RCVS elections: questions to our candidates.

RE: RCVS elections: questions to our candidates.

Silvia Maldonado — Wed, 16 Mar 2022 19:00:55 GMT

Olivia, I highlight from your video this thought: "if a disaster comes in 5 minutes before closing time and every person stays late to deal with it, that's vocation. If every person stays late every night because appointments are routinely overbooked, that's bad management"

RE: RCVS elections: questions to our candidates.

Olivia Cook — Wed, 16 Mar 2022 11:58:45 GMT

As of today, the manifestos and the videos are public. And may God have mercy on our souls ;)

RE: RCVS elections: questions to our candidates.

Olivia Cook — Mon, 07 Mar 2022 17:14:43 GMT

Well the video is done. It’s grim, but the message I think comes across fairly well even if I look like crap doing it. Thank you Arlo fo the tip about the autocue, that was a lifesaver trying to get it into 2 minutes 30 :)

RE: RCVS elections: questions to our candidates.

Alastair Welch — Tue, 01 Mar 2022 22:16:08 GMT

Michael,

I am not seeking a solution to the problem of lack of availability of 'close' or 'affordable' veterinary care but instead advancing ideas that will help solve the current workforce 'crisis'. I have seen it described as a recruitment and retention crisis but we are able to recruit more bright 18 yo than ever before so to me the main problem is retention. The average length of career post graduation is significantly shorter for the cohort of recent graduates compared to those a decade or two ago. If we can improve VS retention then I suspect (as a side effect) affordability and proximity of care will improve, but advocating a solution which worked with a different generation and a different workforce is a fantasy.

I would remove in its entirely the College's rules regarding 24/7 provision and leave it to the market.

Currently a member of the public (with whom you have no previous relationship) can wake you from your sleep, demand to be seen, not pay you and then disappear. Refusal to attend (should anything untoward happen) risks endangering one's right to earn a living. It is a complete nonsense and this is no longer fit for the 21st century. I believe, perhaps counterintuitively, that removal of the 24/7 obligation would increase clients' access to OOH care (and have lots of other benefits). The current situation encourages lots of problems: dickhead clients shopping around for the cheapest option; dickhead clients who use the firm down the road through the day but can't be bothered to drive the extra distance to the OOH provider; bad-debt clients who (aware that if they make the right noises) will get seen by the inexperienced team member when the day-time team might tell them to get lost, chronic issues where an Ooh appointment is more convenient for the client. At the back of (often at the front of) a VS mind is the sword of Damocles of an RCVS investigation. In truth you have to try pretty bloody hard to fall foul of the rules but the mere threat of a Concern is of significant concern to enough of the profession such that the option of seeing the unnecessary case is the path chosen.

As practices have shifted to the outsourcing of OOH provision the burden on those actually doing the work (whether dedicated provider or traditional practice) has become increasingly challenging. Were practices free to choose the level of service to offer clients and to choose who they could offer the service to their OOH workload could be managed appropriately. The ability to simply say to an unregistered member of the public 'sorry, go away' would empower VS and practices to provide a service for their clients rather than the current limitless service available to anyone who is awkward enough. It would not stop practices such as your's from seeing unregistered holiday makers (might I be so bold as to suggest that those seeking repose within the beauty of the Yorkshire Dales as perhaps not representative of the average client seeking OOH veterinary care), it would not stop practices who (for perfectly understandable commercial reasons) are happy to see the itchy dog at midnight but it would prevent the abuse of the system such as occurs just now. Initially there would be a period of transition but in time the animal owning public would learn that OOH care is not a right but a privilege and clients would have the opportunity of voting with their feet. If the ability to see a vet OOH was seen as sufficiently desirable then such practices would thrive.

I don't think this will solve the problem, but it will help a little. Dreaming of a return to the good old days is of no practical use whatsoever.

RE: RCVS elections: questions to our candidates.

Arlo Guthrie — Tue, 01 Mar 2022 10:26:16 GMT

[quote userid="12375" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236147#236147"]I am of the view that one should never say something online that one would not say face to face,[/quote]

Alastair Welch Sure. But that is missing the point.

I am of the view that one should never say something online which should be said face to face.

In this example you said:

[quote userid="12375" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236131#236131"]Your ignorance of modern veterinary life is impressive[/quote]

You could have said: "I think you are ignorant of modern veterinary life".

What you actually said: "your ignorance is impressive", is rude, arrogant and should ONLY be said face to face, where:

a) The target of your sarcasm can throw a punch at you.

b) The target of your sarcasm can reply immediately, and the discussion has more nuance.

All of the rest of your post is irrelevant really, because I wasn't dismissing your underlying point, just hauling you up for the obnoxious way you made it.

RE: RCVS elections: questions to our candidates.

cairncross — Tue, 01 Mar 2022 06:53:34 GMT

I agree with much you say on this but I fear the difference here would be that they either wouldnt join the profession knowing this was coming or would leave completely in the first 2 years not complete so leave for ever

RE: RCVS elections: questions to our candidates.

Dinu Catilina — Tue, 01 Mar 2022 00:32:35 GMT

[quote userid="3169" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236150#236150"]Would make a lot of difference if all grads had to do 2 years to complete PDP.....[/quote]

And on call.

RE: RCVS elections: questions to our candidates.

Michael Woodhouse — Mon, 28 Feb 2022 22:04:11 GMT

[quote userid="12375" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236147#236147"]

Michael's approach of a return to a time when 'things worked', with everyone doing 'their' bit is as beguiling as it is naive.

[/quote]

Maybe, but what is your better solution to the problem? Because we had something that did work. The solution mustn't be a token offering so needs to be reasonably close, able to do a home visit where needed and be affordable. Anything less is not acceptable.

Would make a lot of difference if all grads had to do 2 years to complete PDP.....

RE: RCVS elections: questions to our candidates.

Michael Woodhouse — Mon, 28 Feb 2022 21:34:10 GMT

[quote userid="5012" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236132#236132"]We are told that folk want a full on, fully staffed and fully monitored OOH service. As a profession we seem slow to accept and adapt to change.[/quote]

How sure are we that is what the clients want? How much of that is us projecting what we think they should want?

Throughout the summer we can see as many holidaymakers OOH as our registered clients. Never had one yet bothered that we don't have staff on site 24 hours, bothered I have cow blood on my collar from a prolapse, bothered I've told them to come to surgery tomorrow as not an emergency.

They seem grateful to speak to a vet, take advice, be seen (usually) quickly and locally. Endless horror stories of over treatment and eye watering bills.

RE: RCVS elections: questions to our candidates.

Alastair Welch — Mon, 28 Feb 2022 21:27:04 GMT

Arlo,

I am of the view that one should never say something online that one would not say face to face, and I would certainly suggest to Michael that he is ignorant (that is to say unaware of or unfamiliar) of the practice of veterinary medicine as takes place in the bulk of the UK. If you feel this is ill-mannered then you are entitled to your opinion but I don't share it.

Michael's approach of a return to a time when 'things worked', with everyone doing 'their' bit is as beguiling as it is naive. We don't need unrealistic solutions based around yesterday's answers but instead practical solutions based on where we are now rather than where we would like to be. Asking the veterinary workforce who do not partake in OOH provision to suddenly start doing so is simply pie-in-the-sky.

I have done traditional OOH work (work through the day, on call at night, back to work the next day) since I graduated, and I suspect that I will continue to do so until I retire. I am also aware that I have built my life (in terms of family/childcare/wife's work/where we live etc) around this expectation. It suits me (although I would rather do less on-call) but my 'life infrastructure' copes with my working pattern ok. I am also aware that this is not true for much of the veterinary profession and the choices that have been open to me are not necessarily open to all VS.

We must deal in the possible not hanker after a by-gone golden era, if such a time ever existed.

RE: RCVS elections: questions to our candidates.

Sarah Keir — Mon, 28 Feb 2022 16:31:13 GMT

Recruitment and retainment have been issues for the profession for decades; this is not a recent phenomenon. Over the past 80 years in the UK, the profession has sought to engineer itself¹ by controlling numbers of vet schools, numbers of graduating vets and until 20 years ago, who could own veterinary practices. But that world is very much in the past and the needs of the profession and the professionals that work in it are very different and are changing ever more rapidly, particularly due to Brexit and the 2020 COVID pandemic which are catalysts for even faster and broader cultural changes.

Overall, we have increased numbers of vets registered (increase in 50% in the past decade⁵) and a small number of vets leaving although this has remained mostly constant over the past decade. There has always been employee turnover and it is unclear if it is really any higher at present. So, are there other factors at play? For me, this unconsidered category has the biggest effect on availability of working vets. These are the people who trained as vets, are on the register but are not available for clinical work or only for limited hours. Increased demand for services (long before the COVID-driven increase in pet numbers) along with unrealistic expectations of clinical load deliverable by the existing veterinary workforce and systems all contribute. On top of this there is an unmeasured increase in the clinical work needing to be done. This chronic shortage compounded by the acute factors of Brexit and the Covid pandemic has led to a perfect storm. I think it is all 3 – it is an AND.

In short, this boils down to:

More clinical work,
A decrease in the number of vets available to do clinical work and reduced clinical work hours available per vet despite more registered vets,
Vets not liking the current traditional model of working, so finding other ways of ‘vetting’. Current work options are not fitting with their life requirements such as caring for a family or simply not getting home every day exhausted. As a result we are seeing people choosing to do less clinical work, moving to having a portfolio career, working as locums or even leaving the profession entirely.

RE: RCVS elections: questions to our candidates.

cairncross — Mon, 28 Feb 2022 15:53:11 GMT

Agree absolutely i am always there,

RE: RCVS elections: questions to our candidates.

Gillian Mostyn — Mon, 28 Feb 2022 08:25:34 GMT

[quote userid="19228" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236138#236138"]Its not because of how they are being treated in old fashioned practise or the impact of working long ooh hours because that isnt happening now. The people doing that in the main are those with the greatest longevity in the profession. [/quote]

A big part of the problem is a lack of senior vets in our profession to help our younger colleagues survive those first few years. Where do you think they've gone?

The ones still working are the ones that survived that punishing workload.

RE: RCVS elections: questions to our candidates.

cairncross — Mon, 28 Feb 2022 07:58:58 GMT

I have no problem with that its absolutely how it should be. 40h week full stop everyone works hard and under ptesdure

Its how we change the system to cope with that. It cant be left as a statutary obligation on the head of a select few when everyone knows it no longer is possible. 168 hours in a week 9 to 5 mon to fri is 40. Or 279 days worth a year vet cover for 250 million owned animals is falling on the head of possibly a few thousand vets.

RE: RCVS elections: questions to our candidates.

Dinu Catilina — Sun, 27 Feb 2022 22:25:42 GMT

[quote userid="11493" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236140#236140"]I can tell you that none of the vets with a 40h contracts of the modern world work any less than 45~50. [/quote]

Mine do. I don't but that's my choice.

RE: RCVS elections: questions to our candidates.

Francisco Gomez — Sun, 27 Feb 2022 21:02:55 GMT

[quote userid="19228" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236136#236136"] If we were to move into the modern world of central ooh where vets only work up to 40h per week and dont work days following nights[/quote]

I can tell you that none of the vets with a 40h contracts of the modern world work any less than 45~50. There's a huge demand from these people to align themselves to other professionals where you get paid for the hours you work. And guess what? They're entitled to it.

RE: RCVS elections: questions to our candidates.

cairncross — Sun, 27 Feb 2022 19:21:17 GMT

Its not because of how they are being treated in old fashioned practise or the impact of working long ooh hours because that isnt happening now. The people doing that in the main are those with the greatest longevity in the profession.

Nobody under any system can supply less workload less hours less pressure unless they have more vets to reduce the hours worked and the amount dealt with in those hours.

We might have a few hundred more graduating but we have no EU intake for? 3 years now and we have many working as locums, taking time out between jobs many working part time many taking specialist positions where the caseload is lower some taking pisitions managing advising teaching training and counciling those still actually delivering frontline work. NOTHING WRONG WITH THOSE DOING THIS NO JUDGEMENT AT ALL INFERED BY THIS DISCLAIMER.Just making a basic mathematic point if more do less hours and more do more intense work on fewer cases, we need more vets to get the work done or we work smarter giving each case less time on average. Ooh is one place where work snarter could happen with least impact on welfare.

RE: RCVS elections: questions to our candidates.

Clive Ansell — Sun, 27 Feb 2022 18:20:38 GMT

[quote userid="19228" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236136#236136"]So to have a rota with everybody doing their 30 or 40 hours we need? 60 or 70 extra vets. Thats completely pie in the sky thats why we arnt moving with the times we need double to triple the vets. [/quote]

We have more vets schools, and are training more vets than every before. Maybe we need to take a long hard look at why they are not entering or remaining for very long within the profession?

RE: RCVS elections: questions to our candidates.

cairncross — Sun, 27 Feb 2022 18:14:42 GMT

I think you are both right in many ways. Michael operates in the real world of veterinary as it is for him today, my world is fairly similar. The logic of the past where almost everyone shared the workload 24 7 v now where only some do has to be a source of problems for the few left carrying that burden and or organising it.

I certainly realise and accept that though tried and tested and logical it absolutely isnt the future for the reasons that you correctly put forward.

In the really real world where i operate the northern 2/3 of the county has from memory 9 practises all of whom are still in the world of 25 years ago still providing their own ooh. Some are mixed some small some equine some small and equine. Some indepenfant some corporate. If we were to move into the modern world of central ooh where vets only work up to 40h per week and dont work days following nights. I guess that perhaps we could meet ooh demand with 5 to 10 sa vets on per night 2 to 3 equine and 10 to 15 farm depending on season. So to have a rota with everybody doing their 30 or 40 hours we need? 60 or 70 extra vets. Thats completely pie in the sky thats why we arnt moving with the times we need double to triple the vets.

RE: RCVS elections: questions to our candidates.

Arlo Guthrie — Sun, 27 Feb 2022 18:12:20 GMT

As yours is of social media etiquette, or what might be called "manners".

Though I think your point is perfectly sound:

[quote userid="12375" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236131#236131"]When ‘things worked’ being a veterinary surgeon was (on average) the job of a man, working full time, earning enough to sustain a household from a single income and supporting a wife to care for children. The (average) veterinary surgeon now is a woman in a dual income household, working part time, earning above the national average (but quite possibly not enough for a mortgage) and certainly not enough to pay for the expensive wrap-around childcare to enable them to take part in an OOH rota. [/quote]

RE: RCVS elections: questions to our candidates.

Alastair Welch — Sun, 27 Feb 2022 15:07:17 GMT

Clive,

You have got it spot on. It was 25 years ago. The workforce of then was in a position to provide that service, today’s is not.

RE: RCVS elections: questions to our candidates.

cairncross — Sun, 27 Feb 2022 13:21:26 GMT

These individuals wernt impoverished but we did have 2 Frenchies at Sat am clinic needing 150 pounds of work each and they both genuinely had zero pounds of budget. One volunteered her bank statement and on her phone to show her balence and income. I dont know how they aquired the pup beg borrow or steal? Either way that bad choice has left them with less capacity to deal with rainy days. One left? one managed to get family member to cough up after much tears and shouting in the car. The latter Frenchie cases are now common and the st bernard senario dropping away thankfully.

Puppy bubble burst here you couldnt sell one now we are vaccinating litters 2nd time round as no clients, new phenomenon this month, just as vaccs go on short supply!

RE: RCVS elections: questions to our candidates.

Clive Ansell — Sun, 27 Feb 2022 11:27:25 GMT

I don't entirely disagree with Michael, in my first job 1996-2001 we did our own OOH on a 1 in 3 rota, and for the most part it did work well. We only saw our own clients and genuine emergencies, and only the minimum would be done OOH - the service was offered and provided solely on that basis. It was often a telephone based fob off service, but I can't think of a single case going wrong through not being seen when it should have been. Also cases would be hospitalised in an unmanned practice, with a vet or nurse attending on an as needed basis to monitor or give medications. This is now deemed to be unacceptable practice in some circles, and we even read of RCVS DC case reports referring to cases left unattended.

All that said, clients enjoyed cheap OOH care on the back of assistants being poorly paid and often working ridiculous hours, because we were in a profession or it was a vocation, or some such BS.

Fast worward 20-25 years, and clients expectations have changed along with that of the profession. We are told that folk want a full on, fully staffed and fully monitored OOH service. As a profession we seem slow to accept and adapt to change.

RE: RCVS elections: questions to our candidates.

Alastair Welch — Sun, 27 Feb 2022 09:59:39 GMT

Michael,

Your ignorance of modern veterinary life is impressive, perhaps being cocooned in the sepia toned backwaters of the Yorkshire Dales helps but I suspect you would revel in nostalgia wherever you were. If you want to return to the past then keep shouting about it- but the rest of us have moved on.

When ‘things worked’ being a veterinary surgeon was (on average) the job of a man, working full time, earning enough to sustain a household from a single income and supporting a wife to care for children. The (average) veterinary surgeon now is a woman in a dual income household, working part time, earning above the national average (but quite possibly not enough for a mortgage) and certainly not enough to pay for the expensive wrap-around childcare to enable them to take part in an OOH rota.

You can shake your fist and reminisce about how good it was when you were a lad but it won’t change anything.

RE: RCVS elections: questions to our candidates.

Clive Ansell — Sun, 27 Feb 2022 09:44:13 GMT

[quote userid="3685" url="~/001/nonclinical/f/life-in-practice-discussions/30204/rcvs-elections-questions-to-our-candidates/236126#236126"]For what it’s worth, I prefer the more traditional model, but unless OOH centres are going to refuse to see anything that isn’t an emergency (and why would they do that in their business model) then I can’t see how the answer can be the same for both set ups?[/quote]

It can't and it isn't.

If the current outdated and restrictive RCVS 24/7 obligations were removed, both business models could co exist and work along side each other very well. OOH centres (I don't call them emergency or ER clinics!) could still offer a full service to anyone at a premium price as they do; and, more traditional practices that want to offer an OOH service only to their own clients could do so, and non clients and unregistered ones could be directed to the nearest OOH centre (I know in theory that could happen at the moment, but there is a fear in the background of RCVS involvement if anything goes mammaries up)

As I said in an earlier post, I know two practices that would consider doing there own OOH on call again, but the single thing in the way is the (Perceived?) RCVS requirement to see non clients OOH, often with no money, and often a***holes too.