Behind the scenes deliberations on the vet-led team vision

Posted on October 17, 2019 by Robin Hargreaves

It was my privilege to chair BVA’s Vet-led Team Working Group, which sought evidence and opinion from a wide range of bodies and individuals over a series of meetings in 2018. The whole process was fascinating for someone who, like me, would imagine that in a limited way, they work within and try to manage a vet-led team every day.

Clients have never had a wider array of possible providers of health care or health and welfare advice, and never has it been easier to get access to this advice. I think it is also fair to say that never has poor advice and possibly dangerous, poorly regulated intervention been easier to get.

Raising key questions

The question is, how do we protect our clients from poor treatment and advice whilst at the same time getting the greatest benefit from the synergies that are available from working with well-trained and well-regulated providers of services? Services that are of value but that we might not want to or be able to provide as veterinary surgeons directly.

Veterinary nursing seemed a good place to start. An allied profession that has been integrated into the delivery of veterinary health care for many years, increasingly well-regulated until we are now in a situation of having RVNs as true professional colleagues regulated by the same body that regulates the veterinary surgeon.

Might other disciplines like physiotherapists, behaviourists, equine dentists and the like be similarly brought under an umbrella? One that would allow genuine joined-up working and signpost clients to providers who could be trusted to provide rational, evidenced advice, and treatment within a complete healthcare service, centred around the veterinary practice?

We heard examples where this was already working quite well in animal behaviour and equine musculoskeletal therapy.

Importance of regulation

Much of the discussion centred on how such allied professionals might be regulated. Would they all be regulated through the RCVS, as veterinary nursing is, or would their own regulatory bodies manage the day-to-day training and standards whilst being accredited by the RCVS as being credible and effective?

I had my own example from practice of the danger of disjointed, ad hoc access to poorly regulated advice and treatment.

A client who was having behavioural issues with his dog approached a trainer without seeking any advice from us. The trainer visited his home and demonstrated a technique of pinning the dog down until it became submissive when it was causing problems. The first my practice and I knew of this was when his solicitor contacted us for a character reference for an appeal, as the client had been fined, had his dog removed, and been banned for life from owning a dog.

The client had been sitting in our town square when his dog began to misbehave and he applied the technique he had been taught, assuming in good faith that it was appropriate. Members of the public had restrained him, released the semiconscious dog, and called the police.

We were able to get the ban lifted but his dog was not returned to him. Needless to say, the so-called trainer is still at large and is not affiliated to the The Animal Behaviour and Training Council (ABTC) who gave evidence at one of our meetings.

The hub-and-spoke model

VLT hub and spokeThe ABTC are a great example of a self-regulating body that the veterinary profession might work with under a vet-led umbrella to provide services that smaller practices cannot provide in-house. It’s service provision in a way which would protect both the reputation of the practice, the profession and the welfare of our patients.

The vision of a hub-and-spoke model, with the vet and vet practice at the centre and two-way feedback within a vet-led team, was considered by the working group to be very attractive. It could allow the coordination of a variety of trusted allied skills and professions to provide a comprehensive, joined up, well managed, safe, and effective suite of services for both companion and production animals.

It seems self-evident that a system like this could benefit both veterinary businesses and clients and be a real step change in protecting and promoting animal welfare.

Vet nurses are an integral part of the vet-led team. This year’s BVA Congress at London Vet Show will hold a session on the future of RVNs. Join us from 9:30 - 10:50am on 15 November for ‘Vet nurses are not mini-vets! Shaping a distinct future for RVNs’.

Robin Hargreaves

Written by Robin Hargreaves

BVA President from September 2013 to September 2014

Robin is a past president of BVA. He is a director and small animal practitioner at Stanley House Veterinary Surgery in Lancashire. He chaired the BVA vet-led team working group and was previously the BVA representative on the Mind Matters Initiative.