Veterinary Client Mediation Service

RE: Veterinary Client Mediation Service

Niall Connell — Fri, 13 Apr 2018 22:03:16 GMT

I took part in one of the two VCMS sessions which took place on Saturday and Sunday at BSAVA Congress hosted by Jennie Jones from Nockolds. Discussion was round 2 example cases and how they might be dealt with by the practice and by VCMS. VDS took part and were really helpful. I think everyone found the session very worthwhile. Look out for more of these events and case studies in the future. It’s very unpleasant to be on the receiving end of a complaint but the VCMS process of non judgemental, without prejudice mediation aiming for timely resolution is definitely worthy of consideration.

RE: Veterinary Client Mediation Service

Iain Richards — Fri, 13 Apr 2018 15:27:05 GMT

"Remember the Tavistock Square bomb? It happened in front of the GMC or similar. They had, those great and good (registered practising doctors) , no idea what to do, and had to be moved away by paramedics. This is the misapprehension under which we Labour. The College's posturing on this is over stretching and potentially dangerous."

Evidence for this David?

In fact, it was the BMA HQ and the staff did what they could with the limited kit they had, until the ambulances arrived. I think that lives were saved, but I can't be certain.

RE: Veterinary Client Mediation Service

Arlo Guthrie — Fri, 13 Apr 2018 10:23:22 GMT

[quote user="Chris Barker"]Oh and good luck Arlo getting people to continue to contribute[/quote]

Got my work cut out, haven't I

Actually, as I was reading David Mills post before I got to yours, Chris Barker, I was thinking - yeah, probably all perfectly valid points, and fair for him to ask, but really, does it have to be put like that?

[quote user="David Mills"]Obviously you will have these facts at hand.[/quote]

Reads as kind of sarcastic: "Obviously you don't". A more productive way of putting it would be: "Do you have any facts?"

[quote user="David Mills"]See above. Complete pointless speculation.unless above answered. [/quote]

An example of an abrupt writing style which is a luxury only two people who know each other very well, probably communicating privately, can afford. Even just prefacing 'Completely pointless speculation" with "I think it is" would make the same point in a slightly, but importantly gentler way.

[quote user="David Mills"]old fruit[/quote]

Just stop it. Patronising. Totally unnecessary.

God it's hard work moderating! David Mills, I know you're going to come back at me and give me a hard time. The way I see it, you are one of the most important contributors to this group. You ask incisive and important questions and you often make damned good points. I am NOT trying to get in the way of that, but you have GOT to, as Anthony Todd put it: "adjust your style".

RE: Veterinary Client Mediation Service

Chris Barker — Fri, 13 Apr 2018 07:51:33 GMT

For the Directive see https://www.ombudsman-services.org/docs/default-source/miscellaneous-links/adr-q-and-a.pdf?sfvrsn=4 Been in existence since 2015 old fruit

For DEFRA's attitude towards the profession read the EFRACOM report and findings published as far back as April 2008!

Feel free to contact the VDS directly and hear it from the horse's mouth

Oh and good luck Arlo getting people to continue to contribute

RE: Veterinary Client Mediation Service

David Mills — Fri, 13 Apr 2018 00:40:37 GMT

[quote user="Chris Barker"] An EU Directive now requires that businesses provide their clients with access to a mediation system in cases of dispute. [/quote]

What are the terms of this? Independent? ANY dispute? Can it be in house? And we're out soon don't forget, so why do you think the alacrity of adoption by our august regulator? Have any other industries set this up? What is the time for adoption from the EU?

Obviously you will have these facts at hand. [quote user="Chris Barker"]If someone didn’t invest in such a system for the profession then each practice, and each charity clinic, would individually have to spend time and money sourcing a mediator to which they could refer the discontent. [/quote]

See above. Complete pointless speculation.unless above answered.

[quote user="Chris Barker"]DEFRA, and certain MPs, have long held the belief that the public is being short changed by the College's professional disciplinary system [/quote]

Opinion is easy currency. I'm amazed that defra think so. And thinking so, then change get the college's legislative powers.

Have you got sources of this information or is this fed through council?

[quote user="Chris Barker"]which only allows for the prosecution of ‘serious professional misconduct’[/quote]

As is laid out in legislation. Negligence is, and remains, a civil matter, over which thankfully) the College has no say unless its so bad it meets threshold for misconduct.

Kinda links to my other points about this under the radar mission creep into clinical standards. The reasons for it simply aren't there, unless you take into account their suspicion of vets. It's at best career buifdling (Dr viner) and at worst offensive and patronising.

Remember the Tavistock Square bomb? It happened in front of the GMC or similar. They had, those great and good (registered practising doctors) , no idea what to do, and had to be moved away by paramedics. This is the misapprehension under which we Labour. The College's posturing on this is over stretching and potentially dangerous. [quote user="Chris Barker"]RCVS Council (on the recommendation of the then CEO and the Operational Board) came to the view that it would be better for someone to organise a single-source mediator for the profession, and that the RCVS was best placed to organise this.[/quote]

RCVS voting for itself? Ha! [quote user="Chris Barker"]Sorry to disappoint, but so far the response to the VCMS has been positive, and the VDS like it. [/quote]

Well old fruit I'll wait for the VDS to communicate that directly to their members. And if that is lacking I'll ask them why.

[quote user="Chris Barker"]Expect a more detailed exposition of the system from the College, and a review of user experiences by mid-late summer[/quote]

Super. Where members consulted on this over stretching of the colleges powers or not?

RE: Veterinary Client Mediation Service

Chris Barker — Thu, 12 Apr 2018 21:10:22 GMT

Anthony Todd ‘The RC should stick to bad practice and leave pure money matters to the County Court’

David Mills ‘Many of us just see the RCVS overreaching into areas where they have no jurisdiction.’

These comments betray a significant misunderstanding of the genesis of the VCMS. An EU Directive now requires that businesses provide their clients with access to a mediation system in cases of dispute. If someone didn’t invest in such a system for the profession then each practice, and each charity clinic, would individually have to spend time and money sourcing a mediator to which they could refer the discontent.

DEFRA, and certain MPs, have long held the belief that the public is being short changed by the College's professional disciplinary system which only allows for the prosecution of ‘serious professional misconduct’. Even negligence, unless gross and reckless, has to be repeated for it to qualify as SPM. Hence the resentment felt by many members of the public when their complaints (‘concerns’ in the modern parlance) are rejected by the College on the grounds that the alleged behaviour does not amount to SPM.

RCVS Council (on the recommendation of the then CEO and the Operational Board) came to the view that it would be better for someone to organise a single-source mediator for the profession, and that the RCVS was best placed to organise this. I was not initially a great fan of this initiative, thinking that it might sit better with the BVA. However while the initial trial (using the Ombudsman service) proved less than successful, the second, current, system under Nockolds has been far more successful. A triage system involving employees of the College assesses the complaint and advises the complainant of where their concerns might be best ‘prosecuted’. While this has involved some increase in expenditure for the College this has been balanced by a reduction in the number of unnecessary cases being passing into the RCVS disciplinary system.

For the College this is proving relatively cost neutral/cost balanced with only limited increases in resources/manpower; for those VS unfortunate enough to have a spurious concern raised against them there is hopefully a reduction in stress; and for the politicians there is now evidence of an alternative route for the aggrieved, frustrated by the limitations of the RCVS disciplinary system.

David Mills ‘I can only see this being a complete hash. It would be interesting to know the VDS position on it.’

Sorry to disappoint, but so far the response to the VCMS has been positive, and the VDS like it. Their view seems to be that that the new triage system is working well - serious professional misconduct gets directed to the College, mistakes/bad luck/negligence ends up in the VDS in-tray, and the niggling problems that probably should have been sorted out at practice level end up at the VCMS.

I’m just back from the PIC-DC Liaison committee meeting held at the College this morning. I can assure you that the system is being well tested, with sampling/review of cases to ensure that the triage system is working properly, that no cases which should have been processed through the disciplinary system are being missed, and (of equal importance) that the malicious and vexatious complaints are being dealt with correctly and at the correct ‘level’

Expect a more detailed exposition of the system from the College, and a review of user experiences by mid-late summer

RE: Veterinary Client Mediation Service

David Mills — Thu, 12 Apr 2018 19:52:06 GMT

The problem is with all this "very good" is that we cannot just take your word for it.

Many of us just see the RCVS overreaching into areas where they have no jurisdiction. Even in areas they have jurisdiction they have not got a long or distinguished history of behaving like a first rate regulator.

I can only see this being a complete hash. It would be interesting to know the VDS position.on it.

RE: Veterinary Client Mediation Service

Jo Dyer — Thu, 12 Apr 2018 09:49:42 GMT

I also understand that at least one of the corporates has VCMS as part of their complaints policy, if it gets to the point of escalation, and they are very happy with the results.

RCVS wanted an ADR to deal with all the stuff that's not GPM and so was effectively not their responsibility but was leaving the public very unsatisfied, and VCMS seems to be fitting that bill very well whilst also being very acceptable to vets.

RE: Veterinary Client Mediation Service

Jo Dyer — Thu, 12 Apr 2018 09:44:18 GMT

[quote user="Clive Ansell"]The RCVS remit is strictly that of professional misconduct only, they have no jurisdiction over civil disputes or the mostly trivial nonsense complaints we all get from time to time.[/quote]

Indeed. That is why VCMS is in place to deal with everything that would not amount to 'gross professional misconduct' i.e. just about everything. The trouble is that it seems to be very difficult to distinguish sometimes (you wouldn't think so but the number of cases pursued by RCVS which come to nothing but cause huge stress for the vet would suggest otherwise). However, VCMS appear to be very good at differentiating potential GPM and will filter those early and send to RCVS. That's why I think everything should go through them in the first instance, for consistency as much as anything.

[quote user="grumpyoldman"]It will be interesting to know what they will do with the "I didn't get a cuddle when my dog was euthanised", "the vet wanted to go home at 7pm and looked tired and old", "I didn't save my dogs collar and didn't ask them so they disposed of it then I wanted it back 2 weeks later and they had not saved it ", [/quote]

From what I'm hearing, they are really good at these, GOM. I understand in some cases they have put it straight to the client in a very satisfying way for the vet.

RE: Veterinary Client Mediation Service

Anthony Todd — Wed, 11 Apr 2018 23:57:24 GMT

[quote user="robloxley"]Maybe the RCVS view that many cases that end up in their complaints process are because there isn't a better alternative and by providing an alternative, fewer vets end up in the RCVS complaints stream?[/quote]

But if there is a complaint to the RC it appears on the vet's record and is a black mark, and taken very very seriously by the complained.

Cannot the RC decide on the merits of the complaint, particularly if it is about fees, without recording it as a "complaint"?

Easy for a disgruntled client to make a RCVS complaint vindictively, which causes possibly totally unjustified distress for the complained, even if it is thrown out at the preliminary stage.

County Courts can, and do, make professional judgments and can call or insist on professional opinion.

Be good if the RC published an analysis of the complaints received and categorised the reasons?

Anonymously of course.......

RE: Veterinary Client Mediation Service

grumpyoldman — Wed, 11 Apr 2018 22:45:05 GMT

It will be interesting to know what they will do with the "I didn't get a cuddle when my dog was euthanised", "the vet wanted to go home at 7pm and looked tired and old", "I didn't save my dogs collar and didn't ask them so they disposed of it then I wanted it back 2 weeks later and they had not saved it ",

RE: Veterinary Client Mediation Service

Rob Loxley — Wed, 11 Apr 2018 22:38:37 GMT

[quote user="Anthony Todd"]The RC should stick to bad practice and leave pure money matters to the County Court.[/quote]

Maybe the RCVS view that many cases that end up in their complaints process are because there isn't a better alternative and by providing an alternative, fewer vets end up in the RCVS complaints stream?

RE: Veterinary Client Mediation Service

Anthony Todd — Wed, 11 Apr 2018 18:17:55 GMT

[quote user="Bob Russell"]Everybody could improve their communication.[/quote]

Of course [look at the responses here, and we're supposed to be above average "communicators"...]

I don't think the RC should even be involved in this. Sanction it, and/or approve, but actually being behind it sounds too much like a dodgy builder who doesn't repair a roof properly then doesn't return.

There is already an effective County Court procedure and further avenues [Can't Pay We'll Take It Away is informative]

The RC should stick to bad practice and leave pure money matters to the County Court.

RE: Veterinary Client Mediation Service

Clive Ansell — Wed, 11 Apr 2018 17:07:34 GMT

I have no experience of the VCMS, but is it not a completely different tool to the RCVS complaints procedure?

The RCVS remit is strictly that of professional misconduct only, they have no jurisdiction over civil disputes or the mostly trivial nonsense complaints we all get from time to time.

Doesn't the VCMS deal with civil dispute type complaints? along the lines of "the vet couldn't remove my SBT's brain tumour at 6.55pm on a Friday night for a fiver" or "he couldn't cure an incurable disease"

RE: Veterinary Client Mediation Service

Bob Russell — Wed, 11 Apr 2018 17:03:28 GMT

Everybody could improve their communication. It might take up rather more time than it is worth, might involve some stomach churning grovelling just to appease a petty minded client.

I am sure most of us could record things better (I am guilty of that crime).

Perhaps the RCVS could add that to my record now so they don't have to wait for a complaint.

VDS have some of the wisest and most supportive vets in the country. I don't care if they were ever in practice!!!

I have thankfully never seen the inside of the DC world but it does appear that this new system seems to work pretty well and avoids the potentially heavy handed approach that some report by the RCVS.

That said I cannot disagree with any of the DC decisions post-Chikosi so lessons have been learned.

RE: Veterinary Client Mediation Service

Virginia Campbell — Wed, 11 Apr 2018 16:47:14 GMT

[quote user="Beats"]advising me that my communication skills should be improved[/quote]

Surprise!! I had one of those conversations the other day where I spent far longer than I should, explaining carefully and repeatedly options and limitations of diagnosis and treatment till I was blue in the face, and still finished the conversation thinking, "You know, if I don't diagnose and effect a lifelong 100% cure for this dog's multiple chronic health problems, cheaply and with zero risk to the dog and zero side effects of medication, then there will probably be an RCVS complaint and I bet you a burned out phone we will be advised to improve our communication skills. "

I recorded the salient points of the conversation on the computer but not the whole thing because

a) there isn't enough computer memory to record verbatim conversations with that client and

b) I rang her in a spare ten minutes before evening consults and ended up about 20 minutes late for consults.

RE: Veterinary Client Mediation Service

Clive Ansell — Wed, 11 Apr 2018 16:46:38 GMT

[quote user="Iain Richards"]What's a BS complaint?[/quote]

Boy cow poo poo

RE: Veterinary Client Mediation Service

Beats — Wed, 11 Apr 2018 16:21:36 GMT

[quote user="Jo Dyer"]Can you just clarify for me who you mean by 'manager-vet'? Is that someone at your practice, or at VCMS? What does the day away involve? And which system do you personally prefer?[/quote]

another vet I work with who had no involvement with case, but with administrative duties at the clinic such as answering complaint letters, but not the owner.

I wasn't there, so can't really comment.

I'm not sure I have enough experience to have a strong preference. As a selfish employee, I might rank the options in order of least hassle to me personally.

RE: Veterinary Client Mediation Service

Iain Richards — Wed, 11 Apr 2018 15:24:26 GMT

I didn't say 2 months was acceptable, I said it was better than RCVS route and, as I'm now locumming, I take the VCMS route in preference.
What's a BS complaint?

Bit of a sweeping statement about the panel though, most VDS claims consultants haven't been practitioners for quite some time. They are some of the wisest, savviest vets I know.

RE: Veterinary Client Mediation Service

Jo Dyer — Wed, 11 Apr 2018 09:31:03 GMT

Thanks Beats that's really helpful. Can you just clarify for me who you mean by 'manager-vet'? Is that someone at your practice, or at VCMS? What does the day away involve? And which system do you personally prefer?

[quote user="David Mills"]

Just because they CAN find it vexatious doesn't mean they will. I remember ADR. Most BS complaints they said there were communication issues. They weren't.

[/quote]

David I think that must have been the previous ADR trial with Ombudsman Services which was not well-received by anyone.

[quote user="David Mills"]Further, many many complaints are dealt with by practices adequately, quietly, successfully. We hear not of these.[/quote]

Yes, this is the ideal situation. But for clients who want to complain to a higher power, maybe they are vindictive/vexatious or maybe they don't know any other way because the Practice's complaints procedure is not clear, they will go on the internet and end up at RCVS. There they have the option to go to VCMS, who have a range of options including referring them back to the practice to try and sort it out in the first instance; or to ProfCon. I am hearing a lot of positives about peoples' experiences with VCMS which generally is not the case with RCVS investigations, so I'm just wondering why they don't all go through VCMS initially. Why are people given the option to go straight to the top before trying anything else? You can't do that in any other industry.

RE: Veterinary Client Mediation Service

Beats — Wed, 11 Apr 2018 08:10:16 GMT

Limited feedback I can offer:

RCVS complaint:

5 months (roughly) from complaint until resolution
Client paid bill in full (while waiting for response from RCVS)
Time taken by me (outside of working hours) approx 7 hours (writing initial response, contacting VDS, chasing up)
No time expense to anybody else at clinic
Received a letter thanking me for my complaint(?), referring to me by the incorrect gender pronoun etc... and advising me that my communication skills should be improved and a note to that effect would be kept on file for 5 years
No poor online reviews etc for the clinic or further contact from (ex-)client

VCMS complaint:

2 months (approx) to resolution
15mins verbal discussion for me with "manager-vet"
I would guess at perhaps twice length of time, compared to RCVS complaint above, on behalf of "manager-vet", to include a day away
"prompt-payment" discount agreed
removal of negative online review

Not-chasing-the-money:

Time cost = 0-2hours
Payment = £0 beyond what already banked
Clinic reputational effect unknown; no opportunity for personal vindication/criticism

RE: Veterinary Client Mediation Service

David Mills — Tue, 10 Apr 2018 23:46:36 GMT

[quote user="Iain Richards"]

I spoke to them at BSAVA. Time to resolution - 60 days, usually less. That's a lot less than most RCVS complaints, so less time. Plus they can state that the claim is vexatious.

[/quote]

If you still worked in practice, or as a partner or boss, would you think 60 days acceptable?

Just because they CAN find it vexatious doesn't mean they will. I remember ADR. Most BS complaints they said there were communication issues. They weren't.

My issue is thus. This panel, whoever they are, are unlikely to be coalface practionters. Ergo, they don't understand, simply put. Further, many many complaints are dealt with by practices adequately, quietly, successfully. We hear not of these.

All this will provide is a shouting chamber for those bereft of responsibility or buyers regret.

One of the most scary things at BSAVA was the RCVS wanting to ape the NHS system of publishing complication and success rates by practice.

Dr Viner himself scoffed at the minority who raised their hands to say the RFPs should not be funding this rubbish.

Brave new world.

RE: Veterinary Client Mediation Service

Iain Richards — Tue, 10 Apr 2018 21:25:33 GMT

I spoke to them at BSAVA. Time to resolution - 60 days, usually less. That's a lot less than most RCVS complaints, so less time. Plus they can state that the claim is vexatious.

RE: Veterinary Client Mediation Service

David Mills — Tue, 10 Apr 2018 19:42:01 GMT

Next up - TripAdvisor for Vets.

90pc of complaints are vexatious. This will suck a lot of time from people and in most cases the complainer will end up in some "win".

RE: Veterinary Client Mediation Service

Jo Dyer — Tue, 10 Apr 2018 19:08:52 GMT

[quote user="J G Wray"]

Aren’t they confidential?

[/quote]

Well, I didn't think saying something like 'We've had contact with them and they were great' or 'Had an awful time, we will be insisting on direct communication from RCVS about any concerns in future' was going to be breaching confidentiality too much.

Anyway JGW you don't have to share anything here that you are not comfortable with