AHPA Lay or Approved Tuberculin Tester (ATT) Pilot in Private Practice

RE: AHPA Lay or Approved Tuberculin Tester (ATT) Pilot in Private Practice

Busybee — Fri, 12 Apr 2019 21:32:19 GMT

[quote user="David Shepherd"]The testing work is poorly remunerated and increasingly controlled and subject to strict protocols, audited annually by both APHA and XLFarmcare - driving the perception that it would be more suitable for lay people to do it[/quote].

Working in a busy mixed practice in an area that deals with farms on either 'annual' testing or six-monthly testing my first instinct is that I'd love to be able to give up TB testing. However, a (small) part of me quite enjoys it. Like Michael said, it gets you on farms and means we can combine visits with PD-ing, castrating or dehorning. It's also a great social exercise! The enjoyment does depend on the farm's set up, weather and number of cattle (anything over about 150 I get bored!) so I couldn't imagine doing it full time.

I do think the idea of lay testers is a good one, as the majority of vets I know that do do TB testing hate it. It takes up a lot of time, doesn't pay half as well as it should, comes with reams of paperwork (especially since XL have taken over) and may be a reason new graduates aren't keen on entering mixed practice any more.

RE: AHPA Lay or Approved Tuberculin Tester (ATT) Pilot in Private Practice

David Shepherd — Thu, 11 Apr 2019 16:03:04 GMT

Michael's points are very perceptive; however he writes from the standpoint of being in a 4 year area (coming your way soon, Michael!). In 6-monthly areas (increasingly common) the testing workload rapidly takes over normal practice, and practices have coped either by employing more (poorly paid) new graduates or employing (even more poorly paid) Eastern European vets. The testing work is poorly remunerated and increasingly controlled and subject to strict protocols, audited annually by both APHA and XLFarmcare - driving the perception that it would be more suitable for lay people to do it. Interestingly, the current 66 page manual that tells you how to do a TT test includes a stethoscope and thermometer as essential equipment.

Bearing in mind that the contract is up for renewal next year, I could foresee it going to Eville and Jones and being done entirely by lay testers, and taken away from practices entirely. This could be very difficult for many smaller or more remote practices, leading, as Michael says, to difficulties with OOH provision and hence recruitment/retention problems.

Past experience would indicate that APHA will do exactly as they wish, driven by reducing costs only, and will make no effort to engage with practicing vets.

Not sure what the answer is; I have now taken early retirement, partly encouraged by TB disillusionment and doing some part time small animal work.

David

RE: AHPA Lay or Approved Tuberculin Tester (ATT) Pilot in Private Practice

Neil Wheadon — Tue, 09 Apr 2019 22:42:58 GMT

[quote user="Iain Richards"]test should be trained lay with the vet allowed to sort the disease control aspects of TB.[/quote]

We were doing this in Wiltshire 9 years ago, I'm surprised it's taken this long to role it out

Neil

RE: AHPA Lay or Approved Tuberculin Tester (ATT) Pilot in Private Practice

Iain Richards — Tue, 09 Apr 2019 22:27:38 GMT

Hi Martin,

The general view a few years ago was that TB testing was a vet's job as it involved a degree of interpretation (eg oedema). That's now shifted somewhat and I think the general feeling is, "bring it on" not least since the tendering exercise. Jim Scudamore when CVO was very much of the opinion that the test should be trained lay with the vet allowed to sort the disease control aspects of TB. ON refelection he was right. I'll try and put you in touch with Dave Barrett of BCVA. It woul dbe remis of RCVS to consider this without any LA folk to comment on it!

RE: AHPA Lay or Approved Tuberculin Tester (ATT) Pilot in Private Practice

Michael Woodhouse — Tue, 09 Apr 2019 22:04:54 GMT

A few thoughts:

TB testing is a simple manual skill that can be easily learnt by anyone. The more difficult aspects revolve around handling animals, staying safe and dealing with the farmers.

Personally I hate TB testing and I'm not particularly sure I'd see the attraction to doing it if I was a lay person. It is a waste spending 5 years qualifying as a vet only to end up doing something so mundane, that said it does get you on farm. You meet farmers and build relationships. It's the only time you ever see the whole herd, and that is a benefit. It give opportunity to do other veterinary tasks at the same time (PDing etc). I'd say it was rare to do a test and not do something else.

My worry is that some practices rely on TB testing as part of the work and part of the income and the 6 vet practice would drop to 3 or 4 vets without the testing. That then means more nights on call, possibly harder recruitment etc. Anything that reduces the numbers of farm/mixed vets any further has to be a bad thing.

A lot of European vets work as TB testers and I suppose we don't know what will happen there after brexit. My life would be better if I never had to do any TB testing ever again. I would cautiously welcome the idea with appropriate safeguards, and on the understanding the testing was still allocated to the veterinary practice and they kept overall control. Im in Yorkshire on 4 year testing so I may have a different view if I practiced in the south west.