Earlier this month, the government had exempted veterinary surgeries from the requirement to close their doors during the pandemic. Strictly speaking, the exemption meant that practices could carry on offering the same level of service as before, provided they followed further government guidelines on social distancing.
However, the College then advised that non-essential treatments should not be carried out until further notice, and that animals should only be seen in emergency, or if their health was likely to deteriorate as a result of inaction.
This included vaccination, where RCVS advice stated that whilst routine vaccinations were considered not urgent, there "may be scenarios where, in your professional judgement, vaccines are being given to reduce a real and imminent risk of disease; this includes in the face of an animal disease outbreak, or in a scenario where part of a vaccine course has been given and the animal may be exposed to the disease."
The updated College guidelines, issued last Thursday evening, appeared little changed, except to say that its advice concerning vaccinations is under review. Meanwhile, its new flowchart gives a very clear framework for veterinary professionals to work within, essentially leaving it to your own professional judgement to weigh up the risks.
However, the BVA went further, declaring amongst other things, that:
Vaccinations – we are now recommending that primary vaccinations and year 1 boosters in dogs and cats go ahead due to the increased risk of disease outbreak over a longer period of time, and annual leptospirosis vaccination due to the zoonotic risk. If additional component of the core vaccine is due at the same time, it should also be administered. In addition, we’re recommending rabbit vaccinations go ahead due to the seasonal disease risks. Rabies vaccinations should be carried out if required for certification reasons
.... leading to an outcry that the BVA's advice appeared to be being relaxed at precisely the point when the government is imploring the public to stay at home, and that:
To add further fuel to the flames, the British Small Animal Veterinary Association then issued a statement to the effect that it had not been consulted during the preparation of the new BVA guidelines, which BVA past President Robin Hargreaves felt was so economical with the truth that he resigned his BSAVA membership on the spot.
COMMENTAt the end of it all, there is but one simple truth for every veterinary surgeon who is working in these difficult times, and it is this: The government and the RCVS guidance gives you the freedom to exercise your professional judgement concerning whether or not an animal needs to be seen for whatever reason. Provided you can explain why you reasonably concluded that an animal should or should not be seen, that is all that matters. It trumps everything else.
This whole farago has highlighted a number of important issues in the profession, starting with the social media conspiracy theories that the new guidance came after pressure from corporate practices when as far as I can tell, it appears to have been driven by a genuine concern that that failure to vaccinate could cause significant welfare issues in the future.
That seems a reasonable argument, and very much in line with the College advice. But that in turn raises a far bigger question, which is what on earth the BVA (a voluntary membership organisation) was doing issuing what appeared to be instructions ostensibly for all members of the profession. Notwithstanding the fact that BVA recommendations have no legal weight, having all these chefs running around with different recipe books is itself a recipe for muddled communications and confusion over leadership.
In turn, that raises the even bigger question of what the BVA's role should be. Should it be snuggling up in bed with the RCVS, issuing joint edicts? Or should it instead be holding the College to account, challenging its decisions and demanding clarification where clarification is necessary. I would argue the latter. In this situation, the ONLY organisation issuing guidelines about vaccinations for practising vets should be the regulator. And it is the role of the BVA to challenge those guidelines if necessary, or to demand clarification.
Which leads me on to the next thing, which is that increasingly, members of the profession seem to demand explicit rules or guidelines to operate within. There are lots of hypotheses for why this might be true. Perhaps because we live in a more (or seemingly more) litigious world and veterinary professionals like the reassurance rules provide. Perhaps it is because the younger cohort of vets lack the self-confidence needed for decision-making. Perhaps corporatisation has a part to play, in that employees of larger organisations tend to play more by the rules. Or perhaps it is a consequence of the growth in the 'refer everything’ culture which means vets take fewer clinical risks.
Whatever the reason, it seems clear that in some cases, the RCVS tack of "you're a professional, decide for yourself" is perfectly reasonable, whereas on other occasions, such as Schedule 3, more explicit guidelines are demonstrably necessary. Once again, surely the role of the BVA as the "Voice of the profession” is not to issue its own advice, but to press the College for more explicit guidelines as necessary.
Lastly, there is the role of Facebook in all of this. Quite obviously vets are no more immune to conspiracy theories than members of the public who think that coronavirus is spread by 5G telephone masts. Sadly, the truth is usually far less exciting. However, the problem at the moment is that the growth in social media and Facebook groups has left the regulator and the representative associations on the back foot, such that it is often left to individuals from those organisations who 'happen to come across OK online' (rather than having any properly defined role) to firefight.
Photo: https://www.scientificanimations.com/wiki-images/
The webinar will consider questions such as how practices can maintain turnover whilst sticking to the government and regulator guidelines, and how this can be done without compromising the customer experience.
Hosted by Past President of the British Veterinary Association Gudrun Ravetz, three additional veterinary business experts - Brian Faulkner, Alison Lambert and Alan Robinson - will come together to share their advice on how to minimise the impact that coronavirus has on the practice, the team and a practice’s clients.
Veterinary professionals can submit questions directly to the panel who will answer them during the live event.
To register for the webinar, visit the Boehringer www.boehringer-academy.co.uk.
The Queen’s Medal - the highest honour that the RCVS can bestow upon an individual veterinary surgeon - was given to Dr Mary Stewart MRCVS, a retired academic who spent most of her career at the University of Glasgow where she was responsible for the development of the modern vet school.
Dr Stewart was nominated by Professor Stuart Reid, the Principal of the Royal Veterinary College and former Dean of the Glasgow Veterinary School. In his nomination he said: “Mary Stewart is one of the unsung heroes of the veterinary profession. A veterinarian graduating from Cornell in 1949, Mary has been MRCVS since 1951 and without doubt has been one of the major influencers of ethical approaches in the vet-client-patient environment and, in particular, the impact of euthanasia on both owners and attending veterinarians. Conducting nearly all her professional career in the UK, the vast majority at the University of Glasgow, Mary was of the generation selected by Sir William Weipers to create the modern school at Glasgow, an institution in which Mary played a pivotal role that would have reach nationally and internationally.”
The Inspiration Award is given to vets or nurses to recognise their ability to inspire and enthuse others consistently throughout his or her career. This year, it has been awarded to Dr Freda Scott-Park MRCVS. Freda is a former president of both the British Veterinary Association (BVA) and the British Small Animal Veterinary Association (BSAVA) as well as the current coordinator of the Highlands & Islands Veterinary Services Scheme and a campaigner for identifying the links between animal and other forms of abuse through The Links Group.
The Impact Award is given to vets and nurses who have recently made a considerable impact that has affected the profession at large, animal health or welfare, or public health. This year two Impact Awards have been bestowed. The first is to Dr Rosie Allister MRCVS, a leading campaigner and researcher for and about veterinary mental health, as well as a veterinary educator, the manager of the Vetlife Helpline and a member of the RCVS Mind Matters Initiative Taskforce.
The second Impact Award recipient is Hannah Capon MRCVS, the co-founder and director of Canine Arthritis Management (CAM), a self-funded social enterprise that provides advice to both other veterinary professionals and animal owners on the treatment and management of arthritis in dogs.
This year the RCVS is also awarding three Honorary Associateships, bestowed upon those who are not veterinary surgeons or veterinary nurses but who are making a considerable impact in the veterinary sphere, whether in the field of campaigning, charities, research, politics or journalism, for example.
This year’s first Honorary Associate is Professor Maureen Bain, Professor of Comparative Anatomy and Histology at the University of Glasgow’s Institute of Biodiversity, Animal Health & Comparative Medicine, and an Associate of Glasgow Vet School who has dedicated her career to research on improving the quality and safety of eggs for human consumption.
The second Honorary Associate is Mike Flynn, the Chief Superintended of the Scottish Society for the Prevention of Cruelty to Animals (SSPCA), for his collaborative work with the veterinary profession in areas such as the illegal puppy trade and the Links Group.
The third and final Honorary Associate is Professor Roberto La Ragione, the Deputy Head of the Surrey Vet School where he is also Professor of Veterinary Microbiology and Pathology and Head of the Department of Pathology and Infectious Diseases. Professor La Ragione was nominated for his contribution to veterinary education and research.
RCVS President Niall Connell (pictured right) said: “My hearty congratulations to all of this year’s award winners. Once again, it was a very strong field of people who have made and are making an indelible impact on veterinary science, the professions, animal health and welfare, food safety, public health, and plenty more besides."
Normally RCVS Awards & Honours are presented at Royal College Day in July. However, due to the coronavirus pandemic, the 2020 awards ceremony will instead be part of the proceedings of a combined Royal College Day and Fellowship Day, which will take at the Royal Institution on 2 October 2020. This event may be subject to cancellation and postponement depending on the latest Government advice and restrictions on the prevention of transmission of coronavirus.
Specifically, the statement explains that:
Vets will risk assess each case and exercise their clinical and professional judgement to decide whether face-to-face treatment or care is essential or whether services could be provided remotely. These assessments will vary across the country due to local disease risks. They will also vary between clients due to individual circumstances.
On the specific issue of pet vaccinations, BVA guidance says that following a risk assessment both for animal health and welfare and with regard to Covid-19, some vaccinations could go ahead. But this does not mean that all vaccinations now have to be, or should be, carried out. Vets will risk assess each case to decide whether certain vaccinations are essential at this time.
BVA is asking all animal owners to respect their vets’ clinical and professional judgement and be patient during this time.
The first webinar will be run by Dr Sarah Caney (pictured right), the CEO and founder of Vet Professionals, and Dr Hannah Newbury, technical lead vet at MSD Animal Health.
It will cover how telemedicine can benefit you, your practice and your patients. Sarah and Hannah will offer practical tips on how to set up a remote consultation, what you can do via telemedicine during the UK lockdown, and how to carry out these consultations and provide care during this time. There will also be an opportunity to ask specific questions in advance.
The series will also explain the financial benefits of remote consulting and the release of a new telemedicine platform.
To register for the first webinar, visit: https://attendee.gotowebinar.com/register/4735768510902351372.
Click here to submit your questions before the webinar: https://getfeedback.com/r/hBY8qihT/q/1.
The company says it has made the test available in response to customer demand and growing evidence that in rare cases pets living with COVID-19-positive humans can be at risk of infection.
The test will be available to veterinary surgeons in North America this week and will roll out across most of the world in the coming weeks, via the company's worldwide network of laboratories.
Jay Mazelsky, President and Chief Executive Officer of Idexx Laboratories said: "We have continued to monitor the rapidly evolving public health crisis worldwide, paying special attention to the effects on pets.
"While there is currently no evidence that dogs or cats play a role in transmitting the disease to humans, it became clear offering the test was the right thing to do when we saw clinical evidence that pets—especially cats and ferrets—can in rare cases be at risk for infection. And, we heard from our customers around the globe that veterinarians needed a testing option."
Idexx recommends the test is used when three specific criteria are met:
Idexx says leading health authorities agree with the company that transmission of the SARS-CoV-2 virus is primarily person-to-person and advise against testing asymptomatic pets. Since mid-February, the company has tested over 5,000 specimens for the virus, from cats, dogs, and horses with respiratory symptoms in 17 countries. To date, it has found no positive results, suggesting that dogs and cats living with infected people generally remain uninfected, except in rare and isolated cases.
For information about the Idexx SARS-CoV-2 (COVID-19) RealPCR Test for pets, visit idexx.com/covid19-pet-test.
The study also suggests that encouraging the idea that client-orientated behaviours make for a 'good vet' will help many vets improve their mental wellbeing.
Liz found examples of new graduates who value their client-oriented skills, such as being able to tailor clinical plans to individual clients' needs, but still couldn’t shake the feeling that a 'better vet' would offer a more academic or specialist approach to cases.
Even when they skilfully adapt a plan for an owner who is unable to afford advanced tests to find out what is causing their pet's illness, this jars with the vets' beliefs that by reaching a specific diagnosis they would be doing a better job. Thus they chronically feel like a 'bad vet', despite demonstrating high-level skills in communication and clinical problem-solving.
The paper argues that learning to form positive client relationships in difficult situations leads to vets who are more resilient and have greater mental wellbeing.
However further analysis found a clear sentiment of 'the client is the enemy' in colleagues' discussions and social media.
During a difficult case, with complex conflicting pet and pet owner needs, vets who choose to emphasise the client as difficult and unreasonable can receive temporary solace when talking to similarly-minded peers or by accessing social media. However, this thinking prevents them from developing client empathy, impacting their mental health negatively in the long-term.
Liz therefore believes everyone in the profession has a responsibility to frame the strengths of the 'good vet' as being as much about the pet owner as the pet.
Liz said: "It's really important not to think of this as a message that we must all be 'nicer' to our clients. I have heard vets say clients' limited finances or not wanting to put their pet through treatment have forced them to go against their 'professional code'. This simply isn’t true: the RCVS Code of Conduct emphasises a need to work alongside clients to problem-solve these complex situations. Animal welfare can be supported through palliative or symptomatic treatments, which may be offered after difficult negotiations with very upset pet owners. This should therefore be a skill that is celebrated, rather than being considered not 'gold standard'.
"Being able to work with a client who is highly troubled by their financial limitations or the impending loss of a pet is difficult, particularly when these anxieties manifest as anger and accusation. The social media message of the client as the enemy obstructs this skill, as it becomes easier to rant about the 'difficult client'. Unfortunately, where this becomes embedded, it prevents the career satisfaction that comes from working with clients."
Reference
Photo courtesy RVC
The system consists of a number of small wireless sensors which are placed in each fridge and which transmit data to a base station. It records a temperature history for each fridge, transmitting the data in real time to secure cloud storage, from where it can provide reports on the changing temperature in each fridge for compliance and regulatory purposes.
RemoteM is self-installed and battery operated, and it transmits data using the mobile phone network, so it is not reliant on a power source or working internet connection. Temperature alarms can be sent to one or more recipients, using email, automated voice calls or SMS.
Dalehead Veterinary Group, which has practices in Settle, Bentham and Gisburn, began trialling the RemoteM system almost a year ago.
Dalehead has six fridges at its Settle practice. Before installing RemoteM, practice staff needed to record daily readings of fridge temperatures, taken at different times of the day. As well as being a time-consuming process, it risked being inaccurate, as simple in-fridge monitors do not record all fluctuations in temperature.
Practice Manager Emma Spence said: "RemoteM has already saved us at least £4,000.
"One of our small animal vaccine fridges failed overnight, and the instant alarm meant we were able to respond immediately, with our on-call vet moving the stock to another fridge without risk of deterioration. At various times of year when we can have high values of stock in individual large fridges, this could have been even more critical."
The practice says the system has also proved useful in alerting staff to fluctuating temperatures in warm summer months, helping to ensure that vaccines and medicines are used in optimum condition.
For this reason, RemoteM sensors are also used outside fridges to monitor stock held at ambient temperatures, where the alarm trigger is set at 25 degrees to ensure stock does not exceed manufacturers' recommended storage temperature limits.
Another benefit of the system has been that Dalehead's insurer has said that with RemoteM, it is happy for the practice to continue to use its older fridges, instead of stipulating that they are replaced every three years.
So, it's not just saving the practice money, then. It's helping reduce pollution too.
For more information, call 0330 223 4553, email: info@remotem.co.uk or visit: www.remotem.co.uk.
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.
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