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Tall task on surveillance

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THE AHVLA set the Surveillance Advisory Group a pretty tall task when it asked it to suggest a future model for delivering veterinary surveillance in England and Wales. The group, chaired by Professor Dirk Pfeiffer, of the Royal Veterinary College, was given just three months to come up with its recommendations, a timescale which seems all the more remarkable when one considers that the UK's Veterinary Surveillance Strategy, launched in 2003, was several years in gestation. With its budget for surveillance set to be cut by 30 per cent by 2015, the AHVLA is keen to deliver surveillance ‘more effectively and at an affordable cost to the taxpayer’ – and the task facing the advisory group was further complicated by the fact that the agency had recently already embarked on rationalising its laboratory testing services (VR, January 14, 2012, vol 170, pp 34, 35).

In the circumstances, it is commendable that the advisory group's report, which was published last week, makes recommendations aimed not just at maintaining the current level of surveillance but at improving it. It sets about this by, first, specifying 12 basic requirements of the system based on their importance to surveillance and society, covering the type of service that is needed, data requirements, the levels of expertise that will be required and how the arrangements should be governed. Next, it sets out the principles on which a new model of surveillance should be based, covering issues such as the development and maintenance of animal health expertise to underpin surveillance, ensuring that the service is accessible, and the systematic sourcing and integration of data (see p 402 of this issue).

A key recommendation of the report is to establish a network aiming to give 95 per cent of livestock holdings access to a postmortem facility or collection point within one hour's travelling time of the holding. This recommendation – one of a number in the report aimed at improving the throughput of samples to underpin surveillance – seems ambitious given that only 50 per cent of holdings have such access at present, but the review group seems to believe that it is achievable. Under the model proposed, a tiered network of surveillance facilities would be established, made up of species- or sector-specific centres of expertise at selected AHVLA sites located in regions of high livestock density; satellite centres offering facilities for postmortem examination and sampling; and collection points to facilitate carcase and/or sample drop off and collection.

The advisory group does not define the number, nature or location of sites, having had neither the time nor the financial and other data that might have allowed it to carry out the necessary analyses. However, in discussing the need to increase the throughput of samples and the practicalities of how this might be achieved, it makes the important point that the service will have to be cost-effective and attractive for both government and industry.

Another key recommendation is that the roles and responsibilities of existing AHVLA staff should be reviewed with a view to establishing different tiers of expertise to support the new tiered surveillance structure. The suggested levels of expertise include investigators to support private vets, gross pathologists and subject-specific experts, although it is envisaged that most of these people would have more than one level of expertise. Among the proposals is that locally based government vets would liaise with private veterinary practices and carry out investigations on farms when asked to do so by the practice. They would also carry out routine postmortem examinations on the farm or at collection points, and give guidance to practitioners to enable them to carry out better or more focused postmortem examinations outside of the laboratory when appropriate. The idea is that government vets could be ‘embedded into private veterinary practice to develop species expertise, support private veterinary practice and enhance the surveillance network’.

Financial as well as practical considerations will inevitably affect the feasibility of the proposals, and how they might be taken forward will clearly be affected by the outcome of the ongoing debate on sharing costs and responsibilities for animal health. As the BVA President, Carl Padgett, commented last week, the next stage must be for the proposals to be fully costed in an open and transparent way before any decisions are made.

One of the problems for surveillance is that the financial benefits are not immediately apparent, which can make it difficult to convince people of the need to pay for it. With government funding set to reduce, this remains of concern. The proposals clearly depend on partnership working and, as the advisory group points out, the benefits would be limited if any aspects are not implemented. Expertise is a precious and fragile resource and the existing structure must not be dismantled unless a demonstrably workable alternative is firmly in place.

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