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Veterinary Record commented in March that, having decided to close more than half of its centres carrying out postmortem examinations (PMEs) for disease surveillance purposes in England and Wales, the AHVLA seemed to be shutting them down quickly (VR, March 22, 2014, vol 174, p 286). With the announcement last week that the Winchester centre is closing this month, one year earlier than planned, it seems to be ploughing ahead even more precipitously than we feared.
In March, the AHVLA indicated that the Winchester centre would ‘remain open until April 2015, pending the outcome of [its] expert PME provision and carcase transport procurements’. This was in line with a previous statement in December, when the AHVLA first announced the outcome of its surveillance review (VR, December 14, 2013, vol 173, p 564). However, in an update on this and other closures posted on its website last week (on May 29), the AHVLA announced that ‘Surveillance activity [at Winchester], originally scheduled to end in summer 2015, will now cease in June 2014.’
The decision to close the centre one year early is, apparently, ‘a result of recent staffing changes locally’, which perhaps says something about the resources now available to the agency nationally. In the meantime, the AHVLA says, ‘Pending the procurement of an alternative postmortem provider in the area, an interim carcase collection and transport service will be put in place to transport carcases directly from farms to the AHVLA's surveillance centre at Bury St Edmunds.’
Bury St Edmunds is about 145 miles from Winchester by road, which is likely to make timely collection and examination of carcases difficult, and the sudden change of plan means that, for the time being at least, a large chunk of southern England will be left without a local centre. With the closure of this and other centres, the AHVLA aims to retain what it describes as ‘a smaller, but still geographically well distributed, network of AHVLA postmortem facilities and expert pathologists’, and hopes that the reduction in its own facilities will be ‘offset by an expansion in non-government providers of postmortems and expert diagnostic services’. However, the AHVLA only got round to inviting tenders from possible alternative PME providers in this and other areas a few weeks ago and the tendering exercise doesn't close until the end of this month (on June 27). It hopes to be able to award contracts in August, to start in September. At this stage it cannot be clear what the outcome will be but, even if the tendering exercise is successful, it seems to be cutting things a little bit fine.
None of this is indicative of the orderly transition to new arrangements that one might have expected for an activity as important as disease surveillance and tends to reinforce the impression, which has been clear throughout the surveillance review, that the changes are being financially driven and are being made in haste in response to a preordained budgetary timetable. It is certainly a far cry from what Veterinary Record, the BVA and others have long argued is necessary as the surveillance arrangements in England and Wales are changed, which is that the (as yet unproven) new arrangements should be tried and tested, or at least up and running, before the existing system is dismembered.
The rushed nature of the exercise is apparent in other ways, too. For example, an important aspect of the overall plans for surveillance is that more first-opinion PMEs should be undertaken by private practitioners. In theory, this is a good idea because it could help increase the geographical reach of surveillance, although it does raise questions about the quality of the data that will be obtained. It also requires that practitioners have the necessary postmortem and diagnostic skills. It has been clear for some time that this may require further training but it was only last month that the AHVLA undertook a survey to try to assess what the demand for such training might be.
The number of AHVLA centres providing postmortem services in England and Wales is being cut from 14 to six. AHVLA surveillance activity at Aberystwyth, Luddington, Polwhele and Preston has already ceased; at Newcastle as well as Winchester it stops this month, while at Langford and Sutton Bonington it will continue until September. This leaves centres at Bury St Edmunds, Carmarthen, Penrith, Shrewsbury, Starcross and Thirsk, supported by the poultry facilities at Lasswade. In the areas where centres are closing, the AHVLA plans to provide an interim collection service until the early autumn, by which time it hopes that alternative local PME services or alternative transport arrangements will have materialised.
It may well be, as the AHVLA argues, and as was suggested when the new surveillance model was originally proposed (VR, April 21, 2012, vol 170, pp 400, 402-403), that the changes currently in train might ultimately lead to a more effective and sustainable system of surveillance. It is also possible that the changes could present new opportunities for practitioners, some of which will be discussed in a debate called ‘Surveillance cuts: threats or opportunities for vets?’ during the BVA Congress at the London Vet Show in November. However, as the Government falls over itself to implement the changes, there is a danger of working arrangements being damaged and expertise being lost. At present, it is creating gaps in the surveillance network without any firm indication that these will be filled.
▪ The programme for the BVA Congress at the London Vet Show, which will be held at Olympia from November 20 to 21, is available at www.bva.co.uk/events/3095.aspx. Accessed May 28, 2014
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