Veterinary Development Council

Veterinary Led Team Working Group

Members:-David CatlowNeil CutlerBob MooreCatherine McLaughlinPeter ScottBill Reilly

Secretariat:-Catherine LawrenceRachael Gledhill

Terms of Reference

To identify the range of services that could be supplied to the farming community by a veterinary led team

Those services that could be undertaken by non veterinariansThose specialist services that could be delivered by the veterinariansThose services provided by others with which vets need to integrate/co-operateThose typical Official Veterinarian services that might be delivered as part of a veterinary-led team

To identify how these services are currently delivered

To describe the benefits of bringing non veterinary services into the team e.g. increased profitability, appropriate treatments, and veterinary contact

To assess the desire of vets and non vets to work together to deliver the services

General Points

•Priority is animal health and welfare

•Overlap other groups – different models/shared staff

•Clients

•Farmers

•AHVLA

•Practitioners

•Technicians

WHO?

Farming perspective

Foot trimming

Blood samples for other than notifiable disease

Vaccinations / injections

Removal retained after-birth

Uterine irrigations

Scanning for pregnancy

Mobility scoring

Sampling for health screening e.g. bulk milk samples

Welfare monitoring

Body Condition Scoring

Disbudding

Calving

Examples

•Who should?

•Who does?

•Who could?

Farming perspective

•most appropriate and cost effective

•Vet (generalist/specialist)

•Technician under “supervision”

•Technician

Farming perspective

 Acts of veterinary surgery

•Only veterinary surgeons are permitted in law to carry out such procedures, although animal owners or their employees may undertake certain acts such as disbudding.

•Other lay persons (however trained or supervised) may not undertake such activities.

  

  

Acts of veterinary surgery for which an Exemption Order is in place

•These are confused. For example testing for tuberculosis can be carried out by suitably trained lay testers employed by AHVLA but not lay persons employed by veterinary practices. Lay persons employed by veterinary practices can blood sample for brucellosis but not for other diagnostic purposes such as metabolic profiling.

•Lay persons carrying out activities for which Exemption Orders exist have little or no regulation or supervision.

•Most of the Exemption Orders do not require direction or supervision, of the lay person, by a veterinary surgeon.

 

  

Activities that are not deemed to be an act of veterinary surgery

•For example cattle foot trimming.

•These be carried out by lay persons over whom there is no statutory control.

Farming perspective

•Wide range of potential activities

•Undertaken by appropriate people and charged accordingly

•Veterinary team includes technicians, “generalists” and specialist veterinarians

•Potential for “veterinary led team”

AHVLA

•Farmers “need access to quality assured, affordable services”

•Lay TB testers: “would consider amending the legislation” if support from the profession

•Blood samplers “exempted for specific purposes” change “could increase the workforce available to us” during disease outbreaks

•“Some tasks are not acts of veterinary surgery such as inspections…we would not expect to prescribe who did it provided they were suitably trained and competent”

AHVLA

•Support for the development of a veterinary team that included non veterinarians

•Appropriately trained

Veterinary Perspective

269 responders

Targeted at farm, mixed and equine practice

Survey Monkey

26% Yes

74% No

Does your practice currently employ any technicians?

Veterinary Perspective

Equine dental technicians 3% (2)Scanners 10% (6)Foot trimmers 24% (16)Others 63%

What technicians do you currently employ?

Veterinary Perspective

36% Yes

64% No

Has your practice considered employing technicians?

Veterinary Perspective

yes 12% (28)

no 88%

Does your practice have an agreement with self employed technicians?

Veterinary Perspective

Are you aware of your clients using technicians not provided by the practice?

yes 67%no 23%not sure 10%

Dental techniciansScannersFoot trimmersAI

Veterinary Perspective

Would you employ technicians in the future as part of a veterinary led team?

yes 67%

no 13%

Veterinary Perspective

•Potential for the development of a veterinary led team

•Need to be confident about training and supervision

Veterinary Perspective

Technician’s Perspective

Independent evaluation of the level of training undertaken by barefoot trimming organisations within the UK, enabling a mechanism whereby “approved” practitioners can be recognised by the veterinary profession

In the interest of continuing professional development we are keen to promote shared learning across the veterinary-led team. 

The Equine Podiatry Association

“would encourage a more open and transparent relationship between client, hoof care provider and Veterinary Surgeon”

•Welcome any opportunity to improve links with the veterinary profession.

•One major problem faced by the foot trimmers is a lack of interest and engagement by some local vets. In some instances a lame animal will be referred by the local vet. This is not desired by the foot trimmer, who would prefer to be dealing with routine preventative trims.

•Improved communication will help fruitful partnerships develop between vet and farmer.

•We would agree that better partnership between the vet and trimmer would benefit the farmer in many ways.

National association of Cattle Foot Trimmers

•We do not believe the foot trimming technician under the employment of the local vet is the preferred way of working. Instead, we would welcome any initiatives that would encourage all trimmers to engage in on-going CPD and that trimmers should be working towards, or attaining, a 'category 1' status While licensing of some form is not wanted. we realise it may prove necessary to encourage trimmers to attend professional development and check days.

Technician’s Perspective

•Work more closely with the veterinary profession

•Partnership rather than employed

•Training and regulation

•Better partnership working

•Technicians employed by veterinary practices

•Improved regulation, training

Principles for the Way forward

Recommendation 1

The British Veterinary Association should undertake a consultation and opinion poll, which captures the views of the UK veterinary profession, to establish the appetite or otherwise with regard to allowing technicians to undertake specified veterinary service activities (such as blood sampling, disbudding and tuberculin testing) under veterinary direction.

Recommendation 2

•The Royal College of Veterinary Surgeons should consider the best course of action to establish an acceptable process of training for, and regulation of, technicians who undertake activities under existing or new Exemption Orders.• •This should include a clear differentiation between veterinary direction and supervision.

•In addition the assurance of competency and appropriate approved training, accreditation and registration must be clearly identified.

Recommendation 3

Defra should consider the necessary further legislative changes that would allow suitably trained lay persons to carry out minor acts of veterinary surgery (such as disbudding) under the employment and direction or supervision of a veterinary surgeon.