OOH care provision.

RE: OOH care provision.

Evelyn Barbour-Hill — Thu, 10 Dec 2015 03:06:31 GMT

[quote user="Clive Ansell"]

This has happened before, but I have come across another client this morning that has been banned from the OOH provider that the practice uses. There is therefore no OOH care provision in place for this client.

Should the client be told to fine another practice? should the practice sort out alternative OOH arrangements? or should the client sort out their own OOH arrangements?

The dog needs dental work, but I am not happy to proceed until I know there is adequate OOH care in place. As the practice owner is away, I've told the clients it is their problem to sort out.

What do others think?

[/quote]

It's a problem for the primary practice to sort out, by whatever means they choose. The practice has the responsibility to provide 24-hour emergency attendance to their client's animal. The "OOH provider" is just a subcontractor.

Sacking would be simplest.

But, for the unfortunate locum, with the boss away, I guess Clive's action is the best that can be done.

RE: OOH care provision.

Hannah Wynne Richards — Wed, 09 Dec 2015 16:17:58 GMT

I would definitely sack - but since I have a good relationship with a local re-homing charity. I would (for the dogs sake) also ask them to take it on, and then sort its teeth out FOC - but not until it's signed over, and the legal property of the charity.

Wynne

RE: OOH care provision.

Clive Ansell — Wed, 09 Dec 2015 16:16:14 GMT

Tangent

RE: OOH care provision.

Clive Ansell — Wed, 09 Dec 2015 15:41:53 GMT

[quote user="Kate Richardson"]What is the reason for banning them? Bad behaviour or financial?[/quote]

Both, but primarily for using abusive, aggressive behaviour and threatening violence towards a young trainee nurse. They barged through past reception and removed their status epilepticus cat against advice and threatening all those that tried to stop them. Police were called at the time. Clients banned with immediate effect, and police to be called if they ever turn up again.

RE: OOH care provision.

Bob Russell — Wed, 09 Dec 2015 15:40:05 GMT

We have a suitable 'sacking' letter, but this does not remove the insistence by the RCVS that we must relieve suffering. I have been tempted to include a sentence limiting my future involvement to euthanasia of the patient to relieve suffering, but that would guarantee a place on social media and the standard troll input.

I have a version of the sacking letter banning a particular individual from the practice under all circumstances. Someone else can bring a pet in but not accompanied by Mr X.

This was written after the son of a client phoned and threatened violence with a knife. Apparently his sense of humour, but it fell a little flat when the staff member made a formal complaint. His father (a very nice individual) could not have been more apologetic and was very upset. Son still banned six years later!

RE: OOH care provision.

Hannah Wynne Richards — Wed, 09 Dec 2015 15:33:22 GMT

I would write a letter stating that since their own behaviour - whether financial or otherwise has made it impossible to retain them as clients, whilst still complying with Royal College regulations, then I have no option but to discontinue providing daytime services. The onus is on them to find, and register with a practice which doesn't use this OOH service.

Wynne

RE: OOH care provision.

Glenn Hodgson — Wed, 09 Dec 2015 14:46:37 GMT

We formed a sacking letter with help.from the VDS. It gives 14 notice to find emergency cover and no notice to find routine care.

I'll not work with and violent people, overt liars etc. Might find Myself as a test case :-)

The vds advised in its creation and were happy with it. They said 7days was plenty and we added a bit for our comfort.

RE: OOH care provision.

Bob Russell — Wed, 09 Dec 2015 14:16:31 GMT

i am not putting the onus on the vet. It is the RCVS that will be putting the individual vet under scrutiny!

It goes without saying that the onus is on the owner, but since when has this type of person taken responsibility for anything?

Starting to sound a bit like Wynne but we are not talking about the well behaved, intelligencia here!

RE: OOH care provision.

Gillian Mostyn — Wed, 09 Dec 2015 13:42:29 GMT

Bob...you're putting the onus of responsibility on the vet, where it should always be on the owner. We are always free to ban clients and, as long as we have given them some notice, they have to find veterinary cover for their pet whether for routine work or OOH. The problems they will face doing so is, frankly, not our problem!

Clive....I would have done the same- told the client to arrange OOH cover themselves.

RE: OOH care provision.

Bob Russell — Wed, 09 Dec 2015 13:13:33 GMT

[quote user="Glenn Hodgson"]

It is my understanding that if a practice gives a client 7 days notice in writing, they can refuse to see any of their pets whatever the scenario??

Once trust is gone it is very hard to do best for a patient as we utterly rely on the client.

[/quote]

The practice might be covered but the individual vet is likely to be hauled across the coals should a patient suffer (or be perceived as suffering!).

RE: OOH care provision.

Glenn Hodgson — Wed, 09 Dec 2015 13:09:25 GMT

It is my understanding that if a practice gives a client 7 days notice in writing, they can refuse to see any of their pets whatever the scenario??

Once trust is gone it is very hard to do best for a patient as we utterly rely on the client.

RE: OOH care provision.

Bob Russell — Wed, 09 Dec 2015 12:56:23 GMT

Would the Police attend unless there was already trouble?

Some people think little or nothing of aggressive and violent behaviour and are content to bully their way through life.

As for OOH services charging, our previous one managed to drain an insurance company of £600 for a 1" wound that opened up post op. I had removed a small mass and the dog was a bit hyperactive! I would have used a bit of sedation and resutured or stapled.

Drama created from a minor complication. I will accept some degree of responsibility for post-op complications but not £600 which was far more than the bitch spay and lump removal cost in the first place!

RE: OOH care provision.

Kate Richardson — Wed, 09 Dec 2015 12:39:19 GMT

What is the reason for banning them? Bad behaviour or financial? We are surely obliged to see an animal for welfare reasons if necessary even if only to euthanase on welfare grounds (unless as Bob points out there is serious risk to staff- what would you do in that situation- call the police to attend? Maybe the practice has to have a serious talk with the clients about this and discuss ways of resolving it- if its behavioural then a frank (recorded) discussion may be necessary; if it's financial, maybe build up some credit (either at the practice or the OOH clinic for use in the event of an emergency? Maybe the practice could come to some form of arrangement with the clients that they would see it post dental procedure if absolutely necessary (OOH could contact a nominated person from the practice if they phoned?) Difficult situation re post op problems, do all clients get charged full OOH fees by OOH clinics if its a genuine post op problem? As we do our own OOH, we would use our discretion re fees, depending on the problem

RE: OOH care provision.

Bob Russell — Wed, 09 Dec 2015 11:52:15 GMT

They may be banned, but the OOH provider still has the basic responsibility for welfare etc. The only exception I would make here is where a client has threatened violence. These people will not be seen and will have been informed in advance of this fact.

RCVS be damned in this situation. My responsibility for my safety and that of staff over-rides even animal welfare.

We now work with a nearby practice and they have informed me of one client they would not see. I have to respect this as the client's behaviour was unacceptable. This did not end up being a problem as I euthanased the patient!