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InFocus

Is the RCVS practice standards scheme fit for purpose?

VETERINARY PRACTICE
reports on some of the sessions at the Veterinary Business and Management Congress, run jointly by the SPVS and VPMA, in Oxfordshire in late January

“THERE is an argument that the
practice standards scheme is not fit
for purpose as far as the
stakeholders – vets, clients and
animals – are concerned,” the SPVS
president, Gudrun Ravetz, told the
“contentious issues” question and
answer session – sponsored by
Henry Schein – at the joint SPVS-
VPMA congress last month.

Responding to two questions – the
first asking about the
purpose of the scheme, the
second asking if all practices should be
inspected to minimum
standards – she said that
SPVS supported the
scheme in principle but believed there
should be changes.

The core standards are legal
minimum requirements but, she said,
she was not sure inspections should be
mandatory. The scheme should be
“practical based”, she added.

The VPMA president, Pauline
Graham, said she believed that every
practice should conform to core
standards. “The scheme needs tweaks,”
she declared, “but it is a very good
thing. It is a no-brainer that every
practice should be in it.”

The RCVS president, Jacqui
Molyneux, said the College was looking
at the PSS with a view to a complete
overhaul. A consultation had been
completed and was now being discussed.

She said the scheme should belooking at behaviour and clinical
standards and not just premises. It
needed to be flexible and modular and
there had to be consistency of
inspections.

“There are potentially some very
exciting changes on the way,” she said,
adding that the public already believed
every practice was inspected.

Comments from the 50-strong
audience included: “The scheme has got
to be seen as something that the
profession wants”; “We need a basic
scheme that is mandatory and another
voluntary scheme monitoring
performance on
a range of
issues”; and
“The scheme
should be
helpful rather
than regulatory.”

Another
asked whether membership of the scheme had raised
standards. Mrs Molyneux said she did
not know how that could be measured
when the scheme was not mandatory.

Former RCVS and SPVS president
Des Thompson had the final word on
this subject: “We should have a practice
standards scheme we are all proud to be
part of.”

Is a new veterinary school
needed?

“Do we need a new veterinary school in
the UK and what effect will it have?”
was the question posed by Richard
Holborow, the immediate past president
of SPVS.

“No!” was the firm response from the BVA president, Peter Jones.
But, he continued, it is going to
be here and we have to work
with it.

The BVA had met with
representatives of the
University of Surrey and
Professor Roberts had expressed disappointment at the BVA’s stance. The university said it
had consulted widely but it hadn’t
included the BVA in the process.

Noting that the jobs market was
tough, Mr Jones said the new course,
with its focus on large animals, public
health and food production, might steer
graduates into different jobs. He also
commented that there was already huge
pressure on EMS in south-east England.

“I don’t think we need another
veterinary school but there may be at
least two other universities that follow,”
he added.

For the RCVS, Jacqui Molyneux said
the College could not stop it happening
“although some members feel we
should”. Veterinary courses were
attractive to universities as they were
uncapped. The College was neutral in its
response but the onus was on it to make
sure the university did it properly.

She pointed out that the College
registered more than 500 overseas
graduates each year in addition to about
1,000 “home” graduates and there was
no shortage of jobs – yet.

Peter Jones commented that people
seeking to go into equine practice could
not get jobs.

Pauline Graham said that when her
practice [Capontree Vets in Cumbria]
advertised a job they got 50-60 applicants. “Many want to give large
animal practice a go,” she said, “but they
have no real passion for it.”

Gudrun Ravetz asked whether we
would still have omnicompetent vets.
She said that more vets were needed in
public health and the profession needed
a higher profile in all the areas where
vets should be.

Mr Holborow concluded by
expressing disappointment with the
additional school; he described it as
regrettable and said that universities
were taking a short-term view.

What about decoupling?

Hazel Bentall raised the issue of the
possible decoupling of prescribing from
dispensing by practices and wondered if
this would have an effect on animal
health.

Gudrun Ravetz said that decoupling
was a real threat and the profession had
to wake up to it. “We need to get our
house in order, especially with
antimicrobials, but,” she added, “don’t
panic. The BVA has done a really good
job on this.”

Phil Sketchley, chief executive of
NOAH, said the issue had recently
come back under discussion but there
was no need for gloom and
despondency. It would be difficult for
decoupling to apply only to
antimicrobials, he said: it would apply to
much more. Stating that there was
mischief coming out from other
quarters and inappropriate figures being
quoted, he thought decoupling could
happen but it was unlikely.

Peter Jones said the matter was
being driven by the Danes who wanted
more stringent controls on
antimicrobials and who believed that
vets should prescribe but not dispense.
They accused vets of making too much
money from selling antimicrobials.

“We must stand up and defend our
cause,” Mr Jones said. “Decoupling
could be a disaster for large animal practices and could have a detrimental
effect on animal welfare.”

Asked about a possible time-frame
for any new legislation on this, Mr
Sketchley said the European
Commission was producing an impact
assessment but there were a lot of ifs
and buts surrounding the issue.

New disciplinary process

Brian Pound wanted to know what
impact the new arrangements for the
preliminary investigation and
disciplinary committees would have –
and he asked, “What is a lay person?”

A lay person is a non-vet, explained
Jacqui Molyneux, who announced that
the new arrangements had just been
approved by Parliament; they become
law in April and will come into effect in
July this year but are likely to have very
little impact as “they really formalise
what is already happening”.

The main change was that cases
should proceed more quickly, she said.
A huge number of people have to be
available for hearings to take place,
including barristers and witnesses, but
with a bigger pool of people to call on
the disciplinary committee itself should
be able to proceed much more quickly.

In other questions, incoming SPVS
president Adi Nell wanted to know the
panel’s opinion on whether the various
veterinary associations could work more
closely together.

Gudrun Ravetz said “Yes,” adding:
“We aim to work together where we can
and where it makes sense, but our
associations have unique functions and
there will always be differences.”

Pauline Graham said the SPVS and
the VPMA had been working together
and moved a long way.

Peter Jones said the BVA had a
different relationship with the Royal
College from the one it had with its
divisions. “We have a lot of
collaboration with the College but there
are issues where we disagree. However,
we cannot help but work together.”

Hazel Bentall called on the BVA “to
support its divisions as much as the
divisions support the BVA”.

Des Thompson said that the
divisions do CPD better than the BVA
and he couldn’t see why the BVA
should be involved at all.

Phil Sketchley commented that
various groups were now talking to each
other and said it was crucial that the
veterinary profession spoke with one voice.

Looking after vets in practice

This 90-minute session had started with
John Sheridan asking, “If the principal
role of SPVS, the BVA and VPMA is to
look after vets in practice, is there any
evidence that the financial health of
practices has improved over the last 10
to 20 years as a result of their efforts?”

Peter Jones said that the BVA
concentrated on its members rather
than being concerned with the health of
practices, though it had begun to look
more at the business aspects of practice.

He added that in its recent member
survey, nearly a third of members wanted the BVA to work on improving
the public face of the profession.

Gudrun Ravetz said that SPVS
provided tools for practices including
the surveys of fees and salaries; the
society was also looking at models of
practice ownership and was giving much
more support to new graduates.

Pauline Graham said the VPMA was
offering tools to educate and support
practices; she believed things had moved
on a lot in the last 20 years.

Mr Sheridan said he had been
hoping to hear some numbers about the
financial health of practices. He said
there were some data about but not
necessarily the right data.

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