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24/7 emergency care: a new emphasis

by
01 October 2014, at 1:00am

Jayne Laycock reports on her 'pick of the month’ CPD webinar with the RCVS registrar Gordon Hockey and former council member Clare Tapsfield-Wright who chaired the standards committee.

OUR responsibilities in providing 24/7 emergency first aid and pain relief for any suffering animal have never been disputed by the profession but fulfilling this obligation continues to raise grey areas requiring further discussion.

One area frequently cited by RCVS members is knowing when it is reasonable to say “no” to a client who is demanding an out-of- hours visit which appears to be purely for their convenience, as opposed to the welfare of their pet.

By saying “no” to these cases, vets are concerned they could face disciplinary action by the RCVS and this can sometimes be used as a threat by a client demanding a visit.

Recognising the conflict which often exists between a client’s expectations for out-of-hours care and the vet’s obligations in providing emergency first aid and pain relief led the

RCVS to review its emergency care supporting guidance after extensive consultation with both the profession and pet owners.

The Webinar Vet provided a platform for the RCVS to lead a webinar discussing this review and the consequential changes made to the guidance notes. The RCVS made important points during the webinar. It wanted to highlight that “the responsibility for an animal’s welfare ultimately lies with the owner”. The vet’s duty is to help owners meet these responsibilities by giving appropriate advice and/or care. It is also the responsibility of owners to transport their pets to the surgery in an emergency and steps should be taken by the owners to ensure they have plans in place for this if an emergency situation arises.

For this reason vets are not obliged to attend away from practice unless in their personal judgement it is appropriate to do so. Vets are, however, responsible for any telephone advice they give and for an animal once present in the practice.

Disciplinary action towards the vet would only be considered where there is a wilful disregard for animal welfare.

The RCVS also wanted to stress the overriding importance of the vet’s safety which must always be prioritised over animal welfare.

A vet is well within his or her rights to decline a visit if there are safety concerns. This could, for example, be because a client is being abusive down the phone or exhibiting any sign of aggressive or threatening behaviour.

Considerable bugbear

Outsourcing of emergency work has also been a considerable bugbear cited by the profession with practices performing their own out-of-hours being frustrated by non-registered clients wanting to use their service as it is more convenient than using the outsourced out-of-hours centre provided by their own practice.

The RCVS considered practice to client communication key to ensuring that clients are fully aware of their practice’s out- of-hours provision at the point of registration. 

Practices need to provide information at the outset of a professional relationship with a client covering their out-of-hours provision. This should include telephone numbers, the location of the service, initial costs and the nature of the service. 

This information can be provided in the format of leaflets, posters and notices as well as clear statements on the practice’s website/social media. 

Practices which are contacted by non- registered clients are also within their rights to charge a greater fee for a call-out compared to the fee usually charged for a registered client.

With multi-site practices on the rise and outsourcing of emergency work, the transfer of patients also has to be taken into consideration.

The RCVS advises that the transfer should only be based on clinical need, not convenience or commercial reasons. Transfers should always have a detailed history and clinical notes with them and transfers should always be kept to a minimum.

The RCVS was also keen to stress that vets who are senior managers could be accountable even if they are not on the clinical front line. Their role in deciding staffing levels and implementing protocols plays an important part in providing appropriate emergency care and will be taken into account if the provision of care has been deemed inadequate. 

These were just some of the main points discussed within the webinar but more were raised and answers to questions asked by the participating audience also proved interesting and informative.

I have to commend the RCVS for taking steps to review and make positive changes to its guidance notes for emergency 24/7 care and this webinar provides a clear explanation of why these changes have been made and how they should be put into practice.

Being a topic which is likely to affect every one of us in practice, I would highly recommend taking an hour of your time to log in and watch this webinar available on both the RCVS and The Webinar Vet’s websites.

You can also find more information at www.rcvs.org.uk/247care.