The RCVS has confirmed that surgical insemination in dogs is prohibited by animal welfare laws and amended Section 27 of the supporting guidance to the Code of Professional Conduct so that it now sits alongside tail docking, dew claw removal, prosthetic testicles and feline renal transplantation from living donors on the list of banned procedures.

RCVS Registrar, Eleanor Ferguson said: "Changes to the chapter of the supporting guidance to the Code of Professional Conduct titled ‘Miscellaneous procedures: legal and ethical considerations’, specifically in regards to surgical artificial insemination in dogs, were discussed at a meeting of the Standards Committee on 30 January 2019.

"The proposed changes to the guidance were to clarify that surgical artificial insemination (AI) in dogs is prohibited by animal welfare legislation – specifically the Animal Welfare Act 2006, which prohibits mutilations. Prohibited procedures are defined as those which interfere with sensitive tissue or bone structure. Surgical AI in dogs is not one of the exemptions permitted within the Mutilations (Permitted Procedures) (England) Regulations 2007.

"Due to an unfortunate oversight, the guidance had not been updated following this legislative change, although, in the interim, the guidance still made it clear that surgical AI in dogs was unlikely to be in the animal’s best interests and could only be carried out and justified in very limited circumstances and for exceptional reasons.

"However, we apologise for the oversight, and as soon as the College was made aware that the guidance on surgical AI did not conform exactly with the legislation and regulations, a paper was prepared for the Standards Committee to consider as soon as possible and update the guidance accordingly.

"As always, if any members of the profession or the public have any questions about any aspect of our Code of Professional Conduct and supporting guidance, they are welcome to contact our Standards and Advice Team on advice@rcvs.org.uk."

The RCVS Disciplinary Committee has suspended Dr Jacqueline Bohnen, a South African veterinary surgeon who had been working in the County of Moray, Scotland, for being misleading and dishonest in relation to her treatment of a Cavalier King Charles Spaniel in March 2017.

Dr Bohnen faced two charges. The first was that in March 2017, she failed to attend to Belle, a Cavalier King Charles Spaniel, in order to provide appropriate and adequate care including: assisting Belle with urination, monitoring her with a view to considering alternative treatment options, and monitoring her with a view to providing her owners with an update on her condition.

The second charge was that Dr Bohnen later claimed dishonestly that she had attended to the animal, both to the owners, in clinical records hospital records, in a note provided to colleagues and during internal disciplinary proceedings held at her practice.

At the outset of the hearing the Committee considered an application from Dr Bohnen for the hearing to be postponed as she was now based in her home country of South Africa, and said she could not apply for a visa to return to the UK until later in the year and internet access in her location was poor.

However, the Committee found that the RCVS had properly served the notice of inquiry to Dr Bohnen in accordance with the current rules, that she had had sufficient time and opportunity to apply for a visa since receiving the notice and that, in any case, she could remotely ‘attend’ the hearing via Skype or telephone if necessary by travelling to somewhere that did have adequate internet connectivity, and so it refused the application. 

The Disciplinary Committee then considered the facts of the case and heard evidence from the owners of Belle, the clinical director of the practice that Dr Bohnen worked in at the relevant time and a veterinary nurse, who was a student doing her training at the practice during the time of the events in question.

Having considered all of the evidence, the Committee dismissed the parts of the first charge relating to considering alternative treatment options and updating the owners in relation to Belle’s condition. They did, however, find the charge proven in relation to Dr Bohnen failing to assist Belle with urination.

The Committee found all aspects of the second charge proven in its entirety after Dr Bohnen admitted in advance of the hearing, that her representations were false and misleading.

The Committee then went on to consider whether the second charge and the aspects of the first charge that were found proven amounted to serious professional misconduct both individually and cumulatively.

The Committee considered that Dr Bohnen’s conduct in failing to assist Belle with urination, whilst falling below the standard to be expected of a reasonably competent veterinary surgeon, did not amount to serious professional misconduct. 

The Committee did however find that Dr Bohnen’s conduct with regards to the second charge constituted serious professional misconduct.

Professor Alistair Barr, chairing the Committee and speaking on its behalf, said: "The Committee considers that the respondent’s dishonesty was the prime aggravating factor in this case. Although overall it could be regarded as a single incident, the Committee has found that it involved the fabrication of a number of notes and clinical records in the immediate aftermath of the death of the dog, but, thereafter, the respondent continued to deny the falsity of the fabricated records that she had created up to and until the conclusion of her interview by the practice on 30 March 2017. 

"During that time, the respondent had contacted the alarm company responsible for the security of the premises of the practice, to enquire whether the security system would record the times of the alarm being switched on and off. This indicated that the respondent’s dishonesty continued over a significant period of time, and that her persistence in sticking to her story became premeditated. In other words, the respondent’s conduct over this time indicated a clear attempt to deceive."

Regarding the sanction for Dr Bohnen, the Committee considered that the principle aggravating factors in the case were serious dishonesty towards both her colleagues and the owners of the dog and involved clear breaches of the Code of Professional Conduct. By way of mitigation, the Committee noted that Dr Bohnen is of previous good character with no other professional findings against her and that she had demonstrated some insight into her behaviour and had admitted being dishonest and misleading prior to the hearing. 

Summing up, Professor Barr said: "Because of the seriousness of this case, the Committee did not consider that it was appropriate to postpone judgement, take no further action, or to administer a reprimand and warning as to future conduct. The Committee considered that the respondent’s conduct, involving significant and admitted dishonesty over a period of time, required a significant penalty, in order to protect the welfare of animals and to serve the public interest.

"Accordingly, the Committee has decided to direct that the respondent’s registration be suspended for a period of nine months."

Dr Bohnen has 28 days from being informed of the Committee’s decision to lodge an appeal with the Privy Council.

Whilst you're here, take a moment to see our latest job opportunities for vets.

The RCVS and the BVA have called on the government to add veterinary surgeons to the Shortage Occupation List as part of the UK’s preparations for leaving the European Union.

The organisations made a joint submission to the Migration Advisory Committee (MAC) as part of its review into the Shortage Occupation List which began in autumn 2018 and will report back in spring 2019.

The BVA and the RCVS had previously made calls for the profession to be added to the list in 2017 when the MAC held a call for evidence on the impact of the UK's exit from the EU on various professions. The latest submission is a development on this previous submission, focused on the need for the post-Brexit immigration system to recognise the issues affecting the veterinary workforce, which is already under-capacity, and reiterating its importance in areas such as public health, food safety, disease surveillance and control, education, research, clinical practice and animal welfare.

The submission details how the demand for veterinary services does not currently match supply and that the UK is therefore reliant on overseas registrants, particularly from the rest of the EU, who currently make up around 50% of new registrants in a given year.

The RCVS and BVA add that, in the post-Brexit immigration system, this reliance on overseas vets needs to be recognised by adding veterinary surgeons to the Shortage Occupation List, thus reducing the immigration requirements needed for overseas veterinary surgeons to live and work in the UK and streamlining the application process for employers.

Amanda Boag, RCVS President, said: "We wanted to use this submission as an opportunity to reiterate the circumstances currently facing the profession, particularly in light of the uncertainties around the UK’s exit from the EU and the impact this could have on the supply of veterinary workforce from the rest of the EU, which is crucially important in a number of areas. We need, therefore, for veterinary surgeons to be immediately added back to the list so that we can ensure that this flow of workforce continues and that animal health and welfare is protected.

"In the meantime we are continuing to work with BVA and the Department for Environment, Food and Rural Affairs (Defra) to look at how we can develop ‘home-grown’ veterinary capacity in the UK through expanding the UK veterinary education sector, increasing retention rates within the profession, and looking at how the veterinary team could be reformed to allow allied professionals, such as veterinary nurses, to take on extra tasks and free up veterinary time. However, these are all long-term projects and not quick fixes to the issues facing the profession."

As well as calling for a future immigration system to prioritise the veterinary profession, RCVS and BVA also recommend that veterinary employers be exempt from the Immigration Skills Charge to avoid additional barriers or burdens to the employment of overseas vets and recommend that there is no minimum earning cap for veterinary surgeons applying for work visas, on the basis that veterinary surgeons are "skilled professionals who may choose to work in the UK for reasons other than remuneration".

Simon Doherty, BVA President, said: "It is in MAC’s gift to reinstate vets on the Shortage Occupation List and this evidence makes a strong case for it to happen as quickly as possible.

"Vets deliver multiple benefits to animal health and welfare, public health and food safety, and they have a crucial role to play in future trade deals and keeping standards and confidence in UK exports high.  The profession is also indebted to a high proportion of skilled EU vets who have chosen to make the UK their home and place of work. 

"With this in mind, the future immigration system must be geared around preserving veterinary capacity rather than introducing new layers of bureaucracy or restrictions on flexible movement between roles. We have raised concerns that extending the Immigration Skills Charge to EU workers would hit some areas of the workforce disproportionately hard, particularly the abattoir industry where 95 per cent of Official Veterinarians hail from overseas.

"With uncertain times ahead and demand for some veterinary services predicted to spiral after Brexit, it has never been more pressing to take decisive action to safeguard against shortfalls in capacity and give a vital vote of confidence in the veterinary workforce."

To read the full submission, visit https://www.rcvs.org.uk/document-library/joint-rcvs-and-bva-submission-to-migration-advisory-committee/ 

The RCVS Disciplinary Committee has directed the Registrar to remove Laura Padron Vega, a former Official Veterinarian, from the Register for dishonestly backdating certificates in order to avoid new animal welfare regulations.

Miss Padron Vega faced four charges. The first and second alleged that in February 2016, for the purposes of an application to the Food Standards Agency for a Certificate of Competence under the Welfare of Animals at the Time of Killing Regulations 2015, she backdated two separate veterinary witness certificates to 7 December 2015. The third charge alleged that her acts of backdating were misleading, dishonest and in breach of the RCVS Principles of Certification.

The fourth charge against Miss Padron Vega was that, between September 2015 and February 2016, she failed to fulfil her duties as an Official Veterinarian in respect of: failing to prepare herself for the implementation of the Welfare of Animals at the Time of Killing Regulations 2015; failing to have regard to the information provided to her by her employers about the regulations and their implementation; failing to take any steps to ensure that the two individuals for whom she had given veterinary certification were licensed to perform slaughter in accordance with the regulations; and failing to identify that two individuals were not licensed to slaughter in accordance with the regulations.

The Committee heard that the Welfare at the Time of Killing Regulations were introduced on 5 November 2015 which placed the responsibility on slaughtering operations not to permit animal welfare abuses and required certification by a veterinary witness regarding compliance.

The new regulations required existing slaughter licence holders to apply for a Certificate of Competence before midnight on 8 December 2015 or they would not be permitted to continue operating even with experienced operatives.

During the hearing, Ms Padron Vega admitted charges 1 and 2, admitted that she had been in breach of the Principles of Certification and admitted the fourth charge against her.

However, she denied she had backdated the certificates in a misleading or dishonest way, maintaining that she had done so by mistake.

In considering the facts of the case, however, the Committee rejected this argument and, taking into account that she had been responsible for veterinary certifications in the UK since 2001, found that her conduct was knowingly misleading and dishonest.

The Committee then went on to consider whether the charges she admitted and the charges found against her constituted serious professional misconduct, both individually and cumulatively.

The Committee found that all the charges amounted to serious professional misconduct.

In relation to charge 4 in particular Stuart Drummond, chairing the Committee and speaking on its behalf, said: "The Committee has found that the respondent failed to read even those emails which her employer sent to her which were marked ‘urgent’ or ‘OV importance high’. She must have known that her employers were directing attention to some new statutory scheme for she was provided with PowerPoint slides in that regard which she could read at any time of her convenience. The Committee has been driven to the conclusion that the respondent did not even bother to read those slides for, had she done so, she would have known that she needed to apprise herself of the requirements of the impending new statutory scheme. 

"The respondent’s failings in this regard are little short of extraordinary, especially given her obligations as Lead OV for FAI Farms. The total abdication of her responsibility to understand the requirements of the Regulations governing the slaughterhouse operations constitutes, in the judgement of this Committee disgraceful conduct in a professional respect."

The Committee then went on to consider the aggravating and mitigating factors in the case. In terms of aggravating features the Committee noted a lack of insight into the gravity of her conduct, that her conduct undermined in the most serious way public confidence in veterinary certification, and that there were animal welfare implications on her conduct as a number of chickens had to be removed from the slaughterhouse and alternative arrangements made because an auditor from the Food Standards Agency found that it was not compliant.

In mitigation the Committee considered that, despite the potential risk of harm, there was no actual harm occasioned to animals, that Miss Padron Vega has had a long and otherwise unblemished career and no previous issues with the RCVS and that she had admitted some of the charges against her.

Stuart Drummond added: "Ultimately, the Committee was driven to the conclusion that the public’s desire to see the implementation of the highest certification standards in relation to activities which impact on animal welfare and public health, and which did not occur on 3 February 2016, must outweigh this particular veterinary surgeon’s desire and need to continue in practice. This is not a conclusion which the Committee has arrived at lightly. On the contrary, it has reached this decision because it has been driven to the conclusion that it would be failing in its public duty to protect the wider public interest in the maintenance of standards of honesty and right conduct in a member of the profession.

"It is, therefore, the conclusion and decision of this Committee that the only proper sanction that can be imposed in this case is that the respondent’s name should be removed from the Register and it directs the Registrar accordingly."

Miss Padron Vega has 28 days from being informed of the Committee’s decision to lodge an appeal with the Privy Council.

Yorkshire-based Richard Sutcliffe MRCVS has been suspended for six months after being convicted of common assault, and for conducting surgery and administering POM-V medicine to a person.

The first charge related to his conviction on two counts of common assault by beating two individuals at an incident in December 2016, as a result of which he was made subject to a community order and a restraining order, as well as being fined and made to pay a victim surcharge and costs.

The second charge related to him undertaking, or attempting to undertake non-emergency surgery on the eyelid of one of the individuals referred to in the first charge, and administering, or attempting to administer, a Prescription-Only Veterinary Medicines to the same person. 

The third charged related to an allegation that he had supplied the same individual with a Prescription-Only Medication other than in accordance with a valid prescription.

The second charge and third charges related to incidents which occurred some considerable time before the assault, not as a consequence of it.  

At the outset of the hearing Mr Sutcliffe admitted the first and second charges against him and that these constituted serious professional misconduct. He denied the third charge. In relation to that charge the Committee found that, having considered the totality of the evidence, it was unable to be sure that the College had proved the allegation to the requisite standard of proof, namely so that the Committee was sure. Accordingly Charge 3 was dismissed.

The Committee decided that the convictions in the first charge rendered Mr Sutcliffe unfit to practise veterinary surgery and that his conduct in Charge 2 constituted serious professional misconduct.

The Committee then went on to consider sanction.

The Committee considered the aggravating features for both charges. For the first charge it considered the actual injury to one of his victims and risk of injury to the other, noting also that both of his victims were vulnerable people and one was a child, and that the overall incident during which the assaults occurred lasted over a seven hour period.

For the second charge, aggravating factors were that the non-emergency surgery performed by Mr Sutcliffe was wholly inappropriate, that there was a risk of injury to the individual on whom he performed the surgery and that his conduct was reckless.

The mitigating factors considered by the Committee were that Mr Sutcliffe recognised the gravity of the findings against him and demonstrated insight into the allegations, that the incident in charge 1, though prolonged, was an isolated one, that the incident in charge 2 was consensual and did not result in actual harm and that neither charge had any connection with Mr Sutcliffe’s veterinary practice, nor did they affect client care or animal welfare. 

Professor Alistair Barr, chairing the Committee and speaking on its behalf, said: "As recognised by the Committee, the respondent has displayed insight as to the seriousness of his behaviour. Having regard to the evidence of all the character witnesses and the written testimonials the Committee accepts that the respondent’s conduct as set out in charges 1 and 2 was wholly out of character and, therefore, there is no significant risk of repeat behaviour. The Committee considers that the respondent would be fit to return to practise, having regard to his excellent track record as a veterinary surgeon to date, after any period of suspension.

"Having regards to the aggravating and mitigating factors in this case, the Committee has decided that it is sufficient to maintain public confidence in the profession and declare and uphold proper standards of conduct to give a direction for suspension of the respondent’s name from the Register of Veterinary Surgeons.

"The Committee considers that the period of suspension must be sufficient to mark the seriousness of the charges but must be proportionate and fair in the circumstances of the case. The Committee has therefore concluded that the appropriate period of suspension is six months."

Mr Sutcliffe has 28 days from being informed of the Committee’s decision to appeal to the Privy Council.

The RCVS Council has approved changes to the supporting guidance that underpins its Code of Professional Conduct to allow for non-veterinarians to support veterinary surgeons in the certification of products of animal origin for export.

The plans developed by the Animal and Plant Health Agency (APHA), an agency of the Department for Environment, Food & Rural Affairs (DEFRA), involved the creation of a new role of Certification Support Officers (CSOs), non-veterinarians who would support the work of Official Veterinarians (OVs) in the signing of export health certificates for products of animal origin such as meat, dairy, processed products and animal by-products.

The proposals for the creation of CSOs by APHA has arisen due to concerns about the growth of exports in recent years and the potential for an up to 300% increase in products requiring OV certification if the UK has to certify exports of products of animal origin to the EU once the UK leaves the EU. Under APHA’s plans CSOs will work under the direction of veterinary surgeons and support their certification work (for example, verifying temperature checks), although the final certification will always need to be signed by OVs. The role will not involve certification relating to live animals or germinal products.

At the RCVS Council meeting on Thursday 1 November 2018 Council members agreed to facilitate APHA’s proposals and to make changes to the RCVS requirements so as to allow CSOs to support OVs in their certification work.

Amanda Boag, RCVS President, said: "As we have stated in our recent statement on ‘no-deal’ Brexit, it has been estimated that there would be 325% increase in veterinary certification requirements if the UK leaves the EU without a deal, and with these proposals Defra and APHA are preparing for this by increasing the support available for Official Veterinarians. Furthermore the proposal is in line with the concept of a vet-led team, with veterinary surgeons focusing on tasks only vets can do, whilst delegating some tasks to suitably trained and quality-assured members of our teams.

"We appreciate that there were some concerns over the level of education and training required by CSOs and are glad that the APHA has accommodated those views by increasing the level of education to three A-Levels (or equivalent in Scotland) and clarifying the nature of the training required by CSOs.

"By signalling its support for the proposals, RCVS Council has been assured that the integrity and value of the veterinary signature will be upheld and we are glad that we can play a key role in helping the veterinary profession prepare the UK for leaving the EU."

The RCVS position statement on the potential impact of a ‘no-deal’ Brexit scenario is available at www.rcvs.org.uk/brexit

A motion to conduct a trial of remote prescribing without performing a physical examination (ie. via telemedicine), thereby redefining what it means for an animal to be "under the care" of a veterinary surgeon, was put before RCVS Council last week. I was there to hear the arguments …

The motion was introduced by Kate Richards MRCVS, Chair of the RCVS Standards committee, who explained that it'd been driven by three things, namely: the Vet Futures Initiative, the RCVS Strategic Plan signed off by Council in 2017 and the RCVS telemedicine consultation that took place earlier this year. 

The latter of these showed that 69% of vets opposed the idea of prescribing without a physical exam, which rather beggars the question why it's being discussed at all. However, as Kate explained, when asked whether certain types of products could be remotely prescribed, the answer was more equivocal: 52% of vets said "yes".

Kate also explained that over the last two years, there had been a number of good quality discussions at Standards Committee and Council, but that decision-making had been "hampered by a paucity of evidence on the opportunities, risks and benefits of telemedicine to animals and the public".

The full wording of motion was: "Council is invited to consider the recommendation of Standards Committee to conduct a limited and time-bound trial to assess the benefits and risks of allowing the remote prescription of POM-V (excluding opiates, sedatives and potentially also critically important antibiotics) where there has been no physical examination."

However, in order for the trial to take place, it would be necessary to make a temporary change to the Supporting Guidance of the Code of Professional Conduct concerning the definition of "Under his care" (Ed's note. C'mon RCVS, isn’t that a bit anachronistic? Both your CEO and your President are now "her". "Under Care" would do it.), adding the words in italics to para 4.1: "A veterinary surgeon cannot usually have an animal under his or her care if there has been no physical examination; consequently a veterinary surgeon should not treat an animal or prescribe POM-V medicines via the Internet alone, other than in circumstance where a telemedicine service is a part of the RCVS telemedicine trial".

In the best interests of animal welfare

Amanda Boag (MRCVS, Vets Now, RCVS President) then reminded everyone that: "RCVS Council needs to act in the best interest of animal welfare and the public, and whilst sustainability of veterinary services is important, it isn't our role to promote anything novel or to protect traditional models."

Really? Strikes me that the sustainability of veterinary services isn’t just "important", it's an essential part of ensuring good animal welfare. Surely, therefore, it most certainly is the role of Council to protect traditional business models or, for that matter, to promote novel methods if (and I stress "if") doing so protects or enhances animal welfare.

Don’t confuse telemedicine with remote prescribing

Jo Dyer (MRCVS, small animal locum, Devon) opened by pointing out that this is not about telemedicine per se. Telemedicine has been going on since the invention of the telephone in the late 1800s, supplemented over the last 20 years or so by photography and video sent over the internet. Telemedicine does not, in and of itself, require a change in regulation.

What this is about, she explained, is the much narrower act of remote prescribing without physically examining the animal, something which would require the profession to redefine "under his care", which in turn "makes up the foundation of what forms the relationship with the owner and the animal in order that we can safeguard the use of medicines, safeguard the animals under our care and safeguard our clients."

No evidence remote prescribing increases access to veterinary services

Jo argued that the only reason Council should be considering the prescription of medicines without a physical examination would be if it were in the interests of animal welfare. And yet, she said, there is no evidence to support this idea.

Some have suggested that it could increase access to veterinary care. However, Jo said she had been unable to find any evidence to support this idea either. Not just in the veterinary profession, but in the medical profession in the Western and the developing world.

Jo also noted that the trial proposal was to use commercial organisations which have a financial interest in a positive outcome, which would render the results biased and unreliable.

She then raised the issue of antimicrobial resistance, highlighting the use of cytology and culture sensitivity to make sure the right antibiotics are used. Remote prescribing, she said, would be a retrograde step, even if only non-critical antibiotics could be prescribed remotely.

Spawning a new class of limited service provider

Next she highlighted the impact of the trial on 24-7 cover. Under the proposal, "Those under a trial would be required to actively support clients in identifying a veterinary practice that could physically see their animal in both routine and emergency situations."

As Jo pointed out, this would by definition mean that any veterinary surgeon, not just those practising telemedicine, could set themselves up as a limited service provider and refer all cases they didn’t want to see (whether OOH or not) to a local practice. This, she argued, should only happen after a proper debate, and not be just the unintended side-effect of regulation change to allow remote prescribing.

In fact, there is evidence that this is exactly what is happening in human medicine. Only the following evening, the BBC aired Diagnosis on Demand: The Computer Will See You Now, a documentary about telemedicine and artificial intelligence in human medicine. It should be required watching for all RCVS Councillors.

The programme makers visited GP at Hand, a telemedicine business based on the Lillie Road in Fulham, London that has been formed in partnership with Babylon. Coincidentally just up the road from where I used to live, it's a pretty nondescript sort of a place, but now home to the fastest-growing GP surgery in the UK. Since late 2017, it has amassed a staggering 30,000 clients from across London, virtually none of whom will ever visit the place. The problem is that GP at Hand has skimmed away fee-paying clients from across the capital that had in effect been helping to subsidise local care elsewhere.

More information needed for such an important decision

Jo concluded by saying that a decision of this magnitude, particularly when it seems to go against the wishes of the majority of the profession, demands checks to ensure no conflicts of interest, legal advice and wider consultation with organisations such as the VMD, Defra, the BVA and its subdivisions and the VDS. Therefore, she would propose a new motion to delay the decision until more information is made available.

Chris Barker (MRCVS, small animal practice, Cumbria) was up next. He felt that the RCVS consultation was very effective and gave a good picture of what veterinary surgeons see as the risks inherent in remote prescribing. However, he felt that the analysis has been marshalled to suit an agenda and minimises the concerns of general practitioners.

Fragmentation and multiple consultants leading to a loss of responsibility

The trial, he said, will lead to fragmentation of veterinary provision and send the message to the public that it is quite OK to go to more than one vet for advice and treatment, and that will lead to confusion and the loss of individual responsibility for the veterinary care of an animal that exists today.

An inspection with no history: not a proper examination.

Chris argued that the act of prescribing demands a physical examination, but that a video consultation could only ever be an inspection. He also highlighted the importance of patient histories and argued that the immediacy of telemedicine simply doesn’t allow a practitioner to get the patient history from another vet.

Chris also argued that the profession is not structured to allow for clients to consult multiple veterinary service providers simultaneously: once a client leaves his practice, he has a duty under GDPR to expunge much of their records, and he for one didn’t much care for the idea of re-registering a client at 2:00am.

Some of the issues Chris raised may of course be solved by technology in the foreseeable future. GDPR already calls for data portability, presumably it will not be long before owners expect the same data portability for their animals' clinical histories.

Who wants clients who only ever call when telemedicine has failed?

Still, his overall point was an important one: whether or not there will be vets out there who are happy to pick up and see failed telemedicine cases at 3:00am in the morning from people who are not clients of their practice and who don’t otherwise contribute financially to the business.

90% of vets say remote prescription is high risk or inappropriate

Lastly, Chris drew attention to a question in the RCVS consultation which asked respondents what risk they thought there would be in a remote consultation when the consulting vet did not know the owner, did not know the animal and does not know the situation in which the animal is kept: "90% of responding veterinary professionals either chose it as high risk or simply not appropriate at all. I know of no better body of people than practitioners in Britain to understand the welfare and the risk to the welfare of animals."

The risk of misdiagnosis

Martin Peaty (MRCVS, equine practitioner, Wiltshire) spoke next, highlighting the risk he saw to animal welfare from misdiagnosis. He drew attention to concerns raised by the Quality Care Commission in human medicine, in particular that there is no access to the long term medical records of the patient, and the risk of misdiagnosis: "And that’s in human patients who can fluently articulate their symptoms", he said, "I think we should be much more cautious in exercising care before allowing remote diagnosis and prescription."

Martin's point seemed especially apposite in the light of an article which appeared in The Times two days later: 'NHS app 'no match for trip to the GP', in which Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs expressed concerns about online consultation systems, particularly for vulnerable groups, such as children.  

Remote prescribing demands that vets sacrifice principles

Martin also outlined the three principles which underpin current practice: physically examining the animal, considering its history and providing 24 hour care, the latter in part in case of a reaction to a prescribed medicine.

"These proposals ask us to sacrifice these principles for telemedicine businesses whilst for good reason they remain in place for other veterinary practices. I think that is hypocritical. I think it is wrong."

Not enough follow-up

Sue Paterson (MRCVS, a referral specialist who offers a dermatology telemedicine service to the profession and the public, Merseyside) jumped in next. She was unashamedly enthusiastic about the benefits of telemedicine, in particular how it allows practitioners to engage with the public and make veterinary advice more accessible, not to mention because: "I am sick to death of people coming into consults when they have been on Facebook or they’ve been on to talk to Dr Google."

However, despite her enthusiasm and despite finding that users of her service do not want antibiotics, just advice, help and reassurance from people they trust, Sue was still against the idea of remote prescription: "I don’t want to prescribe because I can't follow those cases up, because I can’t maintain the level of client care that I think is really important, so for me, I would not want to see this change to the code."

We won’t know what we missed, or the consequences of what we missed

Caroline Allen (MRCVS, charity veterinary director, London) said the biggest issue for her is that without a physical examination, she won’t ever know what she missed (the heart murmur, the goitre, the subtle muscle wastage), or for that matter, the animal welfare consequences of what she missed.

As others had done, Caroline highlighted the importance of getting a weight every time and how difficult it is for clients to measure accurately.

Lastly, she made the thought-provoking point that allowing the remote prescription of drugs without a physical examination would risk legitimising Dr Google in the eyes of the public. After all, if no veterinary physical exam is needed, surely owners can just look it up on the internet for themselves?

In defence of the RCVS

At this point in the discussion, RCVS CEO Lizzie Lockett addressed the suggestion that the whole process of investigating and voting on telemedicine was being driven by hidden agendas, something she absolutely and eloquently rejected. She explained that sure, some parties had been more engaged in the whole process than others, but emphatically denied there had been any influence. Council, she said, had asked Standards to investigate and develop a proposal, which it had done diligently. Now it is down to Council to decide whether the proposal stands or falls; the College exists to implement the decision.

RCVS Vice President, Professor Stephen May went further, saying that many present would be aware that he'd been a vocal critic of the way that a number of other regulators in modern society push things out to court for decisions, rather than taking decisions collectively and then sticking by them. "I’m really proud that we are discussing this and I’m really pleased that this is up to us how we move things forward in the interest of animal health and welfare and supporting the public in that."

The need for a more nuanced, less polarised debate

However, he said he was worried about the way the debate was being polarised into a yes or no when he felt the profession should thinking about how it should adapt to the changing circumstances, thinking about cases which are amenable to a distant relationship and in what context that is appropriate, taking into account the risks. 

Remote prescription is already happening, illegally

Melissa Donald (MRCVS, small animal practice, Scotland) questioned whether telemedicine and remote prescription is what the public wants. She said that remote prescription is already happening, illegally from abroad, and that the College needs to have a more robust response than "it’s not our problem". She therefore recommended a further period of consultation, particularly with public focus groups, and internet research to see how much remote prescription is already happening. 

Vets are professionals

Tim Walker (Lay) said he was struck by the need to assemble better evidence. He felt there needs to be more thought given to the transference of responsibility for cases between a telemedicine provider and a traditional practitioner. Tim also felt that the definition of "under his care" will almost certainly need to be rethought in the not-too-distant future, because the idea of a patient being under the care of just one practitioner is starting to look dated; in the human sphere, patients are looked after by teams of people.

Tim highlighted the approach he said is taken by the GMC, which obliges doctors to be able to demonstrate that they have done sufficient due diligence to prescribe, not that they can simply do so automatically under certain circumstances. That, he said, is what professionalism should be about.

Taking the lead

Mark Castle (Lay) said he thought that the public was looking for a choice, that technology is constantly throwing up new opportunities, and he expected that in the future more and more will be able to be done remotely, so he wanted the RCVS to take the lead in this area.

Lucy Goodwin (MRCVS, BSAVA Head of Education) was positive about the idea of conducting a time-limited, controlled trial: "We say we want evidence, so let’s go and collect it", but had a number of reservations. Not least of these was the fact that the participants in any trial would be on best behaviour, so it may not be able to extrapolate the numbers to the profession at large. Beyond that, she was also concerned that the scope of the trial should be better defined, in particular which categories of drug could be included within it. 

Vets don't want a trial of telemedicine

Mandisa Greene said that whilst she is positive about telemedicine as it had been described, and not averse to a trial, she didn’t see the point in a trial when the people who actually do the prescribing don’t want it. 

A voice in favour

Chris Tufnell (Past President) began by declaring that he consults to the Affordable Pet Care Company which is shortly to launch a telemedicine service, although he said the service would be unaffected by the decision being taken by Council. He was also at pains to stress that he hadn’t had any other fingers in this particular pie, in particular that he hadn’t been to any of the Standards Committee meetings or presented to them, or been involved in formulating the proposed trial.

Whether you agree or disagree with Chris, it was at least good to hear someone speaking in favour of the motion. Chris opened by arguing that veterinary surgeons are good at making decisions based on imperfect information: "Client histories, as we know, are of variable quality. We make decisions daily on whether we are happy with the information we get from the practice lab or whether we need to send the sample to a reference lab. When I started in practice, practice lab machines were routinely described as random number generators."

"We make decisions on a daily basis on what the limitations of our abilities are. It’s called professional judgement and what we are proposing here is actually a test of our definition of 'in our care'. We’re talking about testing the possibility of making remote prescriptions. The responsibilities around prescribing won’t change, and those responsibilities include the responsible use of antibiotics."

Chris then argued that all the motion was calling for is a trial of something that unlike, for example, deregulating advertising and practice ownership, is not going to give a slice of the consultation fee to non-vets. He also pointed out that people will always be able to highlight cases that would be completely unsuitable for remote prescribing, but that this is not about replacing the consulting room.

Filling the void

What it is about, he said, is removing barriers to care; filling the vacuum between a concerned owner, and the £60 - £100+ they’ll be charged for a consultation. It’s a vacuum that is currently filled by the 'free' (except it's not) phone advice given out by practices, by Facebook and by Dr. Google. 

He then pointed to an example from the US, where 83% of people who visited https://www.whiskerdocs.com for pet advice and thought their problem was suitable for home treatment, were in fact wrong and ended up being instructed to visit their veterinary practice. This, he said, could lead to better productivity in practice.

Could telemedicine help retention?

Telemedicine, he said, could also provide a role for people thinking of leaving practice, which is potentially an important factor at a time when retention is proving such an issue. 

Evidence-gathering, clinical freedom and professional judgement

Like others, Chris argued that the trial is about putting the RCVS at the forefront of progression in our increasingly digitised society, at a time when remote information from wearables is going to become more and more common. In summary, he said: "This trial is about an evidence-based profession looking for evidence, it’s about clinical freedom and it’s about putting professional judgement in the hands of the professionals."

A two-tier service

Lynne Hill (Past President) said her main concern is about having to redefine "under his care" and how remote prescribing via telemedicine would lead to a two-tier level of care, which she thought would be wrong.

She also highlighted that the College had debated the definition of "under his care" in relation to farm animal practice, where some farmers have multiple vets, some of which offer herd health care and nothing else. Deregulating to account for this has, she said, been responsible for the demise of farm animal practice. Quite simply there are less vets around to see animals. 

Show me the money

Lynn also noted the altruistic nature of the debate thus far, and reminded everyone that this is really about business and making money. The companies that are set up to provide telemedicine and possibly take part in the trial will not be in it for the welfare of animals, but to make money.

She also scoffed at the idea that telemedicine and remote prescribing will mean the 10% of people who do not currently have a vet are "now going to get madly involved in telemedicine." The reason they don’t have a vet at the moment, she said, is because they don’t want to pay. Telemedicine doesn’t change that. 

Lastly, as others had done, she highlighted the difference between human medicine, where patients can describe their symptoms, and veterinary medicine, where they can’t.

Leadership is about taking the right decision, not jumping on the bandwagon

"Leadership is not always about jumping on the bandwagon and going forward because something is out there. Leadership is actually about looking and deciding and making the right decision."

The disingenuous antimicrobial argument

Dave Leicester (MRCVS) was up next, arguing that it would be wrong to say that a body of professionals can be trusted to make decisions about animal welfare, but not about prescribing. He also felt it was a little disingenuous to do a lot of hand-wringing over antimicrobials when, as a profession: "We’ve managed to make a 3rd generation cephalosporin the most prescribed antibiotic in cats."

Finally, Dave made the point that in his 15-year experience working for OOH emergency service providers, they’d managed to work very successfully without access to patient medical histories.

Setting veterinary standards

Claire McLaughlin (Lay) reiterated that the role of the RCVS is to set veterinary standards, something it can’t very well do without knowing what is going on in practice, and finding out how these things work in practice. “We need to be in a process which takes us to able to set those standards. Whether the trial that is proposed is the right trial or not, we can’t just say no, it’s fine as it is because people will work within their professional competence. As Eleanor [RCVS Registrar] will tell you, they don’t work within their professional competence because they come before disciplinary committee all the time. I think we would be remiss if we didn’t start a process now or continue this process in a way that allows us to set appropriate standards.”

Colonel Neil Smith (MRCVS, Chief Veterinary Office for the Army) began by declaring that he provides telemedicine services for animals in disparate parts of the world as part of his day job, but these animals are very much under care and there is an existing relationship with patients. He is also involved with the provision of limited veterinary services for homeless people via StreetVet, a charity which has had to form relationships with practices that can cover the 125 hours per week when it is not present. 

Lowering veterinary standards

Neil explained that his "massive" concern with the proposal lies in particular with the part that says: "Given the limited nature of the service that can be provided by telemedicine alone, however, it is proposed that those under a trial would be required to actively support clients in identifying a veterinary practice that could physically see their animal in both routine and emergency situations."

This, he said, would lower veterinary standards, if all somebody providing telemedicine has to do is point people in the direction of a practice. 

For that reason, Neil said, he could not support the proposal as is, and would instead recommend that it goes back to Standards and is then brought back at the next council meeting with a clearer idea of what the trial is all about.

Accessible care

Caroline Allen then jumped in again, saying that whilst she agreed with the idea that more data is needed, she also thought that telemedicine and remote prescription is being driven by the issue of accessible care, and it is that, in fact, which needs to be investigated and understood and debated first.

The digital age

Past President Professor Stuart Reid highlighted that the veterinary students of today live their lives in the digital environment and their world will be very different from ours. The same goes for pet owners. He reiterated that as the regulator, the RCVS needs to be ahead of the game, and that if this is what the public wants, then it has to find a way of regulating it. 

Stuart finished by saying that he felt conflicted about the vote; that he had significant problems with the proposal and is not entirely sure that a trial is the right thing, but: "In the referendum we're about to have, I want to say yes but I want to see what the deal is as well." He added: "I didn't vote out by the way, in case this gets back to my employers, but I do think we have to think very carefully about throwing the baby out with the bathwater here."

Pressure to prescribe

Martin Peaty then recounted how at a Vivet Conference last year, a provider of telemedicine (which he thought was Babylon) explained that doctors on its system were retained on the basis of a post-consultation customer satisfaction survey. That, he thought, would make it difficult for practitioners not to prescribe things when they know it will affect their job. 

David Bray (Lay), said he believed the telemedicine and remote prescribing will come and it will become more common to have pets treated by multiple vets, so he was fully supportive of a trial. 

When it came to the vote ...

Guessing at which way the people who spoke might have voted, it seemed as though there were probably enough councillors with sufficient reservations about the motion, which would have given the go ahead for the trial, for it to be voted down.

That said, the overall sentiment in the room seemed to be that the discussion about the regulation of telemedicine and remote prescription needs to continue, and not get kicked into the long grass simply because of a disagreement over the proposed trial. 

At this point, Jo Dyer and others stepped in to argue that the decision to proceed with the trial should not be made until the issues raised in the debate had been addressed. There was then a lot of going backwards and forwards, discussing whether this would need a new motion, which is not allowed under Council rules, or whether the existing motion could be amended, which is allowed.

In the end, the decision was taken to hold two votes, the first being to refer the issue back to the Standards Committee which was carried by 18 to 12, with one abstention. 

The second vote was:

"Council is invited to consider the recommendation of Standards Committee to prepare and develop a proposal for a time-bound and limited trial to assess the benefits and risks of allowing the remote prescription of POM-V with appropriate stakeholder engagement and with consideration of the issues that we've discussed today and the detail on them, including 24/7 care and classes of drugs, especially antimicrobials. So we are asking for the detail on that to be worked up on the basis that it will at some time come back to Council."

The second vote was carried by 21 to 8 with 3 abstentions. 

In other words, the trial will not now go ahead unless Standards can develop a new proposal which addresses the concerns raised by Council.

VetSurgeon Conclusion

Looked at solely in terms of its impact on animal welfare, this debate seems to come down to one question, which is whether more animals will benefit from easier, cheaper access to veterinary services available via telemedicine and remote prescription than will suffer as a result of misdiagnoses and missed diagnoses that will surely be the inevitable consequence of veterinary surgeons working only from the more limited, and potentially inaccurate or even false information they will get from a video consultation.

For sure, more wearables are coming, and they will overcome some of the problems caused by the fact that animal patients cannot describe their symptoms. Doubtless someone will also invent a set of weighing scales that makes it possible for owners to do the job reliably accurately. Patient histories will surely become more portable. But these things are not with us just yet. 

In any event, it is not just about the immediate impact on the quality of care delivered to patients. The way the trial has been framed thus far takes us in the direction of a two-tier profession. What happens if more veterinary surgeons prefer, or make a better living from working from the comfort of their own home without the added responsibility that comes with providing the physical care. Who’ll do the ‘real' vetting?

If you look at the popularity of human telemedicine, the 30,000 patients who have signed up for telemedicine at the small practice in the Lillie Road in London, it seems obvious that patients want the convenience of consulting online, without having to schlep to the practice and find a parking space. It also seems self evident that if online consultations are offered at a lower price point, it will inevitably lead to more pet owners availing themselves of veterinary advice, though as Lynn Hill said, it’s unlikely to cause a mad rush whilst Dr Google is still free. 

Perhaps, though, there is another valid way to solve this conundrum. Rather than rushing headlong into a trial that could irrevocably change the very nature of the profession, how about establishing some pragmatic ground rules from the outset. For example, that unless by unanimous agreement of Council in the future, telemedicine should only be allowed as an extension of the service offered by existing bricks and mortar practices to their existing clients. 

When it comes to remote prescribing, surely the safest way to regulate it (if you’re going to allow it at all) is to do so on a drug-by-drug basis. Perhaps trial it with the endo- and ecto-parasticides for existing clients of existing practices. Find out whether the convenience of the online consultation leads to higher standards of parasite control for greater numbers of pets. If it doesn’t, then ditch it. Either way, it doesn't preclude trying another category of drug.

That’s my tuppence worth, for what it’s worth, which probably isn’t quite tuppence!

The RCVS has published a series of case studies designed to help veterinary surgeons and veterinary nurses in gaining properly informed consent from clients for procedures and treatments.

The case studies were developed by the RCVS Standards Committee and use a variety of examples of where miscommunication between a client and the veterinary practice can lead to an inadequate level of consent being gained for procedures and treatment, including euthanasia.

Examples include damaged teeth being removed during a clean and polish dental procedure without the owner’s express permission and not giving the full range of options available in the case of a dog with an osteosarcoma.

The case studies follow the Standards Committee approving changes to chapter 11 (‘Communication and consent’) of the supporting guidance to the RCVS Code of Professional Conduct in January 2018 to give further advice on how to discuss informed consent with clients, who can be responsible for gaining consent for a procedure and additional guidance on consent forms.

Dr Kate Richards MRCVS, Chair of the RCVS Standards Committee, said: "We hope these case studies will prove useful to practitioners who are having to deal with the complexities around making sure that procedures are fully explained to ensure informed consent is gained.

"We understand the difficulties that are encountered and so these case studies, based on real-life scenarios, highlight where things may go wrong and how these incidents can be avoided by being thorough and ensuring that good communication is at the heart of all we do."

To view the case studies, visit www.rcvs.org.uk/informed-consent.

Chapter 11 of the RCVS supporting guidance on communication and consent is available to view at www.rcvs.org.uk/consent

The RCVS is calling on everyone to nominate veterinary surgeons, veterinary nurses and laypeople who are working above-and-beyond for the benefit of animal health and welfare, the veterinary professions or public health, for one of its 2019 honours and awards.

This year the College is seeking nominations for six awards:

• The Queen’s Medal: the highest honour that can be bestowed upon a veterinary surgeon for a highly distinguished career with sustained and outstanding achievements throughout.

• The Veterinary Nursing Golden Jubilee Award: this award is aimed at veterinary nurses who have had a sustained and distinguished career, who can demonstrate a leadership role within the profession and who can act as an ambassador for the value of veterinary nurses and their work.

• RCVS International Award: this award is for vets, vet nurses or laypeople who work internationally, from either within or outside the UK, in making an outstanding contribution to, for example, raising veterinary standards, veterinary education and improving animal health and welfare.

• RCVS Impact Award: this award is for vets or vet nurses who have recently, or are currently, undertaking a project, initiative or similar that has a significant impact on the profession at large, animal health or welfare, or public health. Such impact could have been made through any field of veterinary endeavour, including clinical practice, research, education or veterinary politics.

• RCVS Inspiration Award: this award is for vets or vet nurses at any stage of their career who have demonstrated the ability to inspire and enthuse others consistently throughout. It is open to those who have inspired and motivated individuals anywhere within the profession and recognises those who have gone ‘above and beyond’ what may normally be expected from a professional colleague.

• Honorary Associateship: this honour is conferred to a small number of laypeople each year, in recognition of their special contribution to the veterinary sphere. It recognises the full range of individuals who contribute to the veterinary sphere including scientists, lecturers, journalists, charity-workers, farriers, farmers and those involved in the commercial field.

For this year’s honours and awards nomination period, the College has produced a video using footage from Royal College Day 2018, featuring interviews with those who were recognised with RCVS honours and awards on the day. 

The video is available to view at www.rcvs.org.uk/honours where you can also download further information and guidance about the criteria for nominators and nominees for the awards, as well as how to make nomination.

Dr Niall Connell, RCVS Junior Vice-President, is taking the lead in promoting the awards this year. He said: "Throughout my time in the veterinary profession, and particularly since joining RCVS Council, I have met so many veterinary nurses and veterinary surgeons who are truly inspiring individuals.

"The RCVS honours and awards scheme is a perfect opportunity to celebrate some of the individuals that have done or are doing something really special – whether that’s by inspiring their colleagues and peers or doing things that benefit animal health and welfare or society at large.

"Across all six awards there really is something for everyone – vets and veterinary nurses at all stages of their careers as well as laypeople are all up for recognition and so I’d strongly encourage everyone to think about someone they know who deserves recognition and get in touch.”

The deadline for nominations is Friday 18 January 2019. 

For an informal talk about the awards and how to make a nomination you can contact Peris Dean, Executive Secretary, on p.dean@rcvs.org.uk or 020 7202 0761.

The RCVS Disciplinary Committee has issued a reprimand and warning to Essex-based Donald Stuart Bremner MRCVS, following a conviction of harassment and perverting the course of justice.

Dr Bremner was convicted in 2017 of harassing his ex-wife, and for perverting the course of justice by sending his daughter an e-mail, pressuring her to ask her mother to withdraw the charges against him. He pleaded guilty to both of the charges, saying he did not understand that it was a condition of his bail that he could not contact his ex-wife. He also expressed shame and remorse at his actions, explaining that his behaviour was triggered by extreme anger, grief and stress.

In relation to the charges, the Respondent was committed to prison for 12 months, suspended for 12 months, ordered to comply with a Rehabilitation Activity Requirement within 12 months, and ordered to pay £85 in costs and £115 as a surcharge to pay for victim services.

The Committee found the facts proved based on the certified copy of the certificate of conviction, as well as the Respondent’s admissions to the facts of the charges. It was satisfied that the Respondent brought the profession into disrepute by the seriousness of his convictions. In addition, the Committee regarded the Respondent as having deficient insight and a need to fully accept personal responsibility for his actions and their consequences. 

The Committee was also satisfied that the nature of the communications sent by the Respondent which led to the convictions and the breach of bail conditions, coupled with deficient insight amounted to serious professional misconduct and rendered him unfit to practise veterinary surgery.

The Committee considered various mitigating factors including the fact that no actual harm occurred to any animal, there were no concerns raised about the respondent’s practice, that he has a long and unblemished career, and that he showed some insight into his offences which continues to develop.

The Committee also took into account that preventing the Respondent from practicing could mean the loss of jobs for 33 or so employees, which weighed heavily on their decision. The Committee also agreed with the RCVS’s submissions that there was a very low likelihood of repetition of the offending behaviour. Aggravating factors included the emotional harm caused to the Respondent’s ex-wife, and that the harassment was a course of conduct sustained over a period of five months.

Therefore, when taking into account the particulars of this case, the Committee decided to impose a reprimand and warning on the basis that it would be proportionate to maintain public confidence in the profession in light of the serious nature of these charges. 

Chitra Karve, chairing the Committee and speaking on its behalf, said: "The Committee was of the view that the conviction for intending to interfere with the course of justice was particularly serious, in light of the need to maintain public confidence in the profession, because it involved a disregard of proper criminal process.

"However, a particular feature of this case is the risk to the jobs of 33 or so employees if the Respondent were to be prevented from practising as a result of the Committee’s imposition of a sanction. It is this mitigating factor which weighed most heavily with the committee and they therefore concluded that both a Reprimand as to this conduct and a Warning as to any future conduct is sufficient and proportionate in this case to meet the need to maintain public confidence in the profession and uphold proper standards."

Mr Bremner has 28 days in which to make an appeal about the Committee’s decision to the Privy Council.

The RCVS Disciplinary Committee has found Cheshire-based Paul Stuart Thomason MRCVS not guilty of disgraceful conduct after hearing charges that he undertook a pre-purchase examination of a horse called Reba which caused him to have a potential or actual conflict of interest with the seller, about which he failed to inform the prospective buyer.

Dr Thomason initially denied both heads of charge, but on the third day of the hearing he changed his plea and admitted the charge in its entirety.

The first part of the charge related to the fact that the seller of the horse was a both a client of Dr Thomason’s practice and a personal friend of his, and he therefore had a potential and/or actual conflict of interest.

Dr Thomason did not disclose this professional and personal relationship to the prospective purchaser before the pre-purchase exam.

The prospective purchaser only discovered Dr Thomason’s relationship with the seller when reading the vetting certificate at home, and stated that, in the past, she had had a similar experience in which the horse was then found to be lame. She later found out the extent of the personal relationship, when invited to join the seller on a social media site.

The Committee found that, in this set of circumstances, Dr Thomason should not have undertaken the pre-purchase exam at all, and, at the very least, disclosed his personal and professional relationship with the vendor.

The Committee also found that although Dr Thomason did have a system in place to inform any prospective purchasers if the vendor was a client of his practice, this failed to work on this occasion and neither the practice nor Dr Thomason told the prospective buyer that the seller was a client before booking the pre-purchase exam. Dr Thomason had no similar system in place to disclose any close friendships with sellers.

Dr Thomason did not consider there was a conflict of interest as he felt confident he could carry out the pre-purchase exam impartially. In addition, it was his belief that the seller had been alerted to the conflict through a system in place at his practice, implemented to safeguard against this type of error. He stated that he in no way attempted to hide his relationship with the seller to the prospective purchaser. 

It was not alleged that Dr Thomason had acted dishonestly.

Ultimately, the Committee found Dr Thomason not guilty of disgraceful conduct in a professional respect.

Ian Green, chairing the Committee and speaking on its behalf, said: "Whilst the Committee concluded that the respondent’s view of his obligations to disclose both the professional and personal relationships he had with the vendor was mistaken, it did not find any improper motivation on his part. It has already noted that he sought to disclose to the prospective purchaser through his system the fact that the vendor was a professional client of his.

"The Committee has weighed all these matters very carefully. It is for the client to determine whether or not to proceed with a PPE when in possession of all relevant facts in relation to any potential conflict of interest, and not for the veterinary surgeon to decide. The autonomy of the client must be respected. The Committee was firmly of the opinion that a failure to comply with the Code is very serious. However, taking into account the particulars of this case, the Committee does not consider that the actions of the respondent amount to disgraceful conduct in a professional respect."

The RCVS Disciplinary Committee has directed the Registrar to remove Greater Manchester-based Viktor Molnar from the Register after he pleaded guilty to illegally importing puppies to the UK.

Mr Molnar had been convicted at Manchester and Salford Magistrates’ Court in March 2018 of five counts of importing puppies to the UK in contravention of the Rabies (Importation of Dogs, Cats and other Mammals) Order 1974.

At that court hearing he also pleaded guilty to one count of keeping premises as a pet shop without the authority of a licence granted by a local authority.

As a result of his conviction Mr Molnar was sentenced to 270 hours of unpaid supervised work and was ordered to pay compensation of £2,683.93 and costs of £250.

The Committee, which proceeded with the hearing in Mr Molnar’s absence, found that the RCVS charges against Mr Molnar were proven and went on to consider whether, individually and cumulatively, they resulted in Mr Molnar being unfit to practice being a veterinary surgeon.

Ian Green, chairing the Committee and speaking on its behalf, said: "The Committee accepts the College’s submission that the fact that they [the puppies] were imported contrary to the law of the UK, because they were underage and had not been properly vaccinated, undermines the integrity of a system which is designed to ensure that effective vaccination and precautions against disease take place in every case.

"The Committee also notes that the convictions in this case were directly linked to the respondent’s veterinary practice, as they related to animals sold from his veterinary practice address. By operating an unlicensed pet shop, and by doing so through an email address that referred to his occupation as a veterinary surgeon, the respondent was abusing his position as a veterinary surgeon, and acting in a way that was liable to undermine the reputation of the profession."

The Committee therefore found that, because Mr Molnar’s conviction was directly linked to his veterinary practice and posed a substantial risk to animal welfare and public health, his conviction meant his conduct fell far short of what was expected of a professional.

In considering the sanction for Mr Molnar the Committee considered that, while he had no previous convictions or adverse professional findings against him, the case against him was very serious "because of the risk of serious harm both to animals and the public, as well as being for financial gain."

Ian Green said: "The Committee considered that the respondent, as a veterinary surgeon, must have known the serious implications and consequences of what he was doing by importing these puppies unlawfully. The public should expect to be able to trust a veterinary surgeon to ensure that his conduct does not put at risk the health of both animals and humans."

Mr Green added that the Committee felt that the only appropriate sanction was to direct the Registrar to remove Mr Molnar’s name from the Register.

The Royal College of Veterinary Surgeons has been recognised as one of the best workplaces for women by the Great Place to Work Institute.

The College was ranked seventh in the medium-sized company or organisation category (50 to 449 employees) of the Best Workplaces for Women initiative. 

This year is the first that the Great Place to Work Institute has run this initiative and, in making its rankings, it looked at a number of factors including the number and proportion of women in leadership positions, pay parity between men and women, workplace policies and how they support female employees, as well as training and development and mentoring.

Amanda Boag, RCVS President, said: "I am delighted that the RCVS has been recognised for being an excellent and supportive place for women to work and pleased that the hard work of the team at Belgravia House in this area has been publicly rewarded in this way.

"One of the key themes of my Presidential year is diversity and I think it is very important that, as a regulator, we reflect the veterinary profession (which is currently 63% female for veterinary surgeons and 98% female for veterinary nurses) as far as possible. With two-thirds of the staff at the RCVS being women it demonstrates that the College is largely reflective of the profession it serves. 

"However, it’s not just about the numbers and with 60% of the Senior Team at the RCVS being women, including the CEO and Registrar, it demonstrates that the College has developed a culture in which women can shatter the glass ceiling and pursue leadership roles.

"Also, with policies such as flexible working hours, encouragement of home working, shared parental leave and enhanced maternity and paternity pay, the College goes the extra mile to support working parents."