The charges related to the unexpected death of a cat called Hope during an operation to explore a growth in her mouth, and Dr Dantas-Holmes' subsequent communication with the animal's owners.
Dr Dantas-Holmes accepted that Hope’s death was most likely due to her failing to flush fluid through the giving set attached to an intravenous drip, leaving air in the tubing and causing some air to enter Hope’s bloodstream when the cannula was placed and the giving set’s control opened.
The first set of charges related to Dr Dantas-Holmes’ initial phone call to Hope’s owners ten minutes after Hope’s death, in which she said that Hope had died because of a reaction to anaesthetic drugs. Dr Dantas-Holmes failed to mention that the cause of death was still to be determined and failed to mention that a likely cause was in fact an air embolism and/or a complication relating to the intravenous drip.
Following her initial phone call to the owners Dr Dantas-Holmes viewed CCTV of her actions.
The owners then came into the practice later in the day, and the communications during that time constitute the second set of charges: that, during this meeting, Dr Dantas-Holmes didn’t correct her earlier statements about the cause of Hope’s death, and that she didn’t mention that there was an ongoing investigation or that a likely cause of death was an air embolism and/or complication.
The third set of charges related to Dr Dantas-Holmes’ subsequent clinical records, in which it was alleged that she failed to include references to the findings on review of the CCTV footage of Hope’s death, and the possibility of an air embolism and/or complication relating to the intravenous drip.
The fourth and final set of charges were that her conduct was misleading, and/or dishonest.
With regard to the first set of charges, the Committee found that Dr Dantas-Holmes did tell the owners that Hope died because of a reaction to the drugs, but that given the short nature of the phone call to the owners and the distressing circumstances there was no duty to discuss the investigation, or to mention the likely cause being an air embolism.
Concerning the communications with the owners when they came to the practice, the Committee found that Dr Dantas-Holmes did fail to mention that anaesthetic drugs might not have been the cause, and that she also failed to mention the investigation. Dr Dantas-Holmes had agreed with the Practice Manager, however, that she would not discuss the possibility of an air embolism or complication, and so that charge was not found proved.
On consideration of whether Dr Dantas-Holmes had failed to include relevant findings in the clinical reports, the Committee found both charges proved, and, in relation to the final set of charges, the Committee found that while Dr Dantas-Holmes had misled Hope’s owners, it was unintentional, and she had not been dishonest.
Ultimately, the Committee found Dr Dantas Holmes not guilty of disgraceful conduct in a professional respect.
Stuart Drummond, chairing the Committee and speaking on its behalf, said: "The findings of this Committee demonstrate that there were errors and omissions in communications with the owners. When communicating with a client it is the professional’s responsibility to ensure that the client has heard and understood what has been said. The importance of good and effective communication is particularly important when an unforeseen and shocking event occurs such as it did in this case.
"The particular circumstances of this case demonstrate how important it is to communicate effectively and the need for the veterinary surgeon to ensure that their clinical records for which they are wholly responsible, are complete.
"The Committee concluded that its findings demonstrated a departure from professional standards but that the falling short was not so grave as to amount to disgraceful conduct in a professional respect."
The Disciplinary Committee heard that Mr Samuel had been convicted of five animal welfare offences at Leeds Magistrates' Court in January 2016. The charges related to causing unnecessary suffering to a number of animals including twelve dogs and four cats, and failing to take steps to ensure that the needs of the animals for which he was responsible were met. The animals were kept at the Armley Veterinary Practice, for which Mr Samuel was, at the time, practice principal.
Mr Samuel was sentenced to 12 weeks' imprisonment suspended for 12 months on the condition he completed 150 hours' unpaid work and paid a fine of £100. He was also ordered to pay costs of £500 and a victim surcharge of £80. He was also made subject to a disqualification order for three years.
Dr Samuel subsequently appealed against his conviction in April 2018. His appeal was dismissed in respect of five of the charges but was upheld in respect of one charge, which, as a result, did not form part of the College’s case.
Dr Samuel declined to attend the hearing in person and was not represented before the Disciplinary Committee. In considering the facts of the charges against Dr Samuel the Committee found them proven.
The Committee then went on to consider whether the proven charges, both individually and cumulatively, rendered Dr Samuel unfit to practise as a veterinary surgeon.
The College’s case was that the convictions concerned animal welfare and therefore went to the heart of his practice as a vet, that Dr Samuel behaved in a manner incompatible with being a veterinary surgeon, that he failed in his core responsibility as a veterinary surgeon to protect and act in the best interests of animal welfare, and that he maintained he had no responsibility for the animals on his practice premises – an assertion referred to as ‘an extraordinary position for a veterinary surgeon to take’.
Ian Green, chairing the Committee and speaking on its behalf, said: "ust as the judgment of the Crown Court and the Magistrates Court had found, the Committee also found that Dr Samuel must have known that the animals were in distress and were in a neglected state. The Committee was sure that Dr Samuel must have been aware of the animals notwithstanding his continued denial. The Committee concluded that Dr Samuel was unfit to practise because of the facts underlying the convictions. Dr Samuel had an overriding duty of care for the animals and to take action in relation to their health and welfare because they were living under the roof of his veterinary practice."
In considering its sanction against Dr Samuel, the Committee concluded that removal from the Register was the most appropriate option. It took into account the fact that the animals were found starving in a cellar without water, that Dr Samuel had not demonstrated insight into the serious nature of his offences, that he continued to deny responsibility and, furthermore, found no evidence that he no longer posed a risk to animals in the future.
Ian Green added: "The Committee decided that the behaviour found proved was fundamentally incompatible with being a veterinary surgeon because in this case there had been a serious departure from standards as set out in the RCVS Code of Professional Conduct for Veterinary Surgeons…. Furthermore, there had been serious harm caused to a number of animals and a risk of harm to a number of other animals."
Dr Samuel has 28 days from being informed of the Disciplinary Committee’s decision in which to make an appeal to the Privy Council.
The Committee’s full decision and findings can be found here
The original survey was sent last year to more than 5,000 UK-registered veterinary surgeons and veterinary nurses who gained their qualification from a non-UK EU institution, with a response rate of around 55%.
This year the Institute for Employment Studies (IES), on behalf of the RCVS, contacted over 6,000 veterinary surgeons and almost 50 veterinary nurses – including those previously surveyed as well as EU registrants who have joined since the last survey – who trained in non-UK EU countries to seek their views on the implications of Brexit for European veterinary professionals.
Chris Tufnell, RCVS Senior Vice-President and Chair of the College’s Brexit Taskforce, said: "The aim of this survey is to gain a greater understanding of the views and expectations of our EU colleagues now that certain elements of the UK’s withdrawal process from the European Union, as well as the timing, have become clearer. The survey will also be looking for the views of colleagues on how the College has addressed the challenges of Brexit so far.
"It is particularly important that those who responded to last year’s survey do so this year because the aim is to get a sense of how their views and plans are shifting as the Brexit process moves forward."
As with last year’s survey, the views collated through the consultation will help the College understand the immediate and longer-term impact of the UK’s exit from the EU, gather evidence that could be used to make a case for special treatment of veterinary professionals with regard to future immigration policies and allow the College to provide informed advice to European veterinary professionals as they make decisions about their future careers.
Dr Tufnell added: "I would strongly encourage EU veterinary professionals to respond to this survey, even if they didn’t do so last year, as their views really do matter to us and really do have an impact on our Brexit policies and the views we put forward to the government in these critical times."
The deadline for sending responses to the IES is Wednesday 18 July 2018 and all data will be managed and analysed by IES, an independent not-for-profit research institute, on a confidential basis with no individual responses being seen by the RCVS.
The College says it intends to conduct a third survey when the terms of the UK’s withdrawal from the EU, and the impact of this on non-UK EU nationals, are better defined.
The proposed framework has grown out of the VN Futures research project, run jointly with the BVNA, which identified developing a structured and rewarding career path for veterinary nurses as one of the key demands of the profession.
It has been developed by the VN Futures Post-Registration Development Group in conjunction with the RCVS Veterinary Nurses Education Committee and Veterinary Nurses Council.
The College says the proposed framework is designed to provide accessible, flexible and professionally relevant post-registration awards for veterinary nurses in order to provide an enhanced level of veterinary nursing practice, while also providing specific modules that veterinary nurses at all career levels can study independently for their continuing professional development (CPD).
Julie Dugmore, Director of Veterinary Nursing at the RCVS, said: "One of the strongest messages that came out of the research we conducted with the British Veterinary Nursing Association prior to the publication of the VN Futures Report was that there was a need for a more structured and rewarding career path for veterinary nurses.
"Throughout the VN Futures roadshow events nurses felt they were often entering a career cul-de-sac after a certain amount of time in practice and so the need for further post-registration qualifications which promote excellence and recognise advanced knowledge, skills, competency and experience in designated areas were strongly expressed.
"We have taken this feedback and developed it into a comprehensive framework for two defined post-registration qualifications and are very interested in hearing what both veterinary nurses and veterinary surgeons have to say about all aspects of what we are proposing.
"Once we have collated the responses, we will incorporate the feedback into the framework for further consideration by the relevant committees and VN Council. The eventual aim is that these qualifications will, once sufficiently bedded in, lead to the development of an Advanced Veterinary Nurse status so that members of the VN profession with the sufficient skills and experience will get the recognition they truly deserve."
The two new qualifications included in the framework are a Graduate Certificate in Advanced Veterinary Nursing and a Postgraduate Certificate in Advanced Veterinary Nursing. Details of the courses’ structure, candidate assessment criteria, accreditation standards, student support, candidate eligibility rules, the RCVS enrolment process and the procedures for certification will be set out in a framework document as part of the consultation process.
The document also includes a prospective list of designations for the two courses covering areas of advanced veterinary nursing knowledge such as wellness and preventative health; rehabilitation and physiotherapy; anaesthesia and analgesia; triage, critical care and emergency nursing; pharmacology; animal welfare; education and teaching; management and leadership; research; and, dentistry.
The consultation will be launched in early July with an email sent to all veterinary nurses and veterinary surgeons containing a link to the survey and asking for their views on the proposals. Details of the consultation, once launched, may also be found at www.rcvs.org.uk/consultations
The VN Futures Report is available to download from www.vetfutures.org.uk/vnfutures
The hearing proceeded in Ms Kay’s absence as she failed to attend. The Committee heard a number of charges relating to her practising while under the influence of alcohol, breaching undertakings to the College to abstain completely from alcohol, alleged serious clinical failings in relation to the treatment of two dogs, Izzy and Alfie, and making disparaging remarks to a client about other veterinary surgeons (the complete list of charges can be found on the College’s website: www.rcvs.org.uk/concerns/disciplinary-hearings/).
In relation to the first charge, (that in September 2016, while a locum veterinary surgeon at Haven Veterinary Surgeons Group, Great Yarmouth, she was under the influence of alcohol), the Committee heard from a veterinary nurse at the practice who told how on different occasions Miss Kay had appeared to need more assistance than expected, was overly friendly in speaking to clients, was unable to prepare a syringe correctly, and finally, on 14 September 2016, was found asleep in the car with an open can of alcohol by her feet. The Committee also heard from a number of other witnesses from the Haven Veterinary Surgeons Group who also provided evidence of Ms Kay’s behaviour on the day in question. Following deliberations, the Committee found the first charge to be proved.
The second charge related to the breaching of undertakings which Ms Kay had given to the College to the effect that she would abstain completely from alcohol. When samples were taken on 3 August 2017, however, it was found that she had been consuming alcohol in the recent past. The Committee was therefore satisfied that the second charge was proved.
The Committee then turned to the third charge, that in March 2017 Ms Kay had displayed a number of clinical failings when performing surgery on a cocker spaniel, Izzy, belonging to Mrs Debbie Coe. The Committee found the majority of the charges proved, amongst others that she failed to obtain informed consent for surgery, performed surgery in her own home when it was not registered as a veterinary practice and it was not possible to ensure sterility, and that she failed to provide suitable post-operative analgesia to Izzy.
The College then turned to the fourth charge, which concerned her treatment of Mrs Coe’s other dog, Alfie, a Miniature Schnauzer. The charge was that in March 2017, Ms Kay euthanased Alfie in an inappropriate manner, and used a controlled drug without having a registered veterinary premise from which to dispense it. After hearing from an expert witness the Committee found the charges proved.
Finally, the Committee heard evidence relating to the fifth charge, namely that in or around July 2016, Ms Kay made disparaging remarks to Mrs Coe about other veterinary surgeons who had treated Alfie, and that between 17 March and 31 March 2017 she had sent inappropriate texts and voicemail messages to Mrs Coe about the treatment of her dogs and payments owed in relation to this. The Committee thought there was not enough evidence in relation to the voicemails, but found the remainder of the charge proved.
Taking all into account, the Committee found that Ms Kay’s conduct had fallen far short of the standard expected of a member of the veterinary profession and concluded that her conduct clearly amounts to disgraceful conduct in a professional respect.
Alistair Barr, chairing the Committee and speaking on its behalf, said: "The Committee considered that the only appropriate sanction is that of removal from the Register. Such a sanction is required to protect animals and to send a clear message to the Respondent, and to all veterinary surgeons, of the unacceptability of the conduct identified in this case. Such conduct undermines public confidence in the profession and fails to uphold proper standards of conduct and behaviour.
"Accordingly, the Committee has decided that removal from the Register is the only appropriate and proportionate sanction in this case."
Ms Kay has 28 days from being informed about the Disciplinary Committee’s decision to make an appeal to the Privy Council.
Fees will now be £340 for a UK-practising member, £170 for members practising outside the UK, £56 for non-practising vets under the age of 70, and free for non-practising vets over 70.
Restoration fees, charged in addition to retention fees, increase to £85 following voluntary removal, and £340 following removal for non-payment.
Lizzie Lockett, RCVS CEO, said: "This year we asked Council to agree a fee increase to help us prepare for unknowns such as Brexit, as well as fortify our proactive work to help support the professions.
"Over the past few years we have put increased resources into projects such as: Mind Matters, our mental health initiative; Vet Futures, our joint project with the British Veterinary Association; Vivet, our innovation hub; and our recently launched Leadership Programme. Unfortunately there has also been a rise in Disciplinary Committee hearings and we are having to allocate further funds to making our building fit for purpose, and so a small increase has been necessary.
"This still places us at the lower end of fees for regulatory bodies while providing a secure financial foundation."
This compared with 339 who were removed for non-payment last year.
A list of those who have not paid their fee has now been published and the College encourages practices to check the list (www.rcvs.org.uk/removals2018) to be sure that no employees are named.
Those who have been removed from the Register but have subsequently paid to be restored are not named on the list.
Anyone removed from the Register can no longer call themselves a veterinary surgeon, use the postnominals MRCVS or carry out acts of veterinary surgery – to do so would be in breach of the Veterinary Surgeons Act and therefore illegal.
The College says it would also like to remind veterinary surgeons that, although paying the fee is required to remain on the Register, to complete their registration in full they need to confirm they are compliant with the continuing professional development (CPD) requirement and complete the criminal disclosures form. Both of these are required by the Code of Professional Conduct and can be completed on the ‘My Account’ area.
Anyone with queries about completing the registration process should contact the College’s Registration Department on 020 7202 0707 or registration@rcvs.org.uk.
Mr Wood was convicted of three offences which involved the download of 38 videos and 13 indecent images of children, at Portsmouth Magistrates’ Court in December 2017.
In January 2018, he was sentenced to a three-year Community Sentence for each offence, to run concurrently, and was made subject to a five-year Sexual Harm Prevention Order.
He was also fined £1,000 and ordered to pay costs of £340 and a victim surcharge of £85.
Mr Wood was also placed on the barring list by the Disclosure and Barring Service and required to register with the police pursuant to the Sexual Offences Act 2003 for a period of five years.
Mr Wood appeared before the Disciplinary Committee, admitted his conviction and accepted that it rendered him unfit to practise veterinary surgery.
In determining the sanction, the Committee says it took into account a number of mitigating factors: his conviction involved no actual harm or risk of harm to an animal; there was no financial gain; he had engaged in open and frank admissions at an early stage; he was experiencing mental ill-health at the time of the offence; he had taken subsequent steps to avoid a repetition of such behaviour; there had been a significant lapse of time since the incident; and he showed insight into the harm caused by his offence.
The Committee also considered that the purpose of a sanction is not to punish, but to protect the welfare of animals, as well as maintain public confidence in the profession and declare and uphold proper standards of conduct. On consideration of the appropriate sanction, the Committee decided that postponement of judgement was not appropriate, and that taking no action was not an option.
The Committee then considered whether a reprimand or warning was appropriate, but they considered that would not match the gravity of the offence – a period of suspension would also mean Mr Wood would automatically return to the Register after the period of time without the College being able to review his fitness to practise, rendering it an inappropriate sanction. The Committee therefore determined that the removal of Mr Wood from the RCVS Register was the only way to protect the wider public interest and maintain confidence in the profession.
Ian Green, chairing the Committee and speaking on its behalf, said: "The Committee has not taken this decision lightly, and, lest it be misinterpreted, it has not taken it in order to satisfy any notional public demand for blame and punishment.
"It has taken the decision because in its perception, the reputation of the profession had to be at the forefront of its thinking and ultimately it was more important than the interests of the Respondent.
"The decision is not simply based on the fact that these offences were of a sexual nature but because they were repeated frequently over a significant period of time, and at the time, the Respondent knew on his own admission that what he was doing was wrong.
"Accordingly, the Committee had decided that removal from the Register is appropriate and proportionate in this case. The Committee will direct the Registrar to remove the Respondent’s name from the Register forthwith."
Mr Wood has 28 days to appeal the Committee’s decision after which, if no appeal is received, the Committee’s judgment takes effect.
Currently Principal of the Royal Veterinary College, University of London, and previously Dean of the University of Glasgow’s School Of Veterinary Medicine, Stuart has been a member of RCVS Council since 2005, and served as RCVS President in 2014-15.
As chair of the Education Policy and Specialisation Committee in 2011, Stuart oversaw the College’s review of veterinary specialisation, which also led to the new Advanced Practitioner status.
He has also been a driving force behind the joint RCVS and BVA Vet Futures project since its inception in 2015.
As Chair of the RCVS Governance Panel, he recently saw through reform of the College’s governance arrangements to improve the efficiency and accountability of its decision-making processes.
Stuart has also chaired the RCVS Science Advisory Panel.
He continues to chair the College’s Mind Matters Initiative, which aims to improve the mental health and wellbeing of all those in the veterinary team.
A particularly notable achievement during his Presidential year was to allow UK veterinary surgeons to use the courtesy title ‘Doctor’ if they so wished.
Lizzie Lockett, RCVS Chief Executive said: "We have been incredibly fortunate to have someone of Stuart’s calibre, character and international renown on our Council for so many years. His contributions and commitment to the RCVS, as well as to the wider veterinary professions, are as significant as they are often understated.
"On behalf of RCVS Council and all the staff, I should like to say how delighted we are that he has been honoured in this way. Such recognition is very much deserved and we send him our warmest congratulations."
Mr Adams was convicted at Gorey District Court, County Wexford, Republic of Ireland in March 2015 for:
Nine offences of prescribing animal remedies to animals not under his care;
Five offences of forging entries in official animal remedies records owned by farmers to suggest he had made visits to farms when he had not;
Seven offences of dispensing a prescription-only animal remedy but not preparing a veterinary prescription containing the details of the animals;
Two offences of failing to affix labels in the required form to prescription-only items when selling or supplying animal remedies;
Six offences of failing to annotate the dispensed prescriptions with the word ‘dispensed’ and failing to sign and date them;
Three offences of failing to keep a record or purchases and sales (including quantities administered) in respect of each incoming and outgoing transaction; and
Two offences of selling animal remedies on a wholesale basis without an animal wholesaler’s licence.
The charges related to treatment of animals not under his care throughout 2012 and 2013 which were investigated by the Department of Agriculture, Food and Marine in the Republic of Ireland.
In relation to these convictions Mr Adams received a 12-month prison sentence, suspended for two years, was fined a total of €40,000 and ordered to pay costs of €16,400.
Following his conviction his conduct was considered by the Veterinary Council of Ireland’s (VCI) Fitness to Practice Committee and, in September 2017, the VCI a sanction of 12 months’ suspension from its Register. This sanction was upheld by the High Court in the Republic of Ireland in November 2017.
As well as being a registered veterinary surgeon in the Republic of Ireland, Mr Adams was also on the UK-practising Register with the RCVS, so his convictions were considered under the College’s own complaints and disciplinary process.
At the outset of the hearing, Mr Adams admitted the charges and accepted his convictions rendered him unfit to practise. The College also asserted that Mr Adams' convictions rendered him unfit to practise, noting a number of aggravating factors including the risk of injury to animals, dishonesty, premeditation, financial gain and misconduct sustained and repeated over time.
In considering the College’s case and Mr Adams’ own admissions, the Disciplinary Committee agreed that his conduct rendered him unfit to practise veterinary surgery.
Professor Alistair Barr, chairing the Committee and speaking on its behalf, said: "The Committee found the conduct to be at the serious end of the spectrum for such misconduct, it being systematic, prolonged and illegal conduct relating to the supply of animal remedies which posed a significant risk to human and animal health.
"Accordingly, the Committee found that the convictions which led to these charges cumulatively render Mr Adams unfit to practise."
In considering the sanction, the Disciplinary Committee took into account a number of mitigating factors including that he had been practising since 1993 and had no previous disciplinary findings, had made open and frank admissions at all stages to the College and had practised between April 2013, when the matters first came to light, and February 2018, when he was suspended by the Veterinary Council of Ireland, without incident.
It also considered the conditions that were imposed upon Mr Adams by the VCI in terms of notification that he was intending to return to practice, auditing of his practice, his continuing professional development (CPD) and having to undertake personal and professional support programmes and arrangements for professional mentorship for one year after his return to practice.
In view of the sanctions already imposed by the court in Ireland, and his suspension by the VCI, the Disciplinary Committee decided that a period of two years’ suspension from the UK Register of Veterinary Surgeons was the appropriate sanction.
Professor Barr said: "Whilst Mr Adams would be able to practise in the Republic of Ireland before he was able to practise in the United Kingdom again, the Committee considered that the conditions attached to his supervision in Ireland meant that he would be subject to close supervision before he was allowed to practise again in the United Kingdom and that only a longer period of suspension would allow this to happen.
"The Committee therefore decided that only a suspension of two years would maintain public confidence in the profession and declare and uphold proper standards of conduct for the serious nature of these charges."
Mr Adams has 28 days from being informed about the Disciplinary Committee’s decision to make an appeal to the Privy Council.
The outreach programme began earlier this month at the Devon County Show (pictured right), where the College used the opportunity to spread the word about its petsneedvets campaign, handing out over 1000 promotional bags in the process.
Next on the itinerary is the Royal Welsh Show near Builth Wells from the 23rd to 26th July. From there, the College will be heading to the BBC Countryfile Live event, held in the grounds of Blenheim Palace in Oxfordshire from the 2nd to 5th August.
Ian Holloway, Director of Communications at the RCVS, said: "Following the success and popularity of our stand at Countryfile Live over the past two years we decided that this year we would broaden our horizons and attend some of the UK’s most prestigious and well-attended regional events.
"We have our ever-popular careers materials available, and it was wonderful to see dozens of young people at the Devon County Show asking us about how they can become veterinary surgeons and veterinary nurses, as they always have the past two years at Countryfile. This is a really encouraging level of interest in the professions and we’re very happy to provide information to help them fulfil their aspirations.
"Attending more and different public events is a trend we are very keen on continuing with and we will be looking at other events to attend in different parts of the UK for next year."
For more information about upcoming events involving the RCVS visit www.rcvs.org.uk/events
Photo: Royal College of Veterinary Surgeons
The Committee heard seven charges against Dr Elefterescu. The charges were:
In September 2015, in relation to a male cat called Kitty Brown, he failed to undertake an adequate examination prior to surgery and that he undertook an unnecessary laparotomy.
In February 2016, in relation to a male cat called Storm Page, he failed to undertake an adequate clinical examination prior to anaesthesia and made dishonest or misleading entries in the clinical records stating that he had undertaken a full clinical examination.
In February 2016, in relation to a male cat called Sampson Page, he failed to undertake an adequate clinical examination prior to anaesthesia and made dishonest or misleading entries to the effect that he had undertaken a full clinical examination.
In February 2016, in relation to Tibial Plateau Levelling Osteotomy (TPLO) surgery performed on a female Bichon Frise called Lucy Allen, he failed to undertake adequate examinations into the possibility of a cranial cruciate ligament rupture or failed to record the same; performed the TPLO surgery with insufficient clinical justification; performed the surgery inadequately; failed to take steps to rectify inadequate surgery having obtained post-operative radiographs; made dishonest/ misleading entries into clinical records; and, in a letter to the RCVS on 7 August 2016, made dishonest and misleading comments.
In February 2016, in relation to a male cat called Kipper Morley, he failed to take and record a sufficiently detailed history; failed to undertake an adequate clinical examination; that, having noted the possibility that Kipper might have anaemia, he failed to make arrangements for urgent investigations to be undertaken; that, having decided to administer intravenous fluids to Kipper, failed to make arrangements urgently; and failed to keep clear, accurate and detailed clinical records.
Between September 2015 and February 2016, he failed to keep clear, accurate clinical records in relation to seven cases.
In February 2016, in relation to a male cat named Chino Biggs, he failed to undertake adequate clinical examination and dishonestly made entries in the clinical records saying that he had undertaken aspects of an examination when he had not done so.
Having heard evidence from complainants, witnesses (including expert witnesses) and the respondent himself the Committee determined that the facts of all the charges were proven – with the exception of part of Charge 6 regarding his keeping inadequate clinical records in relation to a male cat called Dax Parham.
The Committee then went on to consider whether the proven charges, both individually and cumulatively, amounted to serious professional misconduct. In relation to the first and fifth charges the Committee found that, while Dr Elefterescu’s conduct fell below what was expected of a professional veterinary surgeon – they did not constitute serious professional conduct.
In relation to the parts of the second, third, fourth, sixth and seventh charges that were found proven, the Committee determined that each constituted serious professional misconduct.
In relation to these determinations, Ian Arundale, chairing the Committee and speaking on its behalf, said: "The respondent’s clinical failures… are very serious, amounting as they do to failures in the basics of animal care and resulting in suffering to the animal. They involve widespread breaches of the Code, including not only the obligation in relation to animal health and welfare… but also the specific obligations of the Code in relation to record keeping.
"In addition to his clinical and record keeping failures the respondent has been found to have acted dishonestly. This dishonesty would have impacted upon professional colleagues and any owner who viewed the records. It has the potential to undermine public confidence in the profession. The respondent was also dishonest in a letter written in August 2017 to his regulator."
In considering Dr Elefterescu’s sanction, the Committee took into account a number of aggravating and mitigating factors.
Aggravating factors included actual and risk of injury to animals, dishonesty, recklessness, breach of client trust, repeated misconduct and limited insight into his failings.
In mitigation the Committee considered that, at the time of the misconduct, the respondent was new to the UK, he had language difficulties which resulted in communication problems, that he was unfamiliar with UK veterinary computer systems and procedures, that he is of good character, that he has taken steps to avoid a repetition of his misconduct and that there have been no subsequent complaints since the dates of the matters in the charges.
However, the Committee found that, in light of the seriousness of the charges found against him, the only sufficient sanction was to direct the Registrar to remove Dr Elefterescu’s name from the Register.
Mr Arundale, commenting on the sanction, said: "The respondent’s misconduct involved very serious departures from the professional standards set out in the RCVS Code…. In particular, the unnecessary surgery (both the initial and revision) carried out on Lucy Allen constituted very serious harm to an animal. The Committee considers that the respondent’s lack of insight into his failings, and his wholly unjustified confidence in his abilities constitute an ongoing risk to animal welfare. In these circumstances, the Committee has determined that the only sanction which is appropriate and proportionate, in order to ensure the welfare of animals, the public interest and the reputation of the profession, is to direct the respondent’s removal from the Register."
Dr Elefterescu has 28 days in which he can lodge an appeal with the Privy Council regarding the Disciplinary Committee’s decision.
Ms Mulvey faced a number of charges relating to the treatment of a cat called Spooky: that she failed to provide Spooky’s owner, Mrs Parsons, with either Spooky’s lab results or an adequate explanation as to why they could not be provided; that she failed to respond adequately or at all to communications from Mrs Parsons; that she failed to respond to requests from the College for information relating to Continuing Professional Development (CPD), her professional indemnity insurance (PII), and her correspondence with Mrs Parsons.
At the beginning of the hearing Dr Mulvey admitted the facts to all the charges, and accepted that they constituted disgraceful conduct in a professional respect. The Committee had been provided with written evidence from Mrs Parsons, her husband, and four College staff, namely Gemma Crossley, Maria Fearon, Robert Girling and Michael Hepper.
Mrs Parsons provided a statement in which she spoke of how, in August 2016, she had taken Spooky to CornYard Veterinary Centre for a skin irritation where she was seen by Dr Mulvey.
Dr Mulvey decided to take blood tests and send them to the laboratory, but they agreed to defer them actually being tested until Mrs Parsons gave permission. Mrs Parsons then returned to the practice with Spooky to take said samples, after which followed a series of attempts to contact Dr Mulvey for the test results. Finally, in October, she demanded a refund, after which she began a small claim in County Court.
Mr Parsons went to the practice at the beginning of December 2016 and obtained the refund. At this point Mrs Parsons made a complaint to the College. The Committee received information from Mr Parsons, who corroborated the facts of the complaint, and from College staff who confirmed the many attempts to contact Dr Mulvey, starting with requests for documents by Ms Crossley and Ms Fearon, repeated requests for CPD and PII information from Mr Girling, and finally a hand-delivered letter by Mr Hepper, during which he learnt that her PII had lapsed at the beginning of 2017.
The College submitted that Dr Mulvey’s conduct fell far below the standard expected of a veterinary surgeon. It submitted that failing to provide the test results and communicate with the Parsons could have had a negative impact on animal welfare and damaged the reputation of the profession, while having PII is a fundamental obligation of the RCVS Code of Professional Conduct. Finally, not responding to the College about the concern raised, CPD or PII compromised the College’s ability to maintain public confidence in its regulatory processes.
The Committee considered that no harm had actually come to Spooky and that there were problems with the testing laboratory which slowed down the process. In addition, some of the lack of communication was due to a receptionist not following protocol, and Dr Mulvey was going through a particularly difficult part of her life and was clinically understaffed. The Committee heard from four different character witnesses, and were given 16 more written testimonials.
The Committee heard that in 2013 there had been complaints from three separate clients, all of which concerned Dr Mulvey’s failure to communicate and to process insurance claim forms, after which she agreed to participate in the Performance Protocol and entered into undertakings with the College.
The Committee having considered all the facts and background circumstances found that Dr Mulvey’s conduct was disgraceful in a professional respect.
The Committee went on to consider what sanction was appropriate. In reaching its decision the Committee took into account a number of aggravating factors, namely that there was a slight risk to the health of Spooky and that the disgraceful conduct occurred over a prolonged period of time. The Committee also considered that there was blatant disregard of the role of the RCVS and the systems regulating the profession.
In determining the sanction the Committee also considered mitigating factors, including that Dr Mulvey, apart from those previous concerns, had a long and unblemished career and that she’s made a huge difference to the health of the animals within her care. She also admitted her shortcomings, and had very impressive references.
The Committee therefore determined to postpone its decision on sanction for a period of one year on condition that Dr Mulvey enter into the following undertakings:
To agree to the appointment of a veterinary surgeon as a work place supervisor by the College and meet with them at least once every month
Allow the supervisor access to all aspects of running of the practice and to implement any recommendations made by the supervisor relating to the administration of the practice and the provision of out of hours’ cover.
To allow the supervisor to provide a report in relation to the matters set out in 2 above to the RCVS at least one month before the resumed hearing of this case.
To appoint within two months an experienced Practice Manager (who does not need to be full time).
To enrol in the voluntary Practices Standards Scheme and to achieve the Core standards of the Scheme within the next 12 months.
To submit a plan to the supervisor of CPD for the next twelve months within one month of agreeing to these undertakings. The plan should then be implemented and shall include aspects of practice management.
To pay all of the costs of complying with the undertakings, with the exception of the costs associated with the appointment and performance of the supervisor.
Ian Green, chairing the Disciplinary Committee and speaking on its behalf, said: "The Committee recognised that Dr Mulvey has been subject to undertakings before and yet committed the disgraceful conduct the subject of this inquiry. But it bore in mind the context of that conduct and it observes that the undertakings previously imposed in reality address a particular aspect of her practice.
"This Committee hopes that when the matter is relisted before it, the Respondent will be able to demonstrate that she has finally been able to address her administrative shortcomings. If she cannot do so, she will know that the Committee that sits on her case at the resumed hearing is likely to have more restricted options for disposal of her case."
The first charge was that in April 2016, having examined a horse named Alfie on behalf of his owner, Mr Villar gave an opinion to the potential buyers but failed to make it clear that he had not undertaken a pre-purchase examination; failed to declare to the buyer that he had a conflict of interest with regard to the owner; and, failed to explain the pre-purchase examination process to the buyers.
The second charge was that, in July 2016, during a telephone conversation with the buyer, Mr Villar was dishonest and failed to provide clear and accurate information because he told the buyers that he had only been asked to trot Alfie to check he was sound when he had, in fact, carried out a more substantial examination.
The third charge was that Mr Villar had offered to either the owner or the buyer, or both, that he would prepare a veterinary insurance certificate in relation to Alfie when he knew he did not have sufficient records (eg the microchip or passport number) to do so.
The fourth charge was that Mr Villar failed to respond adequately to communications from the buyers about Alfie.
The Committee found that Mr Villar had not in fact carried out a pre purchase examination (“PPE”) and referred to guidance from the British Equine Veterinary Association which identified that pre-purchase examinations are carried out on behalf of buyers. It noted that in this case, Mr Villar had undertaken an examination on behalf of the owner. Accordingly, it did not find that Mr Villar had failed to explain the PPE process to the potential buyers.
However, the Committee did find that Mr Villar had failed to declare that he had a conflict of interest in regards to Alfie’s owner. The Committee said that Mr Villar should have told the buyer that he had been acting on behalf of the owner and was not a neutral party in the potential sale.
The Committee found all aspects of the second charge not proven, on the basis that it was not satisfied so as to be sure that Mr Villar had told the potential buyers that he had only been asked to trot Alfie and check that he was sound.
The Committee found all aspects of the third charge proven on the basis that, in an email sent to the College in March 2016, Mr Villar admitted that he did not have the sufficient records to prepare a veterinary insurance certificate.
The Committee found the fourth charge not proven on the basis that the buyers were not his clients. The Committee therefore concluded that he had no obligation to respond to them, and indeed could not do so in certain respects in order to preserve the confidentiality of his client.
The Committee then determined that the charges found proven, when taken individually or in combination, did not amount to serious professional misconduct.
Ian Green, chairing the Committee and speaking on its behalf, said: "The following mitigating factors were present in this case: the circumstances of the incident, the fact that there was no premeditation, the fact that he was requested by his client to advance an opinion to [the buyers] concerning Alfie and that his ill judgement was on the spur of the moment and the fact that he had no financial gain. These are all important factors. Likewise, the fact that he did not know that the [buyers] regarded him as their pre-purchase examination vet is an important matter.
"The respondent’s conduct was clearly against the principles of behaviour articulated by Mr Morley [who acted as an expert witness for the College] in his expert report and in his evidence. Nevertheless, the Committee does not find that in the particular circumstances of this case, namely being asked to speak to a potential purchaser without warning and without being made aware of the contractual arrangements which had been made between the respondent and [the owner], the respondent should not properly be the subject of a finding of disgraceful conduct in a professional respect."
There will now be significant changes to the RCVS Council, as follows:
A gradual reduction in the number of elected members of RCVS Council from the current 24 to 13 by the year 2021.
A change of composition to include six lay members and two veterinary nurse members. Furthermore, the number of Council members appointed by each university whose veterinary degree is recognised by the RCVS will be reduced from two to one and Privy Council will no longer be required to appoint members. From 1 July 2020 university membership will undergo further changes as, from then on, veterinary schools will collectively appoint three members in total to serve on Council.
Members of Council will no longer be able to serve more than three consecutive four-year terms of office and, after serving three consecutive terms, they will not be eligible to re-stand as a candidate for two years.
Members of Council may be removed from office if they fail to satisfy any conditions about fitness to be a member, as determined by their peers on Council. If removed from office they will not be eligible to re-stand as a candidate for two years.
Introducing the LRO before the House of Lords last Tuesday, Lord Gardiner of Kimble said: "The proposed changes… reduce the size of Council and revise the balance of membership between vets and non-vets, including veterinary nurses and lay persons. They will bring the RCVS in-line with many other modern-day regulatory bodies and allow for greater efficiency, transparency and accountability to both members and the general public. For all the reasons I have outlined today, I commend the use of Legislative Reform Order to make changes that will benefit the veterinary profession."
The full text of the Legislative Reform Order can be found on www.legislation.gov.uk and the full transcript of the debate in the House of Lords can be found in Hansard Online (https://hansard.parliament.uk).
Professor Stephen May, RCVS President, said: "We have been looking at reform of Council as an issue of some urgency since 2013, in recognition of the fact that, with the formula-driven growth of Council, it was becoming unwieldy, which has an impact on the cost of each meeting and the frequency with which it could reasonably meet.
"This reform has been long in gestation and so we are glad that this has now been approved and that we can look forward to a more modern, agile and efficient governance structure, aimed as always at benefitting the professions, animal owners and animal health and welfare."
One immediate impact of the LRO relates to the results of this year’s RCVS Council election as the Ministerial sign-off now confirms that only the first three candidates (in order of number of votes) will take up their four-year terms at RCVS Day on Friday 13 July 2018. These are Susan Paterson, Mandisa Greene and Neil Smith, all of whom are current members who were re-elected.
The RCVS Veterinary Nurses Council agreed reforms to its own governance last year, including shortening the term of office from four years to three years; introducing a consecutive three-term limit for elected members; and, reducing the size and changing the composition of VN Council to six elected veterinary nurses, two appointed veterinary nurse members, two appointed veterinary surgeon members from RCVS Council, and four appointed lay members.
The results, in order of number of votes, are:
Elected: Susan Paterson – 3,976 votes
Elected: Mandisa Greene – 3,819 votes
Elected: Neil Smith – 3,544 votes
John Innes – 3,502 votes
David Catlow – 3,310 votes
Matthew Plumtree – 2,677 votes
Iain Richards – 2,635 votes
Karlien Heyrman – 2,487 votes
John Davies – 580 votes
Thomas Lonsdale – 542 votes
Due to the fact that a Legislative Reform Order (LRO) that amends the College’s governance has completed its passage through the House of Commons and House of Lords and is expected to be signed off by the relevant Minister to bring it into law, only the first three candidates are expected to take up their posts on Council at RCVS Day on 13 July 2018.
Eleanor Ferguson, RCVS Registrar and Returning Officer for the election, said: "I would like to thank all the candidates who stood for Council this year and would like to, in particular, congratulate Susan, Mandisa and Neil for being re-elected to RCVS Council.
"The LRO that is likely to be signed off in due course will reconstitute the makeup of Council – with greater lay and veterinary nursing input – and will also reduce the overall size of Council, including the number of elected members. Because of this only the first three – as opposed to the first six under previous rules – candidates are likely to be taking up a four-year term at RCVS Day 2018. Our commiserations go out to all the unsuccessful candidates, especially in this unusual transitional year, and we thank them for their participation in this year’s election."
The results of the election will be formally declared at this year’s RCVS Day – the College’s Annual General Meeting and awards ceremony – which takes place at the Royal Institute of British Architects on Friday 13 July 2018.
This was the sixth time that Mr Warwick Seymour-Hamilton had applied for restoration after being removed from the Register in June 1994, the reasons for which related to the condition of his practice premises and his record-keeping following an inspection by the RCVS. His most recent restoration hearing took place in May 2017.
In his application Mr Seymour-Hamilton said that he wanted to be restored to the Register to aid his research into herbal medicines and, during the course of the hearing, he also challenged some of the evidence given to the Committee in the June 1994 hearing. In particular he challenged the assertion that his practice was open when it was inspected by the RCVS as, he submitted that, he had retired three weeks’ prior to the inspection due to ill-health.
Mr Seymour-Hamilton told the Committee that he did not wish to return to clinical practice but wished to restore his membership of the RCVS in order to prescribe his own herbal treatments and to obtain peer review that would allow his treatments to be licensed. Furthermore, he produced, during the hearing, a continuing professional development (CPD) record card in which he had logged 1,438 hours of CPD in 2017.
In considering his application for restoration the Committee dismissed his challenge to the details of his original hearing in June 1994.
Ms Judith Way, Chairing the Committee and speaking on its behalf, said: "The Committee has noted that this issue is ancient. It is not for this Committee to consider it. Moreover the finding of the Committee represents a determination which was not challenged by the applicant until one of the more recent restoration applications. He never appealed it. Nor did he attend at the original hearing. It acknowledges that the premises could well have been closed given their condition, but whether they were or not is not for it [the Committee] to decide. It is quite possible the applicant has persuaded himself of the position. This is not an issue which is a persuasive factor in this application."
Regarding Mr Seymour-Hamilton’s contention that he would use his RCVS registered status to further his research into herbal treatments Ms Way said: "The Committee accepted there were no direct public protection issues which caused it concern, although it did retain some anxiety that the applicant’s commitment to herbal medicine could govern the way in which he would wish to care for an animal. A more rounded veterinary approach, which involved a full evaluation of an animal’s condition, a coherent diagnosis and a subsequent discussion about treatment with the client is called for."
Turning to his CPD she added: "His CPD now has a bias for herbal medicine as does his extensive reading. The Committee was not satisfied that his skills are up-to-date and that he could practise veterinary medicine safely. The Committee was not satisfied that he would approach a sick animal with the full and rounded approach required of a veterinary surgeon. Nor did his confidence in this regard allay the concerns of the Committee. He expressed belief in himself on the basis of his practice which came to an end some 24 years ago."
The Committee did acknowledge that Mr Seymour-Hamilton’s removal from the Register had a considerable impact on him and that, not only is he ashamed of it, but he believes it is frustrating his ability to advance the cause of herbal medicine.
In conclusion, Ms Way said: "Taking all these matters into account, the Committee has concluded that the applicant has not satisfied it on all of the evidence that he is fit to be restored to the Register and so this application is refused."
The Disciplinary Committee heard that Miss Oakes had signed a Greyhound Board of Great Britain (GBGB) Veterinary Surgeons Residential Kennel Inspection Form which indicated that there were 55 greyhounds in the kennel, when there were in fact more; that she had stated that the kennels were in an acceptable condition, when they were in fact not; and that she knew the form was inaccurate and/or was dishonest in relation to what she had indicated on the form.
The kennels in question, Rough Cottage, were owned by Louise Eccles and her husband, Rod Eccles. Mrs Eccles was licensed by GBGB as a trainer, allowing her to train and race greyhounds and making the kennels accountable to inspections by veterinary surgeons.
At the time of the form in question, Miss Oakes had been attending Rough Cottage for about a year-and-a-half on a monthly basis, up through August 2016. At that point, on or around 1 August 2016, Mrs Eccles had left Rough Cottage for personal reasons.
Miss Oakes subsequently visited the premises on 14 August 2016 along with Amanda Gething of Northern Greyhound Rescue, when she learned that rather than there being 55 dogs, there were more than 80.
On 16 August, she and Amanda Gething returned to Rough Cottage with Lucille Cavadino, from Lancky Dogs, a greyhound rescue organisation. They became aware of the existence of kennels on the premises that were not of acceptable standard, but Miss Oakes found that the dogs housed in these kennels were fit and healthy.
Miss Oakes also spoke to Mr Eccles around this time, and although he had plans to rehouse some of the dogs she was concerned that he might change his mind. Miss Oakes took the decision to complete and sign the kennel inspection form that Mr Eccles had handed to her, knowing that the details contained therein were incorrect. She stated that the reason that she did this was to appease Mr Eccles so that he would not hinder the plans to remove and rehouse the dogs. She admitted to the area GBGB Stipendiary Steward that she had signed the form and that it contained incorrect information.
At the beginning of the hearing Miss Oakes admitted all the charges except for the final one, namely that she had been dishonest about what she had indicated on the form. When she gave evidence during the hearing, however, she admitted that she had been dishonest and so all charges were found proved.
The Committee then turned to deciding whether these charges, having been found proven, would result in a finding of disgraceful conduct in a professional respect against Miss Oakes. The Committee considered her motives in signing the form were to try and safeguard animal welfare, but considered that she was misguided in how she chose to achieve that aim. The Committee, therefore, found that signing a form that is known to be misleading or inaccurate is in definite breach of the Code of Professional Conduct, and concluded that her conduct constituted disgraceful conduct in a professional respect.
When considering a suitable sanction, the Committee took into account a number of mitigating factors, including some 62 testimonials that were submitted in favour of Miss Oakes, and the fact that she believed she was acting in the best interests of the animals’ welfare.
Chitra Karve, Chair of the Disciplinary Committee, said: "So far as mitigating factors are concerned, the Committee is satisfied that the Respondent’s motivation for what she did was governed by her overwhelming wish to promote the health or welfare of the greyhounds at Rough Cottage.
"The Committee is satisfied that no actual harm or risk of harm to any animal occurred in this case. There was no financial gain to the Respondent and the Committee has been told that she charged no fee for her extensive efforts in organising or assisting with the removal and rehousing of the greyhounds from Rough Cottage.
"The Committee considers that this was a single and isolated incident and that the risks of similar behaviour being repeated in the future are low."
Chitra added: "The Committee has decided that it will be sufficient to protect the welfare of animals, to maintain public confidence in the profession and to declare and uphold proper standards of conduct, for the Respondent to be given a formal warning as to her future conduct."
The campaign gives 11 reasons why owners should register their pets with a veterinary practice, and encourages them to visit www.findavet.org.uk to find the right vet practice for them and their pet.:
Just like people, your pet can benefit from regular health checks to help stay happy and healthy.
Emergencies can happen at any time – registering means you’ll have easier access to emergency vet care whenever you need it.
Your vet knows a lot more about your animal than Dr Google and can provide tailored advice for your pet.
Regular weight checks and nutritional advice can help to keep your pet in shape – your practice’s vet nurses can often help with this.
Many vet practices run pet socialisation and training classes where you can meet other pet owners.
Your vet practice will hold your pet’s medical history to help diagnose any problems quickly.
Your veterinary practice can offer great advice about which pet is right for you because they will know you and your family.
Your vet practice is best placed to recommend other services for your animal, whether that’s pet groomers and trainers, or referral to an advanced practitioner or specialist.
Veterinary staff are often animal owners too, so they understand that pets are a much-loved part of the family.
Vets and nurses have made a solemn promise to look after animals under their care; they study for many years and have to keep their knowledge and skills up to date.
There are some medicines that only vets can prescribe, so it helps to be registered with a practice.
BVA President John Fishwick said: "Pets need vets to ensure their lifelong wellbeing, which is why it is concerning that a large number of pet owners in the country have not registered their animals with a practice. It is important that owners have access to reliable advice and veterinary care to be able to best look after their pets, and so we are calling on the profession to get involved in promoting the wealth of benefits that registering with a vet practice provides."
RCVS President Professor Stephen May added: "Owning an animal is a huge responsibility, which is why access to professional veterinary advice is vital. With this campaign we aim to highlight some of the very considerable benefits of registering pets with a veterinary practice, and raise awareness amongst pet owners who have not yet registered of the value of having access to professional veterinary advice, expertise and treatment to keep their animals healthy. We would be delighted if practices across the country would help share these messages on their own social media accounts."
Vets, vet nurses and veterinary practices can help spread the word on the value of registering pets by sharing campaign resources on social media using the hashtag ‘#petsneedvets’, downloading campaign resources and using the opportunity to encourage local pet owners to register with their practice.
To further highlight the value of veterinary care and the special bond between a veterinary professional and the animals under their care, BVA is also encouraging existing clients to share pictures of their pets at the vets online using the hashtags #lovemyvet and #lovemyvetnurse.
The Pets Need Vets campaign stems from the aim of the joint BVA and RCVS Vet Futures Action Plan to develop communications tools to assist the public’s understanding of veterinary costs and fees, and promote the value of veterinary care.
More information on the campaign and shareable resources are available at https://www.bva.co.uk/petsneedvets and www.rcvs.org.uk/petsneedvets
Reference
The consultation, which was held by the College early in 2017, asked for the views of veterinary surgeons and nurses, animal owners, and stakeholders on the use of telemedicine in veterinary clinical practice.
The consultation was designed to help identify potential risks associated with telemedicine, identify areas where it may help address the needs of both clinicians and the public, and support the potential development of new professional standards and guidance.
The online survey of veterinary professionals received 1,230 responses, while the public consultation received 229 responses and the survey of organisations/stakeholders received eight responses.
The headline question asked of veterinary professionals was whether RCVS 'supporting guidance to the Code of Professional Conduct' should be amended to allow remote examination to take the place of physical examination in certain circumstances. 41% said 'Yes', 40% said 'No' and 18% were unsure.
Veterinary professionals and organisations were then asked a series of questions in order to establish how they rated the risk associated with telemedicine according to activity type, practice type, clinical sign or syndrome, mode of technology, and familiarity with client, animal or environment.
Unsurprisingly perhaps, the majority felt that providing just general advice presented a low risk. At the other end of the scale, most felt that the use of telemedicine to diagnose disease or injury would be either 'high risk', or 'not appropriate at all'.
Likewise, the majority said the risks would be low or medium where the client and environment were known and the animal seen before, for the same problem. By contrast, the majority said telemedicine would be either 'high risk' or 'not appropriate at all' when the client, animal and environment were all unknown.
When asked whether the current definition of 'under care' should be extended to allow veterinary surgeons to prescribe veterinary medicines where there has been no physical examination of the animal, 69% said 'No', 16% said 'Yes' and 15% were unsure.
However, when asked whether certain types of veterinary medicines should be able to be prescribed without a physical examination of the animal, the majority of respondents to the professional survey (52%) were in favour.
The results of the consultation were first considered at a special meeting of the Standards Committee in August 2017, where it was noted how the consultation had revealed significant confusion around current supporting guidance to the RCVS Code of Professional Conduct and that, at a minimum, clarification as to what was currently permissible was needed.
The Committee determined a key issue going forward was whether to change the Supporting Guidance to the RCVS Code of Professional Conduct regarding 'under care' to allow veterinary surgeons to prescribe POM-V medicines based on telemedicine alone.
Given the complex nature of the issues and the wide-ranging implications, the Standards Committee presented a range of options for amending RCVS Guidance to RCVS Council at its meeting in November 2017. After discussion, Council asked the Standards Committee to continue their review and to present more detailed proposals to Council regarding the future of telemedicine in clinical veterinary practice.
Anthony Roberts, RCVS Director of Leadership and Innovation, said: "We would like to thank all those who took the time to respond to the consultation – although Council has not yet made any firm decisions, we felt it would be useful to share our research so far.
"The use of telemedicine is growing rapidly in human healthcare and it is only right the RCVS assesses the opportunities it could bring to improve access to veterinary services. It is critical, however, that we understand the issues it presents 'at the coal face' and consider all the available evidence before making any changes to our Guidance. The RCVS should ensure its regulatory framework fosters innovation and maximises the opportunities to improve the quality, efficacy and accessibility of veterinary services, whilst at the same time protecting animal health and welfare."
The Standards Committee will meet again in April 2018 to take further evidence and develop proposals to take the issue forward.
Meanwhile, the full summary is available on the College’s website: www.rcvs.org.uk/telemeds-summary/.
There were two charges against Mr Staton, the first being that he failed to comply with eight requests from the RCVS sent by letter between November 2014 and August 2017 in relation to his continuing professional development (CPD) records.
The second charge was that between 1st January 2012 and 7th November 2017 he failed to have professional indemnity insurance or equivalent arrangements in place.
Mr Staton’s request to adjourn the hearing and agree undertakings was not opposed by the RCVS. The Committee had regard to advice of the Legal Assessor and submissions from both counsel for the RCVS and legal advisor for Mr Staton. In accepting Mr Staton’s request for adjournment and his undertakings no admissions have been made in respect of the charges against him.
In deciding whether to accept the adjournment and undertakings, the Committee was asked to consider a number of factors including Mr Staton’s age and health, his unblemished career of more than 50 years, the fact that he had closed his practice and retired from clinical practice on 31 March 2018 and that he had no intention of practising as a veterinary surgeon again. For those reasons the Committee felt it would be disproportionate to take Mr Staton through a full hearing.
Ian Green, chairing the Committee and speaking on its behalf, said: "In coming to this decision the Committee considered the respondent’s application to adjourn this inquiry in the light of the evidence he adduced. It had regard to the interests of justice, the public interest in ensuring high standards are maintained by veterinary surgeons and the need to ensure the protection of animals and their welfare."
Should Mr Staton seek to apply to rejoin the Register then the proceedings will become active again and a Disciplinary Committee hearing will be scheduled.
The changes follow a jointly-funded research project by the RCVS and the British Small Animal Veterinary Association to evaluate how effective the PDP is in supporting graduates during the transition from veterinary school to veterinary practice.
The research was carried out by the Work Psychology Group and included online surveys, telephone interviews and a focus group with recent graduates and representatives from practices that are currently employing recent graduates.
The aim was to understand both positive and negative experiences of the PDP amongst veterinary graduates and their employers considering existing obstacles to learning and development, any gaps in support provision and common areas of confusion, anxiety and concern.
Christine Warman, RCVS Director of Education, said: "We are really grateful to everyone that took the time to give us their views and are pleased that this report gives us such a solid foundation on which to base necessary changes. What came across very strongly from the feedback we received was that the overall purpose and aims of the PDP were welcomed by graduates, employers and other stakeholders as something that is useful and good for the profession.
"Most agreed that having a formal support mechanism for graduates is essential for navigating the transition between the structured environment of veterinary school to the ‘coalface’ of veterinary practice.
"However, it was clear that there are issues with the PDP in its current format, including comments around it being a 'tick-box' or 'check-list' exercise in which the number of tasks completed was seen as more important than a focus on qualitative aspects such as confidence and progression as well as a lack of focus on development of non-clinical skills.
"As a result the Work Psychology Group came up with a series of recommendations which were approved by our PDP Working Group in December 2017 and then our Education Committee in February 2018. Some of these recommendations, as set out below, can be actioned in the short-term and we hope that these will rectify some of the concerns that were raised.
"In the longer-term the future of the PDP and the further recommendations of this research are also being considered as part of our Graduate Outcomes Project which is taking a more holistic view on the skills and competences of future veterinary professionals."
The short-term recommendations accepted by the RCVS Education Committee are:
Developing guidance to support graduates and employers through the process of reflection on their progress.
Considering how to build opportunities to capture and record reflective learning into the PDP.
Making it a requirement of the PDP that every graduate who is participating in the PDP has a named workplace mentor assigned to them, as well as a Postgraduate Dean.
Asking assigned mentors to sign-off their graduate’s progress on the PDP on a regular basis (eg every other month) and write a short commentary on the graduate’s progress on a six-monthly or annual basis.
Sharing resources between the BSAVA and RCVS looking at where further resources can be developed.
Gaining feedback from other professions as well as the veterinary schools regarding platforms that have been used for similar purposes and have been successful. This process would consider the key requirements of a PDP platform and ensure that the right questions are asked to gain feedback.
Sheldon Middleton, Chair of BSAVA’s PDP Committee, said: "We’re really pleased with the start we’ve made to help graduates and their employers take positive steps to tackle the challenges of transitioning between university and practice, and we have a plan to improve further, working with RCVS to really make a difference.
"We are also pleased to have this opportunity to reflect on such comprehensive feedback after our first year, this empirical evidence from those involved is invaluable, we have learnt lessons and highlighted areas for further development, so now we’re looking ahead to make sure we implement our improvement plan."
"The BSAVA Resource Bank received positive feedback (1.5.4) however, the majority of stakeholders and graduates were unaware of this resource and we will work to address this."
The full report from the Work Psychology Group can be downloaded from the RCVS website at: www.rcvs.org.uk/lifelong-learning/professional-development-phase-pdp/pdp-research/
The Codes of Professional Conduct for both veterinary surgeons and veterinary nurses stress the need for effective communication with clients and ensuring that informed consent is obtained and documented before treatments or procedures are carried out.
At its January meeting RCVS Standards Committee approved changes to chapter 11 (‘Communication and consent’) of the supporting guidance to the Codes to provide further advice to the professions on matters that should be discussed with clients to ensure informed consent is gained, provide clarification on who can gain consent for a procedure and give some additional guidance on consent forms.
Nick Oldham, Standards and Advisory Manager at the RCVS, said: "We hope that this updated guidance is more accessible, readable and will aid members of the profession in developing a more comprehensive approach to gaining informed consent for treatments and procedures and therefore reduce the risk of miscommunication and misunderstanding which can lead to concerns being raised by clients.
"For example, we have updated our guidance to encourage veterinary surgeons to consider discussing a number of additional factors with a client before obtaining consent. This includes the nature, purpose and benefits of any treatment or procedures, the likely outcomes including potential risks, financial estimates, informing the client when other treatments may have available and checking that the client understands what they are agreeing to rather than assuming the client understands both the potential financial outlay and possible side effects.
"Furthermore, there is now additional guidance for veterinary surgeons on who should be seeking consent. While ordinarily it is expected that the veterinary surgeon undertaking the procedure or providing treatment is responsible for obtaining the client’s consent we know that this is not always practical.
"Therefore we clarify that the responsibility of obtaining consent can be delegated to another veterinary surgeon and, failing that, a registered veterinary nurse or student veterinary nurse could obtain consent provided that they are suitably trained, have sufficient knowledge of the proposed procedure or treatment and understand the risks involved.
"The RCVS Standards and Advice Team is also in the process of producing a series of fictional case studies based on informed consent issues encountered by the College’s Preliminary Investigation Committee which we hope will further help the profession."
The updated supporting guidance can be found in full at www.rcvs.org.uk/consent
The Code of Professional Conduct and its supporting guidance can also be downloaded as an app for smartphones and tablets at www.rcvs.org.uk/codeapp
Members of the profession seeking confidential advice on matters relating to professional conduct can contact the Standards and Advice Team on 020 7202 0789 or advice@rcvs.org.uk
Mr Smith was convicted of conspiracy to commit a fraud in which potentially dangerous horses were drugged and then sold to unsuspecting owners, at Maidstone Crown Court in June 2016. He was given 30 months' imprisonment, which formed one of the charges heard by the Disciplinary Committee.
There were also a number of charges related to his treatment of five different animals while in practice at the Lakeview Veterinary Centre in Folkestone, Kent. The charges were:
In relation to a Clydesdale mare named Grace on 14 August 2014 he failed to perform an adequate examination and/or undertake sufficient investigation and/or take a history of her; that after his initial visit to Grace on that day he failed to respond adequately to the owner’s telephone reports that Grace had deteriorated and/or failed to improve; and, that he failed to make adequate clinical records for Grace.
Between 29 September 2014 and 31 January 2015, in relation to a Labradoodle named Holly, he failed to keep adequate clinical records.
In relation to a cat named Maisey the allegations were that he failed to examine and investigate the cat adequately, he made a diagnosis of diabetes mellitus and gave insulin to administer to the cat without first undertaking the minimum investigation required, failed to keep adequate clinical records and sent an incorrect, misleading and dishonest statement to the RCVS regarding his treatment of Maisey. All charges date between 30 October and 19 December 2014.
In relation to a cat called Comet the allegation was that between 1 April and 17 April 2015 he failed to keep adequate clinical records and failed to respond adequately and appropriately to concerns raised by the owner.
Regarding a Yorkshire Terrier with diabetes named Poppy the allegation was that in two emergency out-of-hours calls made by Poppy’s owner to Mr Smith in April 2015 regarding the dog’s condition, he failed to recommend veterinary treatment or keep adequate clinical records. Furthermore, when the owner attended the practice following the two calls and the death of Poppy, he attributed the care to another member of the practice and failed to communicate effectively with the owner.
Having heard from a number of witnesses, including Mr Smith, and having received representations from Mr Smith in relation to the above charges, the Committee found almost all of the charges proven, with the exception of those relating to Mr Smith’s alleged conversation with Poppy’s owner at the practice following her death.
The Committee then went on to consider whether the various proven charges amounted to disgraceful conduct in a professional respect and whether the conviction rendered Mr Smith unfit to practise veterinary surgery.
In relation to the clinical charges the Committee found that, both individually and cumulatively, they amounted to disgraceful conduct in a professional respect.
The Committee also determined that the conviction rendered Mr Smith unfit to practise veterinary surgery and noted that it involved prolonged dishonesty, breach of trust, disregard for animal health and welfare and a "total abrogation of Mr Smith’s professional responsibilities."
Cerys Jones, chairing the Committee and speaking on its behalf, said: "The Committee was particularly concerned because the dishonesty went to the heart of Mr Smith’s responsibilities as a veterinary surgeon. His registration as a veterinary surgeon enabled him to take part in the conspiracy, and that role involved him conducting certified examinations on animals and supplying drugs for administration to animals. Reliable and honest certification is a vital element of the veterinary surgeon’s public role."
In considering the sanction against Mr Smith the Committee looked at the clinical charges and the conviction separately.
In relation to the clinical charges the Committee found that his treatment of the animals in these cases was fundamentally incompatible with being a veterinary surgeon. The Committee therefore directed that Mr Smith’s name should be removed from the Register of Veterinary Surgeons.
The Committee said that the case demonstrated that Mr Smith’s lack of treatment or his inappropriate treatment of these animals caused harm and that in some regards, for example the writing of accurate and contemporaneous clinical notes, Mr Smith demonstrated a total disrespect for the Code of Professional Conduct.
The Committee went on to say: "Further, he deliberately lied to his regulator. He demonstrated deep-seated attitudinal issues including a misplaced belief in his own abilities and had no insight or commitment to do anything different in the future. In those circumstances the likelihood of repetition was significant in the Committee’s view."
In considering the sanction for his conviction of conspiracy to commit fraud the Committee took into account a number of aggravating factors including the premeditated nature of the conduct, the fact it was repeated over four years and the fact that harm was caused to both animals and people as a result of his actions.
Cerys Jones said: "As the decision notes, some of the riders were novices or children and as a result of their experience they lost confidence in riding a horse. As the independent veterinary surgeon Mr Smith was in a position of responsibility because he was certifying the horses as to their suitability. A particularly aggravating feature in this case is that Mr Smith had previously been removed from the Register for falsely certifying horses for export."
In relation to the conviction the Committee also directed that the Registrar remove Mr Smith from the Register.
Mr Smith has 28 days from being informed of the Committee’s decision to make an appeal against it.
The full findings can be found here.
There are 10 candidates standing in this year’s elections, including four existing Council members eligible for re-election and six candidates not currently on Council. They are:
Mr David Catlow MRCVS
Mr John C Davies MRCVS
Dr Mandisa Greene MRCVS
Miss Karlien Heyrman MRCVS
Professor John Innes FRCVS
Dr Thomas Lonsdale MRCVS
Dr Susan Paterson FRCVS
Mr Matthew Plumtree MRCVS
Mr Iain Richards MRCVS
Colonel Neil Smith FRCVS
Ballot papers and candidates' details have been posted to all veterinary surgeons eligible to vote and an email containing a link to a secure voting site unique to each member of the electorate has also been sent by Electoral Reform Services which runs the election on behalf of the College.
All votes must be cast, either online or by post, by 5pm on Friday 27 April 2018.
This year the College invited all election candidates to produce a video in which they answered up to two questions submitted directly to the RCVS from members of the electorate. All videos have been published on the RCVS website (www.rcvs.org.uk/vetvote18) and YouTube channel (www.youtube.com/rcvsvideos).
Key question themes this year included recruitment and retention, the College’s concerns investigation process and veterinary education. The list of accepted questions has also been published on the RCVS website.
The biographies and statements for each candidate in the RCVS Council election can be found at www.rcvs.org.uk/vetvote18.
Eleanor Ferguson, RCVS Registrar and Returning Officer for the election, said: "Last year we had a record number and proportion of the electorate vote in an RCVS Council election and we would once again stress the importance of voting to ensure that you have a say in the future direction of travel for the College and its policies."
Those who are eligible to vote but have not received either an email or ballot paper should contact Luke Bishop, RCVS Senior Communications Officer, on l.bishop@rcvs.org.uk.