House visits

Re: House visits

Mark Hedberg — Thu, 24 Feb 2011 20:37:13 GMT

Is there a link to this somewhere?

[quote user="Gerry Henry"]

Like the Vet Practice sting, for in principle, against in practice.

[/quote]

Re: House visits

Eamon McAllister — Thu, 24 Feb 2011 18:39:22 GMT

[quote user="Hannah Wynne Richards"]

Why do so few bother to vote ?

Wynne

[/quote]

82% must think that it is pointless and maybe they are right. It is not like a "normal" election where everyone has to stand every 4 or 5 years and there is an option to get shot of the lot all at once. The fact that only six are elected annually ( quadrupling the expense) seems designed to prevent any radical change and maintain the status quo. If the RCVS allowed us to have a referendum on whether or not the Council does a good job then I bet "turnout" would skyrocket.. Turkeys / Xmas .

Re: House visits

Hannah Wynne Richards — Thu, 24 Feb 2011 17:02:54 GMT

Why do so few bother to vote ? I ask awkward questions, demand straight answers, give candidates who try to be evasive a hard time, and then vote-one of the things I'm vehemently opposed to is an extention of the number of appointed representatives on RCVS Council-whilst we still have the opportunity to vote for the majority of Council members, we can't really blame RCVS if we end up with very few actually selecting Council members-because the rest of the profession can't be bothered

Wynne

Re: House visits

Eamon McAllister — Thu, 24 Feb 2011 15:42:24 GMT

[quote user="Tanya Fielding"]

Perhaps we should be asking all candidates for RCVS elections where they stand on this issue before we vote again

[/quote]

Only about 18% of us bother to vote for them anyway. They are the self selected and unelected who are ruining this profession.

Re: House visits

Gareth Dowdeswell — Thu, 24 Feb 2011 15:32:52 GMT

I think we'll only cover the same arguements for and against in this thread, not sure it'll be very productive. In answer to why the vet didn't attend the hearing, the report said he owned his own practice in Germany, and I don't think the RCVS has any sanction overseas, so I imagine he decided it wasn't worth the hassle of attending.

[quote user="Hannah Wynne Richards"]

Took the trouble to read the full report-available on RCVS website-instead of condemning DC out of hand-also the dog was found too large to transport when the ambulence attended-it wasn't that the owner refused to availthemselves of the service

Wynne

[/quote]

To be fair the report is very difficult to find - I couldn't find it at all from the RCVS website, only read it by using the direct link in the other thread.

Re: House visits

Gerry Henry — Thu, 24 Feb 2011 15:31:35 GMT

Like the Vet Practice sting, for in principle, against in practice.

Re: House visits

Edward Jones — Thu, 24 Feb 2011 15:30:59 GMT

[quote user="Robin Grimmer"]Most OOH providers do stipulate the vet and nurse must remain on the premises at all times - which is at variance with the RCVS GtPC guidelines.[/quote]

An employer has a duty of care to ensure that company policy does not conflict with professional responsibilities. An employment tribunal would take a very dim view if an employer failed in this.

Interestingly, the RCVS is apparently in the process of investigating OOH providers' policies toward OOH visits at the moment. I've not heard official word of this and I've no idea if the results will be published.

Re: House visits

Tanya Fielding — Thu, 24 Feb 2011 15:24:09 GMT

Perhaps we should be asking all candidates for RCVS elections where they stand on this issue before we vote again

Re: House visits

Gillian Mostyn — Thu, 24 Feb 2011 15:14:19 GMT

[quote user="Gerry Henry"]Nobody should be compelled to visit an unregistered client[/quote]

This was a registered client

As I said in the other post, all these 'what ifs' are pointless - every situation would be judged on its own merits.

Re: House visits

Gerry Henry — Thu, 24 Feb 2011 15:09:13 GMT

Yup, and we'll end up like the ambulance service. Clogged with the savvy but idle who can't be bothered to make their own arrangements to attend A&E but know that if they make the right noises an ambulance must attend.

Nobody should be compelled to visit an unregistered client in the middle of the night particularly if it means leaving the surgery unattended for any length of time. You know how it will go; dog with cut paw (turns out was cut last week) calls you out; owner can't pay/won't pay, meanwhile the genuinely sick animal is kept waiting in the car park until the duty vet and nurse (he/she would be MAD to do a house call alone) get back to base. Alternately, a bogus but believeable call from the other end of the city demands a visit; vet + nurse set off only to find the surgery has been very professionally done over in their absence. Easily solved say all those not involved with practice finance, just recruit more staff so the centre is manned even when the first team are attending to a house call... then the phone rings and somebody demands a house call then and there ... so the second team rock off into the night leaving the centre unattended.

And so it goes.

Re: House visits

Gillian Mostyn — Thu, 24 Feb 2011 11:01:08 GMT

[quote user="Dagmar Steele"]maybe people defend him or his position because they are afraid they might get into the same situation one day...[/quote]

That's my point exactly. They are unlikely to get into the same situation if they had cared in the first place and helped the owner. (And I don't mean necessarily by doing the visit themselves.)

Re: House visits

Dagmar Steele — Thu, 24 Feb 2011 09:56:15 GMT

[quote user="Gillian Mostyn"]

It amazes me that so many people are rushing to the defence of a vet who didn't even bother to defend himself.

[/quote]

maybe people defend him or his position because they are afraid they might get into the same situation one day...

as far as I know the Vet in question is a German citizen who only came to the UK to work shifts in the OOH clinic. This might be the reason for not turning up, maybe he has found a new job somewhere else and doesn't care about the ability to work in the UK for the next ten months, maybe he has to make a living and plainly couldn't get time off work to attend?

Re: House visits

Hannah Wynne Richards — Thu, 24 Feb 2011 09:29:58 GMT

Robin You say the problem is that OOH providers have policies that are at varience with the GtoPC-I suppose the answer is for veterinary surgeons to check compatability of policies with the Guide BEFORE accepting a position-and not working for an OOH provider who is not complient. If everyone did that they would have a choice of complying or closing down-which is the choice private small veterinary practices have always had-again a case of needing a level playing field

Wynne

Re: House visits

Robin Grimmer — Thu, 24 Feb 2011 09:12:57 GMT

Fair point - there are a few points about this case which weakens the defence. The witness statements of the owner, ambulance driver and the vet from the other practice that did perform the visit all corroborate and were regarded as reliable witnesses. The witness statements of the nurse and vet from the OOH are a bit vague in places. And as the nurse only worked 3 shifts per month I would have thought she would remembered that night in detail. And yes the vet didn't appear or send any representation. No VDS??

If I was the vet on-call for a practice doing its own OOH that night then yes I would have done the visit even if it was not a registered client. However working for an OOH centre is different for the reasons I mentioned above. Which is why think the sentence was harsh. Most OOH providers do stipulate the vet and nurse must remain on the premises at all times - which is at variance with the RCVS GtPC guidelines.

Re: House visits

Bob Russell — Thu, 24 Feb 2011 09:11:28 GMT

[quote user="Gillian Mostyn"]

[quote user="Michael Woodhouse"]They need the arrangements. A good lawyer [and maybe attending in person] and I feel the chap would have got off.[/quote]

Agreed

The vet seemed to show the same contempt for his hearing as he did the night in question. If he had taken an active part in either case I doubt the problem would be there for us to discuss.

It amazes me that so many people are rushing to the defence of a vet who didn't even bother to defend himself.

[/quote]

I think these posts defend the position the vet was in but not the way he behaved. From what I gathered he did not even speak to the owners directly. To some extent this vet got what he deserved because he failed to attend to explain his side of things. I know he should have been innocent until proved guilty and did not need to attend but this is the real world!

Re: House visits

Gillian Mostyn — Thu, 24 Feb 2011 08:49:35 GMT

[quote user="Michael Woodhouse"]They need the arrangements. A good lawyer [and maybe attending in person] and I feel the chap would have got off.[/quote]

Agreed

The vet seemed to show the same contempt for his hearing as he did the night in question. If he had taken an active part in either case I doubt the problem would be there for us to discuss.

It amazes me that so many people are rushing to the defence of a vet who didn't even bother to defend himself.

Re: House visits

Michael Woodhouse — Wed, 23 Feb 2011 22:00:39 GMT

[quote user="Catherine Williams"]The law may say that an owner has to be able to provide veterinary care and legally the onus may be on the owner but how many owners are aware of this? [/quote]

[quote user="Catherine Williams"]Maybe this is a can of worms I shouldn't open but can we just say the onus is on the owner and that alleviates us from taking the blame? [/quote]

I'm with you on this one 100%. It is so very rare that a dog's welfare would be compromised if it was moved. Ever heard of a person who was so ill it was decided to rush a doctor out to them at treat them at their home rather than ship them to hospital. Maybe once in a blue moon when trapped in a car, but very very rare.

Animal Welfare Act is clear - owners responsibility to get the animal care when it needs it, not ours to go to the dog because they are weak, have a small car, a drinking habit, or are a lazy arse.

I have said on the other thread that I would have gone out, but I don't believe that the dog's welfare would have been compromised in any way moving it. I do think leaving the dog in the garden, collapsed for 3 hours caused it to suffer more!

They need the arrangements. A good lawyer [and maybe attending in person] and I feel the chap would have got off.

Re: House visits

Robin Grimmer — Wed, 23 Feb 2011 19:50:10 GMT

[quote user="Hannah Wynne Richards"]

Wynne

[/quote]

I have read the report and the nurse couldn't remember whether it was busy or not and the vet didn't comment one way or the other. The call log may not be an accurate representation of how busy they were or how many inpatients they had to look after. Anyway I don't think this is the point. The point is that the OOH provider seemed to have an unofficial policy of not doing house visits but this was not backed up in writing so the sword has fallen on the vet.

Since this scenario is a very common occurrence i.e owner requesting a home visit out of hours from an OOH provider, this is clearly something we need clarity on.

Re: House visits

Catherine Williams — Wed, 23 Feb 2011 19:08:36 GMT

[quote user="Robin Grimmer"]

I think the onus should be on the owner to arrange transport for their pet in the case of emergency, and that they should make provisions for this particularly in the case of giant breeds.

[/quote]

Maybe this is a can of worms I shouldn't open but can we just say the onus is on the owner and that alleviates us from taking the blame?

In my experience owners don't think about what they will do if their dog can't move under it's own power, that's not just the giant breeds but also families with Golden Retrievers and GSDs. It's not uncommon for us to get calls from people with a big dog who is having mobility issues and owner lives on their own, or the car is a high 4x4 etc and they don't know how to cope. It's not something people seem to consider.

Very few owners seem to research what the OOH provision is, we have a few intense owners who have closely questioned us about emergency care but they are the rarity. The other local practices use 1 of 2 dedicated OOH providers, both a minimum of 30min away and I frequently get phone calls from owners who can't or won't go that far, I accept that some of this is convenience but the conversation along the lines of "I wouldn't have used them if I knew I had to go so far..." is not an uncommon one.

The law may say that an owner has to be able to provide veterinary care and legally the onus may be on the owner but how many owners are aware of this? How many owners have actually considered the emergency situation? I don't think we can condemn it as the owner's problem until we are sure they are aware of their responsibilities. Owners do expect a visit to be possible, they may not want to pay for it, they may not understand the limitations of what is possible on the visit but they still expect an older style James Herriot service when home visits were quite normal. The veterinary world has moved on but I'm not sure owner expectation has. I'm not sure how we educate people to the need to plan and think. Sadly I think "how will I cope in an emergency" is very low on client's list when buying a dog, and to be honest I wish first they'd think about bigger issues "can I afford this dog?" or "Is this the right dog for me? (high energy collies bouncing off the wall in inactive pet homes comes to mind)" Laying the blame at the owners may be the ultimate responsibility but don't we need to at least ensure that they understand the situation, because if owner expectation and vet expectation don't coincide then there is bound to be problems

Personally I'm not a big fan of home visits as I always find it difficult to work out how much of the surgery I need to take with me, I can't give as good a service as I would like and it definitely takes me longer to get the treatment to the patient. Having said that if the patient can't come to me I will go on a visit, the emergency that turns up without warning is rare in our practice, you'll get a call first. If it's an out of hours visit it is always with a warning that if a GDV comes through the door then the visit may be delayed and the confidence that I have the luxury of a large practice so we always have another vet we can call on if needed. We have an informal 2nd on call rota so there is a fair division of who you call 1st and being grumpy does not mean that you evade emergency calls, we're very good at not calling on staff unless we need to but I am confident that when the snow hit the ground and clients were calling that they couldn't get their pets to us then in a genuine emergency I could staff the surgery and my boss would get out to the client if needed, it is part of the practice policy. I know I'm lucky that I'm not the only vet in the practice but surely there must be a clear policy, & if that is to be a strong reluctance to do home visits then owners must be clearly informed so that they can plan in advance, or at least consider it.

I now await the brickbats

Re: House visits

Edward Jones — Wed, 23 Feb 2011 19:06:47 GMT

[quote user="Robin Grimmer"]In a dedicated OOH service you may be covering up to 20 different small animal practices. Your catchment area will be much larger. You will have many more inpatients, especially at weekends when user practices may transfer their inpatients to the OOH provider.[/quote]

Certainly true, I can see how it's difficult. But, the guide lays out the responsibility for doing visits (only if needed on clinical or welfare grounds) and I don't see why this should be changed and would resist any move to do so.

I think an OOH provider must make arrangements for doing OOH visits when necessary (which is rare). Do these OOH clinics really run completely single handed with no option for back-up? Is there no working relationship between OOH clinics to back each other up when it all hits the fan?

I'm not one to get all soppy, but the whole point of us having a monopoly on veterinary medicine is to maintain adequate standards of care. If we start shedding those responsibilities then we'd deserve to lose that right to the monopoly.

[quote user="Robin Grimmer"]As practising vets we are all happy and relieved to put those phones over to the OOH service and go home and relax.[/quote]

Good point. Although I go home and relax because my OOH provider has a good policy on home visits.

Definitely a dividing issue, this one!

Re: House visits

Gerry Henry — Wed, 23 Feb 2011 17:55:00 GMT

If the dog was too big for the ambulance then I guess the ambulance was too small for the practice. We've just bought a DVLA approved veterinary ambulance which, when fully opened out in the back, could accomodate a great dane with room to spare. I do think that owners of outsized dogs, like the owners of outsized bodies, should consider the consequences of their purchase/gluttony before indulging.

Re: House visits

Hannah Wynne Richards — Wed, 23 Feb 2011 17:36:28 GMT

I do however agree with Gerry that it was disgraceful that those members of DC who's practices refused to visit were not similarly disciplined-it should be a level playing field with exactly the same standards for all

Wynne

Re: House visits

Hannah Wynne Richards — Wed, 23 Feb 2011 17:32:47 GMT

Wynne

Re: House visits

Robin Grimmer — Wed, 23 Feb 2011 17:29:55 GMT

[quote user="Hannah Wynne Richards"]

But the practice wasn't busy

Wynne

[/quote]

How do you know that?

Re: House visits

Hannah Wynne Richards — Wed, 23 Feb 2011 17:26:00 GMT

But the practice wasn't busy

Wynne