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It Shouldn't Happen AT A VETS
Panorama 22 July 2010
BBC1’s Panorama team sent an undercover trainee nurse to report on the practices employed by vets and nurses working for one of the UK’s biggest veterinary chains. Parkvets supports any action, whether by television producers, the public or the Royal College of Veterinary Surgeons, which serves to highlight areas of unethical behaviour within the veterinary profession.
When dealing with any profession, members of the public have to put their trust in individuals who have a level and type of knowledge which is not easily questioned by the lay-person. Unfortunately, whilst the level of trust required from clients is complete and consistent, the standards of care these same clients receive can differ markedly from one practice to another depending on levels of expertise, equipment available, company culture and individual motivations. At the very least though, there is a basic level of integrity which all clients have a right expect from veterinary practices and Panorama clearly demonstrated that this expectation is not always met.
At the outset of the program Panorama reported that one in five veterinary practices is now part of a corporate group – a move away from the cosy ‘James Herriott’ image of the local vet. Parkvets is a privately owned practice within which the owners work on a daily basis. Whilst we have to operate as a commercial business in order to survive, behind the scenes we are able to maintain a supportive and team oriented practice which puts animal care at its very heart.
Our aim is to offer first opinion practice to the standards you would expect of a referral centre. This ambition is what sets Parkvets apart from some of the practices highlighted in the Panorama program.
Firstly, although we have a large nursing team, over half of our nurses are fully qualified with all but two of the remaining nurses being student nurses.
Secondly, whilst this team is capable and allowed under RCVS regulations to perform a number of medical procedures, at Parkvets we believe that our clients expect their vets to provide most, if not all, of the medical care for their pet. As a policy, therefore, our nurses provide support for the vets but do not act in isolation without veterinary guidance, nor do they perform a number of tasks which they legally can under RCVS guidelines.
In essence, even when technically a vet could delegate a task to a nurse, Parkvets encourages vets to personally perform as much of the medical intervention as is practical. Our vets are extremely conscious that it is their reputation and credibility on the line at all times and therefore it is vital that they remain in control of all their cases.
For the same reason Parkvets veterinary surgeons are taught the importance of honesty and integrity in both billing and insurance. We hold regular clinical and financial reviews during which bills are checked and clinical notes reconciled with charges. If we found anyone to be charging for items not used or recommending treatments, tests or procedures which were patently of no benefit, we would consider this a very serious matter indeed and would take appropriate action.
Panorama reported trainee nurses working alone in satellite branches and acting outside of the RCVS guidelines, they also filmed a recent veterinary graduate performing surgery with the support of a trainee nurse at one of the group’s branches. Parkvets would not allow a trainee nurse and a recent veterinary graduate to be alone in a satellite branch, performing a medical procedure requiring an anaesthetic. Even our most experienced vets would not perform surgery at a branch without the assistance of an appropriately qualified nurse.
Because of our structure the vast majority of medical procedures take place at our hospital meaning that there are always senior and experienced vets and nurses available for support. If there is an emergency procedure out of hours these same clinicians can be contacted to provide guidance if necessary and they will always come into the hospital - whatever the time - if their presence is needed. In contrast to many practices, Parkvets’ inpatients remain in the Foots Cray hospital and are never without a nurse and a vet.
The program raised the issue of insurance claims being massaged to the benefit of the client or the practice, and once again Parkvets can hold its head up high in this area. Every insurance claim has to be signed off by a vet making them personally responsible for the accuracy of the claim. Claims are then checked by our insurance administrators before being submitted to the insurer. Deliberately misreporting a claim carries too great a risk for our vets and would be viewed very seriously by Parkvets’ Directors.
The program highlighted some rough handling of patients by both nurses and vets, and also illustrated a lack of respect for the fact that all the patients are someone’s much loved pet. Although the staff in the program were clearly overstepping the mark, there are times when a vet’s treatment of an animal may be perceived as rough, but it could be necessary in order to restrain them or to keep them safe. What is absolutely unacceptable is losing touch with the fact that the animal is scared and probably in pain. Any report of such disrespect or unnecessary manhandling would be considered as a serious breach of the owner’s trust and would inevitably invoke disciplinary action.
In summary, Parkvets’ approach to cases is to be as thorough as necessary to ensure the animal receives the highest standard of care and treatment. The best way to deliver this care is decided by the veterinary surgeon in charge of the case and requires their clinical judgement for which they and the practice are fully accountable. At Parkvets we do not prescribe how a vet should approach a case, instead we advocate thoroughness in full communication with the owner. Along the way we expect our vets to perform the vast majority of the medical care themselves utilising their nursing team for support.
We are happy to discuss any elements of the program in more detail with any of our clients and would invite them to call Managing Director Diane Grant on should they have any specific concerns.
