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The profession must evolve to thrive
  1. Josh Loeb

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‘For things to stay the same, everything must change.’

To some extent, this famous quote from the novel The Leopard by Giuseppe Tomasi di Lampedusa summarises the situation facing the veterinary profession.

Vets’ core role is to ensure the health and welfare of animals. As veterinary peer Lord Trees notes this week (see pp 448-449), the profession has much to be proud of in terms of past achievements. Looking to the future, however, it faces challenges concerning how to continue successfully discharging this fundamental duty towards animals.

So, he asks, what must change within the profession for its essence to be preserved?

Lord Trees argues that embracing technology and delegating more tasks to regulated veterinary nurses (RVNs) form part of the answer.

Clever use of technology could yield increased productivity, helping veterinary businesses to remain financially sustainable while keeping costs down for clients.

One could argue that vets in fact have little choice but to embrace biosensors, artificial intelligence and the like. Yes, theoretically the powers that be could refuse to even discuss what such innovations will mean for the profession – but, sooner or later they would be forced to. It is better to voluntarily embrace new technologies, where appropriate, than to be forced belatedly and hurriedly to reform.

The profession also has choices to make regarding the wider ‘veterinary team’. Broadly speaking, RVNs are underused. In some practices they are treated almost as vet equivalents, in others as essentially little more than glorified cleaners, 2018 RCVS research has shown. This disparity is unsustainable. Just as vets should not fear technological change, so they should be sanguine about the prospect of more delegation to RVNs

Delegating more responsibilities would boost the role of RVNs while at the same time freeing vets to focus on more expert, and perhaps less routine, tasks. Reluctance to delegate could be seen – legitimately – as protectionism.

But to truly reap the rewards there will need to be either a reform of Schedule 3 – the exemption to the Veterinary Surgeons Act stipulating the parameters within which vet nurses can work – or completely new legislation governing RVNs.

RCVS proposals on this have been in the pipeline since 2017, but progress has been slow. It is unclear when the college intends to publish its plans for reform.

Clarity is needed about what RVNs can and cannot do within the law

In the meantime, clarity is needed about what RVNs can and cannot do within the law.

The college has published a series of case studies in a bid to bring clarity. However, it has repeatedly declined to produce either a clear and definitive ‘Yes’ list (a list cataloguing the procedures RVNs are allowed to perform) or an equivalent ‘No’ list (one pinpointing procedures that RVNs are strictly banned from doing).

You may not be persuaded by the idea of a ‘Yes’ list because it could detract from vets’ professional judgement, but surely it could not hurt for the RCVS to publish a ‘No’ list to make clear what procedures RVNs definitely aren’t permitted legally to undertake.

It could include cat castrations, epidurals and extractions using surgical instruments.

These procedures are already ruled out by a combination of the law, the code of conduct and supporting guidance. However, finding this information can be cumbersome.

A list of acknowledged ‘grey areas’ (a ‘Maybe’ list, if you will) could also help.

It could be prefaced with a disclaimer stating that discretion should be sought on the suitability of both the individual procedure and the RVN undertaking the task, since not all tasks will be suitable for all RVNs all the time.

What’s clear is that stasis is not an option. If it is to flourish, the profession must evolve – fast.

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