For the survey, veterinary surgeons and nurses were asked: "Thinking about the last time you (or your OOH provider on your behalf) were called by a pet owner out-of-hours within the last fortnight, was the call ...
a) Something which was clearly NOT an emergency (eg vaccination, nail clip, dematt, pet passport etc.)
b) A condition which should have been seen in normal working hours (either because it has been present for some time already with no deterioration or because - in your opinion - it could have waited till the morning).
c) A genuine emergency, which needed prompt attention to prevent the animal suffering.
475 members took part, 69% of which were vets and the remainder vet nurses.
Of the out-of-hours (OOH) calls they had taken:
28.2% were genuine emergencies, which needed prompt attention to prevent the animal suffering.
64.8% were about a condition which should have been seen in normal working hours (either because it has been present for some time already with no deterioration or because it could have waited till the morning).
6.9% were about something which was clearly NOT an emergency (eg vaccination, nail clip, dematt, pet passport etc.)
So in total, 71.7% of the calls to veterinary surgeons OOH are unnecessary.
This raises a number of important questions, chiefly whether a profession struggling with a staffing crisis can afford to maintain the blanket requirement for all practices to make provision for OOH, particularly now that society places so much greater demands on the profession than it did when the rules were invented, demanding wormers in the middle of the night and then blackening the name of the vet on social media if they refuse. It happens.
Is it time to go the same way as some other countries and let the market meet the demand?
Or can anything else be done to relieve the pressure that OOH places on the profession? Ideas floating around include making all veterinary OOH telephone lines premium rate, charging at least enough to focus the caller's mind on whether it is actually necessary to renew their pet passport at 3:00am. Or perhaps a concerted effort by all parties to communicate the message that OOH is A&E. You shouldn't ring unless you really need to. But that message may not carry much weight when at the end of the day, it's the insurance company footing the bill.
Reducing the number of spurious calls doesn't, of course, help the staffing crisis. But it is surely pertinent to ask whether an obligation for 100% of general practices to make arrangements to service something which is 70% unnecessary is the most efficient way to operate.
Maybe the time has come for the profession to consider OOH and general practice as two very distinct things. Discuss.
The RCVS didn't want to comment.
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I’m sorry to say that this study is flawed Arlo (excluding the queries re vaccinations etc) because sometimes an owner doesn’t know whether it’s an emergency or not. Also, and sadly, the exacerbation of a condition that the owners haven’t sought advice and help for may well present as an emergency, though it wasn’t before.
So a follow-on survey is required.
Hi Julie Turner. Um, I wouldn't agree it is flawed. We knew when we framed the question that of course owners are not as well qualified to judge whether or not something is an emergency. But what we can usefully see from this survey is that there is a huge gulf between the number of calls and the number that actually require any treatment, some of which (6.9%) are people who absolutely should not be troubling an emergency service out of hours. Of the remainder, there'll be a spectrum from those who a) should have presented the dog earlier, in working hours, or b) who really should know that one vomit is not a reason to seek emergency help, to c) those who really DO need an expert to be able to differ between things that can wait till morning and those that can't. Yes, I agree, further work needed to investigate that. But the purpose of this quick poll was to establish how efficient OOH as a service is. Evidently, there is a huge amount of resource / big drain on the profession, with a lot of wastage, Your 'also' point was covered by the survey, because in that situation, the case would have counted as an emergency, regardless of the history.
Thanks for your reply Arlo. I don't disagree about many of the calls - it's a big problem, I'm simply concerned that as scientists, we need to be rigorous in our messages (and apologies, I was speed-reading a bit!
Publishing Editor: Arlo Guthrie
Clinical Editor: Alasdair Hotston Moore MA VetMB CertSAC CertVR CertSAS FRCVS
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