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This week the BVA launched its vision for the veterinary team of the future.
The set-up is described as a ‘hub and spoke’ model, and is vet-led, with the vet ‘hub’ coordinating services and care out to the ‘spokes’ – allied veterinary professionals – who should refer back to the vet hub when necessary.
The allied professionals include an array of technicians with expertise that many vet practices already employ or work closely with, including farriers, behaviourists, physiotherapists, embryo transfer technicians, meat hygiene inspectors and equine dental technicians. And, of course, veterinary nurses.
The model proposed by the BVA supports a clearer, expanded role for vet nurses, with the aim to introduce new career pathways for them. It also recommends the veterinary nursing title be protected in law.
Anything that can provide clarity around Schedule 3 of the Veterinary Surgeons Act, which allows certain tasks to be delegated to vet nurses, is to be welcomed, and there are many who already support the expansion of their role.
From human medicine, the model of the advanced nurse practitioner looks ripe for development for the veterinary nursing profession.
It makes sense for vet nurses to take on more tasks from the vets
The development of the vet nurse role is attractive for a number of reasons. Job satisfaction and the opportunity for career development should go some way to improving retention of vet nurses and making their jobs more rewarding. In a situation where vets are scarce, it also makes sense for vet nurses to take on more tasks from the vets where their training and competency allow.
Another element of the BVA’s proposal is the regulation of allied professionals, which should to some extent be solved with the new RCVS regulatory process for paraprofessionals. While some are already regulated, such as farriers, others have a rather ‘Wild West’ approach. An often quoted example are the equine dental technicians, who are currently unregulated. Although there are voluntary exams and member organisations they can join, there is no requirement to do so. While those who are serious about their job will take the time to learn the skills required, there is nothing to stop anyone with no skills or training setting up as an equine dental technician.
Better communication with these allied professionals can only benefit patients and clients, and was discussed recently in our ‘What is your client thinking’ column in regard to vets and farriers working better together (VR, 13 April 2019, vol 184, p 486).
The BVA also hopes its model will respond to the new opportunities and changes that will come about from technological innovations and the possibility of remote prescribing. Telemedicine already exists in the vet profession, but there are plenty of areas in which this can expand.
If the profession gets this right, we should expect to see a number of benefits; for example, a more flexible experience for the client and better use of medicines could both be envisaged. There are plenty of opportunities for vets to use telemedicine to allow greater contributions from the allied professionals they work with, and now is the time to think about how this can best be done.
Although the development and improved engagement with allied veterinary professionals is positive, the prime motivation for the veterinary profession as a whole has to be animal health and welfare and client satisfaction.
So this hub and spoke system has another benefit, making it clear that vets have overall and final responsibility for patients.
It also highlights that while it makes sense to delegate many tasks that currently are only allowed to be done by vets, there are some elements, such as diagnosis, prescribing and many surgical and medical treatments that must remain the vet’s sole responsibility.
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