IN the north-west of England, one of the longest established veterinary hospitals in the country is continuing to lead the field, setting up a new multi-disciplinary referral centre.
The name of the Rutland House Veterinary Hospital in St Helens, Merseyside, is well-known in the profession; for many decades it has been in the forefront of practice and has produced some of the profession’s bestknown names. The current partners are orthopods Ian Barclay and Duncan Midgley and dermatologist Sue Paterson.
The partners realised that they had reached the limit of expansion in their existing location but were keen to develop the business and expand their referral caseload.
The answer was found in a redundant furniture store four miles away which they have developed into a multi-disciplinary referral centre, leaving the original site as a first opinion veterinary hospital.
Tremendous freedom
The new building was acquired as a shell with little internal structure, allowing tremendous freedom for the layout that the partners could design. I asked who their architect was, but practice manager Janie Clare replied that she and the three partners had designed it themselves.
They had met architects initially but had found them unsatisfactory, failing to grasp the issues of working with animals in a healthcare setting. The end result, opened last October, is a very attractive building and a comfortable and functional working environment.
The waiting room is large and bright, and its L-shape allows separation of cats and dogs, resulting in fewer stressed or excited patients. The eight consulting rooms are each large enough to accommodate family groups that often arrive with referral patients, and one is windowless for the ophthalmologists.
Another room opens into the entrance lobby rather than directly off the waiting room and will become a condolence room. Two consulting rooms are used primarily by the dermatologists who, in addition to their busy skin caseload, have a particular interest in ear cases.
These back onto a treatment room fitted with two work-tables (one of which is a tub-table for flushing ears), a bank of cages for day-patients and a laboratory. This area also houses a CO2 laser, a BAER machine for hearing tests and a video otoscopy set-up, which gives excellent visualisation of the depths of the ear canal and makes diagnosis and thorough cleaning far easier.
Large meeting room
Also on the ground floor is a twobedroom flat and a 60-seat meeting room. This is used for internal CPD, for regular meetings for referring practices and for breeder groups, and is made available without charge to any local group which wishes to make use of it.
The floor plan allows the dog waiting area to be used as additional meeting space, for example to run parallel vet and nurse sessions, or as a catering area for meetings held in the main room. The separate cat waiting area ensures that the practice can still operate around such use.
The kennels and operating suites are upstairs, accessed by a lift. The wards are deliberately kept small, reducing noise, aiding infection control and helping to keep patients relaxed.
There are four dog wards, one furnished with walk-in kennels for large or long-stay patients, and one for cats. Ellie Mardell, head of the feline medicine service, specified the cat kennels very carefully, including a resting shelf in each, and although none of the in-patients was using the shelf when I visited, they did all seem extraordinarily relaxed, lying on their sides and backs rather than warily upright.
Strict hygiene
Prue Neath, newly appointed head of surgery, has instituted strict hygiene controls. People are only allowed into the surgical suite in scrubs and clogs, or with outdoor clothes covered with a Tyvek suit together with hat and shoecovers.
The prep room is particularly spacious, with five tub tables along one wall and the five operating theatres along the other wall, interspersed with scrub sinks. There is also a busy minor procedures room with ultrasound facilities, although the well-equipped endoscopy suite, which is primarily used by the internal medicine specialist Rebecca Littler for gastro-enterology cases, is downstairs to avoid any aerosol contamination of theatres.
The third floor is occupied by spacious offices for the veterinary consultants so they have a quiet area for report writing and phoning clients and referring veterinary surgeons.
New services
Currently the practice offers referrals in canine and feline medicine, dermatology, ophthalmology, soft tissue surgery and orthopaedic surgery.
Plans for the future include the addition of a cardiology service by the end of the year, and after that an oncology service to complement the existing disciplines.
A CT scanner is scheduled for installation in June as an addition to the mobile MRI scanner which visits twice monthly.
It is good to see that such a wellknown and long-established practice is not resting on its laurels but continuing to set the trends within the profession.