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

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

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

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

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

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

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

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

An animal welfare charity called Naturewatch Foundation has launched a survey to find out what veterinary surgeons think about the canine fertility industry.

The charity says it estimates there has been a ten-fold increase in fertility clinics in the past two years, and it is now aware of at least 339 dog fertility businesses across the UK.

Such clinics, which typically offer artificial insemination, progesterone testing, cytology and ultrasound scanning, are often operated by lay people, rather than veterinary professionals.

There have been concerns about the seeming indiscriminate use of breeding procedures by some fertility clinics, and about links to low welfare breeding operations.

Naturewatch says some fertility clinics have been found selling and administering prescription medicines and offering to perform operations.

The charity now wants to understand what veterinary professionals think about this new industry, and is running a short survey until 21st August 2022.

In particular, Naturewatch wants to know who you think should be permitted to perform commonly offered breeding procedures.

It also wants to hear your thoughts about possible solutions.

Are canine fertility clinics inherently problematic?

Or could canine fertility clinics - if operated ethically and regulated properly - bridge the gap between breeders and the veterinary profession?

Complete the survey here: https://action.naturewatch.org/canine-fertility-clinic-survey-for-veterinary-professionals 

Krka has launched Flovuxin, a fast-acting, single-dose, injectable solution for bovine respiratory disease (BRD) caused by Mannheimia haemolytica, Pasteurella multocida, Mycoplasma bovis and Histophilus somni, associated with pyrexia.

Krka’s Farm Key Account Manager Charlotte Read said: “BRD remains a priority issue on farm and advising farmers on the management of BRD risks, and treatment options when needed, is a key task for farm vets.

"Flovuxin’s combined formulation is a high efficacy BRD treatment acting within six hours¹, to improve treatment outcomes.” 

Reference

1. Julien Thiry, Laura Elvira Partida, Juan Vicente GonzálezMartín, Eric Pagot, Florian Voisin, Hubert Theys, Guillaume Lequeux, Allan Weingarten, Vincent de Haas (2014); Treatment of naturally occurring bovine respiratory disease in juvenile calves with a single administration of a florfenicol plus flunixin meglumine formulation; The Veterinary record 174(17)

Loseley, the ice-cream maker, has announced that it has developed a new way of making flavoured ice-cream by adapting the diet fed to its cows.

The first variety to be made using the new technique is 'Eton Mess', for which the company's herd is being fed a diet of strawberries and meringues.

Loseley says its cattle - which are housed at the Beechdean Dairies farm in Buckinghamshire - have already been feeding on the ingredients found in the much loved pudding for over a year, to ensure their milk supply is infused with the strawberry and meringue flavours. Apparently, huge amounts of strawberries are having to be air-freighted into the UK in order to ensure an uninterrupted supply through the seasons.

Andrew Howard Managing Director of Beechdean Dairies said: "We have been perfecting the quantities in the cattle feed for over 18 months to perfect the Eton Mess flavour. The cows need to be fed just the right quantities of meringues, strawberries, fat and hay to make the perfect Eton Mess ice cream. We believe ice cream should be great quality, tasty and interesting. Our products will always deliver against these criteria."

Vince Bamford, Fast Moving Consumer Goods Editor at The Grocer, the UK's leading grocery trade magazine said: "Loseley's flavour development process is cutting edge - I have tasted the product and it is delicious. It is an exciting innovation for the ice cream category."

Vetlife has published a new information leaflet to help veterinary professionals suffering from loneliness. 

The charity highlights that loneliness affects the mental wellbeing of many in the profession, from locums being away from friends and family, students away from loved ones, those who feel isolated at their practice, and vets worried about the lonely farmers they are supporting.

Vetlife Helpline Manager Rosie Allister said: “Every call to Vetlife Helpline is completely confidential and we would never speak or write about them, even anonymised, but we do hear themes around loneliness in our calls.

"It takes courage to acknowledge feeling lonely. There’s a stigma to it, and it’s often trivialised. Saying you’re lonely can feel like disclosing a vulnerability. People feel they need to hide it, to put on a façade.”

The new leaflet encourages those who are experiencing loneliness to open up if they are struggling and gives advice on how it can be combatted.

It can be downloaded here: https://www.vetlife.org.uk/mental-health/loneliness-isolation/ 

CPD Solutions has launched the first postgraduate certificate (PGCert) in Soft Tissue Surgery in the UK.

Awarded by The University of Central Lancashire (UCLan), the programme starts in March 2024.

The programme combines practical training with reflective learning and enables veterinary surgeons to achieve their PGCert within 12 months. 

Vet and PGCert Programme Manager, Alison Malone, said: "This course came about as a result of listening to what vets in practice want, and many wanted a focused soft tissue surgery curriculum without the orthopaedic element amid concerns that their practices don’t have the case load to benefit from the advanced learning.

"The Soft Tissue Surgery PGCert provides delegates with hands-on experience for the cases they will be seeing frequently, making a dramatic impact to their daily work life”.

The Soft Tissue Surgery PGCert comprises three modules: Essentials of Small Animal Soft Tissue Surgery, Small Animal Abdominal, Perineal and Urogenital Surgery, and Small Animal Head, Neck and Thoracic Surgery.

Each module begins with three days of practical sessions at CPD Solutions Training Centre in Warwickshire provided by tutors Lynda Rutherford, Faye Swinbourne, Will Robinson, Lara Dempsey, Elinor Field and Lee Meakin.

There are 20 spaces on the PgCert in Small Animal Soft Tissue Surgery starting next March.

The course costs: £10,947 + VAT, plus you'll also need to register with the University of Central Lancashire, which costs £2630 (No VAT) for UK students.

www.pgcert.com

White Cross Vets, a family run group, has been named by The Sunday Times as one of the best places to work in the UK, for the fifth year on the trot.

The company, which operates 16 practices, achieved the highest placing of any veterinary business, reaching 38 in The Sunday Times 'Best 100 Best Small Companies To Work For' league table. It is the first animal health / veterinary business to rank in the prestigious list 5 years running, and it remains the only veterinary practice ever to achieve a three star 'extraordinary' rating in the list’s history.

The Best Companies to Work For survey is now in its 17^th year and is designed to rank the cream of Britain’s motivated workforces. It is widely recognised as the most searching and extensive research into employee engagement carried out in the UK.

To achieve the listing in the Best Companies table, all of the White Cross team anonymously answered a series of in-depth questions about everything from personal development opportunities, to workplace wellbeing, contributions in the local community and overall opinions about the business. 

Tim Harrison, Managing Director of White Cross Vets, said: "It really has been a case of high fives all round since we found out about this year’s placing, which puts us in this prestigious league table for the fifth consecutive year. We are a family run business that places a huge amount of importance on the wellbeing and happiness of our people and to be recognised for that is incredibly rewarding."

White Cross Vets was also recently awarded with an industry award in recognition of the initiatives it has introduced to ensure its team remain happy, healthy and fulfilled in their work. The company scooped the Society of Practising Veterinary Surgeons’ inaugural Wellbeing Award after the judges scored entrants on everything from development opportunities through to stress reduction initiatives and how they promote wellbeing. 

Tim added: "Our employment initiatives include everything from giving everybody a day off and cake for their birthday, right through to providing four donation days a year where people can volunteer with a charity of their choice. We also provide a health care scheme and recently started offering subsidised Fitbits and gym membership as well as running a cycle to work scheme. 

"One of our big priorities also involves supporting mental health, and we provide training on this, alongside a 24 hour helpline for emotional and wellbeing support.

"In addition to all of this, each year we run an annual congress packed with Continuing Professional Development (CPD) opportunities and thought-leadership talks on the latest topics affecting our industry. It’s at this event that we also hold an awards ceremony for our 170 strong team, where vets, nurses and client care co-ordinators are singled out for their superb achievements."

A new study has found that 89% of farm fridges may not maintain temperatures within the 2–8°C range recommended for the storage of most vaccines.

In the study, which was supported by MSD and led by Rosie Lyle of Bishopton Veterinary Group, 18 farmers placed temperature loggers in the fridge where they normally store vaccines. Temperatures were then monitored between February and April. Throughout this period, 89% of loggers recorded a temperature outside the 2–8°C range at least once, and 43% recorded temperatures outside this range more than 50% of the time.

The authors say that these findings raise potential concerns about vaccine efficacy.

Rosie found that 55% of the loggers recorded a temperature over 8°C, and 39% recorded a temperature below 2°C.

Across all the fridges monitored, the maximum temperature recorded was 12°C and the minimum was -11.5°C.

Rosie said: "This is a surprisingly wide range. Obviously, these findings are concerning for farmers as we know that both too high and too low temperatures can impair vaccine efficacy.

"Live vaccines tend to be particularly sensitive to elevated temperatures, whereas inactivated vaccines are more affected by freezing, especially when the adjuvant contains aluminium salts".

"It’s important for both farmers and vets to be aware of potential concerns about vaccine efficacy, given the possible impact on herd health and the potential for vaccine failure to reduce trust in vaccines and herd health recommendations".

In light of Rosie’s findings, other XLVets practices are now encouraging farmers to take action to improve medicine storage, including using max/min thermometers or temperature loggers to track fridge temperature, as well as taking steps to maximise the efficiency of each fridge.

Susan Goodfellow, Marketing Manager at XLVets, said: "We wouldn’t have known that this is an important issue to highlight to farmers without collecting the information, so Rosie’s study was very valuable.

"In the XLVets community, we support clinical leadership with these kind of projects – we actively collect data and make sure that farmers can benefit from the latest findings. As a group of independent practices working together, we can achieve much more than we could in isolation."

The Codes were approved by RCVS Council and the Veterinary Nurses Council earlier this year, following a lengthy consultation and review process that began in 2009, and will replace the existing Guides to Professional Conduct.

The College says the new Codes are principles-based, easily accessible and, at 16 pages long compared to the 50-page Guides, much more concise. They bring the College's guidance into line with the codes of conduct of other regulatory bodies, and help to describe those professional responsibilities that are fundamental to veterinary surgeons' and veterinary nurses' practice.

To expand on and clarify these professional responsibilities, an additional 27 chapters of supporting guidance have been published on the RCVS website, which also consolidate and update all existing RCVS guidance for veterinary professionals.

Both Codes set out five principles of practice: professional competence; honesty and integrity; independence and impartiality; client confidentiality and trust; and, professional accountability.

The veterinary surgeons' Code features an update to the declaration made on admission to the profession and, for the first time, the veterinary nurses' Code includes a declaration to be made on professional registration.

Among the professional responsibilities introduced in the Codes are: mandatory recording of continuing professional development; a mandatory professional development phase for new veterinary surgeons and period of supervised practice for registered veterinary nurses (RVNs) returning to practice after a break; a Performance Protocol; and, notification to the RCVS of any matter that may affect fitness to practise, including convictions (although this will require further consideration by the College).

For the first time, mandatory clinical governance has been introduced, and minimum practice standards have also been incorporated, at equivalence to the core standards set out in the RCVS Practice Standards Scheme.

A pocket-sized hard copy of the Code will be posted to all vets and RVNs shortly, which will include references to where the supporting guidance and further information can be found on the RCVS website. The online versions - at www.rcvs.org.uk/vetcode and www.rcvs.org.uk/vncode - are fully searchable by keyword, and PDF versions will soon be available to download. A digital version is also being explored, to enable veterinary surgeons and veterinary nurses to access the Codes and supporting guidance on smart phones and tablets.

Although only registered veterinary nurses have agreed to abide by the VN Code of Professional Conduct, the College hopes that all veterinary nurses will consider it a useful benchmark of professional standards.

Dr Jerry Davies, RCVS President, said: "I am delighted that this significant piece of work has come to fruition. The RCVS has shown that, despite aged legislation, the Codes will, through imaginative interpretation of the Veterinary Surgeons Act, ensure the public and their animals continue to receive the level of professional service they have come to expect from veterinary surgeons and veterinary nurses in the UK."

The Veterinary Benevolent Fund (VBF) has announced the retirement of its President Dr. Lydia Brown, who had served the maximum of nine years as a trustee and member of the VBF Board.

Lydia became a director of the VBF following the merger of the Fund with the Vet Helpline (VHL) and the Veterinary Surgeons' Health Support Programme (VSHSP) in January 2005.

A past-president of the Royal College of Veterinary Surgeons (RCVS) and former chairman of the RCVS Trust, Lydia was a driving force behind the establishment of the VSHSP in 1999. This support programme was developed in response to the genuine need for a confidential service to treat veterinary surgeons with a wide variety of addictive conditions. Since then she has been involved in the expansion of the Helpline service from a telephone service to an increasingly-widely used email service.

The charity says that it is as a result of Lydia's thoroughness, sympathy and understanding, that very many veterinary surgeons and veterinary nurses have been helped to recover from many forms of addictive conditions and health problems. 

The RCVS has announced it will be launching a new nine-month alternative dispute resolution (ADR) trial this autumn which will be administered by the law firm that runs the General Optical Council’s ADR scheme.

Nockolds Solicitors was approved as the new administrator of the ADR trial by RCVS Council at its June 2016 meeting at Cardiff City Hall. The company was identified and approved by the RCVS Operational Board as meeting its requirements, a decision which the RCVS says has been welcomed by the Veterinary Defence Society and the British Veterinary Association, as well as receiving lay and consumer support.

The current trial, which was launched in November 2014 and is administered by Ombudsman Services, will come to a close by 1 October, when the new trial with Nockolds will start.

Nick Stace, RCVS Chief Executive and Secretary, said: "In order to be able to make an informed choice about how we wish to design and implement a permanent ADR scheme we wanted to ensure that we have as many different options and as much data as possible. It is very important that we get the permanent scheme right and this is why Operational Board made the decision to have a second trial. It was also clear that satisfaction levels from consumers for the previous trial were lower than we would have liked and that we therefore need to explore other options.

"It is important to note that this will not just be a re-run of the first trial with a different administrator – there will be some significant differences between this and our first trial with Ombudsman Services.

"First, this will be a truly alternative process as consumers will be able to access the trial directly rather than having to go through the College’s concerns process first.

"Second, this will be a process of mediation meaning that expert advisors from Nockolds will facilitate communication between the complainant and the veterinary surgeon to try and find a satisfactory solution to the concern."

The trial will be promoted to both the public and the profession as an alternative to the College’s formal concerns investigation process and participation in the trial will be voluntary. There will also still be a panel of veterinary advisors overseeing the trial and helping staff at Nockolds with any clinical queries they may have.

Jennie Jones is a Partner at Nockolds and will head up the trial. She said: "We are committed to providing a service that mediates complaints to find a fair, efficient and proportionate resolution. We are looking forward to working with everyone involved in veterinary profession to develop an effective mediation service that can be accessed by both the public and members of the profession.

"The service will focus on finding effective and practical resolutions. Understanding the root cause of the complaint and re-establishing effective communication are the crucial first steps in mediation and helping the parties to find a solution they can both accept. Over the coming months, we will be working with the RCVS, representative bodies for the profession and consumers to launch the service.

"In addition to mediating complaints, we will share insight in mediation and complaint resolution to inform practitioners and stakeholders and to enhance standards at veterinary practices. This enables complaint analysis to be used to help improve client care, avoid complaints and maintain trust and confidence in the profession."

A bespoke website for the trial will be set up in time for the launch on 1 October 2016.

The Disciplinary Committee of the Royal College of Veterinary Surgeons has postponed judgment on sanction for 12 months in the case of a Hampshire veterinary surgeon found guilty of serious professional misconduct for cumulative failures to provide adequate professional care, and insufficient regard for animal welfare whilst treating a dog.

At a hearing which concluded last Thursday, Peter Ardle MacMahon MRCVS faced a six-part charge after working as a locum for Vets Now at North End in Portsmouth where, on the night of 14/15 July 2009, he treated Wilfred, a Cocker Spaniel who had ingested broken glass along with raw mince. 

The Committee found that, having decided that surgery was an appropriate treatment, Mr MacMahon had not removed the glass identified on a radiograph. Nor had he even superficially searched the stomach contents he had evacuated to check that a large piece of glass he had previously identified on the radiograph had been removed. He had also not taken adequate steps to prevent contamination of Wilfred's abdominal cavity prior to the incision to the stomach.

Mr MacMahon admitted he knew there had been considerable spillage of stomach contents into Wilfred's abdomen. The Committee found that, with this knowledge, for Mr MacMahon to use only 250ml of fluid to lavage the abdomen was inadequate. This contributed to the Spaniel developing chemical peritonitis which might have developed into septic peritonitis but for a second operation the next morning, after the dog had been returned to the care of his usual veterinary practice. The Committee also expressed concern that Mr MacMahon had failed to effectively communicate the abdominal contamination to Wilfred's usual vets when he was handed back into their care. 

Taken as individual allegations, these would not, in the opinion of the Committee, constitute serious professional misconduct. However, the Committee was of the view that, taken cumulatively, the charges were proved, and therefore the treatment given to Wilfred, fell far short of the standard to be expected in the profession.

When considering mitigating and aggravating factors, the Committee accepted that Mr MacMahon and the veterinary nurse assisting him were unfamiliar with the premises in which they were working, resulting in a difficulty in locating important equipment, and there were also multiple urgent cases during the evening the operation took place. The Committee also noted that 17 months had passed since the operation, and no further complaints against Mr MacMahon had been received by the RCVS.

The Committee further took into account that Mr MacMahon had little recent experience, having returned to practising veterinary medicine in January 2009, following almost ten years spent outside the veterinary profession. During this hiatus he undertook no continuing professional development (CPD), and completed only a five-week period of supervised practice prior to re-entering the profession. 

Mrs Caroline Freedman, Chairman of the Disciplinary Committee said: "The Respondent placed himself in this situation: he knew that he had been out of practice for ten years, had not done any formal CPD during that time and chose to accept an appointment to work as a locum in a sole-charge out-of-hours emergency clinic. A foremost aggravating factor is that animal welfare was adversely affected. A non-critical patient was placed at risk by the Respondent's failures."

The Committee reiterated that the purpose of sanctions was not to be punitive, but to protect animal welfare, to maintain public confidence in the profession and to maintain professional standards.  "A postponement of judgment, with suitable undertakings from the Respondent, is the correct course of action," said Mrs Freedman. Mr MacMahon has subsequently signed undertakings relating to CPD in both surgical and medical disciplines, and the Committee has postponed for 12 months its judgment as to any further sanction.