The mandatory regulation of veterinary practices, including statutory powers of entry and inspection, is one of the main parts of the College's proposals for new primary legislation that would replace the current Veterinary Surgeons Act 1966.
The working group, which is expected to present the details of a Mandatory Practice Regulation system to Council by the end of 2024, will be chaired by RCVS President Sue Paterson FRCVS.
It will include Standards Committee Chair Linda Belton MRCVS and Practice Standards Group Chair Belinda Andrews-Jones RVN, alongside veterinary, veterinary nursing, lay and external representatives.
Sue said: “With over 70% of practice premises currently under its ambit, our Practice Standards Scheme (PSS) has shown how keen practices are to maintain high standards.
"However, it is a voluntary scheme and, as a result, there is no mechanism to ensure standards across all practices, or to ensure change in those rare situations where it is needed.
“At present, the RCVS only regulates individual veterinary surgeons and nurses, and the veterinary sector does not have an equivalent to the Care Quality Commission, which considers human healthcare premises.
"This means that the onus for maintaining standards within the workplace falls on regulated individuals rather than the business structure.
"We will consider what a scheme that puts more statutory responsibility on business owners to maintain standards should look like.
“I look forward to working with colleagues in RCVS Council, VN Council and other veterinary organisations via this group to really flesh out what this regulatory system might look like in the future, to make sure it is appropriate, robust, proportionate and enforceable.
"Establishing these details will also prove invaluable in our lobbying work with government, ministers and MPs.”
Once a month, a new discussion will be posted by the site editor titled: "WHAT WOULD YOU DO (in xxx clinical situation)?"
In addition, VetSurgeon members are strongly encouraged to start your own "WHAT WOULD YOU DO?" discussion at any time.
All members are then invited to share what they would do for the case described, and we also use the opportunity to question which approach offers the best value for pet and owner, and brainstorm new ways of approaching the problem.
Importantly, criticising (as opposed to questioning) anyone's approach is strictly forbidden.
The aim is to share what most vets are doing, question whether there are better ways of doing things and brainstorm fresh ideas, something which is always a beneficial but perhaps especially so in a cost-of-living crisis when, for a variety of reasons, veterinary fees have escalated above and beyond inflation.
As a result, it has become increasingly important to question, for example, the value of certain diagnostics and whether a different approach could offer clients more value.
By way of example, the first discussion was: "WHAT WOULD YOU DO: cat over-grooming central abdomen?", which you can read and take part in here: https://www.vetsurgeon.org/f/clinical-questions/30842/what-would-you-do-cat-over-grooming-ventral-abdomen
The second discussion is now live, and asks: "WHAT WOULD YOU DO: Young dog presented having had its first single or cluster of seizures?
Come and share your thoughts here: https://www.vetsurgeon.org/f/clinical-questions/30875/what-would-you-do-young-dog-presented-having-had-its-first-single-or-cluster-of-seizures
Full rules here: https://www.vetsurgeon.org/f/clinical-questions/30841/what-would-you-do-discussions-rules-and-objectives
For the research, the medical histories of 188 Basset Hounds and 270 Dachshunds presenting to CVS’ Dovecote Veterinary Hospital and Chestergates Veterinary Specialists, and the University of Ghent were retrospectively assessed.
Information included signalment, whether the dog had received a diagnosis of TL-IVDE, the duration of clinical signs, affected discs and anatomical region and the neurological grading at presentation and discharge.
Basset Hounds and Dachshunds are both chondrodystrophic breeds which are predisposed to IVDE.
However, the study found 77.4% of Dachshunds had presented with IVDE, compared to only 36.2% of Basset Hounds.
Dachshunds also presented earlier (66.5 months) compared to Basset Hounds (median 87.5 months).
Dachshunds had a lower proportion of midlumbar IVDE and were more frequently non-ambulatory at discharge than Basset Hounds.
In addition, Dachshunds were more likely to be paraplegic without sensation at presentation than Basset Hounds (16/154 Dachshunds compared to just one Basset).
The Basset Hound is the largest chondrodystrophic breed and the physical characteristics of this larger body conformation may have benefits, with previous studies suggesting the protective effects of being a larger dog2.
One hypothesis is whether breed conformation and anatomy – the relative height/weight ratio - influences the severity and occurrence of IVD and points to a link between the size of the patient and the space in the vertebral canal.
A smaller spinal cord versus vertebral canal ratio in the Basset Hound may indicate a less compressive lesion.
Sergio Gomes, Head of Neurology and specialist in veterinary neurology at Dovecote Veterinary Hospital, who led the study, said: “This is the first time that IVDE data for Basset Hounds has been directly compared with that for Dachshunds.
“We now need to look closely at the conformation and anatomy of the Basset Hound to see what learnings we can take.
"This could have positive future implications for Dachshund breeding programmes, so that longer term we can try to minimise this painful and common canine condition.”
References
Each candidate will produce a written reply to two questions of their choice, which will be included on their candidate profile webpage ahead of the start of the election.
The 14 candidates who are standing in this year’s election for the three available elected places on RCVS Council are:
The biographies and election statements for each candidate are available to read at www.rcvs.org.uk/vetvote24.
The three candidates with the most votes will join Council for their four-year terms at the College’s AGM in July.
The College says it will only accept one question per person and questions must be decent.
Offensive, defamatory and inaccurate questions will not be passed on to candidates.
You can email your question to: vetvote24@rcvs.org.uk
All practices are eligible to register and no FCA authorisation is needed.
Carefree Credit says it will also process applications to make practice administration hassle free.
Mike Aldred, Director at Carefree Credit, said: "With the deepening cost of living crisis, owning a pet has never been more expensive for many pet owners and having these longer terms available will really help their pets get the treatment they need."
To register your practice with Carefree Credit, email office@carefreecredit.co.uk or call 0345 313 0177.
https://www.carefreecredit.co.uk
The response offers further evidence concerning the CMA’s potential concerns, and says that voluntary measures relating to transparency of fees and ownership could be introduced before the conclusion of a market investigation.
The BVA has formed a working group to develop guidance on transparency, client choice and the value of veterinary care to support companion animal practices.
British Veterinary Association President Anna Judson, said: “We’re keen to see healthy competition and consumer choice and we recognise that some of the areas identified by the CMA would benefit from further scrutiny.
"We are already taking steps to support vet practices by developing guidance for the profession in relation to transparency of fees, transparency of ownership, prescribing and dispensing of veterinary medicines, and contextualised care.
“However, we are extremely disappointed to see the suggestion in the CMA’s report, as well as in subsequent media reporting, that veterinary professionals might prey on owners’ desire to do the best for their pets by using these circumstances as a “strategy” to promote more sophisticated or expensive treatment.
"Vets enter this high-pressure profession out of genuine care for animals and will always prioritise their health and welfare."
“We also have significant concerns about the suggestion that practices might be mandated to provide information to clients about quality or outcome-related measures.
"We do not see primary concerns about the quality of veterinary treatment and we believe such a requirement would not meaningfully support consumer choice.
"Instead, it would be extremely challenging to deliver and could significantly exacerbate many of the complex issues faced by our members, who are already under significant pressure.
There will be a panel discussion about the CMA investigation at BVA Live this year.
https://bvalive.vetshow.com
COMMENT
There are lots of good points made in this latest response to the CMA, if no more than a nod to the real issue here: which is the often eye-watering cost of modern veterinary care.
But it is hugely disappointing to see the BVA (and others) berating the CMA and the media for suggesting that vets might prey on owners' desire to do the best for their pet, rather than asking WHY people think that, and how can the profession regain trust.
That, surely, is the starting point here: for the profession to stop feeling sorry for itself, and instead think how it can change to meet the needs of its customers and dispel their perception of being taken for a ride.
The CMA investigation is a bit of a red herring: the price of veterinary care is not going to be significantly changed by displaying the prices for a few standard procedures on practice websites, with greater transparency over practice ownership or with slightly cheaper prescriptions, all of which is just tinkering.
The biggest influence on the size of the client's bill is not marketplace competition, it's the vet's recommendation.
Paul Manktelow, Chief Vet at the Blue Cross has already hit the nail square on the head when he called on the profession to practise pragmatic medicine.
The BVA now alludes to this with talk in its response of 'contextualised care' - a concept which allows practitioners to offer pragmatic medicine (aka what people can afford, rather than 'gold standard'), without the judgement that it is inherently associated with.
The benefits of 'contextualised care' are well explained by Ruth Serlin at VDS Training here.
That's great, but will it be enough?
Perhaps not, because whilst someone might be happy to walk out of the car showroom with a Dacia Sandero knowing they cannot afford a Bentley, they may be less happy to accept the Dacia level of care for their beloved pet, when they watched 'Supervet' only the night before.
If that's true, then pragmatic medicine will have to be combined with all sorts of other measures, such as reviewing and reducing the cost of regulation, questioning the value of diagnostics and changing to a less 'referall' (sic) culture.
The new product, which is for the management of any condition where eye health is supported by providing additional moisture or lubrication, is suitable for dogs, cats, horses, rabbits and other animals.
Oculeze contains glycerine (0.8%), Aloe vera, chamomile and propolis extract, the latter of which contains polyphenols which Millpledge says have been shown to support corneal health by multiple mechanisms of action including modulation of the tear film and a reduction in inflammation, apoptosis and oxidative stress1.
Millpledge says Oculeze lasts longer on the ocular surface than non-lipid lubricants2 because it evaporates more slowly3.
This prolonged action means fewer administrations, which should help client compliance.
Oculeze comes in two sizes - a 10 millilitre bottle and a pack of ten resealable 0.6 millilitre vials, suitable for short term use and travel.
The 10ml bottle includes a filter, preserving sterility for up to three months after opening.
Oculeze is available direct from Millpledge or from your usual wholesaler.
https://millpledge.com/shop/oculeze
sales@millpledge.com
The scheme will allow regular referrers to gift free treatment worth up to £5000 to clients in need of financial assistance
Hospital Director Nicola Bromley said: “We recognise the challenge it is for families who may need specialist care for their animal friend but are unable to find the necessary funds.
"We highly value the relationship we have with our referring vets in providing options to their clients, and we hope this scheme will empower them to give hope to those who need it most.
"We are committed to supporting our referring primary care vets through collaboration, to make the whole sector as good as it can be for every animal.”
The new scheme will be activated immediately and apply to referrals made from January 2024, meaning practices and primary care vets who already refer to Fitzpatrick Referrals can refer pro bono cases immediately.
https://www.fitzpatrickreferrals.co.uk
DISCUSSION
The new product contains astaxanthin (an anti-oxidant), fucoidan (a fucose-rich, sulfated polysaccharide) and indigo (a deodorant), which together are claimed to fight against gum infections, deodorise the mouth, and reduce the build-up of plaque and tartar.
Bob Ferguson, Commercial Lead for Accord Animal Health said: “We are excited to bring to the UK and Ireland market, Vivinicord Chews, a novel combination of natural ingredients designed to aid pet owners support their dogs’ oral health.
"Dental disease and associated infections are such a huge issue for vets and owners, we believe Vivinicord Chews can be a valuable part of the solution.
“Vivinicord Chews will only be available for owners to buy from their local veterinary practice, supporting our mission of building a sustainable partnership with our veterinary customers.”
Vivinicord comes in packs of 30 chews with a shelf life of 24 months.
For further info or stock enquiries, contact: info@accord-animalhealth.com / 01271 385 200
This new injectable fluralaner formulation is approved for the immediate and persistent killing of fleas for one year (Ctenocephalides felis and Ctenocephalides canis), from 3 days to 12 months after treatment for the ticks Ixodes ricinus, and Dermacentor reticulatus, from 4 days to 12 months after treatment for Rhipicephalus sanguineus, and from 7 days to 12 months after treatment for Ixodes hexagonus.
MSD says it will also reduce the risk of Babesia canis via transmission by Dermacentor reticulatus from day 3 after treatment for up to 12 months, and also reduces the risk of infection with Dipylidium caninum via transmission by Ctenocephalides felis for up to 12 months.
Victoria Miles, UK Companion Animal Business Unit Director, MSD Animal Health said: “Imagine not having to worry about flea and tick protection for a whole year."
Bravecto 150 mg/ml powder and solvent for suspension for injection for dogs can be administered to dogs and puppies six months of age and older.
The product is already available in France and Germany and MSD told VetSurgeon.org that stocks are expected in the UK in September, for which the company is now taking pre-orders.
Contact your MSD Account Manager for further information on pricing.
The strike follows a breakdown in negotiations for better pay and conditions earlier in the year.
Valley Vets, which is owned by VetPartners, offered a 7.27% increase to its lowest paid staff, with smaller increases for higher paid staff.
However, the BVU rejected the offer, describing it as a "derisory real terms pay cut".
A postal ballot was held and 94% of members voted for industrial action, with a 93% turnout.
The BVU says it is open to restarting negotiations in the hope that an improved offer will make the strike unnecessary.
Ms Evans was charged with causing or allowing a veterinary nurse colleague to order a prescription-only medicine from a practice supplier knowing that it was intended for human use, and made a false entry prescribing the medication on the clinical records of a cat belonging to her nurse colleague.
She was also charged with falsely recording details purporting to be the results of the blood tests on cat and then entering notes on the animal's clinical history which falsely indicated that there had been a meaningful result, and then indicating to the animal's owner that there had been a meaningful result, when in fact the tests had failed to produce any meaningful results.
The final charge was that her conduct in making the false entry for the prescription-only medication, and all elements of the second charge was dishonest and misleading.
Ms Evans admitted the first charge on the basis that she had allowed rather than caused the order to be made, all the other facts of this charge were admitted.
She admitted the second charge on the basis that she had failed to inform the cat’s owner of the test results, all the other facts of this charge were admitted.
She also admitted that elements of her conduct had been dishonest and misleading.
Having found the charges proven by Ms Evans’ admissions, the Committee considered whether her admitted actions and conduct amounted to serious professional misconduct.
Ms Evans, through her legal counsel, accepted that the admitted charges passed the threshold for serious professional misconduct, though that question still needed to be determined independently by the Committee.
The Committee found that Dr Evans’ conduct had breached several key parts of the Code of Professional Conduct and its supporting guidance, particularly around honesty and integrity.
It also found aggravating factors in this case, including the risk to human health by allowing the prescription-only medication to be ordered knowing it was for human use, the abuse of her professional position, the breach of client trust, the potential adverse impact on the welfare of the cat for whom she falsified the blood test records, and the potential adverse impact on the welfare of the cat for whom she had falsely recorded the prescription-only medicine.
The Committee found no mitigating factors relating to the facts.
Paul Morris, chairing the Committee and speaking on its behalf, said in relation to the first charge: “In the Committee’s view, this irresponsible approach to a prescription-only medicine risked human health, potentially compromised an animal’s welfare, since the clinical record suggested the cat had been given Fluconazole when it had not, constituted an abuse of the trust placed in her as a registered veterinary surgeon and was in breach of legal provisions designed to safeguard human health.
“Such behaviour falls far below the standard expected of a registered veterinary surgeon, undermines public confidence in the profession and would be considered deplorable by colleagues and the public alike.
"The Committee was thus satisfied that charge 1 on its own amounts to disgraceful conduct in a professional respect.”
He added: “Acting dishonestly runs contrary to one of the most fundamental principles of the profession.
"The public need to know that they can rely on the honesty and integrity of the people to whom they entrust the care and welfare of their animals.
“Further, Dr Evans’ conduct in both incidents had the potential to undermine public confidence in the profession of veterinary surgery and bring the profession into disrepute.
"In all the circumstances, the Committee was satisfied that Dr Evans’ behaviour as reflected in charge 2 fell far short of the standard expected of a veterinary surgeon and amounted to disgraceful conduct.
“Accordingly, the Committee found proved the allegation that Dr Evans was guilty of disgraceful conduct in a professional respect.”
Having found serious professional misconduct in relation to all charges, the Committee considered what the most appropriate and proportionate sanction would be for Ms Evans’ actions and conduct.
In doing so, it considered 137 positive references and testimonials from Dr Evans’ professional colleagues and clients, poor staff morale at the practice at the time as well as compelling, exceptional evidence relating to Dr Evans’s health at the time of the two incidents.
In mitigation, the Committee considered the fact that Dr Evans had no previous disciplinary history and had a hitherto unblemished career as a veterinary surgeon; her open and frank admissions; the circumstances of pressures at work exacerbated by Dr Evans’ desire to please everyone and not let anyone down; the fact that Dr Evans was feeling very isolated; the significant insight into her conduct and its impact; effective and targeted remediation to ensure there would be no likelihood of the conduct being repeated; genuine expressions or remorse and apology; support from her employers; and the very significant number of positive testimonials.
Summing up the Committee’s decision on sanction, Mr Morris said “In all the, somewhat exceptional, circumstances of this case, the Committee was satisfied that a reprimand and a warning not to behave in this way again, would provide adequate protection to animals, as it was satisfied Dr Evans was most unlikely to ever make such a flawed set of decisions again.
“The Committee was satisfied that Dr Evans does not represent a risk to animals going forward, indeed from the character evidence it is clear that she always puts the welfare of animals first.
"She has also shown, since this episode, that she can work under pressure and not resort to making bad decisions and thus the Committee considered the wider public interest would best be served in this case by a reprimand and a warning.
“Notwithstanding the serious nature of Dr Evans' conduct, the Committee was satisfied that a fully informed member of the public would not be shocked if Dr Evans were allowed to continue to practise.
“The decision of this Committee is, therefore, that Dr Evans be reprimanded and warned about her behaviour.
"Dr Evans should, however, be under no illusion of how serious it is to have a finding of disgraceful conduct in a professional respect made against her and she should not take lightly the decision of this Committee to reprimand and warn her.”
www.rcvs.org.uk/disciplinary
The RCVS says this is the first time that two leading organisations in veterinary QI are collaborating to establish a new evidence-based model for QI specific to veterinary care.
The project is being overseen by Jocelyn Toner MRCVS, an experienced veterinary surgeon with a background in shelter medicine and an interest in evidence-based interventions to improve welfare outcomes.
The team will test the model against a prevalent problem in practice and measure the cost of making the changes against the benefit it brings.
They will refine the model based on lessons learned before they make it available to all veterinary practices, to tackle any area a practice wants to improve, regardless of practice type or specialism.
The aim is to help time-poor practitioners implement proven QI methods to improve outcomes and provide a return on investment.
Jocelyn said: “I’m looking forward to working with colleagues from across the sector to develop a model that will make Quality Improvement more accessible, and show that it can have a real economic benefit.
"We know that there is increased demand for veterinary teams to provide more efficient and effective care while maintaining high levels of animal welfare, improving team welfare and client satisfaction.
"Over recent years an increasing number of veterinary teams have embraced QI techniques.
"Now is the time to take this to the next level by creating an evidence-based model for QI, which can be applied systematically in any veterinary setting.
The project will involve bringing together veterinary professionals to co-design the model and test it in practice.
If you are interested in supporting this work, please register your interest at: rcvsknowledge.org.uk/forms/ktp-interest-form/
If you're in London before January 6th 2008, the Animal's War exhibition at the Imperial War Museum might be worth a visit. Sponsored by The Kennel Club and PetPartners, the family exhibition explores the remarkable role of animals in conflict from the First World War to the present day using hands-on interactives, photographs, film and sound clips, paintings, touchable sculptures, and memorabilia from the Imperial War Museum collections and private and public lenders from all over the world.
With fireworks season approaching, CEVA reminds that it's a good time to let clients know the steps they can take to minimise noise-related stress and highlight the benefits of the using D.A.P.® and Feliway®.