Prior to the start of the hearing, the RCVS received correspondence from Mr Kombert confirming that he did not intend to attend the hearing, either in person or via a video-link, nor did he intend to send legal representation in his stead.
The Committee, chaired by Dr Martin Whiting, decided to proceed with the hearing in the absence of Mr Kombert and any legal representation, on the basis that it was in the public interest and the interests of justice to proceed and that Mr Kombert had been given the opportunity to attend or be represented.
The Committee heard that staff at the practice where Mr Kombert was working as a locum had undertaken a check of the medicines kept in the practice’s controlled drugs cabinet and discovered that 5.5ml of ketamine and 1.5ml of methadone was missing. After the code to the controlled drugs cabinet was changed, Mr Kombert was observed taking an additional 3ml of methadone, which he then administered to himself while on duty at the practice.
After Mr Kombert was confronted with the evidence, he was given the details of the Vetlife charity for support and asked not to return to the practice.
The police were contacted and, on 4 January 2019, Mr Kombert was arrested and interviewed. He received a police caution for theft, with conditions that he should attend and complete a drug-use awareness course, and engage in a restorative justice process, which involved attending the practice to discuss his offences. At this meeting, Mr Kombert admitted stealing the drugs and administering them to himself while on duty, which meant he was not in a fit state to see patients. He apologised for his actions and the matter was then also reported to the RCVS.
In relation to the fact that Mr Kombert had accepted the police caution, made the admissions at the restorative justice meeting and had emailed the RCVS apologising for his actions, the facts of the case were found proven.
The Committee then went on to consider if Mr Kombert’s actions amounted to disgraceful conduct in a professional respect (henceforth called ‘serious professional misconduct’), something which Mr Kombert had admitted to in correspondence with the RCVS.
The Committee found that Mr Kombert’s actions did amount to serious professional misconduct. Dr Martin Whiting, chairing the Committee and speaking on its behalf, said: "The respondent’s conduct was dishonest; it constituted both a breach of trust and an abuse of his position with regards to access to veterinary medicines; it risked animal welfare and jeopardised the reputation of colleagues. It fell far short of the conduct expected of a member of the profession and amounts to disgraceful conduct in a professional respect."
The Committee then considered what the appropriate sanction against Mr Kombert should be, taking into account both aggravating and mitigating factors.
In terms of aggravating factors, the Committee took into account the risk of harm to animals, his dishonesty, the premeditated nature of the misconduct, the breach of trust and the fact it was repeated.
It also took into account three previous matters recorded against Mr Kombert in the United States of America.
These were: a letter of admonition from the Colorado State Board of Veterinary Medicine for practising when his licence had expired; a stipulation order from the same body in which he agreed to relinquish his licence in that state following an allegation that he took controlled substances from a veterinary practice and self-administered them; and a criminal conviction in New York State for obtaining an opioid controlled drug by deception, for which he was sentenced to three years’ probation. The Committee was made aware of the New York State criminal conviction after Dianne Norris, a Probation Officer based in that state, had contacted the RCVS after hearing about the inquiry and informed the College that Mr Kombert was in breach of his probation conditions.
Dr Whiting said: “The Committee has considered the witness statement of Ms Dianne Norris, a probation officer employed by Putnam County Probation in New York, who was responsible for supervising the respondent as part of his probation. Ms Norris explained that the respondent breached his probation on numerous occasions, which took place from November 2017 to 2018…. As a result of the breaches, Ms Norris required the respondent to increase his attendance at support groups to an inpatient treatment program for 28 days from 13 July 2018. He failed to attend.
"Ms Norris explained that warrants were issued for the respondent’s arrest…. The Committee noted that the conduct of the respondent in relation to obtaining controlled drugs from his employers for his own use while in the United States of America was similar to his conduct … [described in] the charges."
In mitigation the Committee considered that Mr Kombert had consistently admitted the charges against him as well as accepting and agreeing with the evidence against him.
However, the Committee decided that in light of the seriousness of his misconduct, including dishonesty and risk of serious harm to animals, removal from the Register was the most appropriate and proportionate sanction.
Summing up, Dr Whiting said: "The respondent has failed to uphold the requisite standards to be expected of him on multiple occasions. The Committee considers that the only sanction that is sufficient to protect the welfare of animals, maintain public confidence in the profession and declare and uphold proper standards of conduct is one of erasure."
Mr Kombert has 28 days from being informed of the outcome of the hearing in which to make an appeal to the Privy Council.
The full facts and findings from the case can be found at www.rcvs.org.uk/disciplinary
Starting in the New Year, the benefits of vaccination will be communicated to both farmers and pet owners, initially focussing on farm use.
The aims of the campaign are to raise awareness of how and why vaccines work and the range of diseases they protect against, to review and improve how vaccines are stored and administered, and to encourage better uptake of existing vaccines.
Further information and tips on storing and using vaccines correctly will be shared, to help ensure that vaccines used will be effective.
NOAH says that research has shown that:
Dawn Howard, NOAH’s Chief Executive said: “It is encouraging that vaccination of the UK’s calves and sheep against livestock diseases has risen to one of the highest levels in seven years1. This increase is encouraging, however still more needs to be done in relation to uptake, storage and usage. We are asking the vet profession to support the #VaccinesWork campaign by spreading the messages with their clients and engaging on social media."
"We will be providing information for farmers e.g. if vaccines are not stored correctly, it will impact on their potency, meaning they could be less effective – not only will there be the potential for the vaccine to fail to protect animals against disease but also farmers may have wasted their efforts – and may be deterred from vaccinating again."
Whilst correct use by farmers is the initial focus, the campaign will include pets. Dawn said: "The topic of vaccine hesitancy is becoming increasingly important. Recognised by the WHO as one of the top 10 global health threats for people in 2019, this phenomenon is translating to the veterinary sector as well, especially in companion animals. The PDSA reports an ‘alarming’ drop in pet vaccinations: the proportion of pet dogs, cats and rabbits receiving a primary course when young has fallen by 18% over the past 3 years, down to 66%3.”
"This is bad news for the health and welfare of the nation’s pets, who are increasingly at risk of disease, and we need to work to address this."
References
https://ahdb.org.uk/knowledge-library/use-of-vaccines-in-cattle-and-sheep-2018-sales-update
https://www.noah.co.uk/wp-content/uploads/2019/10/NOAH-Vision-Paper-8pp-A4-Sep-19-vf.pdf
https://www.pdsa.org.uk/media/7420/2019-paw-report_downloadable.pdf
As a result, clients of LV=GI and Waggel will be able to book an online appointment with a veterinary surgeon within 30 minutes, without having to pay FirstVet's normal £20-30 charge.
Waggel is FirstVet's 26th insurance partner globally, and its third in the UK. The company now has 150 veterinary surgeons working on the platform.
Lucy Broadbridge, LV= GI Pet Product Manager, said: “At LV= GI we’re always looking for ways to help our customers protect what they love, so we’re very excited to be able to work with FirstVet to provide this service to our pet customers. With access to a vet from your smartphone or device, our pet customers will have peace of mind knowing that qualified veterinary advice is on hand 24/7, avoiding unnecessary time, cost and distress of visiting their vet if they don’t really need to."
Under current legislation, there is very little practical assistance that can be offered via an online consultation, other than recommending whether or not the animal needs to be seen by a veterinary surgeon in person. It may also be the case that the online consultation offers little more than a pet owner would get by ringing their normal vet. Nevertheless, online consultations will doubtless grow significantly in 2020, as the players line up to take advantage of any relaxation in the regulations that they hope will allow veterinary surgeons to prescribe medicines for animals they have not seen in person.
Regardless of whether that happens, there is a value in face-to-face communication between a veterinary surgeon or nurse and a client, whether it be for triage or follow up consultations. Independent practices might therefore be well advised to start implementing this kind of technology in practice sooner rather than later, in particular looking at ways that online appointments could be scheduled (perhaps between normal consultations) so as to compete with the short waiting times offered by companies like FirstVet.
The survey was conducted by Mo Gannon & Associates, which asked 2,000 UK adults about their satisfaction with the service they and their animals received from veterinary surgeons, levels of trust in the profession, and whether the service provided by vets represents value for money.
32% of the respondents felt that veterinary surgeons represented excellent (8%) or good (24%) value for money. 38% thought that veterinary fees are fair. However, 29% thought that veterinary surgeons and their services provided poor (21%) or very poor (8%) value for money. The results were very similar to the last time the survey was conducted, in 2015.
Nevertheless, veterinary surgeons continue to enjoy very high levels of trust amongst the public. 94% said they either completely trust (34%) or generally trust (60%) vets. This put veterinary surgeons in third place amongst the most trusted professions, below opticians and pharmacists but above GPs and and dentists.
Satisfaction with the profession was also high. 80% said they were either very satisfied (39%) or satisfied (41%), putting vets in fourth place below opticians, pharmacists and dentists, but above general practitioners and accountants.
RCVS President Dr Niall Connell, pictured right (would you trust this man?) said: "These results clearly demonstrate that there is a great deal of good will towards the veterinary profession and the work they do in treating the nation’s animals and serving their communities. The basis of all good relationships is trust, and it is fantastic to see that our clients continue overwhelmingly to trust our knowledge and expertise and remain very happy with the service we provide them.
"The picture on value for money is clearly a bit more mixed, although clearly 70% of the respondents recognise that we at least charge fair fees in terms of our time and expertise. There is, of course, always more work that we can do in order to help the public understand veterinary costs and fees and promote the value of veterinary care, as demonstrated by last year’s joint Pets Need Vets social media campaign with BVA, in which we highlighted the benefits to pet owners of being registered with a vet."
PBD Biotech says the Actiphage test offers the potential to revolutionise control of bovine TB by allowing detection of the disease within hours from a blood or milk sample.
Last November, the Welsh Government announced a new policy that allowed the use of non-validated tests such as Actiphage in herds affected by a TB breakdown. It followed a similar protocol to one authorised by the UK Government last year for cattle herds in England after the test was used as part of a successful private eradication plan on a Devon dairy farm.
Mossman Farming, in Ceredigion, is located in an area of chronic breakdown. It is a spring-calving milking herd with a total stock of 529, to date 312 dairy cows have been slaughtered. Farmer Chris Mossman agreed to trial Actiphage after hearing about the Gatcombe pilot.
Chris said: "TB is a massive problem in Ceredigion, so when I heard about Actiphage’s use at Gatacombe, helping to clear that dairy herd for the first time in six years, I wanted to try and replicate those findings here. Me – and many other farmers – are losing large numbers of animals. I’m trying to do all I can to get rid of this disease from my herd."
In Spring 2019, The Office of the Chief Veterinary Officer for Wales granted permission for Robert Price-Jones MRCVS to use Actiphage to screen high-risk cattle for M. bovis.
Robert, who has been leading the trial, said: "Actiphage is able to identify the presence of relatively low numbers of M. bovis in the blood stream of infected cattle. It is not dependent upon an immune system response to the pathogen - in contrast to current validated tests - and so has greater sensitivity than such as the official Tuberculin SICCT skin test.
"The benefit of using Actiphage is that it offers the potential for eradicating the disease from the farm; as early identification of animals at risk of bovine TB enables heightened disease management and control."
Under the terms of the Welsh Government’s protocol, cattle not condemned for slaughter can be tested with Actiphage. Those that give a positive result are identified with a ‘management’ marker, monitored and milked separately.
To prevent further contamination of the environment and to minimise risk to uninfected cattle, animals found to be ‘shedders’ are removed from the farm.
Although a decision to remove cattle based on a non-validated test will be at the farmers’ own expense, the APHA (Animal and Plant Health Agency) has confirmed that during the trial, where a positive result is confirmed with statutory tests, the animals will be removed with compensation as normal.
So far, 100 animals from Mossman Farming have been tested with Actiphage and Robert Price-Jones is preparing a paper to publish the findings in early 2020.
PBD Biotech is now seeking more farms to trial Actiphage in order to gain the World Organisation for Animal Health (OIE) validation. The company is offering reduced cost testing to support trials where the findings are made available to support validation of the test.
Vetlife is independent of all other veterinary organisations and is managed by a Board of 11 elected Trustees, all of whom are veterinary surgeons.
The charity employs a small number of staff, so trustees are often asked to undertake operational as well as strategic work and the role demands a substantial time commitment, including attendance at four board meetings in London each year. Trustees also act as ambassadors for Vetlife and to represent the charity within the UK Veterinary community.
Danny Chambers MRCVS is a trustee. He said: "Given the unique challenges facing veterinary professionals it is vital that the mental health support is delivered by people who understand the specific issues facing those working within the veterinary industry.
"This is why Vetlife is so important. We are a mental health charity run by the veterinary community, for the veterinary community. Being a trustee of this charity is a very hands-on role, where you get to influence all aspects of the charity’s work. If you want to help support your friends and colleagues, this is a great and fulfilling way to give back to the profession."
Vetlife President Geoff Little said: "Being a Vetlife trustee allows you to work with other members of a team dedicated to the welfare of others in the veterinary community."
The charity is currently seeking to co-opt a twelfth trustee to sit on the board until the next AGM in September 2020. Their appointment for the following three years would then need to be ratified by the membership. Any veterinary surgeon wishing to stand who is not an existing Vetlife member will be required to become one before applying. If you do not know any current members to propose you, contact the Vetlife office for assistance.
Submissions must be received by 20th January 2020. Interviews will be held in London on 3rd February 2020.
Further information, including an application form is available on the Vetlife website: vetlife.org.uk/support-us/volunteer/ or via the Vetlife office, 020 7908 6382 or info@vetlife.org.uk.
The deadline for nominations for Practice of the Year, Vet of the Year, Vet Nurse of the Year, Practice Manager of the Year and Practice Support Staff of the Year, is 16th January.
The award ceremony will take place on 2nd April 2020 in Birmingham.
James Barnes, Head of Sales & Partnerships at Petplan, said: "We’ve been recognising the brilliant work of the UK’s veterinary professionals through the Petplan Veterinary Awards for 21 years now and every year the standard of entries just gets higher.
"The nominations are a testament to the hard work of all of those involved at practices who care for animals and clients all year round.
"The awards are a perfect opportunity for you to showcase your practice and your colleagues. Being acknowledged is great for team morale and a wonderful opportunity to raise the profile of the practice to new and existing clients alike. If you haven’t already I’d invite you to nominate someone today!"
You can nominate a colleague or your own practice at petplanvet.co.uk/vetawards, before nominations close on 16th January 2020.
The range comprises four products: Calm, Seb, Pyo and Care. All four contain a new active ingredient derived from Ophiopogon japonicus called ophytrium, which Ceva says has been shown to strengthen the mechanical skin barrier1, restore the balance of protective microbial flora2 and sooth the skin1.
The new range consists of both shampoo and mousse formulations: Douxo S3 Calm is designed to sooth itchy, irritated skin while maintaining the skin barrier. Douxo S3 Pyo contains ophytrium and chlorhexidine at 3% which is both antibacterial and antifungal. Douxo S3 Seb contains ophytrium and seboliance and includes an extract from the peel of pomegranate. Ceva says it has an anti-odour action and will help with oily or flaky skin. Lastly, Douxo S3 Care (available as a shampoo only) contains ophytrium and is designed for regular use and maintenance.
The products are all free from soap, parabens, sulphates, phthalates, colourants and nanoparticles. A new, hypoallergenic ‘summertime’ fragrance has been added to the range which pet owners apparently liken to coconut and vanilla.
The Douxo S3 range comes in eye-catching packaging with a pump that can be used with one hand, an ergonomic bottle designed to be easy to grip, even with wet hands, and a visibility line so you can see the remaining quantity of the product.
Dr Melanie Rougier, corporate marketing manager at Ceva, said: “Our new range is the result of over 10 years of clients’ experience with Douxo and a robust programme of market research with four specific studies that included more than 2,000 vets and pet owners and represented over eight months of contact with pet owners. This has allowed us to gain a thorough understanding of our clients’ needs, in terms of performance, formulas, fragrance and ergonomic packaging."
Andrew Fullerton BVSc (Hons) MRCVS, product manager for Douxo at Ceva, added: "The new Douxo S3 range has been developed following extensive market research and field studies to ensure that the shampoos and mousses are not only innovative and effective, but that they are also safe and easy-to-use."
Dr Tim Nuttall BSc BVSc CertVD PhD CBiol MSB MRCVS, RCVS Specialist in Veterinary Dermatology and Senior Lecturer in Veterinary Dermatology at The Royal (Dick) School of Veterinary Studies at the University of Edinburgh, said: "I like that the performance has been proven on a basic science screening level and innovative skin model and then moving on to the in-field trials. This is what we would like to see from topical products."
Douxo S3 shampoo and mousses will automatically replace the current Douxo products via veterinary wholesalers and Ceva says it is working to convert other products in the Douxo range to S3.
For further information, contact cevauk@ceva.com, your local territory manager or visit https://www.douxo.com/uk/Pet-Skin-Care/douxo-s3.
The RCVS assessor’s report said: "The premises are genuinely state of the art, with all the space and equipment needed to provide a full multi-discipline referral service.
"The outstanding feature of this visit was the level of inpatient care, which is impressive with dedicated team leaders and thorough handovers for continuity of care, and the depth of knowledge of the clinical and nursing teams.
"Special mention must be made of infection control and inpatient modules in which all the award points available were obtained."
The assessor's report added: "You have all produced a centre to be proud of, and the feeling of pride and commitment of the team, came across very clearly. I wish you every success as your reputation grows."
Rebecca Lunn, operations co-ordinator at Paragon, said: "Pets always come first at Paragon so to receive four “outstanding” awards from the RCVS is a great compliment and achievement.
"Naturally we are delighted. It’s a real tribute to our entire team and our determination to deliver quality care, excellent service and a compassionate approach to ensure the best possible treatment for our animals.
"To achieve this, we have invested heavily, not only in the best, highly-experienced diplomates but also the most advanced specialist equipment within veterinary science.
"That level of commitment will continue on all fronts as we strive to be the very best we can be."
Earlier in the year, we conducted a survey of veterinary surgeons to ask what you felt were the biggest problems with using Facebook as a way to share or discuss clinical information.
According to the survey, veterinary surgeons felt the greatest problem with Facebook is that you cannot see the professional qualifications of those contributing to a discussion, so unless you know them offline, you have no context for what they post. Even in closed groups, it can be hard, if not impossible to know whether you are talking to someone with many years' experience, or virtually none; an RCVS Specialist, or a general practitioner, or a veterinary nurse.
The father of the world wide web, Sir Tim Berners-Lee recognised transparency as one of the most significant problems with the Internet during the Dimbleby Lecture at the end of last year. He said:
“Another problem people are perhaps increasingly aware of, particularly more recently, has to do with the fact that much of the web has insufficient accountability. There is by design, no approval system people need to go to, to share their information online. They don’t have to come and ask me to post something. So as soon as someone posts something on the web it can be viewed by a huge number of people. This seemed to work when people posted as individuals with their own reputations at stake. But now we have systems which create fake accounts and there are millions of automated systems, bots we call them, for robots, on social media platforms spreading messages of hate and conflict
"Because of this, misinformation has been spreading rapidly. There are not enough systems holding these people and this information to account. They should be testing the truthfulness of the information organisations and individuals are putting online.”
Whilst it is perhaps unlikely that malign foreign governments have been infiltrating veterinary Facebook groups to spread discord or indeed that there are many individuals deliberately spreading misinformation in this small profession, Sir Tim's point is still highly relevant to the sharing of clinical information, advice, experience or opinion.
The problem is that Facebook gives equivalence to everyone's opinion, an equivalence they simply do not deserve.
Sir Tim is right, you should indeed be questioning the truthfulness, or rather the accuracy of clinical information and opinions posted by colleagues online, and the starting point for that is knowing who posted it, and what qualifications they hold.
The new VetSurgeon.org discussion forums make an important step forward with that, by displaying the year and place of qualification next to posts, together with veterinary postnominals, taken from members' full VetSurgeon Profiles. We're also going to make it compulsory for contributing referral practitioners to complete their profile before posting.
The other biggest problems identified in the survey are how quality information gets drowned in a sea of 'me too' replies on Facebook, how it is difficult to refer back to old posts with useful information and how information is badly curated, making it hard to find what interests you.
On VetSurgeon.org content is now curated both by type, for example forum or news posts, and by areas of clinical interest, which each have their own group you can join and subscribe to. That makes it easier for referral practitioners or postgrad students to follow just their specific area of interest, or for anyone just trying to find information quickly.
We also asked what we could do to encourage you to visit VetSurgeon.org more often for clinical discussions. 62% of you said: 'improve the ease of use on smartphones' and 50.9% said: 'create a way for you to put a question to a group of expert clinicians'.
So that is what we've done (or are doing).
The new VetSurgeon discussion forums have been significantly enhanced for mobile phones. The new main navigation makes it far easier to find your way around the site. You can now reply to forum posts on the same page as the original post, which may sound like a small thing, but it makes a big difference. Elsewhere, we've optimised our use of the more limited space available.
Very soon, we'll be unveiling another feature designed to improve the quality of online clinical discussions, and to stop them drowning in a sea of me too replies. In our new Expert Help Forums, all members will be able to ask a clinical question, but only referral practitioners and selected expert general practitioner members will be able to reply (so long as they display their credentials, of course). When they do, they'll get proper recognition for their help, something which is again missing from Facebook.
With all this talk of better standards of clinical discussions on VetSurgeon.org, it is also worth reminding everyone that time spent in the forums counts towards your annual CPD requirement too. Just click the 'Claim CPD' button in the title.
Finally, as with any building project of this magnitude, there are inevitably some snags. Things that don't work or display as expected, especially on older or more obscure devices. If you come across something like that, please do email details (your browser, version and device type) to support@vetsurgeon.org and we'll endeavour to get it fixed, pronto.
Photo: Arlo Guthrie, Editor www.vetsurgeon.org
Intraperitoneal and incisional analgesia in small animals: simple, cost-effective techniques1, considers the findings and limitations of recent studies and makes recommendations on the use of IP and incisional analgesia in companion animals.
Paulo Steagall, lead author of the paper said: "Based on current evidence and a consensus of the WSAVA-GPC members, it is recommended that IP and incisional analgesia should be used for abdominal surgery such as intestinal foreign body removal, splenectomy, etc. These techniques can be particularly useful in high-volume sterilisation programmes due to their safety and cost effectiveness. They should never be administered as stand-alone analgesic techniques, but rather should be used in addition, as part of a multimodal analgesic plan with opioids and nonsteroidal anti-inflammatory drugs (NSAIDs)."
The review says that current literature on IP and incisional analgesia has several limitations including the use of different doses, drugs and volumes of local anaesthetic. Furthermore, acute pain assessment was performed using a number of different pain scoring systems with variable validity, by a number of different people which may introduce bias. Further studies are therefore warranted to continue to investigate the use of IP and incisional analgesia in a number of clinical scenarios.
Nicholas Jeffery, editor of JSAP said: "Local anaesthetics are inexpensive and not limited by geographic availability; this review supports their use to manage perioperative pain as part of a multimodal management approach."
The full article can be found in the January issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here: https://www.onlinelibrary.wiley.com/doi/10.1111/jsap.13084
For further information relating the use of local anaesthesia and the management of perioperative pain, the BSAVA is advising veterinary surgeons to consult a text such as the BSAVA Guide to Pain Management in Small Animal Practice.
Reference
Ane’s research interests lie in the surgical correction of neurological diseases leading to chronic pain and epilepsy. Amongst other things, she has developed an international database and phone application to help dogs and owners affected by epilepsy.
Ane began her veterinary studies in her native Spain before transferring to the Veterinary School of Paris (Ecole National Veterinaire d’Alfort) where she completed a three-year European residency in neurology. She then spent eight years working as a neurology-neurosurgery specialist in the UK.
Ane, who speaks five languages, then moved to the USA, where she joined Tufts University, training students, interns and residents and continuing her passion for research.
Henry L'Eplattenier, clinical director at Southfields, said: “We’re absolutely delighted Dr Uriarte has agreed to join the team.
"She is a very talented neurologist with a passion for neuro-oncology and will bring a wealth of experience and knowledge, which will benefit our world-class team."
Ane said: “I’m thrilled for the opportunity of leading the neurology service of such an outstanding hospital.
"Pets are part of our family and having a neurological disorder can be devastation. I’m committed and looking forward to helping referring veterinarians and owners in such circumstances."
The Burgess Excel Vet Awards have three categories: UK Rabbit Vet of the Year; Rabbit Nurse of the Year and Rabbit Veterinary Practice of the Year.
The newly-announced judging panel is made up of:
The judges will be looking for exceptional knowledge of rabbit care and husbandry and evidence of continued commitment to educating the public on how to care for rabbits correctly. Practices will be assessed on their provision of rabbit-specific materials and their efforts throughout the year to engage with rabbit owners.
Suzanne Moyes, said: "Our work with Rabbit Awareness Week has provided a unique opportunity to gain an insight into the positive impact veterinary practices can have on rabbit welfare. Research consistently demonstrates that there are too many rabbit owners out there who are neglecting the welfare needs of their pets and education is key to addressing this.
"Many vets and vet nurses will have first-hand experience encountering rabbits in practice that have been admitted with entirely preventable illnesses or diseases. As a profession, if we can spend more time engaging with and informing pet owners on how to correctly care for their rabbits, we can drive significant change that positively benefits their lives. That’s a unique position for vets and vet nurses to be in."
John Chitty (pictured right), co-director of Anton Vets in Andover said: "Rabbits are one of the UK’s most popular pets but unfortunately they’re also one of the most neglected. Despite the growing threat of fatal diseases such as RVHD2, vaccine numbers are dangerously low and far too many rabbits are being seen with nutritional and husbandry related issues.
"These awards will highlight the importance of providing the right levels of care and attention to learning the particular needs of rabbits. Doing so has numerous benefits, not just for the UK’s pet rabbits, but for the veterinary practices that are taking care of them too, as research shows rabbit owners will seek out practices that specialise in rabbit care as a preference."
Nominations for the Burgess Excel Vet Awards will open in March 2020 and winners will be announced at the London Vet Show 2020.
One winner from each of the three categories will receive a cash prize of £500.
Veterinary surgeons, nurses and other interested parties can register their interest in the Burgess Excel Vet Awards now by visiting www.burgesspetcare.com/excel-vet-awards.
330 people who took part in the survey were presented with a list of management and leadership skills. Those of the respondents who are leaders were asked to rate their confidence in applying the skills, whilst those in non-management positions were asked to rate their line manager's skills. Both sets of respondents were also asked to place the skills in priority order.
The management skills were: Setting clear tasks and objectives. Providing clear roles and responsibilities. Communicating clearly and effectively. Monitoring and evaluating. Planning and organising. Effectively managing difficult situations.
The leadership skills were: Providing rationale and explaining why. Regularly providing and seeking feedback. Building trust. Providing guidance and training. Creating development plans and opportunities.
Interestingly, the survey found a close correlation between how the leaders and the employees prioritise these things, with management skills being perceived as more important overall than leadership skills.
Communicating clearly and effectively was deemed the most important skill of all (ranked 9 out of 10 by both groups). Meanwhile, creating development plans and opportunities for others was prioritised the least (ranked 3.7/10).
But hang on a moment. If both the managers and the employees agree that creating development plans and opportunities is the least important thing, then surely it is? In other words, if employees say that creating development plans is unimportant, then surely it is unimportant, and if leaders think the same, they would appear to be right.
Maybe, maybe not. Perhaps employees don't know what's good for them, and leaders don't know what employees don't know what is good for them. If you take my point.
Veterinary leaders were then asked to rate their confidence in applying the listed leadership and management skills. The skills which elicited the largest number of 'not confident' responses were: monitoring and evaluating performance, regularly providing and seeking feedback, and creating development plans and opportunities for others.
The skills with which leaders were most confident were: communicating clearly and effectively, building trust, and providing rationale and explaining why.
Again, there was a close correlation between prioritisation of these skills and confidence levels.
VMG Vice President Richard Casey said: “The survey has helped us to identify priorities for learning and development both at our 2020 Congress and during our joint CPD programme next year. It is striking that the very skills required to motivate colleagues to remain in veterinary medicine and to support them in doing so are the ones which so many veterinary leaders admit that they lack confidence. Given the challenges the profession faces, it is also concerning that they appear to be undervalued both by veterinary leaders and the team members who report to them.
"Delegates to SPVS-VMG Congress and our other 2020 CPD events will benefit from a wealth of evidence-based lectures from experts on all aspects of veterinary leadership and management, enabling them to improve their own performance and contribute to an overall raising of standards of leadership and management across the veterinary sector."
Peter Brown, Senior Vice-President of SPVS, said: "We know that veterinary students receive an excellent clinical training and, in recent years, universities have started to include more non-clinical skills on the curriculum. However, these results suggest that when professionals move into more senior roles, be it leading a team or running their own practice, they find they still need to acquire new skills. SPVS’ role has always been to equip veterinary professionals to be effective leaders and SPVS-VMG congress is an excellent opportunity to both hear inspiring speakers and meet and learn from fellow leaders within the profession."
The VMG-SPVS 2020 joint Congress takes place from 23-25 January at the Celtic Manor Resort, Newport, and will feature dedicated streams on effective leadership, management mastery, practice profitability, preparing for a digital future and sustainability in practice.
Details on the VMG-SPVS 2020 CPD Programme can be found here: https://spvs-vmg-events.co.uk/cpd-events/
The scheme uses a traffic light colour system of vaccination reminder stickers which veterinary surgeons can place on the front of passports at each vaccination appointment. If the 6-month pilot is a success, the initiative will be rolled out across the UK in the summer.
BEVA says that despite the best efforts of numerous equine welfare charities to address the obesity issue, a significant proportion of owners are either not recognising obesity in their horses, or not being motivated to take action.
For this reason, the Association decided to try and confront the problem in a different way, using knowledge gained from the Behavioural Insights Team (BIT) – a government think tank specialising in behavioural economics and psychology.
Lucy Grieve, President Elect of BEVA and part of the Association’s obesity campaign working group, said: "Determined to look at new ways to positively engage with horse owners, we harnessed the BIT’s experience of what methods work most effectively and came up with a simple, practical scheme revolving around vaccination visits, which could be affected by vets themselves."
The idea is to use the routine annual or six-monthly vaccination visit as a time to assess a horse’s body condition. After the vaccination is given and the body condition assessed, a colour-coded vaccination reminder is stuck to the front of the passport, both to remind the owner when the next vaccination is due and to start a conversation about body condition.
A green sticker indicates a ‘healthy’ body condition. Amber means the horse is carrying too much fat tissue and needs moderate changes to diet, exercise, management, rugging and clipping regimes. Red implies that the horse is carrying excessive amounts of fat tissue which are placing the horse in morbid danger.
Amber or red stickers provide the opportunity to talk about the potential impact on the horse’s health and what needs to be done.
If there isn't enough time to talk about it during the appointment, the sticker includes a colour-specific QR code which the owner can use to access additional information via their smartphone in their own time.
One of three short, colour-specific videos will explain the reason their horse has been designated the colour of sticker on their passport, leading to a link to more specific advice on what the owner needs to do next. Having swotted up on the background information beforehand, the owner can then discuss the various management options with their vet at a convenient time.
Lucy said: "The first challenge is helping owners recognise when their horse is overweight. Once this has been established then we can make a plan to correct the problem as a team.
"The owner needs to be on board and committed in order to carry out the tough task of reducing the weight of their horse. We hope that owners will be ‘nudged’ by the sticker intervention to consider the information they have been offered and start to tackle the problem before it causes life-threatening disease."
Nine equine veterinary practices were invited to participate in the pilot scheme, including Loch Leven Equine Practice in Kinross. Managing director Liz Somerville said: "We have been focusing on equine obesity for the last couple of years including running a #FitnotFat campaign last year to try to highlight the growing obesity problem in our horses. Unfortunately, it sometimes feels that we are banging our heads against a brick wall so when BEVA came up with a new approach to try and get the message through to our owners it was too good an opportunity to miss."
BEVA says that at the end of the pilot, it will assess how well the project has worked for the vets involved, what proportion of owners used the QR codes, visited the advice pages and sought guidance from their vets.
For more information, visit: https://www.beva.org.uk/Resources-For-Vets-Practices/Clinical-Practice-Guidance/Obesity-in-horses
The company is now inviting practices to sign up for the free Beta trial and shape the development of the new platform and how video consultations can be integrated into traditional ways of working.
The platform, which can be branded with the practice logo, uses an app which clients download onto their mobile devices and use to book appointments. The system has its own appointment booking system, but also integrates with Vetstoria. When an appointment is booked via video, practitioners see it in their PMS. They then visit their online account, select the relevant appointment and click ‘start video call’. Payment can be collected from the owner prior to the consultation.
Susie Samuel, Managing Director of VetHelpDirect said: "While developing this product, we have been mindful that the use of telemedicine in our industry has been hugely controversial. We believe that inviting local vets to trial and refine this technology, using their team to work with their own clients removes many of the risks and dangers otherwise inherent in the proposition."
I agree wholeheartedly. The controversy over telemedicine has been about the idea of allowing the prescription of drugs to animals that have not been seen in person. Using a service like this (or the one launched by the Virtual Vet Group last year) to offer video consultations to patients that are already under your care strikes me as an altogether different kettle of fish. I think it will help improve engagement with existing clients, by reducing unnecessary trips to the practice for follow-up or post-operative consultations, saving time, money and the planet.
Susie added: "In our fast-moving world pet owners are increasingly reliant on technology and expect to be able to access services easily. The results of our recent VetHelpDirect research of 419 owners showed 38% of survey respondents said they would like to have the option of a video consultation if it was offered by their own vet. If we are to keep up with this demand, we need to embrace new ways of working."
VetHelpDirect says that whilst it believes that the growth in the use of this technology will change the way veterinary medicine is practiced, video consultations will always work alongside in-person consultations, as just one tool in an overall strategy of care, and certainly will not replace face to face diagnosis.
Let's hope so.
Susie added: "What is clear from our research is that whilst clients would like to be able to have video consultations with a vet their strong preference is for this to be with their own vet; whilst 38% of people would use video consultations with their own vet this falls to only 7% if it is provided by a vet not known to them.
"Of course, telemedicine is by no means the answer in every case, what the new service does offer is flexibility for practitioners and the ability to work in new ways that will benefit the animals and owners. For example, giving free telephone advice has become common place in many practices but is very hard to monetise. Video consultations provide a commercial solution to this problem.”
For more information, or to join the trial, contact Susie Samuel susie@vethelpdirect.com
The speakers include Aldo Vezzoni, a European Specialist in Small Animal Surgery, Peter Southerden, a European and RCVS Specialist in Veterinary Dentistry, orthopaedic specialist Daniel Lewis, veterinary physiotherapist Barbara Houlding, neurosurgeon Fred Wininger, Gary England, Professor of Comparative Veterinary Reproduction at Nottingham University, Rob Lowe, the ophthalmologist, Nick Bacon, Specialist in Small Animal Surgery, and Rachel Lumbis, a lecturer in Veterinary Nursing at the Royal Veterinary College, and, of course, Noel Fitzpatrick himself.
Dermatology, dentistry, ophthalmology, endoscopy and hepatobiliary disease have all been added to this year's education streams, together with a new ‘Top Tips’ stream, offering practical advice for immediate use in clinical practice.
In total, Vet Festival will have 18 separate education streams covering small animal clinical topics with dedicated nursing and rehabilitation content a key component of the programme.
The integration of veterinary professionals is a fundamental theme of the festival so, in the rehabilitation stream, surgeons, physiotherapists, rehabilitation specialists and hydrotherapists will offer perspectives in tandem.
Over the weekend, 135 lectures will be offered to suit those at every level of clinical practice. Delegates will collect 14 hours of CPD over the two days.
Also new in 2020 is the introduction of a ‘Wellness and development for you and your practice’ theatre, with speakers from both within and outside the profession, including paralympic champion Rachel Morris MBE, psychotherapist Di Gammage and mindfulness leadership specialist, Natalie Pennicotte-Collier. Various wellbeing activities, such as yoga, movement, fitness and mindfulness, will take place alongside the lectures.
Professor Noel Fitzpatrick, Clinical Chair at Fitzpatrick Referrals, who launched Vet Festival in 2015, said: "Outdoor festivals bring joy to the soul and I have always wanted education and continuing professional development to feel uplifting, inclusive and life-enhancing, both professionally and from a personal wellness perspective. That’s what VetFest is all about – food for the mind, body and soul."
Nicole Cooper, VET Festival Event Director, added: “For veterinary professionals keen to learn about the latest thinking and developments in small animal veterinary medicine, Vet Festival is simply unmissable. The breadth of content on offer and the quality of our speakers increases every year but what really sets VET Festival apart is the opportunity it offers for delegates to learn in a relaxed, fun environment.
Tickets for VET Festival can be purchased here: https://www.vetfestival.co.uk/delegate-info/ticket-information
In the first episode of the series, BCVSp Trustee James Swann speaks to Dr Rosanne Jepson about dialysis in dogs and cats. A specialist in internal medicine in dogs and cats, Dr Jepson explains why dialysis might be needed in pets for treatment of kidney disease and whether it's ethical to do this treatment in animals.
In episode two BCVSp trustee Celia Marr speaks to James Wood, Professor of Equine and Farm Animal Science at the University of Cambridge about zoonotic diseases and their importance for animal and human health in Africa.
BCVSp trustee Myra Forster-van Hijfte, who is responsible for Your Vet Specialist’s public outreach programme, said: "Podcasts are a great addition to our website, giving animal owners a convenient and highly engaging way to learn more about the Veterinary Specialist’s role. The advantage of audible platforms is that they enable content to be accessed more or less wherever you are or what you are doing. We hope our listeners will enjoy our first series as much as the team did making them."
The BCVSp says the podcasts are also designed to be a useful resource for primary practitioners to direct their clients to for more information on specific topics.
As part of an increasing focus on wellbeing at Congress, Jenny will be sharing her thoughts on balancing a successful career with family commitments. Prior to becoming a dragon, Jenny worked in banking for 30 years. She became CEO of cash machine company Hanco, bought out the business, turned it round and sold it for £50 million.
The expanded 2020 Congress programme offers 450 hours of CPD delivered by more than 100 globally recognised speakers. The Association says this year's highlights include more 'open to all' streams, a new range of practical workshops, small group sessions, wetlabs and nurse case reports. There will also be an increased number of AVP streams, an infectious disease stream as well as a popular favourites stream, which will include endocrinology, critical care and trauma medicine, ophthalmology and cardiology.
New wet labs are being introduced, with a chicken anatomy refresher focussing on linking this knowledge to clinical presentations and common procedures. There's a similar session for rabbit anatomy along with a new dermatology practical and surgery of the small intestine.
BSAVA Congress Programme Committee Chair Sue Murphy said: "Our ethos with the 2020 programme is to deliver unrivalled education, designed to tackle the current needs of the profession, with topical, clinically relevant and evidence-based content. Each stream is devised by our committee of volunteer vets, nurses and practice managers, ensuring our entire programme is created by the profession, for the profession."
BSAVA President, Sue Paterson said: "We are extremely proud to be hosting such an impressive programme of education at our 63rd annual Congress and 30th year in Birmingham. With our prestigious keynote speaker, the small animal focussed exhibition, the BSAVA Awards and a packed social programme including a DJ, band, Bongo’s Bingo and Silent Disco at the V20 Party Night, Congress 2020 celebrates the very best of the profession; a not to be missed date in this year’s veterinary calendar!"
To register for BSAVA Congress visit www.bsavaevents.com. If you book before the 29th January, you'll get 20% off.
Krka says the new pack, available for cats and for toy, small, medium and large dogs, is designed to offer practices greater dispensing flexibility and to encourage quarterly visits and compliance with healthcare plans.
Selehold is presented in a pipette with a colour-coded cap and transparent tube to enable the owner to check when the full dose has been given. Each pipette is individually wrapped for ease of use and dispensing.
Ms Sabrina Jordan, Country Brand Manager for Krka, said: "We aim to optimise the value we give to our customers by offering them highly effective, tried and trusted, affordable generic medicines with added value.
"Selehold has proved a popular addition to our parasite control range because of its ease of use and cost-effectiveness.
"With many of our customers focusing on encouraging owners to visit the practice quarterly and to sign up to a healthcare plan for their pet, the 3-pack version of Selehold works well as it enables the practice to offer clients a high quality, good value solution that supports this compliance framework."
The meeting will be led by Dr Rosanne Jepson BVSc MVetMed PhD DipACVIM DipECVIM PGCertVetEd FHEA MRCVS, Associate Professor Small Animal Internal Medicine Specialist at the RVC. It will consist of two talks.
The first, ‘Hypertension and concurrent diseases’, will cover how veterinary surgeons should manage and treat hypertension when it presents with other concurrent diseases such as CKD and hyperthyroidism.
The second, ‘Overview of diagnosis and stage specific management of feline CKD’, will review the recently updated IRIS guidelines and discuss the latest and most up-to-date methods in diagnosing and managing CKD in both the early and later stages.
The meeting will account for two hours CPD.
To register for the CPD meeting, contact your local Ceva account manager or email your name, practice name and telephone number to cevauk@ceva.com.
Part of the VN Futures project, the lunchtime webinars will be delivered between February and June 2020 via the Webinar Vet, and the College is encouraging all veterinary surgeons, nurses, practice managers and owners to attend, as it says the webinars will benefit the whole practice team.
All three webinars take place at 12.30pm and last one hour. They are as follows:
Tuesday 4 February 2020 – ‘Maximising the potential of the veterinary nurse’ presented by Louise Northway RVN, BVNA Council member and recipient of the RCVS Inspiration Award. The webinar will give an overview of the role of veterinary nurses under Schedule 3 of the Veterinary Surgeons Act, how VNs can develop their role in practice and take on extra responsibilities and how VNs can approach these conversations in practice through the creation of learning and development plans. This webinar will illustrate how fully utilising the nursing team not only hugely boosts the morale of the work force, but also enhances patient care and increases the efficiency of the business.
Tuesday 10 March 2020 – ‘Veterinary nurses’ time is valuable: How and why to charge for it’ presented by Stephanie Writer-Davies MRCVS, Career Progression Working Group member, and Jane Davidson RVN, VN Council member and regular blogger on veterinary nursing issues. This webinar will provide examples and case studies of how veterinary nurses contribute to practice finances, how practice pricing structures can be developed so that the financial value of veterinary nurses’ time and effort can be better highlighted, and how veterinary nurses can demonstrate their value to clients.
Tuesday 23 June 2020 – ‘Lead or Head RVN: What’s in a name?’ presented by Gillian Page RVN, President of the Veterinary Management Group. This webinar will look at the role of the traditional Head RVN and how development of ‘Lead RVNs’ in different areas of practice can help to allow for growth of other talented team members and provide increased and shared responsibility and progression. This webinar will explore how this enhances practice efficiency alongside development of team members, thus increasing job satisfaction and, ultimately, retention.
Racheal Marshall, Chair of RCVS Veterinary Nurses Council and the VN Futures Board, said: "We hope that veterinary nurses will engage with these webinars in order to gain some inspiration about how they can truly show their value to their team, their clients and the wider public.
"The VN Futures research clearly demonstrated that there was a desire from the veterinary nursing profession to find ways in which VNs could gain greater recognition for the work they do and progress in their careers. These webinars, and our talented presenters, will provide many practical examples and case studies on how this can be done, help build confidence and highlight opportunities for further learning and development."
To sign up to the free webinars, visit: https://www.thewebinarvet.com/sponsors/VN%20Futures.
The guidelines, which have produced by a panel of clinicians and analgesia researchers, summarise the current evidence and offer expert opinion and best practice recommendations for the use of analgesics for common scenarios.
Recommendations include:
Professor Celia Marr, Editor of the EVJ said: "The BEVA primary care clinical guidelines provide up-to-date clarity on the fundamental aspects of equine pain management for the clinician and are essential reading for all those in first opinion ambulatory roles."
The guidelines are the first in a series being produced for primary care vets by BEVA. They can be downloaded here: https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13198
The Disciplinary Committee, chaired by Mr Stuart Drummond, considered six charges against Dr Gunn.
The first charge alleged that, early in 2018, Dr Gunn failed to provide appropriate and adequate care to the dog. In particular, having removed a mass from the right thorax, he undertook an excess number of surgical procedures, including under general anaesthetic, within a 13 day period; performed these procedures without offering alternative treatments or discussing referral with the owners; failed to recognise infected wounds; and administered an antibiotic when the dog was infected with MRSA and E-coli.
The second charge alleged that Dr Gunn failed to communicate adequately, openly and honestly with the owners of the terrier on multiple occasions between 16 January and 3 February 2018. This included but was not limited to: failing to provide the owners with an estimation of fees; failing to inform them in advance of the procedures performed; failing to inform them of options for treatment; and failing to inform them that the terrier had an infection when he knew or ought to have known that she did.
The third charge alleged that Dr Gunn failed to obtain informed consent in relation to the further procedures performed on the terrier in charge one.
The fourth charge alleged that Dr Gunn failed to maintain adequate clinical records in relation to the management of the dog, and that he failed to record the prescription and administration of drugs to treat the terrier.
The fifth charge alleged that Dr Gunn indicated to the owners that euthanasia was the most appropriate treatment option and/or that there were no other realistic treatment options, when this was not the case and when he ought to have known this was not the case.
The sixth charge alleged that, during the course of a referral of the terrier to another practice, Dr Gunn failed to provide an adequate history of his management of the dog and that he informed the practice that the owners had no finances when this was not true, amounting to an incomplete account of his dealings with the owners and to a breach of their confidence.
At the outset of the hearing the respondent admitted to a number of the allegations within the main six charges, which were found proved by the Committee.
Of the charges not admitted to, a number were found proved and the Committee then went on to consider whether or not Dr Gunn’s conduct amounted to serious professional misconduct.
In considering the aggravating factors, the Committee took into account that the dog’s suffering was prolonged because of the persistence of Dr Gunn in pursuing a single ineffective treatment approach.
With regards to mitigating factors, the Committee found that Dr Gunn was remorseful as to his actions, that there was no financial motivation on the part of Dr Gunn in respect of his treatment of the terrier, and that there is a low risk of repetition because Dr Gunn has sought to learn from this experience. A number of relevant and high-quality testimonials were also provided by colleagues and many satisfied owners on behalf of Dr Gunn.
Considering both the aggravating and mitigating factors, the Committee was satisfied that Dr Gunn’s conduct fell far below the standard expected of a registered veterinary surgeon for a number of the charges.
The Committee then considered what sanction to impose on Dr Gunn. The Committee was satisfied that the misconduct found proved was in relation to the treatment of one dog only and therefore it was at the lower end of the spectrum. However, the conduct took place over a prolonged period of two weeks which in the Committee’s view required a sanction. In such circumstances, and with the significant mitigation, the Committee decided that the appropriate and proportionate sanction was to reprimand Dr Gunn and to warn him about his future conduct.
Speaking on behalf of the Committee, Mr Stuart Drummond said: "The Committee concluded that the effect of a reprimand alongside the Committee’s findings on disgraceful conduct in a professional respect was a sufficient and proportionate sanction. The Committee found Dr Gunn to have developed sufficient insight into his failings and it was satisfied that the disciplinary process had been a salutary experience and that he is very unlikely to pose a risk to animals in the future or to contravene professional standards.
"The Committee decided that a warning as to future conduct was necessary to reduce the risk of any repetition of any similar conduct for Dr Gunn in the future. It therefore concluded that the sanction of a reprimand and warning would be a sufficient in the circumstances of this case having taking into consideration all the powerful personal mitigation."
The complete list of charges and the Committee’s full facts and findings can be found at www.rcvs.org.uk/disciplinary
The clinic will assess cats and dogs under six months old where a heart murmur has been detected.
Willows will then recommend a course of action and, if required, carry out keyhole surgery.
Chris Linney, head of cardiology at Willows, said: "This is the first specialist-led, congenital heart disease clinic in the country and will use some of the latest and most advanced equipment available in the veterinary world. As well as advanced ultrasound, we also have state-of-the-art CT available for assessment of complex cases.
"With the support of the 24/7 hospital service and other specialist disciplines here at Willows, it means we can offer excellent care to our patients, their owners and referring vets.
"All young animals with murmurs may benefit from the clinic, but those that are always recommended to undergo assessment are puppies with murmurs grade three (out of six) and over, and kittens with murmurs grade four (out of six) and over.
"By reviewing these animals at a younger age, we hope to be able to put care plans in place that can improve their long-term health.
"We will also offer a precise diagnosis, outlook and prognosis on the cause of the heart murmur and, where needed, carry out minimally-invasive keyhole surgery.
"Often, the earlier these are performed the better the outlook for the patient."
For more information, visit www.willows.uk.net.