Vet Legislation Reform: 1. Embracing the vet-led team

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Tue, 20 Apr 2021 11:15:22 GMT

PS - Still time to take part in the consultation, so if you think I have spouted rubbish, or have something to add: https://www.surveymonkey.com/r/LRDGYZ8

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Tue, 20 Apr 2021 11:13:13 GMT

Update. I have replied to the consultation representing VetSurgeon.org, ie representing the views shared here. I do hope very much that I have done it well.

Here is what I wrote WRT to section 1

1.1 Statutory regulation of the vet-led team

My remarks reflect points raised by veterinary surgeons on www.vetsurgeon.org:

Most feedback on VetSurgeon has been broadly in favour of the broad concept of statutory regulation of the vet-led team, not least because it would create a framework which would help veterinary surgeons know who they can recommend to clients with confidence.

BUT

Currently the recommendation is too woolly. Which specific paraprofessional groups does the College propose to regulate? Where precisely would the line be drawn between behaviourist and dog whisperer? Without knowing this, and whether or not the specific paraprofessionals have been asked whether they would be happy to be regulated, it is impossible to properly judge the value of this recommendation.

AND

Is there a serious danger that if you regulate some allied professionals, you may legitimise some of their other activities. In particular those which sound like a duck. In other words, are veterinary physiotherapists or animal behaviour 'experts' more likely than others to practice quack activities like homeopathy, reiki, chiropractic and crystal healing, and if you give them an RCVS-regulated badge, does this legitimise these things?

What steps will the RCVS take to quantify the percentage of allied professionals who also offer unvalidated treatment regimes, and what steps will be taken to make sure they do not do so under the RCVS banner?

1.2 Flexible delegation powers

Whilst a recommendation which allows the College to be more responsive to change may seem attractive, it raises the question as to what checks and balances will be in place to prevent the RCVS allowing greater delegation at the behest of, or as a result of pressure from a group with a vested interest? In other words, it may suit a corporate business to be able to delegate a task to a less qualified individual for financial reasons without it necessarily being in the best interests of the patient.

This proposal states that increased delegation would only be allowed 'where such delegation can be fully justified and evidenced'. Does 'fully justified and evidenced' need to be better defined? For example, an independent survey of the profession to quantify need, followed by a trial of delegation of the specific task showing effectiveness / safety?

1.3 Separating employment and delegation

A concern raise on VetSurgeon was that allowing VNs to operate under the delegation of a vet, rather than a practice, will make it a nominal requirement.

1.4 Statutory protection for professional titles

There are still concerns that protecting the VN title devalues other members of the veterinary team who have and continue to nurse animals. Also that it would be inaccurate to protect the title because other staff perform the role understood by the word nursing. Also it is unnecessary, as human nurses do not enjoy protection of the title 'nurse'.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Anthony Todd — Mon, 08 Mar 2021 20:03:37 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228979#228979"]Anthony Todd I am probably lacking in common sense, but I don't understand you point! What is it?[/quote]

Only that there seems to be a move to "authenticate" any "job" in order for it to be recognised by some sort of degree or membership of some official body.

Hence a "Degree in Common Sense", from some sort of quasi organisation.

I was [vainly] trying to be cynical.......

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Mon, 08 Mar 2021 17:31:13 GMT

[quote userid="11493" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228947#228947"]Delegation tasks: If a nurse works under the delegation of a vet, but not under the same employment. Who is paying the nurse?[/quote]

Presumably the nurse is self-employed.

[quote userid="11493" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228947#228947"]And why would the vet want to be involved if they are not being paid for the task? [/quote]

That's a good question. I presume the nurse would have to pay the vet a percentage of their earnings for the privilege of their oversight???

[quote userid="10648" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228961#228961"]The nurse invoices the VS for the cost of the POM-V products.[/quote]

Or that (which is another way of skinning the cat).

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228977#228977"]

Is there a degree in Basic Common Sense? I don't think there is even a University Course, yet..........!!

There will be one soon at this rate!

[/quote]

Anthony Todd I am probably lacking in common sense, but I don't understand you point! What is it?

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Anthony Todd — Mon, 08 Mar 2021 17:21:48 GMT

Is there a degree in Basic Common Sense? I don't think there is even a University Course, yet..........!!

There will be one soon at this rate!

[signed]

AJTodd, BVSc, Bcs [but honorary, 'cos I was a Vet for a while ] No, better "Bbsc," Bachelor of Basic Common Sense"!

RE: Vet Legislation Reform: 1. Embracing the vet-led team

janine redman — Sun, 07 Mar 2021 20:47:26 GMT

I remember back in the 90’s discussing regulation of behaviourists and dog trainers , what the difference might be and how to regulate things . Peter Neville , John fisher and David Walker ( veterinary surgeon) started up the association of pet dog trainers , and then came the Association of Pet Dog Councillors etc . However differentiating between what is an abnormal behaviour rather than a normal behaviour that is unwanted by an owner is not simple. Therefore regulating people who seek to modify dog behaviour has to cover your local dog whisperer with experience and no qualifications through to veterinary qualified behavioural therapists.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Alison Clare Hickman — Sat, 06 Mar 2021 16:02:28 GMT

Francisco Gomez I'm having a lovely guess here...

Very random but perhaps possible???? A 'District' RVN that is his/her own company and is required to work with a VS for the purposes of administration of POM-V flea and wormers to patients (home-visits off site to the practice where the VS is located)... The nurse invoices the VS for the cost of the POM-V products. Same could be done for other 'referrals' to other RVN Nurse Practitioners who run their own businesses... Hydrotherapy etc...

Normally it's done through the practice though...isn't it. I have probably just eaten too much cake and talking rubbish. Sorry folks. Back into my cupboard....

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Francisco Gomez — Sat, 06 Mar 2021 09:28:19 GMT

Ok,

I finally have some time to consider this and I have read the thread.

I cannot comment about paraprofessionals because, guess what, I haven't had much contact with them. Do I think 'rodentologists' should be regulated by the RCVS? I'm not sure, I think they are already regulated under common law and the Animal Welfare Act. If they do something that is supposed to be under the RCVS, they are already breaking the law. Making more laws isn't going to legitimise them if they continue to practice outside them. I think, however, that dog trainers, behavioural experts, etc should be regulated, but I'm not sure if the RCVS should be the body that regulates them. Why? Because of point 4. of your summary: I don't want to be responsible if I delegate to a physio, and it starts "healing" my patient with Reiki without me knowing.

Regarding the protection of RVN title, yes I'm for it. Is it necessary? If that means a body that is regulated for tasks they routinely do outside the scope of treating patients (such as client interactions or other practice roles), then I think it might be a benefit for the profession as a whole.

Delegation tasks: If a nurse works under the delegation of a vet, but not under the same employment. Who is paying the nurse? And why would the vet want to be involved if they are not being paid for the task? Did I misunderstand something here?

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Bob Russell — Thu, 04 Mar 2021 17:39:31 GMT

The OOH vet was Mr Chikosi and he was in trouble because he did not visit. There is doubt what his reasoning was behind the decision because he failed to interact with the DC from his protective bunker somewhere in Africa.

This made him guilty in the eyes of the DC and they came out with some daft reasons to justify his guilt. It may well be the case that he was guilty but without his side of things the whole thing just made the DC look a bunch of fools.

I believe the DC have made some wiser decisions since but these are still the same people that would be expected to decide whether on balance of probabilities someone is guilty. Hopefully I will leave the profession before we allow this to happen.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Jill Butterworth — Wed, 03 Mar 2021 20:00:32 GMT

Not sure where this needs to go, Arlo, but what about making corporates accountable ie a collective responsibility for the policies/practice that they impose on their vets and nurses? Rather than letting an individual vet take responsibility for their failings.

For example, I'm thinking of the OOH vet who couldn't/wouldn't attend a home visit.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Thu, 25 Feb 2021 08:34:11 GMT

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228787#228787"](And please don't call me that)[/quote]

Sorry, your Lordship.

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228787#228787"]And I did give other reasons why I'm agin it, which you have indeed acknowledged – partly – in your summary.[/quote]

Apologies for only partly acknowledging. My aim with the summary is to represent the opinions expressed here, so I have updated.

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228787#228787"]But I say again that this is a sterile debate and we mustn't let it distract from the numerous far more important issues in these proposals.[/quote]

Indeed. I will now move on to Part II. But if anyone has other points to make about the vet-led team, please do continue to post here.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Evelyn Barbour-Hill — Thu, 25 Feb 2021 01:37:34 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228764#228764"]

Evelyn Barbour-Hill said:
Because it is unnecessary.

Evelyn Barbour-Hill said:
Because it is inaccurate.

But wouldn't you say the same is true about "Doctor", Dr Barbour-Hill?!

[/quote]

Yes I would. (And please don't call me that).

Though giving reserved title status to a descriptiion (veterinary nurse) is in a different league to permitting certain people to use a salutation (Dr.) if in their vanity they so wish.

And I did give other reasons why I'm agin it, which you have indeed acknowledged – partly – in your summary.

But I say again that this is a sterile debate and we mustn't let it distract from the numerous far more important issues in these proposals.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Wed, 24 Feb 2021 19:27:45 GMT

[quote userid="9515" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228779#228779"]Where is the summary?[/quote]

Appended to the first post, because that appears at the top of every page.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Sarah Keir — Wed, 24 Feb 2021 19:26:08 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228764#228764"]'ve now summarised the main points raised so far during this discussion[/quote]

Where is the summary?

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Wed, 24 Feb 2021 16:01:23 GMT

[quote userid="6550" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228766#228766"]he who professes[/quote]

By that definition, I shall henceforth like to be styled Professor Guthrie.

[quote userid="6550" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228766#228766"]All these terms vary in interpretation[/quote]

My point is that after all the time and effort put into styling vets 'Dr', it seems a little unfair to begrudge nurses who want to protect their title on the basis that it is 'unnecessary' or 'inaccurate'! Let's face it, if you walked into a room and introduced yourself as Dr Russell, I would wager that the majority of people are going to come and bore you about their haemorrhoids, not their dog's pruritus.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Bob Russell — Wed, 24 Feb 2021 11:01:39 GMT

The term doctor originated from latin for teacher.

My father was a university professor but in the states professor seems to be used for many university teachers (he who professes).

All these terms vary in interpretation. A doctor can be someone that falsifies or interferes with documents etc!

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Wed, 24 Feb 2021 09:46:42 GMT

I've now summarised the main points raised so far during this discussion about the 'vet-led team' section of the RCVS consultation.

I hope I have represented these points accurately, but I know I can rely on someone to shout if not!

Can you check ... are there any other points raised by the consultation which we haven't discussed, and I haven't added to the list?

Incidentally, Evelyn Barbour-Hill - sorry, meant to say this earlier.

You say WRT to protection of the nurses' title that you are against:

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228547#228547"]Because it is unnecessary.[/quote][quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228547#228547"]Because it is inaccurate.[/quote]

But wouldn't you say the same is true about "Doctor", Dr Barbour-Hill?!

RE: Vet Legislation Reform: 1. Embracing the vet-led team

patrick murphy — Sat, 13 Feb 2021 15:44:38 GMT

I spent my career saying Equine Dental Technician. gets my goat.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

bob lehner — Sat, 13 Feb 2021 10:38:14 GMT

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228547#228547"]Aaaarrrggh... There is no such thing as an equine dentist[/quote]

Agree - Many years ago I wrote a letter to the Horse and Hound magazine following an article of theirs extolling the virtues of the then new and trendy 'Equine dentists'.

I said that I thought it was unlikely that an equine could become a dentist as they generally lack the basic manual dexterity required of that profession.

Rather to my surprise they published my letter.

(Before you get too pedantic Dr EBH the word 'Equine' is I believe commonly used as a noun as well as an adjective).

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Evelyn Barbour-Hill — Sat, 13 Feb 2021 00:05:58 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228503#228503"]Your concern here is that paraprofessionals may not want to be brought under the RCVS umbrella and if they just carry on regardless, it weakens the whole proposition. So what would you like to see done to mitigate that risk? I guess there are only two choices. Either lobby in advance and get them on board, or make the penalties draconian. Or probably a bit of both. (Or not do it, but I read that you think the concept of bringing animal medical care under one roof is good). [/quote]

Negotiate to get them on board, of course. Draconian penalties would be unacceptable to everybody and would be thrown out at the very first scrutiny by Defra.

But I want to know what the new super-RCVS would do if substantial and important groups declined to come under it.

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228503#228503"]I still think this would be very limited by virtue of what paraprofessionals are actually capable of doing. But what safeguard would reassure you? How about if, for example, any new delegation had to be approved by a panel of general practitioners?[/quote]

Hmmm. How big a panel? Who would choose them?

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228503#228503"]

Allowing VSs to delegate to allied professionals not in their employment.

Not quite sure why it bothers you that the RVN would now be delegated to by the vet, not the practice. As I read it, whilst the nurse would no longer have to be in the employ of the same practice as the vet, they would still work under the delegation of the vet. So they would not be independent. What am I missing?

[/quote]

That they would be independent. That we were always assured that the great safeguard about RVN privileges was that they could only do these things in the employment of the practice where they were doing them. That the "veterinary delegation" is likely to become merely nominal.

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228503#228503"]

Statutory protection for title 'veterinary nurse'.

I just don't know why you fight so hard against this one. Nurses may not have been underpaid and undervalued at your practice, but that is not the case countrywide! That said, I agree that is not a reason in and of itself. I also agree with you that when I am at the vets, it is the vet in whom I place my trust, not the nurse.
But I just don't hear any reason from you why NOT protect the title

[/quote]

Because it is unnecessary. Nurses (in the human field) do not enjoy this privilege. RVN is already a protected title.

Because it is inaccurate. There are many people working in practices who, by any normal everyday interpretation of the words, are veterinary nurses though not RVNs.

Because it is unfair and demeaning to those people who up to now have legally and reasonably described themselves as veterinary nurses, if asked.

When the big campaign was going on, I requested politely that a simple small concession be made: that anyone who had been earning their living under the description veterinary nurse for, say, the last five years could continue to do so. This was rejected without consideration. Many people, including Lord Trees (who apparently can do no wrong) read my proposal carelessly and rejected it in the misunderstanding (possibly deliberate) that I was proposing that people be grandfathered in to RVN privileges, which quite clearly I was not.

However, this is a sterile debate and the issue is of no importance compared to the many alarming proposals of the LWP. Let's not get bogged down in it.

[quote userid="3094" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228507#228507"]an someone please enlighten me? What on earth is a Rodentologist?[/quote]

The "rodentologists" are a bunch of people "accredited" by the "Cambridge Cavy Trust", which is essentially a person called Vedra something. She invented the word "rodentologist".

They constantly offend against both the Veterinary Surgeons Act and the Animal Welfare Act. They carry out major dental interferences in guinea pigs without any anaesthesia, analgesia or sedation.

For some reason neither the RCVS nor the RSPCA is ever able to nail them.

If you want more, do a search of old posts on vetsurgeon.org. Or ask Mark Rowland.

[quote userid="3094" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228507#228507"] I know what an Equine Dentist is [/quote]

Aaaarrrggh... There is no such thing as an equine dentist. Some veterinary surgeons, such as Rob Pascoe, Chris Pearce, Sam Hole, Neil Townsend, would accurately be described as such, but these veterinary surgeons choose to remain described as veterinary surgeons.

I think you are referring to Equine Dental Technicians. This is important.

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Fri, 12 Feb 2021 11:42:07 GMT

[quote userid="18277" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228531#228531"]

Evelyn Barbour-Hill said:
(Of course, it would be great if the corporate owner could be brought under RCVS control, but that does not feature anywhere in the plans we are discussing)

Just wanted to pick up on this from Evelyn - very good point and something I think a lot of us would be keen to see happen.

[/quote]

Nick Jackson this is one for discussing in the Practice Regulation thread: https://www.vetsurgeon.org/001/nonclinical/f/life-in-practice-discussions/29664/vet-legislation-reform-3-assuring-practice-regulation

[quote userid="2985" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228529#228529"]When do they need the reply by? (I'm a bit behind on my emails, since Xmas)[/quote]

Peter Faulkner Hi Pete 23rd April (5pm, if that makes any difference )

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Arlo Guthrie — Fri, 12 Feb 2021 11:19:19 GMT

[quote userid="18277" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228530#228530"]Sorry I may have come across as disdainful[/quote]

Not at all!

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Nick Jackson — Fri, 12 Feb 2021 11:19:02 GMT

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228498#228498"](Of course, it would be great if the corporate owner could be brought under RCVS control, but that does not feature anywhere in the plans we are discussing)[/quote]

Just wanted to pick up on this from Evelyn - very good point and something I think a lot of us would be keen to see happen.

There is actually within this consultation some move to consider RCVS regulation of practices, Section 3 I believe. Again these proposals are a little ambiguous to my eye as to what level of regulation they would permit or desire to achieve. Would an entire corporate be treated as a 'Practice'? or would corporates be able to shelter behind the myriad practices within their group and ditch those that get caught out?

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Nick Jackson — Fri, 12 Feb 2021 11:12:57 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29662/vet-legislation-reform-1-embracing-the-vet-led-team/228528#228528"]There hasn't been much to campaign on recently[/quote]

A sign of a well hard earned success to some extent I think. Sorry I may have come across as disdainful, not how I meant at all!

RE: Vet Legislation Reform: 1. Embracing the vet-led team

Peter Faulkner — Fri, 12 Feb 2021 11:12:13 GMT

Sounds great!

I'd be up for this, as long as the fitness to practice regime doesn't involve a treadmill and weight lifting?

When do they need the reply by? (I'm a bit behind on my emails, since Xmas)

Pete