Blankets - does it matter what RCVS say?

Re: Blankets - does it matter what RCVS say?

Anthony Todd — Fri, 02 Aug 2013 20:33:39 GMT

[quote user="glen mcintosh"]Therefore visits will probably cost upwards of £400-500 in addition to any treatment."[/quote]

Surely this amounts to a constructive refusal and seems to forget any consideration of suffering or the animal at all.

What about the cat trapped in the car fan belt, for which my comment got me a severe ticking off?

£500 sir, I'm sorry but etc.?

As an aside the dog in the Chikosi case was run over by a "jeep" driven by the owner, not by a combine harvester, as was my impression. The transcript says that Mr Matthews senior moved to the side of the track in his "jeep" as the combine harvester, driven by his son, approached him.

And from the decision:

His advice that the dog should be moved on a blanket was completely wrong, as the dog may have had an injured back.

Seems pretty unequivocal and unambiguous to me!

That statement needs revision or better, redaction or some other poor sod will be for it, either by the DC or even in a civil action following the movement of an injured animal by a VS.

Re: Blankets - does it matter what RCVS say?

Utlendigur — Fri, 02 Aug 2013 20:03:26 GMT

[quote user="glen mcintosh"]The reason, I suspect, that the decision reads so badly and seems so unjustifiable to so many veterinarians working in practice is that it appears that (based on the RCVS biographical information and other information readily available in the public domain - but please correct me if I am wrong) none - not one - of the Chikosi DC panel have been involved in clinical veterinary practice such that they would have had to deal with any ooh small animal emergency, within the last 15 years (let alone worked in a dedicated emergency clinic). Indeed only one member of the panel appears to have any significant general small animal experience at all, and that was 15 years ago. Since then she has been practicing veterinary ophthalmology and is now a barrister.[/quote]

Agree - wish I could give more than 5 stars for this paragraph alone. You used not to be considered for a place on the vet course unless you'd spent a fair amount of time seeing practice. In practice you are not supposed to step outside your sphere of competence. Practicing vets have to do yearly CPD to keep up to speed. Yet people who have very little recent experience of the real world of veterinary work (with a few notable exceptions like Bob Partridge, Richard Stephenson et al) can decide on the contents of the GTPC or PSS and sit in judgement on vets trying to do the best they can in a less than perfect world. Anyone remember the idiocy of the dictat that all GAs should be supervised by qualified nurses only - that would have brought most practices to a grinding halt in a few days. There is just a huge lack of credibility in this.

Re: Blankets - does it matter what RCVS say?

Gerbil — Fri, 02 Aug 2013 19:34:07 GMT

[quote user="glen mcintosh"]

[quote user="alex gough"]I don't mind people being wrong, but I do hate it when they wrongly accuse someone else of being wrong, in forceful and dogmatic terms.[/quote]

Quite so, and especially when they then try and half-heartedly spin doctor their error in response to public outcry.

The blanket comment was intended to be read as it was written in the decision. Any one of the five panel members could have said - "hey, hang on a minute, this doesn't sound right". None of them did. And you don't get to be an RCVS councilor on the DC by being a shrinking violet.

It has nothing to do with context, or conditions a), b), c) etc. No, the entire decision, including the blanket comment was written exactly as the DC panel intended, and written very well and very clearly, I suspect with the assistance of the legal assessor.

The reason the decision reads so badly and seems so unjustifiable to so many veterinarians working in practice is that it appears that (based on the RCVS biographical information and other information readily available in the public domain) none - not one - of the Chikosi DC panel have been involved in clinical veterinary practice such that they would have had to deal with any ooh small animal emergency, within the last 15 years (let alone worked in a dedicated emergency clinic). Indeed only one member of the panel appears to have any significant small animal experience at all, and that was 15 years ago. Since then she has been practicing veterinary ophthalmology and is now a barrister.

[/quote]

That post is worth 10 stars not 5. I hope the DC is really writhing over this one. they have overstepped their remit with an attitude of omnipotence and this one has come back to bite them. If I am ever in the situation of being disciplined, I would want to be investigated by people who have real world experience of the situation I may have been put in, not some MRCVS by name only

Re: Blankets - does it matter what RCVS say?

Glen McIntosh — Fri, 02 Aug 2013 19:28:24 GMT

[quote user="Malcolm Ness"]I am also guessing that though he (and perhaps other vets in charity practice, deputising services and elsewhere) earnestly believes that his contractual obligation trumped his professional obligation, as he discovered more about the subject, he came to appreciate that he had made a wrong call.[/quote]

I have no idea about what Mr Chikosi's beliefs were at the time of the incident, however I know that for most vets working in "deputising services" and charity clinics etc it is not a matter of their contractual obligations trumping professional obligations, but earnestly believing that they are dealing with two conflicting professional obligations:1) an obligation to perform house visits (albeit under certain circumstances) and; 2) to maintain continuous 24 hour care for the patients of the practices they serve. This conflict has always been the source of angst for veterinarians working in these areas of veterinary practice and it is perfectly understandable that many feel incredibly let down by a decision that only serves to magnify this angst.

This decision is unprecedented in that there have been not one, but two responses from the RCVS clarifying its position with regard to the decision.

Something isn't quite right.

The 28 day window for appeal has been and gone, and from the RCVS's latest response I gather that there has been no appeal made.

Perhaps RCVS councilor Bob Partridge could now further expand on his comments made in other threads, which appear to be directly at odds with the decision and the RCVS' unequivocal support of that decision (apart from the blanket comment):

[quote user="Bob Partridge"]Just to reiterate - the advice on my OOH website (www.petaande.com) has not changed, nor do I see any reason to change it.[/quote]

That advice with respect to house visits reads:

"A second nurse will have to be called into the hospital to provide cover for in-patient care whilst the primary nurse accompanies the vet on a visit, inevitably this will also add further delay to any visit. In general any “out-of-hours” visit will take at least 1-2 hours to organise in addition to the journey time (remember the vet may not be familiar with your particular location – whereas the hospital is signposted).

Unfortunately there is also a significantly increased cost (with additional staff having to be called in to provide cover). Therefore visits will probably cost upwards of £400-500 in addition to any treatment."

Re: Blankets - does it matter what RCVS say?

Glen McIntosh — Fri, 02 Aug 2013 18:52:14 GMT

[quote user="alex gough"]I don't mind people being wrong, but I do hate it when they wrongly accuse someone else of being wrong, in forceful and dogmatic terms.[/quote]

Quite so, and especially when they then try and half-heartedly spin doctor their error in response to public outcry.

The reason, I suspect, that the decision reads so badly and seems so unjustifiable to so many veterinarians working in practice is that it appears that (based on the RCVS biographical information and other information readily available in the public domain - but please correct me if I am wrong) none - not one - of the Chikosi DC panel have been involved in clinical veterinary practice such that they would have had to deal with any ooh small animal emergency, within the last 15 years (let alone worked in a dedicated emergency clinic). Indeed only one member of the panel appears to have any significant general small animal experience at all, and that was 15 years ago. Since then she has been practicing veterinary ophthalmology and is now a barrister.

Re: Blankets - does it matter what RCVS say?

Alex Gough — Thu, 01 Aug 2013 18:51:47 GMT

Out of interest I was at some neuro CPD today and I brought up the subject of the blanket at lunch. The neuro specialist who was lecturing said that in his opinion a blanket was more suitable than a spinal board in an injured dog because strapping a dog to a board would make the dog distressed, and more likely to struggle and injure itself.

I don't mind people being wrong, but I do hate it when they wrongly accuse someone else of being wrong, in forceful and dogmatic terms.

Alex

Re: Blankets - does it matter what RCVS say?

Arlo Guthrie — Thu, 01 Aug 2013 17:45:04 GMT

[quote user="Malcolm Ness"]I am unhappy that the press release was so poor.[/quote]

Just for clarity, the fault lay with 'The Decision' document, which was written by DC and on which the press release was based.

Re: Blankets - does it matter what RCVS say?

Malcolm Ness — Thu, 01 Aug 2013 17:35:09 GMT

[quote user="Bob Russell"]I very much doubt that the DC will put itself in the same position again.[/quote]

I am fairly certain that faced with the same set of facts and reports the DC would find the same. Hopefully the press release will be better written. If I had my way, it wouldn't be written at all - the journos (and anyone else interested) would be directed to the detailed account and made aware of the transcript if that were not enough for them. DC were painted into a corner here first and foremost by Chikosi's decision not to appear. I am guessing that he saw the writing on the wall and appreciated that what he had done was to effectively incriminate himself (albeit probably with honourable intention). I am also guessing that though he (and perhaps other vets in charity practice, deputising services and elsewhere) earnestly believes that his contractual obligation trumped his professional obligation, as he discovered more about the subject, he came to appreciate that he had made a wrong call. Finally, I suspect that though his employer might have stood with him, that support would involve a highlighting of the written policy that I am told (I haven't had sight) confirms that the decision is one to be made exclusively by the vet on the spot and therefore offered no real help at all.

Had Chikosi offered a defence then he could have explained that he was acting with good will and intention; he could have brought witness evidence from other vets in a similar situation who, though they might be made to acknowledge their error, might have been able to say that Chikosi was not alone in his interpretation of the visit policy/protocol. He might have been able to explain that while the owner had no recollection of the discussion, he [Chikosi} had enquired after the state of the dog and advised a blanket on the basis of that discussion. He might even have been able to call a witness or two to concur that that was good advice. In short, he might (in my view, he almost certainly would) have been able to give an account of himself as a well-meaning veterinary surgeon who made an error of judgement that could equally have been made by very many other vets. In which case the DC would have been able to (metaphorically) slap his wrists once they had re-assured themselves that he would not err similarly again.

Regrettably, he chose not to defend himself and left us with a mess.

I am fundamentally happy with the decision though I am very unhappy that it had to be made in the way it was made. I am unhappy that the press release was so poor. I am unhappy about the pernicious effect that some corporates are having on our profession. I am unhappy that a minority of our profession seem to want the benefits of professional independence but at the same time expect to be released from the responsibilities. I am happy that it seems to be a small minority. I am of the opinion that the Chikosi case will have little effect on the way reasonable veterinary surgeons conduct themselves.

Re: Blankets - does it matter what RCVS say?

Bob Russell — Thu, 01 Aug 2013 16:50:05 GMT

I very much doubt that the DC will put itself in the same position again.

Even the most insulated at the RCVS must have realised much of the hoo hah could and should have been avoided, leaving the most important aspect as the centre of the arguments.

A persons livelihood trumps everything but the worst of behaviours.

Re: Blankets - does it matter what RCVS say?

Arlo Guthrie — Thu, 01 Aug 2013 16:29:15 GMT

[quote user="Malcolm Ness"]What you seem to be advocating is a system where somebody, or a group, presumably within RCVS decides the scope and extent of what the DC decision means and the scope and extent of what we (as Vets) should "learn" from it. That is truly Orwellian. [/quote]

I suppose the way you have described it sounds Orwellian, but it is pretty far removed from what I had in mind.

Let's take the Chikosi case as an example.

My suggestion is that:

The Decision is what it is, and stays as it is. From the horse's mouth (i.e. DC)
I would question whether the public announcement needs to be as detailed as it is now. Presumably all the public wants to know is what the complaint is, and that the vet was flogged. With the benefit of hindsight, it is easy to see that it is a dangerous game for the RCVS to be dishing out veterinary advice to the public itself (it was wrong to move the dog on a blanket). To my mind, that discussion should be for the professional audience only.
I suggest the addition of an announcement for vets, which is more the level of detail in the current announcement, BUT highlights things that others could learn from the ruling. It's not DICTATING vot ve haf vays of making you learn. It's not a yardstick against which people will be measured later. It's an advisory. Nothing more.
In this case, the notes might include:
- That the ruling doesn't mean any change to the current position concerning OOH home visits
- Clarification as to what advice the DC felt should be given under those circumstances (all very well and good saying Chikosi gave no advice about how the dog's condition could be alleviated, but that just left many here questioning what it would have been possible to say).
- The blanket thing is clearly disputed between DC and the Operational Board, and no amount of good communication would have solved that.
- An explanation that whilst the striking off seems severe, it is the only solution open to the DC when someone fails to defend themselves.

There are a few other things I would add to that list, but you get the gist.

Malcolm, much of this might have been blatantly obvious to you. Still you have to admit that it was not blatantly obvious to many (most) others in the profession, including some reasonably senior figures. If the announcement had been run past a GP tasked with drawing up a list of questions the ruling would raise amongst the hoi polloi, I bet they would have spotted most of this a mile off.

I guess there are three choices now:

Status quo.Things'll quieten down till the next hoo haa.
DC battens down. I understand that it already releases more info than most other Regulators. So it could cut back and just announce that Joe Bloggs MRCVS has been struck off because the DC felt like it.
The ONE thing that vets really pay attention to is the DC hearing reports. I see it in my page stats, not just for Chikosi. There's an opportunity, I think, to extend the process from being a purely regulatory function, to one that involves the rest of the profession more, both helping to educate and gathering feedback. That way, events like those of the past few weeks could become an opportunity for the RCVS to work with its members, rather than acting as the whipping boy yet again.

I dunno, maybe it is a daft idea. You'd be a better judge of that, Malcolm. But I certainly did NOT mean to suggest anything which in some way lessens your ability to make up your own mind about what you need to learn.

Re: Blankets - does it matter what RCVS say?

Malcolm Ness — Thu, 01 Aug 2013 15:58:27 GMT

[quote user="Bob Russell"]I too have great respect for Malcolm Ness and value his wise posts and absolutely agree that the decision is best left to the clinician on the ground. The press release was suggesting exactly the opposite IMO. It was clearly stating that using a blanket is wrong as it may cause further damage where a spinal injury exists.[/quote]

Thank you for that.

For the avoidance of doubt, I think that the press release was very badly written and misleading (for many of the reasons that have been discussed here) to the extent that the powers that be within RCVS should be looking closely at what went wrong and why with the intention of avoiding repetition. I have enough faith in some of those within the college to believe that that is what will happen.

However, having read the poorly written press release, with still-raised eyebrows I went back to the source data (or at least the more detailed description as it appeared on the website) for clarification and discovered that the advice was given without the vet questioning the owner and consequently any subsequent "advice" was not worthy of the description. The press release should have been written to highlight the point.

I have before advised clients to use blankets to assist in the transport of injured dogs and cats and I have little doubt that I will do so again. Similarly, I will be happy to defend the actions of a colleague who, having made a reasonable assesment of the situation, deciided that advising blanket-assisted transportation was appropriate.

As an aside, has anyone else noticed how rarely these days you see a tartan "travelling rug" (aka blanket) EXCEPT wrapped around a recently RTA-injured dog as it is carried into the consulting room?

Re: Blankets - does it matter what RCVS say?

Bob Russell — Thu, 01 Aug 2013 15:39:08 GMT

[quote user="Malcolm Ness"]

[quote user="Arlo Guthrie"]With every respect Malcolm (and I do respect you a great deal!), you are talking nonsense[/quote]

Quite possibly - it certainly wont be the first time.

However, my nonsense is benign nonsense. What you seem to be advocating is a system where somebody, or a group, presumably within RCVS decides the scope and extent of what the DC decision means and the scope and extent of what we (as Vets) should "learn" from it. That is truly Orwellian. Imagine all the Winston Smiths on Vetsurgeon who could be shown by their posts to have failed to learn the lesson as it was meant to be learned bearing in mind that the very people who would judging in that dystopian future would be those who were largely responsible for the clumsy reporting and alleged misrepresentations that are at the heart of this disagreement.

I wish to retain the right to make my own judgements and accept the responsibility for those judgements which will sometimes be wrong, I certainly don't want the comms dept of RCVS or even officers and councillors in RCVS deciding what it is that I need to "learn" and what information is so special that I don't need to, or by extension, can't be allowed to know.

[/quote]

I too have great respect for Malcolm Ness and value his wise posts and absolutely agree that the decision is best left to the clinician on the ground. The press release was suggesting exactly the opposite IMO. It was clearly stating that using a blanket is wrong as it may cause further damage where a spinal injury exists.

As I read it there was no qualification whatsoever and as such the general public have been informed that this is unacceptable and a complaint might be forthcoming!

I am quite happy to robustly defend my position to anyone should I consider transport this way to be appropriate. I am sure a trip before the DC would be stressful but it is unlikely that I would give them an easy time of it either. (Perhaps this would be viewed as lack of remorse and I would be in bigger trouble!!). I would bet my last dollar that Malcolm would be similarly robust).

We have a profession with a lot of younger members who may not feel such (over?) confidence when faced by the DC and it is therefore important that we accept that many take the wording more literally than the more cynical 'old guard'.

Once again I suggest the DC are a lot more careful and considered with their wording.

I like the idea that there is a general press release for the general public but a much more detailed examination and recommendation report for those governed by the RCVS.

Re: Blankets - does it matter what RCVS say?

Anthony Todd — Thu, 01 Aug 2013 15:20:49 GMT

[quote user="Hannah Wynne Richards"]

Bob Some people now want Royal College to state that the use of blankets is always acceptable. No no no!!!!!!!!!!!!!!!!!

Wynne

[/quote]

An example please, anything including hypothetical, will do, of when a blanket [or a suitable sheet of flexible material] is NOT acceptable to transport an animal over, say 15Kg which cannot stand, by an owner with non-specialised equipment, or a vet. with a small car or a bike for that matter.

And, if you have an example, tell us all the better way.

Re: Blankets - does it matter what RCVS say?

Arlo Guthrie — Thu, 01 Aug 2013 15:00:28 GMT

[quote user="J G Wray"]They had the opportunity to question what had been delivered.[/quote]

No, they don't.

Re: Blankets - does it matter what RCVS say?

Evelyn Barbour-Hill — Thu, 01 Aug 2013 13:45:06 GMT

[quote user="Malcolm Ness"]I wish to retain the right to make my own judgements and accept the responsibility for those judgements which will sometimes be wrong, I certainly don't want the comms dept of RCVS or even officers and councillors in RCVS deciding what it is that I need to "learn" and what information is so special that I don't need to, or by extension, can't be allowed to know.[/quote]

Nicely put. I agree.

[quote user="J G Wray"]The stuff from the President Colonel (sounds like a N African despot when put like that) on blankets, the start of this thread, even less clear or helpful and that's Commed up too.[/quote]

It's all weasel.

I must say I was expecting better from a miltary man.

Re: Blankets - does it matter what RCVS say?

Malcolm Ness — Thu, 01 Aug 2013 13:37:05 GMT

[quote user="Arlo Guthrie"]With every respect Malcolm (and I do respect you a great deal!), you are talking nonsense[/quote]

Quite possibly - it certainly wont be the first time.

Re: Blankets - does it matter what RCVS say?

J G Wray — Thu, 01 Aug 2013 13:35:17 GMT

[quote user="Arlo Guthrie"]Comms has a very limited remit, which is to summarise the findings for the press release / website announcement. As you can see if you compare The Decision with the press release / announcement, the wording is very similar.[/quote]

How similar are these sentences?

I enjoy cooking

my family

and my dog.

I enjoy cooking,

my family

and my dog.

They had the opportunity to question what had been delivered. Do your sources tell you whether they did and we are actually getting a Lesson (biblical) from DC in the statement?

Subsequent stuff from "Gordon" was pure Commmmmmmms and tripe, so there's little to inspire confidence.

The stuff from the President Colonel (sounds like a N African despot when put like that) on blankets, the start of this thread, even less clear or helpful and that's Commed up too.

JGW

Re: Blankets - does it matter what RCVS say?

Malcolm Ness — Thu, 01 Aug 2013 13:23:55 GMT

[quote user="Mark Holmes"]Are you suggesting Malcolm that any opinion that differs to yours is - too quickly made and not reasonably informed?[/quote]

Tetchy and rather silly.

Look back through the reams that have been written on this subject for comments like "I haven't read .....yet" - those are the ones to which I refer. There is even one in one of the free papers recently.

Re: Blankets - does it matter what RCVS say?

Arlo Guthrie — Thu, 01 Aug 2013 12:36:22 GMT

[quote user="Malcolm Ness"]We have now arrived at the very scary (to me) position where you (Arlo) seem to be suggesting that as Vets we should sit back and wait to be told what to think.[/quote]

Normally I agree with more or less everything you say. On this, I couldn't disagree with you more.

I'm not suggesting some Orwellian mind control.

I don't understand your objection to learning. Or having something explained to you. That seems quite bizarre to me.

[quote user="Malcolm Ness"]The problem all along with this "debate" is that too many people have been too quick to jump in with an opinion without taking the time to make sure that their opinion was reasonably informed.[/quote]

I absolutely disagree with you again.

People jumped in with an opinion based on the information presented to them.

Do you think it is the responsibility of every busy practising veterinary surgeon to make sure that they have read the press release, 'The Decision', and rung the RCVS and had the transcript sent.

Or do you think it is the job of a FIRST RATE REGULATOR to make sure that it communicates the facts in an unambiguous and easily digestible (for busy people) manner. That is all I propose.

With every respect Malcolm (and I do respect you a great deal!), you are talking nonsense .

Re: Blankets - does it matter what RCVS say?

Bob Russell — Thu, 01 Aug 2013 12:34:08 GMT

[quote user="Hannah Wynne Richards"]

Bob Some people now want Royal College to state that the use of blankets is always acceptable. No no no!!!!!!!!!!!!!!!!!

Wynne

[/quote]

No they don't!

They just want the RCVS to leave us to make judgements for ourselves. A blanket is often the best way to transport an injured animal. It is not up to the DC to make such broad and unqualified comments for the public to see.

Re: Blankets - does it matter what RCVS say?

Mark Holmes — Thu, 01 Aug 2013 12:20:04 GMT

[quote user="Malcolm Ness"]

[quote user="Arlo Guthrie"]Richard, you know, I think there is a big lesson and an opportunity for the College in all of this. The lesson is that a one-size-fits-all report of DC decisions is simply not enough. There needs to be a simple explanation for the general public, and a far more precise one written specifically for veterinary professionals, one which explains anything which other vets can learn from the decision.[/quote]

........ but there was always a more detailed description of the full process available on RCVS web site - it is there still. If that isn't enough detail then there is a full transcript available on application. The problem all along with this "debate" is that too many people have been too quick to jump in with an opinion without taking the time to make sure that their opinion was reasonably informed. We have now arrived at the very scary (to me) position where you (Arlo) seem to be suggesting that as Vets we should sit back and wait to be told what to think. " .......... one written for veterinary professionals, one which explains anything which other vets can learn from the decision"

........... "explain", "can learn"..........

George Orwell wrote about this and Chairman Mao would be proud to see his legacy alive and kicking!!!

[/quote] Are you suggesting Malcolm that any opinion that differs to yours is - too quickly made and not reasonably informed?

Re: Blankets - does it matter what RCVS say?

Hannah Wynne Richards — Thu, 01 Aug 2013 12:18:43 GMT

Bob Some people now want Royal College to state that the use of blankets is always acceptable. No no no!!!!!!!!!!!!!!!!!

Wynne

Re: Blankets - does it matter what RCVS say?

Hannah Wynne Richards — Thu, 01 Aug 2013 12:16:29 GMT

Hear hear hear HEAR Malcolm.

Wynne

Re: Blankets - does it matter what RCVS say?

Malcolm Ness — Thu, 01 Aug 2013 12:05:08 GMT

........... "explain", "can learn"..........

George Orwell wrote about this and Chairman Mao would be proud to see his legacy alive and kicking!!!

Re: Blankets - does it matter what RCVS say?

Arlo Guthrie — Thu, 01 Aug 2013 12:03:48 GMT

[quote user="J G Wray"]they can advise on the wording and how it will play when disseminated in any particular form.[/quote]

JGW, you are categorically, 100% wrong on this occasion. 'The Decision' is written up by the DC and a legal advisor. Nobody else. Comms is not invited to, and does not advise on the wording - I think because it is felt that it would be inappropriate for Comms to have any influence on what the DC announces in its findings. Comms has a very limited remit, which is to summarise the findings for the press release / website announcement. As you can see if you compare The Decision with the press release / announcement, the wording is very similar.

It does raise the question whether Comms should have a bigger role writing up the DC finding / announcement, precisely along the lines you suggest they have now.

But then you'd accuse them of spinning, so I guess its a bit of a no-win situation!