VMD inspections, Bronze, Silver and Gold Practices

Re: VMD inspections, Bronze, Silver and Gold Practices

patrick murphy — Mon, 24 Jun 2013 13:32:20 GMT

I got it automatically in the origins as a TP. when I had to start paying I mentally gave it 1 year to se if anyone at all noticed my blue sign, let alone ask about it, and the result is that I withdrew from the scheme. already enough to pay for TP and VMD inspections

Re: VMD inspections, Bronze, Silver and Gold Practices

Gillian Mostyn — Sun, 23 Jun 2013 18:55:56 GMT

we did the same- got the paperwork, filled it in and 'ticked all the boxes' and then put it in the bin when we reaslised there was no real ptactice benefit to posting it.

Re: VMD inspections, Bronze, Silver and Gold Practices

Michael Woodhouse — Sun, 23 Jun 2013 17:27:44 GMT

[quote user="patrick murphy"]

52 % of all practices are in the PSS scheme, which indicate it's huge success, is that not 48% are not convinced?

[/quote]

I looked at the PSS and seriously thought of joining, but not sure what it would add to the practice. The printed 'rules' we have almost every box ticked, other than a closing gate at the surgery to be compliant for LA and SA.

Re: VMD inspections, Bronze, Silver and Gold Practices

patrick murphy — Sat, 22 Jun 2013 16:58:34 GMT

52 % of all practices are in the PSS scheme, which indicate it's huge success, is that not 48% are not convinced?

Re: VMD inspections, Bronze, Silver and Gold Practices

patrick murphy — Sat, 22 Jun 2013 16:46:58 GMT

reading the report, not only is it such agood idea, but they are going to put a computer system in play, to HELP us do our modules, which if it is anything like the cheap system they put inplay for our CPD will be a shocker.

Re: VMD inspections, Bronze, Silver and Gold Practices

J G Wray — Thu, 20 Jun 2013 11:02:13 GMT

[quote user="Richard Carter"]My objection is not that PSS requires compliance with the law - it is that the RCVS which has no jurisdiction or legal activity in these areas is pinching these aspects of control in bureaucracy creep[/quote]

Hmmmm. RCVS are incapable of not being acquisitive over areas of regulation that don't exist or don't need to exist, and so they are also seeking a means of controlling businesses owned by vets and Alternative Business Structures, not owned by vets. At the same time they perform semantic gymnastics by saying the PSS is not under RCVS control rather it is the PSS Group. They are very weird.

They do not, at the moment, subsidise the PSS with RFPs membership fees. If they can find a justification to do so, they will leap in however, and they are aching to find a means to compel businesses whether vet owned or ABS to "join" RCVS to operate. They are stymied by having no likelihood of a new VSA giving them this legal scope, so they are looking for other routes.

JGW

Re: VMD inspections, Bronze, Silver and Gold Practices

Rob Loxley — Wed, 19 Jun 2013 20:45:05 GMT

[quote user="Richard Carter"]bureaucracy creep[/quote]

I think that's a great description!

Re: VMD inspections, Bronze, Silver and Gold Practices

Richard Carter — Wed, 19 Jun 2013 18:10:16 GMT

My objection is not that PSS requires compliance with the law - it is that the RCVS which has no jurisdiction or legal activity in these areas is pinching these aspects of control in bureaucracy creep and suddenly instead of a RCVS of a few people we suddenly will be supporting a few 100, all of whom will have very important jobs to do checking you are keeping written records on disciplinary matters for instance.

Re: VMD inspections, Bronze, Silver and Gold Practices

Malcolm Ness — Wed, 19 Jun 2013 17:27:35 GMT

[quote user="J G Wray"]Ah.. the judgement of the eminent. That's surely a thing now consigned to history.[/quote]

Not at all.

It is the system that has marked you out a a veterinary surgeon and it is the same system that allows a large number of students into vet school every September and a similar number into the profession every Summer.

Re: VMD inspections, Bronze, Silver and Gold Practices

Gillian Mostyn — Wed, 19 Jun 2013 17:26:52 GMT

[quote user="J G Wray"]

I wonder what the benefit would be to the practice and to the public.[/quote]

Seems to me that neither the practice nor the public are unhappy with how things have always been before we were ranked.......none of my clients have ever asked where my plaque is or how many stars we've got.

Re: VMD inspections, Bronze, Silver and Gold Practices

J G Wray — Wed, 19 Jun 2013 17:21:28 GMT

[quote user="bob lehner"]The good thing about the PSS is that it draws your attention to these obscure, but none-the-less important things - which many of us might be otherwise blissfully unaware of.[/quote]

Ah, progress, we've identified the good thing about PSS

[quote user="Derek Copeland"]As far as the gold, silver, bronze,again doesnt seem popular but I think its a step in the right direction and yes I would rather take my pet to a gold practice than bronze. Obviously not a popular view with this thread![/quote]

Have a little thinkette about this. The Gold SIlver Bronze thingy could only be applied to practices in the PSS. Why would practices signed up to PSS

agree to this?

[quote user="Virginia Campbell"]Do you think Joe Public will look at the bronze plaque and think "hmm, probably hasn't got all the gear but a good standard of basic care" or "not quite crap enough to be forced to close down"[/quote]

Quite

[quote user="Derek Copeland"]Would the "stone throwers"like to tell me what the current alternative to the PSS is?[/quote]

Well, there isn't, but unless you point out again and again how narrow, shallow and short sighted it is, those who run PSS are just going to go on doing more of the same, because they're not really in control of it. The PSS is poor value because it is based on a misunderstanding to the point of falsehood, that it measures standards that are valued by its audience. It is just a management tool, and conforming to legal standards can be achieved without the straitjacket of PSS. PSS would become something entirely more plausible and useful if it were reorientated toward what the public want.

[quote user="Martin Atkinson"]I would envisage a panel of recently retired veterinary surgeons or those who are able to give up time whilst in practice, similar to the present VDS consultants who judge by those standards which presently apply to those used by the VDS and the RcVS disciplinary committee with which we do not always agree but is there another way?[/quote]

Ah.. the judgement of the eminent. That's surely a thing now consigned to history.

What the fuzzy thinkers at RCVS are requiring of the PSS people is to use a series of measures based on outcomes, hence outcome focused stuff from earlier. There are tools which can be used to determine this. They have proposed 20 areas to measure. The admin associated with this looks daunting and there is always a cost associated with admin. I wonder what the benefit would be to the practice and to the public.

JGW

Re: VMD inspections, Bronze, Silver and Gold Practices

Martin Atkinson — Wed, 19 Jun 2013 16:56:39 GMT

[quote user="Gillian Mostyn"]

Who would you want to judge you, and by whose criterion?

[/quote] Not sure at whom this was directed but I assume me. I would envisage a panel of recently retired veterinary surgeons or those who are able to give up time whilst in practice, similar to the present VDS consultants who judge by those standards which presently apply to those used by the VDS and the RcVS disciplinary committee with which we do not always agree but is there another way?

Re: VMD inspections, Bronze, Silver and Gold Practices

Anthony Todd — Wed, 19 Jun 2013 16:35:40 GMT

Come on, it just needs to be a box-ticking exercise and shouldn't cost much.

As long as it doesn't try to assess veterinary care or proficiency at the same time.

The RCVS should throw it in with the annual registration of practice premises as they'll have so much money left after the new IT program is installed.....

Re: VMD inspections, Bronze, Silver and Gold Practices

Gillian Mostyn — Wed, 19 Jun 2013 16:31:23 GMT

Who would you want to judge you, and by whose criterion?

Re: VMD inspections, Bronze, Silver and Gold Practices

Anthony Todd — Wed, 19 Jun 2013 16:30:22 GMT

[quote user="Derek Copeland"]Would the "stone throwers"like to tell me what the current alternative to the PSS is?[/quote]

It seems to me that there are two distinct measurements of veterinary "care", for want of a better term.

On the one hand, as with aircraft, motorcars, restaurants and builders there are a set of legal or required standards which must be complied with.

Let's take temperature monitoring of autoclaves and refrigerators as a simple example in the vet. field.

The PSS and the MOT seem to take care of that ,but neither are able to measure how a vet practices and how the driver drives.

Trying to adapt the PSS as a measure of veterinary proficiency is as useful as trying to assess the driver when a car goes in for it's MOT.

As an aside, the "gold" practices may well find that they lose business 'cos owners will equate "gold standard "with gold prices........

Re: VMD inspections, Bronze, Silver and Gold Practices

Martin Atkinson — Wed, 19 Jun 2013 16:11:15 GMT

[quote user="Evelyn Barbour-Hill"]So you say, Martin, as so would I from the comfortable position of knowing it won't happen, but will you be so happy when the charge for the inspection is announced? What would it be do you think? Two thousand pounds a year? Five thousand every two years? Ten thousand? Care to guess?[/quote] If clients want greater clarity and accountability they will have to pay for it so it will go on their fees. It might bring a few of the cheapskate practices to account and lead to a better balanced charging structure across the board, then again Porcine Airlines might take over form Michael O'Leary!

Re: VMD inspections, Bronze, Silver and Gold Practices

Evelyn Barbour-Hill — Wed, 19 Jun 2013 15:31:22 GMT

[quote user="Martin Atkinson"] but I would be very happy to subject myself to that level of scrutiny.[/quote]

So you say, Martin, as so would I from the comfortable position of knowing it won't happen, but will you be so happy when the charge for the inspection is announced? What would it be do you think? Two thousand pounds a year? Five thousand every two years? Ten thousand? Care to guess?

Re: VMD inspections, Bronze, Silver and Gold Practices

Martin Atkinson — Wed, 19 Jun 2013 14:22:58 GMT

I've recently seen a dog with a classical ruptured ACL from history of onset to symptoms and standard diagnostic evaluation. It has been seen at a multi-centre tier 2 practice with access to a tier 3 hospital with an orthopaedic surgeon, which has missed the diagnosis and been giving inappropriate treatment for 6 weeks. I made the diagnosis in 10 seconds, the dog came in for surgery the next day. Now we all know I love myself but tell me: which is the better practice in these circumstances? There should be a basic core standard to ensure that practices comply with H&S and employment regulations and have minimal facilities and equipment to do a good basic job and be able deal with emergencies. After that additional bells and whistles mean nothing if the vets don't know what they're doing and can't make a basic diagnosis like the above in less than 6 weeks! I'm afraid that if we're to be assessed properly we've got to bite the bullet and an OFSTED type scheme put in place to examine the competence of individual vets diagnostic skills and clinical outcomes. This under present management is unlikely to happen but I would be very happy to subject myself to that level of scrutiny. There really is no other way.

Re: VMD inspections, Bronze, Silver and Gold Practices

CatherineThomas — Wed, 19 Jun 2013 12:34:37 GMT

I don't understand how they could assess anything other than facilities. It is afterall the practice they are assessing and not the staff. In some practices you could have a completely new set of staff within a year of the visit and then you would have a different quality of care. In small private practices it probably wouldn't change much but for example in a corporate practice there may not be the same continuity.

Although health and safety stuff is rather annoying there are good reasons why it is important. You do not want to be in a situation where it takes a serious incident to show you how bad the health and safety in a practice is.

Re: VMD inspections, Bronze, Silver and Gold Practices

Gillian Mostyn — Wed, 19 Jun 2013 11:57:21 GMT

[quote user="Derek Copeland"]Would the "stone throwers"like to tell me what the current alternative to the PSS is?[/quote]

The current system of ranking according to type of practice is fair - clients can see and understand how a clinic differs from a hospital. Having any other type of banding would indicate quality of care rather than facility - and I don't think it can me made fair to anyone to compare practices in that way.

Re: VMD inspections, Bronze, Silver and Gold Practices

Gillian Mostyn — Wed, 19 Jun 2013 11:53:34 GMT

But it has to be remembered that we are all running a business - and we can only have what the business can afford. There has recently been a thread about a practice struggling financially and this is often due to practices having drugs and toys that the turnover can simply not afford. While I agree that there should be things we all adhere to (and I am actually in favour of strict health and safety laws as the impact of non-adherence can be catastrophic to the person involved) there does need to be some common sense used as to what a 'GP' needs to have and do in-house to still be an excellent vet. As long as there is evidence that referral is undertaken as soon as it is needed, I can't see any issue. However, there does seem to be a trend moving towards larger, high footfall, well equipped practices getting the 'gold star' but smaller, low turnover practices being seen as inferior in their care. Considering that the vast majority of cases need nothing more than a stethoscope, thermometer and some care and skill, I can't see this is doing the profession any good at all. We'll end up with statistics showing that 'only 10% of veterinary practices are reaching a good standard' and other such Daily Mail-type headlines.

I fear the NHS has been trying to introduce league tables for quite a few years and are having a nightmare trying to make it fair to all. I suspect it cannot be done.

Re: VMD inspections, Bronze, Silver and Gold Practices

Malcolm Ness — Wed, 19 Jun 2013 10:24:54 GMT

The entry level PSS currently requires (very) little more than compliance with relevant law. While some might argue vehemently about the sense behind some of that law, that is a different discussion. I struggle to see why a practice that fails to comply with legal requirements (thereby avoiding the related costs and gaining a financial advantage over the law-abiding competition) should not come under pressure to comply or close.

[quote user="Virginia Campbell"]but a good standard of basic care[/quote]

That may, or may not be true. I know of no evidence to suggest that the standard of care is any better in a smaller, more basic or a non legally compliant practice.

Re: VMD inspections, Bronze, Silver and Gold Practices

Derek Copeland — Wed, 19 Jun 2013 10:21:22 GMT

Would the "stone throwers"like to tell me what the current alternative to the PSS is?

It is a long way from being perfect but I think there is a desire to highlight the differences that exist between practices.What is Joe public to do when they look in yellow pages what is the difference between my practice and a lock up unit with cheap vaccines? The best vet in the world would struggle without the basic bells and whistles so perhaps we should check we all have them.We do dont we ?

So yes as a vet who is a pet owner I would take my dog to a gold plaque rather than no plaque what else is Joe Public meant to judge us on at present .

Of course the PSS needs to become far more focused on the abilities ,results and standard of care given by the veterinary surgeons and nurses this is imperative.I do feel that this is the direction they are heading .I would far rather be on inside pushing forward than outside doing nothing .

Also carping on about how does health and safety make me a better vet , who cares its a legal requirement , get over it .

We now have a profession that provides many different levels of veterinary care.There absolutely has to be both a minimum standard and demarcation of the different levels of this care that is both quantifiable and visible.

Although it sounds like it I am not the greatest supporter of the PSS but it seems that we need to start somewhere

Derek

Re: VMD inspections, Bronze, Silver and Gold Practices

Thomas Johnson — Wed, 19 Jun 2013 08:54:10 GMT

[quote user="Virginia Campbell"]

Do you think Joe Public will look at the bronze plaque and think "hmm, probably hasn't got all the gear but a good standard of basic care" or "not quite crap enough to be forced to close down"

[/quote]

I agree, my concern would be that the general public would correlate bronze, silver and gold with satisfactory, good and excellent. Also some people might then consider, not realising that the scheme is voluntary, that a practice without a metallic accreditation has been deemed to be failing.

Re: VMD inspections, Bronze, Silver and Gold Practices

Virginia Campbell — Tue, 18 Jun 2013 22:17:28 GMT

Do you think Joe Public will look at the bronze plaque and think "hmm, probably hasn't got all the gear but a good standard of basic care" or "not quite crap enough to be forced to close down"