BVA calls for ‘hub and spoke’ model for integrated animal care

In response to the rapid changes in the veterinary environment, the British Veterinary Association (BVA) has launched a vision for effective teamwork between vets and allied professionals with the aim of improving animal health, animal welfare and public health.

BVA’s concept of the vet-led team calls on vets and appropriately trained and regulated allied professionals to use a ‘hub and spoke’ model that has the vet at its heart to coordinate services for clients and patients.

Vets should act as the hub for treatment, directing clients to an allied professional after examining an animal, making a diagnosis, and determining the best course of action. Allied professionals - who can include Registered Veterinary Nurses (RVNs), Official Auxiliaries/ Meat Hygiene Inspectors, embryo transfer technicians, equine dental technicians, foot trimmers, farriers, hydrotherapists, animal behaviourists and veterinary physiotherapists - operate as spokes surrounding the hub, returning cases back to the vet whenever further direction is necessary.

BVA’s timely recommendations recognise that the profession is operating within a rapidly changing environment, including an expansion in the range of allied professionals, concerns regarding veterinary workforce shortages, technological innovations, and changes in the expectations of pet owners, farmers, industry and other clients.

To address these changes and clarify where the responsibility for a patient sits and how it is shared between vets and allied professionals, the vet-led team position also calls for:

• The regulation of allied professionals to include mandatory veterinary diagnosis and oversight and appropriate access to veterinary records as pre-requisites before treatment;
• Clarity on the delegation of duties for RVNs under Schedule 3 of the Veterinary Surgeons Act and protection of the ‘veterinary nurse’ title in legislation;
• Consultation with the veterinary profession on any regulatory changes that may arise as a result of technological or other innovation.

British Veterinary Association President Simon Doherty said:

“Against an evolving landscape, it’s essential that the veterinary profession keeps pace with change and addresses the challenges and opportunities it presents.

“Vets across sectors have always worked closely with allied professionals. The hub and spoke model acknowledges and clarifies this working relationship with clear lines of accountability and responsibility for the animals under our care. It also emphasises that vets’ right to diagnose, prescribe, and undertake surgical procedures and medical treatments must not be undermined.

“An effective and efficient vet-led team can help deliver better animal health and welfare, improved client care, and more effective use of skills within the veterinary professions. Given the ongoing workforce shortages, a strengthened veterinary workforce also has the potential to ease recruitment and retention concerns for both vets and RVNs and offer improved wellbeing.

“BVA will continue working with professional bodies and organisations to formalise the hub and spoke model, promote the value of regulation, and drive up professional standards.”

BVA’s Spring 2018 Voice of the Veterinary Profession survey revealed that over half of vets (52%) believe that regulation is one of the top three most important considerations when selecting an allied professional to work with. The same survey also found that many of the allied professions in which vets’ confidence is highest actually have little or no formal regulation in place.

In its vision for the vet-led team, BVA makes a series of recommendations on accreditation and regulation of allied professions and calls for clear and accessible information to be made available to support veterinary decision-making. To gain regulated status, allied professionals should be required to follow veterinary diagnosis and oversight as well as have appropriate access to veterinary records before treatment.

Mr Doherty said:

“There is a need for authoritative information on the regulation and accreditation of the wide range of allied professionals. At the same time, we would ask vets to familiarise themselves with the work of allied professionals and not agree to sign a consent form where their professional judgement is not satisfied.

“Given the technological advances shaping the veterinary profession, such as telemedicine, we believe it is essential that the profession is consulted on any regulatory changes that may arise as a result.”

BVA’s vet-led team position has been prepared with contributions from BVA specialist divisions, the British Veterinary Nursing Association, the Royal College of Veterinary Surgeons and allied professional bodies.