven days a week, 24 hours a day.
Sam said: "It is truly exciting to build a new team of experienced specialists who have clinical excellence as their priority. We also relish the chance to develop great relationships with professional colleagues in first opinion practices. This will allow our hospital to deliver an exceptional level of service for referring veterinary surgeons and their patients."
Dick said: “This is a very exciting step and I am delighted to be instrumental in ensuring that our new centre in Scotland offers the very best in veterinary care”.
The hospital will be based at Deer Park in Livingston, with convenient parking and easy access to the M8 and other major road and rail networks. In addition to clinical services, it will provide a CPD programme, including internship and residency opportunities.
At the heart of the campaign is a website - www.beatdogheartdisease.co.uk - where dog owners can learn more about mitral valve disease and dilated cardiomyopathy, find out which breeds are most at risk and read more about the diagnosis and management of canine heart disease.
Boehringer has also created a Facebook page - www.facebook.com/beatcanineheartdisease - offering regular updates on heart health and a platform for owners to share their stories. Owners can also use the ‘Love Your Dog’s Heart’ Facebook profile frame to help spread awareness of the disease.
The aim of the campaign is to get pet owners thinking about mitral valve disease and having it treated whilst it is still in the asymptomatic phase, in order to slow the disease progression and delay the onset of heart failure1.
Vetmedin practices can access additional ‘Love Your Dog’s Heart’ campaign materials via the Boehringer Ingelheim Resource Hub at boehringer-ingelheim-resourcehub.co.uk.
Reference
The company says it believes it is the first major veterinary business in the UK to make this promise.
As a result of the pledge, salaries for about a third of the pet emergency firm's 1280 employees, including receptionists and animal care assistants, are set to increase to at least £9.50 an hour from April.
Vets Now says it has made the pledge on the recommendation of the Living Wage Foundation, which offers independent advice to employers and says £9.30 is now the real cost of living, not the Government-set national living wage of £8.72 for people aged 25 and over.
Vets Now’s chief executive Mark Ross said: "Our people are our biggest asset and at the heart of everything we do. We want to properly recognise the vital role each and every one of them plays in the business.
"This move demonstrates our commitment to that. We are confident that by paying all of our staff a competitive hourly rate of at least 20p more than the real living wage we will achieve higher morale and lower turnover."
Animal care assistant, Jody Reynolds, who works in Vets Now out-of-hours clinic in Kirkcaldy, said: “It’s amazing that Vets Now has been able to increase salaries to not only meet but exceed the real living wage. The extra will really help towards the cost of everyday living and even allow a few luxuries."
Apparently, there were over 100 times more recorded outbreaks of equine flu across the UK in 2019 than the year before1, and numerous equestrian events were cancelled as a result.
The company says that despite this, as of 2019, only about half of all UK horses are vaccinated2.
Blaise Scott-Morris MRCVS, Equine Marketing and Technical Manager at MSD Animal Health said: "Last year’s outbreaks of equine flu rocked the equine world, raising important animal welfare issues and costing the racing industry millions.
"Furthermore, they highlighted the need for good preventative healthcare and, in particular, vaccination. It’s vital that more owners are encouraged to vaccinate and those that already have, to keep up with their annual vaccinations and health checks so we don’t experience the same suffering again."
MSD's campaign invites horse owners to join the movement to #fightequineflu, and there is a range of materials to help practices promote the campaign and encourage clients to talk about vaccination and preventative healthcare, including an educational infographic poster, a social media pack and new resources on the Chameleon appointment reminder system.
MSD will itself be promoting the campaign on social media (Facebook: @Keeping Britains Horses Healthy, Instagram: @KeepingHorsesHealthy), and through partnerships with consumer channels such as Horse and Country TV.
There is also a new information resource online at www.kbhh.co.uk/achoo, which offers horse owners links to a range of other educational preventative health materials and horse care advice.
To request your Fight Equine Flu practice pack, speak to your MSD account manager.
References
Last year, a cohort of 1,077 veterinary nurses responded to the request for their CPD records, which took place in June 2019 and which also included a random sample of 761 veterinary nurses sourced from across all UK postcode areas. The audit found that 854 (or 79%) respondents were compliant with the annual CPD requirement – a 7% increase on last year’s compliance rate and the highest compliance rate yet from a veterinary nursing CPD audit.
Amongst vets, the audit found that 820 (or 81%) of respondents met the annual requirement – a 13% increase from the 2018 audit. This followed a decline in compliance rates from 82% in 2014 to just 68% in 2018.
Dr. Linda Prescott-Clements, RCVS Director of Education (pictured right), said: "It is fantastic to see that this year’s results demonstrate a significant increase in CPD compliance rates after a number of years in decline for vets and a largely static rate for veterinary nurses and I hope that it is part of a long-term trend towards the professions recognising the value of keeping their clinical and non-clinical skills up-to-date.
"This year we have made a number of changes that should make CPD compliance even easier now, including a clearer and simpler annual CPD requirement of 35 hours for vets and 15 hours for vet nurses, and the 1CPD platform and app which can be signed into through the My Account area and provides the professions with the ability to record, plan and reflect on their CPD."
Further information about the changes to the College’s CPD policy and the 1CPD platform can be found at www.rcvs.org.uk/cpd2020.
The 1CPD app can be downloaded through the Apple App Store, Google Play and via the RCVS website at https://onecpd.rcvs.org.uk/accounts/login/
Rominervin contains 10 mg/ml romifidine hydrochloride, equivalent to 8.76 mg romifidine, presented in a 20 ml vial.
It can be used as a sedative to facilitate handling, examination, minor surgical interventions and minor procedures or as a premedication prior to administration of injectable or inhalation anaesthetics.
Rominervin can also be used in combination with synthetic opiates such as butorphanol to provide deeper sedation or analgesia.
Dechra Brand Manager Emma Jennings said: "Rominervin is highly effective as it has a longer duration of action than other alpha-2 agonists1. It starts to work within one to two minutes with maximum sedation achieved between five and 10 minutes.
"It is yet another valuable addition in our equine anaesthesia and analgesia range that has been designed to provide vets with the therapies they need to operate successfully in day-to-day practice."
Rominervin can be used in conjunction with Dechra’s equine anaesthesia and analgesia app, designed to help veterinary professionals choose optimal anaesthetic protocols and calculate anaesthetic drug doses and administration rates.
For more information visit: www.dechra.co.uk/products/equine
The Disciplinary Committee considered a number of charges against Javier Salas Navarro MRCVS and Roman Kristin over 35 days.
The charges against Dr Navarro concerned his treatment of a kitten named Marnie. They included:
In August 2016, failing to read the anaesthesia consent form in relation to a surgical spay he performed;
When Marnie was readmitted for surgery, failing to read the anaesthesia consent form, failing to undertake adequate assessment of Marnie’s condition; performing surgery without adequately considering her condition; subjecting Marnie to anaesthesia without recognising the seriousness of her illness; failing to obtain informed consent from the owners; administering medication which was contra-indicated; and failure to make an adequate record of his involvement in Marnie’s care.
The charges against Dr Kristin also related to his treatment of Marnie. They included:
In August 2016, failing to undertake an adequate assessment of her condition; failure to recognise and record the fact that Marnie could not pass urine; failure to refer or offer her for specialist treatment; and failure to ensure Marnie received care and treatment overnight.
When admitting Marnie for surgery, that he made a number of clinical mistakes including failure to gain informed consent; and failure to recognise the seriousness of her illness;
that there were a number of failings in relation to Marnie’s care, including failure to arrange adequate overnight care, failure to monitor and record her condition, and failure to gain informed consent for the overnight care.
that he failed to advise Marnie’s owners that he suspected her uterers had been ligated during the spay, failed to advise Marnie’s owners that she required specialist veterinary treatment; and advised that Marnie undergo further surgery at the practice in spite of this meaning her having to undergo further anaesthesia in a week and with poor chances of survival;
that the above conduct was misleading and dishonest.
The Disciplinary Committee found a number of the facts in the charges against both Dr Navarro and Dr Kristin proven (the full details can be found in the documentation at www.rcvs.org.uk/disciplinary).
The Committee found that Dr Navarro breached a number of aspects of the Code of Professional Conduct for Veterinary Surgeons including: making animal health and welfare the first consideration when attending to animals; the provision of appropriate and adequate veterinary care; responsible prescription, supply and administration of medicines; communication with professional colleagues to ensure the health and welfare of the animal; being open and honest with clients and respecting their needs and requirements; effective communication with clients; keeping clear and accurate clinical records; and working with the veterinary team to coordinate the care of animals.
Of the proven charges, the Committee found that his initial failure to read Marnie’s anaesthesia consent form on 5 August did not amount to disgraceful conduct in a professional respect, but that the repetition of this failure on 9 August did amount to disgraceful conduct. It also found that Dr Navarro’s failure to undertake adequate assessment and perform surgery without this assessment amounted to serious professional misconduct. Furthermore, the Committee found that subjecting Marnie to anaesthesia in spite of her being unwell, failure to obtain informed consent and failure to keep adequate records also amounted to serious professional misconduct.
For Dr Kristin, in summary, the Committee found not proven the allegation that he had failed to respond on 5 August 2016 to concerns from Marnie’s owners about her condition while she was recovering from a surgical spay and also all the allegations relating to Dr Kristin’s admission of Marnie to the practice on 9 August on the basis that it was not satisfied so as to be sure that Dr Kristin had been the veterinary surgeon who admitted Marnie on that day.
The Committee found proven the remaining charges and found he breached the following parts of the Code of Professional Conduct for Veterinary Surgeons: making animal health and welfare the first consideration when attending to animals; keeping within area of competence and referring responsibly; providing appropriate and adequate veterinary care; responsible prescribing, supply and administration of medicines; communication with colleagues to ensure the health and welfare of the animal; being open and honest with clients and respecting their needs and requirements; communicating effectively with clients and obtaining informed consent; keeping clear and accurate clinical records; and working with the veterinary team to coordinate the care of animals.
Of the proven charges, the Committee determined that his failure to adequately assess Marnie’s health, to obtain a clinical history, to undertake blood tests and recognise that she was seriously ill, amounted to disgraceful conduct in a professional respect and led to “Marnie’s underlying condition going undetected and undoubtedly contributed to her eventual death two days later”.
The Committee also found that Dr Kristin’s decision to hospitalise Marnie without adequate overnight care, place her on IV fluids without monitoring the treatment or her condition, and failure to obtain adequate informed consent – among other things – amounted disgraceful conduct in a professional respect.
Stuart Drummond, chairing the Committee and speaking on its behalf, said: "As a direct result of Dr Kristin’s acts and omissions, Marnie was left alone overnight on fluids when those fluids had nowhere to go. Had he done his job properly he would have known that and Marnie could have avoided the prolonged suffering caused by the chosen course of treatment that did not address the underlying condition. Every element of Dr Kristin’s behaviour was catastrophic for Marnie, and yet he took no personal responsibility for her welfare and just went home.”
Following its findings on disgraceful conduct in a professional respect, the Committee then went on to consider its sanction for both Dr Navarro and Dr Kristin.
In respect of Dr Navarro, the Committee considered the mitigating factors including previous good character, admissions to some of the facts of the case from the outset; genuine insight and remorse into the seriousness of the actions; his youth and inexperience; and relevant and good-quality testimonials from colleagues. The Committee noted that the testimonials were universally positive and demonstrated that Dr Navarro had reflected on his conduct, had become more mature and confident in his practice and made efforts to rectify the areas in which he had fallen below standards.
Stuart Drummond said: “Although the consequences for Marnie and her owners were clearly devastating, the Committee considered that Dr Navarro’s part in her demise has to be seen in the context of all the evidence. In light of the extensive mitigation, including significant evidence of insight and remediation, the Committee was able to conclude that Dr Navarro did not represent a future risk to animals or the public. In such circumstances, the Committee considered that it was not necessary to restrict Dr Navarro’s registration and that a reprimand was the appropriate and proportionate sanction in his case.”
In relation to Dr Kristin, the Committee took into account positive character evidence from Mr Karel Daniel, a semi-retired veterinary surgeon and Vice-President of the Czech Republic Veterinary Chamber, a similar body to the RCVS in that country, as well as other testimonials on his behalf. In mitigation, the Committee considered Dr Kristin’s previously unblemished career, the fact that it was a single case involving a single animal; some development of insight into his conduct; no evidence of repetition; expressions of remorse; the impact of a family bereavement during the course of proceedings; and his financial position.
However, the Committee also took into account aggravating factors including a lack of candour from Dr Kristin when he was giving evidence, demonstrated by a tendency to blame others rather than take responsibility, as well as his recklessness in suggesting a third operation on Marnie that was not in her interests, rather than referring her into specialist care.
The final decision of the Committee on the sanction for Dr Kristin was that, given the seriousness of the misconduct, it was satisfied that this warranted a six-month suspension period. However, given the mitigating factors, the Committee decided that four months was appropriate and proportionate.
Commenting on the sanction Stuart Drummond said: “The Committee determined that it was important a clear message be sent that this sort of behaviour is wholly inappropriate and not to be tolerated. It brings discredit upon the respondent and discredit upon the profession and, most importantly, caused harm to Marnie and great distress to her owners.
"The Committee did consider whether to remove Dr Kristin from the Register. However, in light of the mitigation in this case, the fact that this was a single case in an otherwise unblemished career, together with the unlikelihood he would repeat his disgraceful conduct, the Committee decided that, in all the circumstances, to remove him from the Register would be disproportionate.
"The Committee therefore decided to order that the Registrar suspend Dr Kristin’s registration…. The Committee was satisfied that a period of four months was appropriate and proportionate in all the circumstances."
The full facts and findings from the case can be found at www.rcvs.org.uk/disciplinary
Prior to the start of the hearing, the RCVS received correspondence from Mr Kombert confirming that he did not intend to attend the hearing, either in person or via a video-link, nor did he intend to send legal representation in his stead.
The Committee, chaired by Dr Martin Whiting, decided to proceed with the hearing in the absence of Mr Kombert and any legal representation, on the basis that it was in the public interest and the interests of justice to proceed and that Mr Kombert had been given the opportunity to attend or be represented.
The Committee heard that staff at the practice where Mr Kombert was working as a locum had undertaken a check of the medicines kept in the practice’s controlled drugs cabinet and discovered that 5.5ml of ketamine and 1.5ml of methadone was missing. After the code to the controlled drugs cabinet was changed, Mr Kombert was observed taking an additional 3ml of methadone, which he then administered to himself while on duty at the practice.
After Mr Kombert was confronted with the evidence, he was given the details of the Vetlife charity for support and asked not to return to the practice.
The police were contacted and, on 4 January 2019, Mr Kombert was arrested and interviewed. He received a police caution for theft, with conditions that he should attend and complete a drug-use awareness course, and engage in a restorative justice process, which involved attending the practice to discuss his offences. At this meeting, Mr Kombert admitted stealing the drugs and administering them to himself while on duty, which meant he was not in a fit state to see patients. He apologised for his actions and the matter was then also reported to the RCVS.
In relation to the fact that Mr Kombert had accepted the police caution, made the admissions at the restorative justice meeting and had emailed the RCVS apologising for his actions, the facts of the case were found proven.
The Committee then went on to consider if Mr Kombert’s actions amounted to disgraceful conduct in a professional respect (henceforth called ‘serious professional misconduct’), something which Mr Kombert had admitted to in correspondence with the RCVS.
The Committee found that Mr Kombert’s actions did amount to serious professional misconduct. Dr Martin Whiting, chairing the Committee and speaking on its behalf, said: "The respondent’s conduct was dishonest; it constituted both a breach of trust and an abuse of his position with regards to access to veterinary medicines; it risked animal welfare and jeopardised the reputation of colleagues. It fell far short of the conduct expected of a member of the profession and amounts to disgraceful conduct in a professional respect."
The Committee then considered what the appropriate sanction against Mr Kombert should be, taking into account both aggravating and mitigating factors.
In terms of aggravating factors, the Committee took into account the risk of harm to animals, his dishonesty, the premeditated nature of the misconduct, the breach of trust and the fact it was repeated.
It also took into account three previous matters recorded against Mr Kombert in the United States of America.
These were: a letter of admonition from the Colorado State Board of Veterinary Medicine for practising when his licence had expired; a stipulation order from the same body in which he agreed to relinquish his licence in that state following an allegation that he took controlled substances from a veterinary practice and self-administered them; and a criminal conviction in New York State for obtaining an opioid controlled drug by deception, for which he was sentenced to three years’ probation. The Committee was made aware of the New York State criminal conviction after Dianne Norris, a Probation Officer based in that state, had contacted the RCVS after hearing about the inquiry and informed the College that Mr Kombert was in breach of his probation conditions.
Dr Whiting said: “The Committee has considered the witness statement of Ms Dianne Norris, a probation officer employed by Putnam County Probation in New York, who was responsible for supervising the respondent as part of his probation. Ms Norris explained that the respondent breached his probation on numerous occasions, which took place from November 2017 to 2018…. As a result of the breaches, Ms Norris required the respondent to increase his attendance at support groups to an inpatient treatment program for 28 days from 13 July 2018. He failed to attend.
"Ms Norris explained that warrants were issued for the respondent’s arrest…. The Committee noted that the conduct of the respondent in relation to obtaining controlled drugs from his employers for his own use while in the United States of America was similar to his conduct … [described in] the charges."
In mitigation the Committee considered that Mr Kombert had consistently admitted the charges against him as well as accepting and agreeing with the evidence against him.
However, the Committee decided that in light of the seriousness of his misconduct, including dishonesty and risk of serious harm to animals, removal from the Register was the most appropriate and proportionate sanction.
Summing up, Dr Whiting said: "The respondent has failed to uphold the requisite standards to be expected of him on multiple occasions. The Committee considers that the only sanction that is sufficient to protect the welfare of animals, maintain public confidence in the profession and declare and uphold proper standards of conduct is one of erasure."
Mr Kombert has 28 days from being informed of the outcome of the hearing in which to make an appeal to the Privy Council.
Starting in the New Year, the benefits of vaccination will be communicated to both farmers and pet owners, initially focussing on farm use.
The aims of the campaign are to raise awareness of how and why vaccines work and the range of diseases they protect against, to review and improve how vaccines are stored and administered, and to encourage better uptake of existing vaccines.
Further information and tips on storing and using vaccines correctly will be shared, to help ensure that vaccines used will be effective.
NOAH says that research has shown that:
Dawn Howard, NOAH’s Chief Executive said: “It is encouraging that vaccination of the UK’s calves and sheep against livestock diseases has risen to one of the highest levels in seven years1. This increase is encouraging, however still more needs to be done in relation to uptake, storage and usage. We are asking the vet profession to support the #VaccinesWork campaign by spreading the messages with their clients and engaging on social media."
"We will be providing information for farmers e.g. if vaccines are not stored correctly, it will impact on their potency, meaning they could be less effective – not only will there be the potential for the vaccine to fail to protect animals against disease but also farmers may have wasted their efforts – and may be deterred from vaccinating again."
Whilst correct use by farmers is the initial focus, the campaign will include pets. Dawn said: "The topic of vaccine hesitancy is becoming increasingly important. Recognised by the WHO as one of the top 10 global health threats for people in 2019, this phenomenon is translating to the veterinary sector as well, especially in companion animals. The PDSA reports an ‘alarming’ drop in pet vaccinations: the proportion of pet dogs, cats and rabbits receiving a primary course when young has fallen by 18% over the past 3 years, down to 66%3.”
"This is bad news for the health and welfare of the nation’s pets, who are increasingly at risk of disease, and we need to work to address this."
NOAH is asking practices to support the campaign by sharing messages and materials which will be published on its website (https://www.noah.co.uk/campaigns/vaccineswork) and on social media, @UKNOAH
https://ahdb.org.uk/knowledge-library/use-of-vaccines-in-cattle-and-sheep-2018-sales-update
https://www.noah.co.uk/wp-content/uploads/2019/10/NOAH-Vision-Paper-8pp-A4-Sep-19-vf.pdf
https://www.pdsa.org.uk/media/7420/2019-paw-report_downloadable.pdf
This second edition of the Pocketbook for Veterinary Nurses contains a number of notable additions including: surgical and anaesthetic checklists, pain scales for dogs, cats and rabbits, dental recording charts, and PROTECT ME information on antimicrobial resistance.
This edition has been edited by Emma Gerrard (pictured right), who built on the work of Louise O’Dwyer, the editor of the first edition. It condenses knowledge from a range of BSAVA titles, including the BSAVA Textbook of Veterinary Nursing, together with information from a number of external sources.
The BSAVA says the Pocketbook for Veterinary Nurses has been put together with an awareness of the value of time in a busy clinical setting. Sections are arranged alphabetically, with cross-references for ease of use.
Ian Ramsey (BSAVA President 2020-2021): “Animals are more likely to get better, and get better faster, if they have good nursing care. This book is packed with the sort of information that allows nurses to deliver that care. It is presented in a format that makes it easy to carry around, but it will find its home at the heart of the clinic.”
The BSAVA Pocketbook for Veterinary Nurses, 2nd edition is now available from the BSAVA website www.bsava.com/shop priced at £15 for BSAVA members and £25 for non-members.
New BSAVA veterinary nurse members, and existing members who renew in 2021, will receive a free copy of the book.
During the course, which counts as 7 CPD hours, some of the best-known veterinary experts in equine nutrition will be sharing their knowledge with the speaker panel comprising Caroline Argo, Andy Durham, Pat Harris, Nicky Jarvis and Sarah Stoneham.
Course organiser Nicky Jarvis said: "Whether it's a conversation with an owner about their overweight horse, examining a geriatric pony with weight loss or formulating nutrition for an orphan foal, tailored nutrition is the cornerstone of every equine case we see in veterinary practice.
"We regularly treat a variety of conditions such laminitis and colic, but are we always confident about the best feeding advice to give our clients? And how often do we walk into a tack room full of the ‘latest’ supplements and wonder if any of them actually work?"
The course will look at a range of clinical conditions to enable vet nurses to build evidence-based feeding advice into their treatment plans, formulate diets for any age of horse and see which supplements are worth the internet hype. The speakers will provide practical tips for everything from the anorexic pony to the stubborn weight loss case.
The course will cover how to:
BEVA President Lucy Grieve said: "Following the National Equine Forum’s Great Weight Debate (Equine) last month, appropriate equine nutrition has never been more topical.
"Equine obesity is a growing problem and this debate has highlighted how teamwork, communication and trust will help to tackle it to best effect. Veterinary professionals are in a unique and privileged position to support owners on all matters of nutrition and this course will give you the knowledge you need to provide practical, constructive help."
From superfoods to supplements: How to know more than the owner will cost £80.00 for members and £160.00 for non-members. To find out more and to book visit https://www.beva.org.uk/Education/CPD/Event-Details/eventDateId/555
The study was part of the RVC’s VetCompass programme which include anonymised veterinary information from over eight million UK dogs. From this pool, a random sample of 22,333 dogs were followed for a year, identifying all health issues that were diagnosed during this time.
The study is one of the largest ever studies to explore the anonymised health records from veterinary surgeries and report on the most common disorders in dogs. The study also looked at whether the health of dogs varied by age, sex and whether the dogs were neutered.
The main findings were:
Dr Dan O’Neill, Senior Lecturer, Companion Animal Epidemiology at the RVC and lead author of the paper, said: "This study shows that it is really important for owners to develop strong habits of caring for their dog’s teeth, ears and weight, right from the time they first acquire a puppy.
"This study shows interesting and strong correlations between human and canine healthcare: the need for good dental and bodyweight maintenance. Given how closely the lives of humans and dogs are intertwined, this should be no surprise really; we often share the same food and exercise. Owners should work closely with their vet to plan appropriate dental and weight care programmes at each visit to their veterinary clinic.”
Hannah James, Health Research Manager at the Kennel Club, and co-author of the paper, said: "As dog owners, the key priority is keeping our pets healthy and happy, but it can be difficult to put into context the most common problems that affect our canine counterparts and which areas we need to pay particular attention to in order to maintain this. These findings help us establish these key areas, and where we as owners, vets and organisational bodies can work towards to improve the day-to-day life of our beloved companions."
O'Neill, D.G., James, H., Church, D.B., Brodbelt, D.C. and Pegram, C. (2021) 'Prevalence of commonly diagnosed disorders in UK dogs under primary veterinary care: results and applications', BMC Veterinary Research.
Photo: Uwe Gelle
The strategy, which is available to read at: www.rcvs.org.uk/diversity, lists six areas where the College and other DIG member organisations can work to improve diversity and inclusion within the veterinary professions at all stages – from school-age children who may be considering a career in the veterinary professions, to engendering positive culture change for those already in the professions.
The six areas are:
The RCVS Diversity & Inclusion Group includes representation from the Association of Veterinary Students (AVS), British Veterinary Association (BVA), the British Veterinary Ethnicity & Diversity Society (BVEDS), the British Veterinary LGBT+ Society, the British Veterinary Nursing Association (BVNA), the Major Employers Group, the Society of Practising Veterinary Surgeons (SPVS) and the Veterinary Schools Council (VSC) and will be responsible for monitoring and evaluating progress within each of the above areas.
Dr Niall Connell, Senior Vice-President of the RCVS and Chair of the Diversity & Inclusion Group, said: "I’ve always been of the opinion that making the veterinary professions more diverse and reflective of British society at large, as well as protecting fellow professionals from discrimination, isn’t just a moral issue, but one that actually improves the quality of the profession and the outcomes we are delivering for our clients and patients.
"If we are losing colleagues to discrimination or just not attracting people from diverse backgrounds in the first place because they think it’s ‘not for people like them’, then we are losing out as a profession, and if we aren’t drawing on a diverse range of backgrounds, experiences, and attitudes in our work, then we are also potentially doing a disservice to our patients and clients. This is why this Strategy is not just a case of being seen to be doing something, but is actually crucial for the ongoing vitality and credibility of the veterinary team.
"It’s important to emphasise that this Strategy is a start, and not an end in and of itself. There will be lots of hard work to be done and challenging conversations to be had, and results may not be quick or immediately obvious, but I am proud that we are taking a proactive approach and not just saying ‘things will change with time’.
Dr Mandisa Greene, RCVS President and a member of the DIG, added: “Fulfilling this Strategy will involve a lot of hard work over the coming months and years but I am glad to say that many of the activities it outlines are already underway both at the RCVS and our partner organisations, building on the pioneering work that organisations such as the British Veterinary Association, British Veterinary Ethnicity & Diversity Society, the British Veterinary LGBT+ Society, Animal Aspirations and others have been undertaking.
“For example, we have already held a joint RCVS and Veterinary Schools Council Roundtable with BAME students in which we heard about their experiences, issues that they have encountered and how they felt they could be better supported. These discussions led to the formation of a new RCVS/VSC Working Group that will take forward actions as a priority.
"Our Mind Matters Initiative has also funded a vital piece of research being undertaken by BVEDS and the Royal Veterinary College on the impact of racism on the mental health of BAME veterinary professionals which will no doubt highlight some critical actions to take to better protect members of the professions from discrimination and improve how discrimination is reported and dealt with.
“On a personal level, I have also been undertaking a number of school talks and providing one-to-one mentoring to school students about veterinary careers because I think it is important that children from a wide variety of backgrounds can see me, as a Black British woman of Caribbean heritage, as a role-model for diversity within the veterinary profession and know that the professions can and should be welcoming to all.”
The new distribution service uses Invatech's Patient Medication Record (PMR) system, called Titan, which was accredited by the NHS a little over a year ago. Titan has now been developed further to support the company's Home Pharmacy service, and integrate with MWI.
The company says the new system offers practices a seamless workflow between prescribing, dispensing and logistics systems.
Tariq Muhammad, CEO of Invatech Health, said: "“The use of PMR systems for the veterinary market has been very light touch until now. Knowing that that we can bring the same level of efficiency and workflow to a new market presents an opportunity to support animal health in the same way that we do for human health."
Alan White, Commercial Director at MWI Animal Health, said: “The Covid pandemic has presented many challenges to veterinary professionals in the UK. Travel restrictions and social distancing measures make it difficult for animal owners to collect the medications and treatments they need from veterinary practices.”
“We are excited to be able to work with Invatech to provide an innovative solution to this problem, where vets can send the medications needed directly to their client. Working in partnership with veterinary practices and Invatech means we can move animal health forward together.”
For more information, visit: https://www.invatechhealth.com/
Hill's says the new diet, which has been through three clinical trials over four years, contains nutrients to help strengthen the skin's natural barrier against environmental allergens and the Histaguard complex with bioactives and phytonutrients to help manage a dog's response to environmental allergens.
Prescription Diet Derm Complete also uses egg as its single intact animal protein source, which Hill's says avoids 96% of adverse food reactions1 and has shown the ability to dampen the inflammatory response in dogs and reduce itching.
Hill's says the new diet represents a real breakthrough, both because it simplifies treatment and because it's the first dietetic food for both adverse food reactions and environmental sensitivities.
Michael Unsworth, Hill’s Vet Affairs Manager, UK & Republic of Ireland said: "Supporting patients with skin sensitivities can be extremely challenging. Not only is it uncomfortable for the pet themselves, but it can cause a lot of distress for owners who just want to give their dogs a happy and healthy life. There can be a lot of pressure to find a quick, effective and affordable solution.
"Our new Prescription Diet Derm Complete is truly a ground-breaking product; the result of years of trials and clinical studies that has seen visible skin healing in dogs with AFR in as little as 21 days2 and not a single dog showing signs of recurrence after using the product.
"We’re thrilled to introduce this innovative, life-changing product to the market, to the benefit of dogs, dog-owners – and of course veterinary professionals - everywhere."
Accompanying the launch, there's a free webinar taking place at 7.30pm on Tuesday 23 February (tomorrow) for veterinary nurses in which Sarah Warren BVetMed MSc (Clin. Onc.) CertVD MRCVS will look at the complex nature of canine allergic skin disease and the importance of individualised treatment plans. To register, visit: https://www.veterinarywebinars.com/hills/canine-dermatitis-hills/
For more information about Prescription Diet Derm Complete, contact your Hill’s representative.