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Difficult balance on 24/7

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WITH so many people affected, the RCVS's call for evidence on the professional obligation on vets to make provision for 24-hour emergency cover would be expected to generate a great deal of interest, and the fact that the College has received more than 300 responses to its consultation confirms that this has indeed been the case. The number of responses nevertheless seems small compared to the large number of signatories gathered by an online petition on the related issue of house visits, which was started by veterinary surgeon Joanne Dyer on the polling website www.change.org; irrespective of whether the petition is based on a misunderstanding, as has been suggested by the RCVS President (VR, February 8, 2014, vol 174, pp 132, 133), the fact that more than 2700 people have signed up to it serves to emphasise just how live this issue is. Questions about house visits and 24-hour emergency service provision also feature prominently among questions considered by candidates in this year's RCVS Council elections, in a ‘Quiz the candidates’ webinar held to help launch the elections,1 so debate on this subject looks likely to continue for some time yet.

The RCVS's Standards Committee is currently considering the responses to the consultation, and the RCVS President has said that comments made by the signatories to Ms Dyer's petition will be fed into its review. In the meantime, the BVA is among those who have responded to the call for evidence, and its comments can be viewed on the Association's website.2

The RCVS consultation was prompted partly by anxieties generated by the outcome of a disciplinary case involving Munhuwepasi Chikosi, who was struck off the RCVS Register last year for failing promptly to attend an injured dog while working as a locum in an out-of-hours clinic (VR, July 6, 2013, vol 173, p 6), and partly as result of concerns raised previously by lay members of the College's Preliminary Investigation Committee about an apparent ‘disconnect’ between the public's expectations of 24-hour cover and the profession's ability to meet them (VR, January 11, 2014, vol 174, pp 28, 29). In its response, the BVA makes clear that it is in favour of maintaining the professional obligation to make provision for 24-hour emergency first aid and pain relief – primarily on animal welfare grounds, but also in terms of maintaining the structure of practice and the culture of the profession, as well as to maintain the profession's standing in the eyes of the public. At the same time, however, it draws attention to some of the many practical issues involved, in terms of sustainability, feasibility, manpower and costs, particularly in remote areas, and says it would like to see the RCVS give clearer advice and introduce greater certainty around what the obligation entails.

On the matter of house visits, the BVA highlights safety concerns. It argues that house visits should remain discretionary but that the RCVS should be prepared to support veterinary staff by placing greater responsibility on emergency providers and practice owners to provide adequate staff levels to comply with Code of Professional Conduct, without any formal requirement to commit to home visits. It says that, if a veterinary surgeon decides that a home visit is necessary, they should ideally be able to attend with another member of staff if this is desired, and that they should not be in a position of having to choose between making a visit and manning the practice. It believes that, for all types of practice, back up should be available if required. It also believes that the definition of the provision of an emergency service for home visits should be clarified.

Regarding public expectations, the Association believes that there is a responsibility on the RCVS to make sure that the animal-owning public and the clients of veterinary practices gain an understanding of the scope of 24/7 veterinary care that is both realistic and practicable to provide. It believes that accurate and pragmatic messages need to be disseminated to the public to qualify their expectations so that veterinary surgeons can meet clearly defined and communicated standards.

This is not the first time the RCVS has looked at the obligation to provide 24-hour cover; it last reviewed the issue in 2009. However, practice and society continue to evolve and the RCVS Standards Committee faces a difficult task in balancing what is desirable with what is practicable and sustainable. The challenge, if it decides to revise its advice, will be to come up with guidance that is both clear and unambiguous, but at the same time is not unduly prescriptive given all the different circumstances and types of practice, and all the different situations that can arise.

Meanwhile, 24/7 cover and house visits are by no means the only subjects covered in the ‘Quiz the candidates’ webinar associated with this year's RCVS Council elections. Other topics include practice standards, increasing numbers of new veterinary graduates, mental health issues within the profession, and an alleged ‘gulf’ between the RCVS and practising vets. A record number of candidates are standing for election this year, including a higher proportion of women. It will be interesting to see whether the elections also elicit a record number of votes.

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