Mr Seymour-Hamilton was originally removed from the Register in June 1994 for failing to maintain his practice’s equipment and facilities in working order and for a total disregard of basic hygiene and care for animals, thereby bringing the profession into disrepute.
The restoration hearing on 20th May was Mr Seymour-Hamilton’s seventh application for restoration. Previous applications had been heard but refused in July 1995, June 2010, February 2015, March 2016, May 2017 and April 2018. However, as the Committee makes its decision on the merits of the case before it, those previous applications were not considered as relevant to its current decision.
The Committee heard oral evidence from Mr Seymour-Hamilton and were shown clear bottles with liquid, a container with tablets and petri dishes with grown cultures as detailed documentary evidence. In respect of any concerns regarding keeping his veterinary practice up-to-date, Mr Seymour-Hamilton said that “you never lose that skill” and explained that he kept up-to-date through extensive reading and conversations with veterinary surgeons in Europe.
However, the Committee had significant concerns as to his fitness to practise safely as a veterinary surgeon for a number of reasons, including that nearly 25 years had passed since he was last in practice and that there was little, if any, evidence of him keeping up-to-date with the knowledge and skills required to practise as a veterinary surgeon.
Ian Green, chairing the Committee and speaking on its behalf, said: "The applicant worryingly did not accept that he was in any way deskilled by the passage of time. The evidence that the applicant has provided showed limited interaction with other veterinary surgeons and there is no documented evidence of the discussions or structure of the meetings he had with veterinary surgeons in Europe.
"There is no evidence of a prolonged and intense period of re-training by way of relevant study to demonstrate that a sufficient level of competence to return to practise has been achieved. In the absence of such evidence the Committee was of the view that there would be a serious risk to the welfare of animals if the applicant was restored to the Register.
"Further, it was a grave concern to this Committee that the applicant demonstrated worrying attitudinal issues towards individuals of a different religion and his attitude to employing a minor when he knew it to be against the law. Such attitudes are incompatible with professional standards the public would expect of a veterinary surgeon."
Finally, with no evidence of public support for the applicant, the Committee concluded that the application for restoration should be refused.
The first opinion Linnaeus Group practice, which also holds RCVS hospital status, is run by a team of nine vets, 14 nurses, nine receptionists and four animal care assistants.
It was given an outstanding rating for client service, inpatient service, patient consultation service and team and professional responsibility.
Maureen Geraghty Sathi, Practice Manager at Maven said: "We’re always asking ourselves how could we do this better? Everyone has to be on board or it would not work."
The practice had a focus team look at awards and the improvements it would need to make to achieve the required standards. Amongst the various things that were highlighted as exceptional were:
A genuinely separate cat waiting area and cat consult room.
An extensive pain monitoring system with pain scoring for all patients in hospital and an outpatient system which enables clients to monitor and chart their pets pain levels at home and review them with their vet.
Daily clinical rounds which involve the entire clinical team as well as management and a member of the customer care team. Aside from discussing clinical cases for the day this platform also enables daily review of any significant events or morbidity and mortality cases to be highlighted and time allocated for review.
A system whereby vets at the practice email clients in advance of any surgical procedure with information on the procedure itself as well as any potential risks associated with the procedure allowing time for further discussion with the client as needed
Consistent use of surgical and GA checklists to maximise patient safety.
In the final report, the RCVS practice standards assessor wrote: "The structures and management in place were of the very highest order. I was really impressed by the commitment of this practice to provide the very highest standards of clinical care to its clients."
Maureen said: "I am massively proud of the team, to see the pride in how they work. It is lovely to be told that you are working to an extremely high level and genuinely reflects the standards of the team day by day."
AceSedate for horses contains 10mg/ml acepromazine as its active ingredient, which the company says means a lower dose volume is required compared to the non-UK licensed equine acepromazine options available.
The dosage of AceSedate is 0.03-0.10 mg per kg bodyweight, however Jurox recommends that the lower end of the dose range is always selected where possible. It can be administered via intramuscular or slow intravenous injection.
AceSedate is supplied in a multidose vial and the shelf life after opening the immediate packaging is 28 days.
Richard Beckwith, country manager of Jurox (UK) Ltd, said: "The launch of AceSedate means injectable acepromazine is now licensed in the UK for horses, giving vets peace-of-mind that a licensed product is now available. It is a welcome addition to our equine anaesthesia, analgesia and sedation portfolio."
For more information, visit: www.jurox.com/uk, contact your local Jurox technical sales representative, telephone the customer services team on 0800 500 3171 or e-mail customerservice@jurox.co.uk.
The article looks at the practice, rationale and motivation for raw feeding before evaluating the existing evidence on both the benefits and risks of such diets.
The recent trend away from heat-treated, manufactured pet food for dogs and cats towards raw diets has been driven by suspicion of the former and perceived health benefits of the latter.
However, feeding raw diets, even commercially-prepared ones, does have risks: a recent paper described 13 cats in the UK that appeared to have been infected by Mycobacterium bovis2 by feeding Natural Instinct Wild Venison, a commercial raw mince for cats.
The leader of the investigation, Professor Danièlle Gunn-Moore from the University of Edinburgh said: "Feeding raw food was the only conceivable route of infection in most cases; this outbreak of tuberculosis has now affected more than 90 individuals in over 30 different locations, with more than 50 of the cats developing clinical disease."
One of the authors of the review, Dr Andrew Wales, said: "Formal evidence does exist for claims by raw‐feeding proponents of an altered intestinal microbiome and (subjectively) improved stool quality. However, there is currently neither robust evidence nor identified plausible mechanisms for many of the wide range of other claimed benefits.
"There are documented risks associated with raw feeding, principally malnutrition (inexpert formulation and testing of diets) and infection affecting pets and/or household members. Salmonella has been consistently found and there is also a risk of introducing antimicrobial-resistant bacteria."
The full review article can be found in the June issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here https://onlinelibrary.wiley.com/doi/10.1111/jsap.13000
References
The materials are designed to help educate pet owners on the benefits of microchipping and the importance of keeping their microchip details up to date.
The company highlights research which shows just how important it is to encourage owners to keep microchip details up to date. In 2017, the BVA found that 44% of vets were unable to reunite stray dogs with their owners due to incorrect information on the microchip database. The Dogs Trust Stray Dogs Survey Report 2017–18 also found that 75% of all microchipped dogs that were unable to be returned to their owners had incorrect contact information on their chip.
To order your 'Chip & Check' display, contact your Animalcare Territory Sales Manager, or call Animalcare's head office on 01904 487687. Display packs are subject to an order of identichip microchips and while display stocks last.
The survey is conducted every four to five years and asks veterinary nurses to answer questions about a variety of subjects including demographic data (for example, socio-economic background, educational attainment, race/ethnicity, disability), work-related data (for example, employment status, location of workplace, type of workplace, hours of work, position in practice) and information about professional achievement (for example, hours of continuing professional development (CPD) undertaken and extra qualifications earned).
The survey, which is conducted on the College’s behalf by the Institute for Employment Studies, also ask respondents about their views on different aspects of their profession, including career plans, challenges facing the profession, and wellbeing.
This year, the survey also asks for your view of the RCVS, including its values, how it should communicate, and what it should prioritise in future years.
Lizzie Lockett, RCVS CEO (pictured right), said: "The results of the Surveys form a very important ‘snapshot’ of the profession at a given point in time, but they also prove useful for years to come in terms of how the College develops its regulatory and educational policy, the areas it chooses to focus on and the issues it chooses to tackle.
"The ensuing reports are also used by a myriad of other individuals, such as those in academia, government and representative bodies, as well as journalists. It’s therefore really important that we have as accurate a picture as possible. So although completing the Surveys is entirely voluntary, we strongly encourage members of the professions to take the time to complete them. It will, ultimately, help the development of appropriate and supportive policies for your profession."
Sarah qualified from the Royal Veterinary College in 1998, gained an MSc in Clinical Oncology in 2003, the RCVS Certificate in Veterinary Dermatology in 2010 and RCVS Advanced Practitioner status in 2015. She is now the President of the British Veterinary Dermatology Study Group.
Sarah previously ran two dermatology referral services before co-founding Vet-AI, a company working on artificial intelligence and an online consultation service for pet owners, where she is now the Chief Veterinary Officer.
Sarah said: "Many diseases that are primarily non-pruritic often become pruritic when the animal develops secondary bacterial or yeast infection. These cases require a thorough dermatologic history and physical examination and successful treatment very often depends on identification of the underlying cause."
"Providing the right nutrition should also be implemented to ensure optimal levels of nutrients required for skin repair, barrier function and health. I will be including a complete pruritus work up, discussing how diet can be part of the management of this particular condition."
To register for the webinar, visit: https://vetportal.royalcanin.co.uk/cpd/webinar/
The research, which was carried out by analysing data from 455,557 dogs which presented at veterinary practices participating in the College’s VetCompass programme, investigated the frequency, severity and duration of anal sac disorder, conjunctivitis, dental disease, dermatitis, obesity, lipoma, osteoarthritis and otitis externa.
The main findings were:
The most common conditions were dental disorder (9.6%), overweight/obese (5.7%) and anal sac disorder (4.5%)
The conditions that lasted the longest were dental disorders (76% of year), osteoarthritis (82%), and overweight/obese (70%)
Scoring out of 21, with higher scores for greater severity, the most severe conditions were osteoarthritis (13/21), otitis externa (11/21) and dermatitis (10/21).
The researchers say that by considering frequency, duration and severity together, the study showed that the conditions with the highest welfare impact overall are dental disease, osteoarthritis and obesity.
It is hoped these results can help vets to target conditions that have the greatest impact on dogs they treat. The evidence also shows owners the value of addressing these important conditions to improve their animal’s welfare. The study also provides evidence for other stakeholders on which conditions merit further research prioritisation.
Dave Brodbelt, Professor of Evidence-based Veterinary Medicine at the RVC and senior researcher on the study, said: "First opinion veterinary professionals see dogs presenting to them with a range of conditions everyday and understand what are the common diseases that they treat. Yet there is a need for clear evidence based welfare assessment of the major conditions of dogs. This work adds to our understanding by allowing the transparent comparison of commonly seen disorders in primary practice and highlights conditions with greatest welfare impact."
Dr Dan O’Neill, Senior lecturer in epidemiology at the RVC and co-author said: "During my 20 years as a first opinion vet, owners constantly asked me to advise them about the most important conditions that they should try to prevent in their dogs. At that time, I could not answer this as it was unknown to science. We now have this answer; and we can now advise owners to focus on dental health, monitoring for joint disease and to pay special attention to their dogs body condition score. Finally, we have the key to prioritising long-term health in dogs overall. This is a huge step forward to improving dog welfare; huge thanks to Dogs Trust for having the vision to support this work."
The study is freely available open access.
Reference
Amongst the speakers were Catherine Oxtoby MRCVS, Risk Manager at the Veterinary Defence Society, and Dr Huw Stacey, director of clinical services at Vets4Pets.
Dr Stacey explained how Vets4Pets and Companion Care practices are embracing a culture of sharing information when things don’t go according to plan in practice.
He said: "We all face challenges in the workplace, and this event focused on how different professions can share ideas and good practice and how they find solutions to any challenges.
"The culture of aviation and maritime is one of minimising risk and putting safety first, and it is fascinating to compare their approach to that found in medicine and veterinary.
"One common theme we discussed was the wellbeing of both professionals and patients or clients, with tiredness being at the top of the list of things that can negatively affect wellbeing and performance.
"Both aviation and maritime recognised that long shifts, particularly overnight, needed to be reduced in order to improve the outcome for everyone.
"In veterinary and human medicine, tiredness and long shifts are often worn as a badge of honour and being tired at work was something that should be admired, rather than addressed.
"But, tired vets are effectively neglecting themselves and their own wellbeing, which in turn leads to pets not receiving the best level of care in practice.
"This is something we’re taking seriously at Vets4Pets and Companion Care, and we’re currently looking at ways to decrease the risk of overworked and tired vets and vet nurses."
Another area of discussion was around the reporting of near misses and when things don’t go right, and how veterinary professionals need to identify and share the learnings from these events, not only within their practice, but with the wider profession too.
He said: "We need to continually emphasise the concept of a ‘just’ culture, to ensure our colleagues feel confident about reporting incidents open and honestly."
"It is not in the interests of the professional, the patient or the client to bottle things up, and at Vets4Pets and Companion Care we’re encouraging all of our practices to adopt the VDS VetSafe system, which provides a mechanism for sharing incident reports across the profession, enabling us all to learn from them to the benefit of our patients."
The Committee's decision to recommend the addition of vets to the list is seen as a major win for the RCVS and the BVA which together submitted evidence as part of the review, which began in autumn last year.
Professions on the list are prioritised for visas required to live and work in the UK. Employers wishing to hire professionals on the list are not required to complete the Resident Labour Market Test, meaning they don't have to advertise vacancies locally before offering the role to an employee from overseas.
The RCVS/BVA submission focused on the need for the UK immigration system to recognise that the veterinary workforce is already under capacity and that this problem is likely to be exacerbated after Brexit. This is due to the potential for increased demand for veterinary surgeons in areas such as export certification, and also the likelihood that fewer veterinary surgeons from the European Union will be joining the Register. It also reiterated the importance of veterinary surgeons in areas such as public health, food safety, disease surveillance and control, as well as education, research, clinical practice and animal welfare.
RCVS President Amanda Boag said: "We are very pleased to see that our submission, made with our colleagues at the BVA, has been welcomed by the Committee and that this recommendation will now be going to the key decision-makers at the Home Office for consideration. While we are still unaware of how the process of the UK leaving the EU will pan out, this is a very important step in ensuring the future security of the profession and mitigating against worsening workforce shortages.
"We would reiterate to the Government that the UK is currently reliant on overseas registrants to meet the demand for veterinary surgeons, with veterinary surgeons from the rest of the EU making up around 50% of new registrants each year. By adding veterinary surgeons to the Shortage Occupation List, and therefore reducing the immigration requirements needed to live and work in the UK, the Government will be helping ensure vital veterinary work continues to be done particularly in areas such as food safety and public health."
Simon Doherty, BVA President, said: "MAC’s recommendation is a huge win for animal welfare and a resounding vote of confidence in the veterinary community and the multiple benefits it realises across the UK. We are absolutely delighted that the committee has heeded our calls and recognised the need to reinstate vets on the list to keep workforce supply and resilience high in the unpredictable times ahead."
Rachel has also qualified as a member of the dentistry chapter of the Australian and New Zealand College of Veterinary Scientists, and regularly tends to the oral health of zoo and sanctuary animals, including bears, cheetahs, tigers and snow leopards.
She said: "I’m excited to be joining North Downs, which is renowned as a centre of excellence for specialist veterinary care, and I’m really looking forward to this new role. There is a clear benefit in having a multidisciplinary team on site to approach oral surgery cases.
"Dentistry is such a rewarding area and can deliver immediate changes to our patients’ health and well-being.
"Many dental diseases can also be prevented, so I am committed to educating owners about their pets’ oral health and also veterinary surgeons and nurses, about new techniques, best practice, materials and equipment."
North Downs hospital director Terry Emmerson said: "Our aim is always to provide first-class care for our patients and to give an excellent service to their owners and the vets who refer cases to us.
"Rachel’s new dentistry service will be yet another specialist discipline on offer at North Downs to further extend the excellent care and treatment we offer here."
The appointment means that North Downs has a total of 11 specialist service, and makes it one of only a handful of centres in the UK that offer a dentistry service run by a dentistry specialist.
Firstly, the BVA recommends that more work needs to be done in order to clarify and communicate the duties that can already be delegated to Registered Veterinary Nurses under Schedule 3.
In addition, the Association says that:
there should be an expanded role for RVNs in general anaesthesia, where the veterinary surgeon maintains overall responsibility
consideration should be given to granting RVNs expanded rights to dispense POM-V flea and worming treatments
consideration should be given to expanding the role of RVNs in the management of chronic cases, including repeat dispensing
consideration should be given to the potential role for RVNs in dispensing contraceptives, anthelmintics and vaccines in a zoo setting
it would be beneficial to incorporate the Suitably Qualified Person (SQP) role within RVN training
The BVA also recommends that there should be accessible, flexible and professionally recordable post-registration awards for RVNs from all academic backgrounds, and has reiterated its call for the protection of the title of 'Veterinary Nurse.'
BVNA Junior Vice President Jo Hinde RVN (pictured right) said: "BVNA strongly supports the vet-led approach as we believe working together as a team is the best way to improve both patient and staff welfare. We are delighted to be working on this project with BVA and are using our best efforts to continue to strive to strengthen the role of the RVN.
"We have always believed the VN title needs to be protected and this is increasingly important as the veterinary profession adapts to new challenges. It is vital that owners can be confident that their pet is being looked after by well-trained and RCVS-registered staff, as well as there being more clarity surrounding Schedule 3 procedures.
"The support for the advancement of the nursing role through post-registration qualifications is a welcome development and we believe this will help enable RVNs to follow their passion for a particular subject and allow them to significantly increase their knowledge in specific areas of interest. When following the vet-led model, this would result in a strong team of individuals with in-depth knowledge that can enhance their patients’ care."
What do you think of these recommendations? Come and discuss here.
The allied professionals that the BVA says should be led by veterinary surgeons include: Registered Veterinary Nurses (RVNs), Official Auxiliaries/ Meat Hygiene Inspectors, embryo transfer technicians, equine dental technicians, foot trimmers, farriers, hydrotherapists, animal behaviourists and veterinary physiotherapists.
To clarify where the responsibility for a patient sits and how it is shared between veterinary surgeons and allied professionals, the new policy statement also calls for:
The regulation of allied professionals to include mandatory veterinary diagnosis and oversight and appropriate access to veterinary records as pre-requisites before treatment;
Clarity on the delegation of duties for RVNs under Schedule 3 of the Veterinary Surgeons Act and protection of the ‘veterinary nurse’ title in legislation;
Consultation with the veterinary profession on any regulatory changes that may arise as a result of technological or other innovation.
British Veterinary Association President Simon Doherty (pictured right) said: "Against an evolving landscape, it’s essential that the veterinary profession keeps pace with change and addresses the challenges and opportunities it presents.
"Vets across sectors have always worked closely with allied professionals. The hub and spoke model acknowledges and clarifies this working relationship with clear lines of accountability and responsibility for the animals under our care. It also emphasises that vets’ right to diagnose, prescribe, and undertake surgical procedures and medical treatments must not be undermined.
"An effective and efficient vet-led team can help deliver better animal health and welfare, improved client care, and more effective use of skills within the veterinary professions. Given the ongoing workforce shortages, a strengthened veterinary workforce also has the potential to ease recruitment and retention concerns for both vets and RVNs and offer improved wellbeing.
"BVA will continue working with professional bodies and organisations to formalise the hub and spoke model, promote the value of regulation, and drive up professional standards."
Covering the topics of worming broodmares and foals, spring and summer worming and winter worming, a total of 20 AMTRA CPD points are available. Virbac says the 3 new training modules offer the opportunity to acquire additional CPD points in time for the June deadline.
The webinars can be accessed on demand at https://sqptraining.learnupon.com/users/sign_in
The organisers say that the vision for the WellVet Weekend is to offer a range of sport and wellbeing events which give the opportunity to recharge, refresh and re-energise.
This year, the weekend includes the Tour de Cambridge cycle ride, the WellVet sports day, HiiT (high-intensity interval training) sessions as well as some thought-provoking workshops delivered in collaboration with Vets: Stay, Go, Diversify (www.vsgd.co).
The WellVet Mindful stream aims to bring a mellow approach to the weekend with yoga and meditation alongside some reflective workshop-based sessions.
This year also sees the addition of the WellVet Family stream, which will focus on supporting new parents returning to practice, and building mind and body confidence after welcoming a new addition to the family.
The weekend will include plenty of social time, with a gala dinner on Saturday night where the headline speaker is none other than the ultrarunning veterinary surgeon, Jasmin Paris. She'll be giving a speech called 'The Mountains are calling, and so is the baby!' in which she'll talk about her achievement in being the first woman (let alone vet) to win the Montane Spine Race, widely regarded as one of the world’s toughest endurance races. Not only that, but she smashed the overall course record by over 12 hours.
WellVet Co-Founder, Liz Barton, said: "We volunteer a great deal of time and energy to run these not-for-profit events, because of the positive impact it offers individuals. It makes it all worthwhile when we see life-changing experiences from the weekend carried forwards to improve the everyday lives of colleagues within the profession. It’s our way of giving something back. Tickets are subsidised thanks to our generous supporters, making them very affordable and meaning that delegates get a lot of content for their money."
Tickets are now available. For more information and to book your place at WellVet Weekend 2019, please visit www.wellvet.co.uk
In August 2017, Georgina Bretman was found guilty of causing unnecessary pain and suffering to her two-year-old dog Florence by injecting the animal with insulin, causing the dog to suffer from hypoglycaemia, collapse, convulsions and seizures, for which it needed immediate veterinary treatment to avoid coma and death.
Following her conviction, Miss Bretman was sentenced to a Community Payback Order, with a requirement to carry out 140 hours of unpaid work. An order was also made to take Florence away from her and to ban her from owning a dog for two years.
At the VN Disciplinary Committee hearing, Miss Bretman admitted the facts as contained within the charge against her and the Committee found the charge proved.
The Committee went on to consider whether the charge rendered Miss Bretman unfit to practise.
The Committee heard from Miss Bretman’s counsel, Mr O’Rourke QC who indicated that Miss Bretman accepted that her conviction rendered her unfit to practise as a Registered Veterinary Nurse. The Committee found Miss Bretman’s actions in deliberately administering a poisonous substance to Florence thereby risking Florence’s death to be “very serious and deplorable conduct on the part of a veterinary nurse, a member of a profession specifically entrusted to look after and care for animals.” It also took into account the fact that Florence needed urgent veterinary treatment to avoid death and that Miss Bretman was in a position of trust over Florence as her owner.
Stuart Drummond, chairing the Committee and speaking on its behalf, said: "Miss Bretman’s conduct was also liable to have a seriously detrimental effect on the reputation of the profession and to undermine public confidence in the profession. The fact that she was a veterinary nurse was made clear at the trial and reported in the press. The Committee considered that members of the public would be rightly appalled that a Registered Veterinary Nurse had committed an offence of this kind.
The Committee was satisfied that this conduct fell far below the standard expected of a Registered Veterinary Nurse and that Miss Bretman’s conviction was of a nature and seriousness that rendered her unfit to practise."
The Committee then heard oral evidence from Miss Bretman in which she explained that she had always been passionate about working with animals and working in the veterinary profession and how she enjoyed her work as a veterinary nurse with a particular interest in hydrotherapy and rehabilitation.
She spoke about the devastating effect of the incident and the shame that was ‘brought down on her head’. She told the Committee that she had been suspended from her job and, since her conviction, had not worked as a veterinary nurse.
However, Miss Bretman said that, while she accepted and respected the verdict of the court, her stance remained that she had not done what was alleged and now hoped to rebuild her career as a veterinary nurse. She accepted that the offence of which she had been convicted was very serious, particularly for a veterinary nurse.
In considering Miss Bretman’s sanction the Committee took into account the aggravating and mitigating factors. Aggravating factors included the fact there was actual injury to an animal, that it was a pre-meditated and deliberate act against an animal for whom she was responsible, the fact that a medicinal product was misused, a lack of insight and a lack of remorse.
In mitigation the Committee took into account the fact she had no previous disciplinary history, had received positive references and testimonials and that, following the conviction, she demonstrated a willingness to be removed from the Register and to not work with animals to avoid causing embarrassment to the RCVS.
Stuart Drummond said: "The Committee was of the view that the nature and seriousness of Miss Bretman’s behaviour, which led to the conviction, was fundamentally incompatible with being registered as a veterinary nurse. The conduct represented a serious departure from professional standards; serious harm was deliberately caused to an animal; the continued denial of the offence demonstrated a complete lack of insight, especially in regard to the impact of her behaviour on public confidence and trust in the profession. In light of these conclusions, the Committee decided that the only appropriate and proportionate sanction was removal from the Register.
"In reaching this decision the Committee recognised the impact this was likely to have on Miss Bretman, which was unfortunate given her young age and her obvious passion for a career as a veterinary nurse. The Committee had considered with care all the positive statements made about her in the references and testimonials provided. However, the need to protect animal welfare, the reputation of the profession and thus the wider public interest, outweighed Miss Bretman’s interests and the Committee concluded that removal was the only appropriate and proportionate sanction. The Committee determined that it was important that a clear message be sent that this sort of behaviour is wholly inappropriate and not to be tolerated. It brought discredit upon Miss Bretman and discredit upon the profession".
The Committee then directed the RCVS Registrar to remove Miss Bretman’s name from the Register. Miss Bretman has 28 days from being notified of the Committee’s decision to submit an appeal.
There were two charges against Dr Mulvey. The first was that, between May and October 2018, she failed to provide the clinical history for an English Cocker Spaniel named Henry to the Tremain Veterinary Group, despite numerous requests. Also, that between August 2018 and October 2018, she failed to respond adequately or at all to Henry’s owner's requests for information, particularly his clinical records and details of insurance claims made for Henry by her practice.
The second charge was that in January/February 2019, she failed to respond to reasonable requests from the RCVS, particularly in relation to her treatment of Henry, her continuing professional development (CPD) and the status of her Professional Indemnity Insurance.
At the beginning of the hearing, Dr Mulvey admitted the facts and conduct alleged in the charges and also admitted that when her conduct was considered cumulatively, she was guilty of disgraceful conduct in a professional respect.
The Committee, having considered the evidence provided by the College and Dr Mulvey’s admissions found all the facts and conduct to be proved.
The Committee also concluded that Dr Mulvey's failure to respond to Henry's owners and to the College amounted to disgraceful conduct both when considered individually and cumulatively.
In respect of the first charge, the Committee decided that Dr Mulvey had breached the Code of Professional Conduct for Veterinary Surgeons by failing to provide clinical records or details of insurance claims.
This was an administrative part of the function of a veterinary surgeon’s role and that failure to provide clients with such information was unacceptable and fell far short of acceptable professional standards. The Committee noted that Dr Mulvey’s failure to provide details of insurance claims had occurred because she had not made those claims, despite offering to do so.
With regard to the second charge, the Committee concluded that Dr Mulvey’s failure to respond to five requests from the College for information about Henry was unacceptable.
The Committee also considered that the omissions took place in the context of Dr Mulvey’s previous Disciplinary Committee hearing in April 2018 during which she agreed to a number of undertakings including supervision on her professional practice by an appointed supervisor. It therefore decided that her failure to provide evidence of her CPD and Professional Indemnity Insurance to the College each individually amounted disgraceful conduct in a professional respect.
The Committee then went on to consider the sanction for Dr Mulvey in relation to the both charges that it had found proved and also in respect of the charges it had found proved at its earlier hearing on 26 April 2018 for which sanction had been postponed for a period of 1 year to enable Dr Mulvey to comply with undertakings she gave to the Committee to ensure that her practice met RCVS Core Standards by May 2019.
The Committee heard from Mr Stuart King MRCVS who had been appointed to act as a Workplace Supervisor for Dr Mulvey during the period of her Undertakings. Mr King provided the Committee with a report upon the extent to which Dr Mulvey had complied with the terms of her undertakings including the extent which she had implemented Dr King’s numerous recommendations.
The Committee also heard from Dr Byrne MRCVS an inspector for the RCVS’s voluntary Practice Standards Scheme that Dr Mulvey’s practice, when inspected by him in early April 2019, had not met RCVS PSS Core standards in a number of areas.
The Committee heard from Dr Mulvey and her Counsel that she accepted that she had not met RCVS Core standards as she had undertaken to do.
In reaching its decision as to sanction for all the matters, the Committee took into account that Dr Mulvey’s misconduct overall was serious because it was repeated.
The Committee also considered aggravating and mitigating factors.
Aggravating factors included the fact that the misconduct was sustained or repeated over a period of time (in relation to charge 1 for a period of approximately 4 months and in relation to charge 2 for approximately 6 weeks).
Other aggravating factors include the fact that Dr Mulvey’s conduct contravened advice issued by the Professional Conduct Department in letters sent to her, and that she had wilfully disregarded the role of the RCVS and the systems that regulate the veterinary profession.
Mitigating factors included that: there was no harm to any animal; there was no financial gain for Dr Mulvey or any other party; there was no ulterior motive behind Dr Mulvey’s conduct; and that Dr Mulvey had in fact both completed her minimum CPD requirement and secured Professional Indemnity Insurance, demonstrating that she had not attempted to hide such information from the College.
It also took into account that Dr Mulvey, prior to the first Disciplinary Committee’s hearing in 2018, worked without any previous disciplinary findings against her from 1976 to 2018. The Committee also noted that she had made efforts to comply with some of the undertakings.
Mr Ian Green, Chair of the DC and speaking on behalf of the Disciplinary Committee, said: "The Committee considered that a warning or reprimand was not an appropriate sanction that would meet the public interest. Instead, the Committee decided that a suspension order for a period of six months would allow Dr Mulvey sufficient time to focus on ensuring her practice met the Core Standards set out in the Practice Standards Scheme, without the daily demands of practising as a veterinary surgeon, and was a proportionate and sufficient sanction to meet the public interest.
"The Committee was satisfied that a period of six months met the public interest as it was sanctioning Dr Mulvey for two sets of similar misconduct which we had determined overall as serious. The Committee also believed that during these six months Dr Mulvey could reflect and reorganise her practice, and there would be little risk to animals and the public in her returning to practice."
Dr Mulvey has 28 days from being informed of the Committee’s decision to lodge an appeal with the Privy Council.
This is despite the fact that 84% of the 524 veterinary professionals that were polled said they believe that veterinary wellness is very important to the success of their practice.
Perhaps as a consequence, the survey found many respondents taking steps to look after their own wellness, with 57% saying they have started an exercise regime, 54% saying they have taken up other hobbies outside work and 44% saying they are talking more openly to colleagues to share problems and offer support.
When questioned about the obstacles to improving wellness in their practice, 'staff not having the time to focus on it' was cited by 76% as the main barrier. 52% said it was not recognised as an issue, while a further 49% said that the lack of trained personnel to champion wellness was the biggest problem.
Of those practices which had initiated a wellness programme, 83% said it made a positive difference. The most commonly reported wellness initiatives were the provision of a counselling service (38%), online resources (32%), and appointing a practice wellness champion (30%).
When asked what one thing their practice could do to enhance veterinary wellness, the two most popular suggestions were:
Improved communication and support with more openness and empathy (26%)
Improved team working with more breaks and a quiet area for staff (24%)
10% said that an acknowledgement that wellness was actually an issue would be a start.
VET Festival organiser Nicole Cooper said: "What we find startling about these results is that, despite a growing appreciation of the importance of veterinary wellness, almost half of the UK’s practices still don’t recognise it as an issue.
"The good news from this survey is that many veterinary professionals are now starting to take responsibility for their own mental health, whether through taking up interests outside work or sharing problems and experiences more openly at work. We urge more practice leaders to step up and to prioritise enhancing the wellness and wellbeing of their dedicated teams.
Veterinary wellness is a focus for this year’s VET Festival, which takes place on 7-8 June at Loseley Park in Surrey. There'll be expanded Wellness Hub offering sessions run by the charity VetLife, yoga and talks on meditation and reducing stress.
Tickets for VET Festival can be purchased here: https://www.vetfestival.co.uk/delegate-info/ticket-information
60 veterinary surgeons, nurses and other team members from White Cross practices in Tividale, Guiseley, West Derby and Alvaston have formed 20 teams of three people, logging a total of 30,000 miles since the initiative was launched in February, or an average of 11,000 steps per team member per day.
James Harris MRCVS from White Cross Vets said: "We spend a lot of the day on our feet but really had no idea about the distance that we clock up. There are about 2,000 steps in a mile so we are walking more than five miles every day! We are always encouraging our clients to make sure their pets have a healthy lifestyle, so it’s great to practise what we preach.
"As well as the steps we take throughout the day many of us are also committed to sports and exercise regimes outside work and that has helped us to reach the top of the leaderboard for a few weeks. You might even find some of us marching on the spot to boost our step-counts and heart rates, so the Fitbit challenge is definitely keeping us active."
General manager Jo Jobling said: "We understand the vital importance of both physical and mental wellbeing, and our Fitbit challenge is a great way for our teams from across our 19 practices to work together to achieve a worthwhile healthy goal, as well as creating some healthy competition with colleagues in other practices. We also have an individual steppers league table which was recently topped by one of our veterinary nurses, Katie Rose from our Tividale practice. It might have helped that she completed a half marathon over that weekend though!"
BSAVA President Sue Paterson said: "By signposting clients to extra downloadable advice or handing them a printed guide when they leave consultation room, we will hopefully reduce their temptation to run potentially misleading ‘Dr Google’ searches to find out more about the diagnosis."
The series includes:
My dog does not like other dogs
My dog has dental disease
My dog has diabetes
My dog has itchy skin
My dog has kidney disease
They join the PetSavers existing library of general online guides on Puppies, Kittens, Rabbits, Guinea pigs, Caring for your elderly pet and Losing your pet.
Printed versions of the new guides can be ordered by veterinary practices to use in their reception areas, in exchange for a donation to PetSavers.
The new guides can be downloaded at http://www.petsavers.org.uk/Pet-guides
The blog is part of a mental health anti-stigma campaign called '&me', being run jointly by the RCVS and the Doctor's Support Network.
&me encourages people within healthcare professions to come forward with their personal mental health stories, to demonstrate that mental health issues do not preclude people from achieving leading roles in healthcare.
Mind Matters Manager, Lisa Quigley said: "By reducing stigma and showing that it is possible to continue to flourish in your career no matter where you are on the mental health continuum, our &Me role models help those who are not yet seeking help or who are struggling with their diagnosis to speak to appropriate people.
"We often talk about veterinary surgeons’ mental health and the wider prevalence of mental health issues within the veterinary professions. We are incredibly pleased to have our first VN &me ambassador and this blog will hopefully open the way for other veterinary nurses at all stages of their careers to talk more openly about their mental health to trusted people and healthcare professionals. We thank its author, Meg Conroy, for her bravery in stepping forward to talk about her own experiences."
Meg said: "In January 2018 I was promoted to Head Nurse for the Hub of practices and had volunteered for British Small Animal Veterinary Association Southern region and Congress committee. I felt on top of the world. I was married in July 2018, the best day of my life. But then suddenly, my black dog was upon me. Everything from the last eighteen months crashed down on me like a tsunami. Everything I had pushed to the back of my mind came flooding back. This is when I truly started to change how I viewed my mental health.
"Before it was a dark, damning secret that I was ashamed of. Now I had supportive colleagues who genuinely just wanted me to get better. After five weeks off work, medication and starting counselling, I was ready to give work another go. I remember taking my first blood sample, shaking and tears filling my eyes. I didn’t think I would ever be whole again. Eight months on from my last episode, I feel stronger than ever, I fought every day until one day it became easier.
"We talk often about what our mental health takes away from us, but what has my mental health given me? It’s given me a greater understanding and empathy towards others. My mental health is a part of me, but it does not define me. Certainly not as a nurse."
Meg’s full blog can be found on the Mind Matters website.
The RCVS is still looking for more ambassadors for the Mind Matters &Me campaign. If you're interested in joining the campaign, you should first contact Dr Louise Freeman, Vice-Chair of the Doctors’ Support Network, on vicechair@dsn.org.uk, for a discussion about the potential personal impact.
First they looked at the names of all the cats and dogs they saw in 2018, finding that the most popular names for dogs were Bella, Poppy and Alfie, whilst the most popular for cats were Charlie, Bella and Molly.
By comparison, the top ten names registered at the practice in the thirties were: Susie, Sally, Judy, Penny, Candy, Sam, Betty, Simon, Wendy and Bridget.
Honestly, who calls their dog Simon? Even in the 1930s.
Tom Ward, from White Cross Vets, said: "The most common names in our research reveal a leaning towards giving pets human names. It’s fascinating that this has gone full circle and was also a trend in the late 1930s, before names such as Fido, Patch, Sooty, Duke and Fluffy became popular with cats and dogs."
White Cross says that more recently it has also seen a surge of pets named after TV and film characters including Elsa from Frozen, Baloo from The Jungle Book, Peppa the cartoon pig, and Khaleesi, Sansa, Brienne and Tyrion, the Game of Thrones characters.
First out of the stalls was Vet AI, a company founded in 2017 by Paul Hallett and Robert Dawson MRCVS, which announced last November that it had filed patents for artificial intelligence technology to deploy in giving online consultations through its newly-launched app: Joii.
More recently, a Swedish company called FirstVet has announced the UK launch of a consultation service it has offered in the Scandinavian countries for a few years now.
All three companies charge £20 for an online consultation with a veterinary surgeon.
All of these services are currently limited in what they can offer pet owners here in the UK, because veterinary surgeons are not allowed to prescribe medicines without having physically examined the patient. FirstVet says that in Sweden, similar rules apply, except that under current guidance, antiparasiticides and feline contraceptives can be prescribed remotely.
This means that for the moment at least, online consultations in the UK can only advise pet owners whether they do or do not need to see a veterinary surgeon in person, or recommend OTC treatments, such as flea control.
Personally, I'm not convinced that it's worth £20 for the privilege of asking a vet whether or not my pet needs to see a vet, although to be fair, Joii includes a free symptom checker to differentiate between those cases that need directing to see a vet in person, and those that would benefit from the online consultation. Also, if a case needs to be referred to another vet after a consultation, Joii refunds the consultation fee.
Nevertheless I think I'd just ring my normal practice and ask. But that's just me. Perhaps others will see a value in the immediacy of the online service, or that it entails less commitment.
FirstVet does, however, have another string to its bow. It has been busy forging relationships with insurers to fund the majority of its consultations. The insured owner gets a free consultation subsidised by the insurance company; if the animal requires treatment, the owner is referred to their normal vet, unless they don't have one, in which case the referral is to the nearest practice which can help.
That seems to make all sorts of sense for insured clients. It really adds value to the insurance policy, to be told you'll have access to free, immediate online veterinary consultations. Almost certainly it will mean pet owners seeking veterinary advice sooner than they might otherwise have done. For the insurer, that in turn might mean earlier diagnosis and therefore cheaper treatment. One assumes it also translates into cost-savings for the insurer by dealing with certain queries without needing a trip to the practice.
Still, the really big prize here for remote consultation companies will come if and when the regulations allow remote prescribing. Not necessarily because they'll make a mark up on the sale of prescription drugs, though of course they will, but because suddenly the proposition to the pet owner is that the consultation can, in many cases, offer more convenient and cheaper treatment than if they had to visit a practice in person.
The problem with that, however, is that the £20 remote consultation may carry a greater risk of misdiagnosis. It may mean that the preventative approach to veterinary medicine goes out of the window, at least until remote monitoring technology catches up. There is also a risk that these new limited service providers will take the bread and butter consultations from bricks and mortar practices, consultations that may have been to some degree subsidising care for other patients. These are all the sorts of things that were hotly debated at RCVS Council last November.
Nevertheless, Vet AI is unashamedly pushing for remote prescribing rules to be relaxed. Founder Robert Dawson MRCVS said: "I think that the ease and reduced cost of access to veterinary advice and medicines will have a positive impact on animal welfare. I also think that it will free up vets' time to see the cases they really need to see.
"But in truth, what I think is not the point. The whole debate at the moment is characterised by members of the profession saying what they think will happen as a result of remote prescribing. What we actually need is some evidence. I'd really like to see some movement from the College on this, for a limited number of treatments like parasiticides, before the end of the year."
As Robert says, the debate is characterised by a lack of evidence. But there is, of course, another way that online consultations could really add value to the client/vet relationship without any of these problems, and that is as an adjunct to the service offered by bricks and mortar practices.
Bricks and mortar practices can already prescribe medicines to animals under their care without physically seeing the animal on every occasion. Furthermore, there are a number of situations where a remote consultation could save both the practice and pet owner time and money. For example, post-operative follow-up consultations.
However, none of the existing providers I've spoken to plan to offer a 'white label' solution. So, if I owned a practice, I tell you what, I'd be looking into online consultation software right now. It is already possible, of course, to offer online consultations via things like Skype. But better still would be a system that allowed clients to schedule an online appointment with their normal vet, perhaps slotted in between their face-to-face consultations. As opposed to the existing online providers, you wouldn't need to refund money if a physical consultation was needed, just - perhaps - set it against the later consultation. You could also offer annual plans to include a certain number of online consultations. You could have online triage consultations carried out by veterinary nurses.
There are lots of possibilities. But if you're a bricks and mortar practice, one thing is for sure, the time to look into all this is now. You could do worse than to start here: https://www.vetnurse.co.uk/b/veterinary-nursing-news/archive/2019/01/16/now-all-vet-practices-can-offer-remote-consultations.aspx.
RCVS CEO Lizzie Lockett said: "I am so proud of our performance in the Great Place to Work Awards and the efforts of everyone at the College, and especially our HR team, who have been tirelessly and creatively striving to make the College a wonderful place to work.
"Consistently being placed in the top 50 Great Places to Work is also a testament to the sustained hard work all of our employees and the important part they play in creating a supportive, interesting and good-humoured workplace.
"We are a service-led organisation and we want to make sure that we give our best to the veterinary professions and the general public. If our team enjoys the work, and the workplace, that will improve the service we are able to offer and, ultimately, benefit animal health and welfare."
The link emerged after six cats were taken to separate practices in England suffering with clinical signs of TB. Further tests confirmed that they were all infected with Myobacterium bovis. Seven more cats from the same household were also infected, but asymptomatic.
Researchers at the University of Edinburgh’s Royal (Dick) School of Veterinary Studies carried out an investigation to identify the source of infection.
The one common factor identified, as detailed in their paper, was that all the animals, which were kept exclusively indoors, had been fed Natural Instinct's Wild Venison cat food.
The authors concluded that whilst not conclusive (they were not able to test the food), their research provided 'compelling, if circumstantial, evidence of an association between the commercial raw diet of these cats and their M. bovis infections.
Natural Instinct withdrew the Wild Venison product last December, as some of the ingredients were not inspected in line with EU requirements.
A spokesperson from Natural Instinct said: "Everything we do at Natural Instinct is done so with the best interests of our customers and their pets in mind. We can assure our customers that Natural Instinct followed, and continues to follow, every food standard, hygiene regulation and best practice required to produce raw pet food in the commercial marketplace.
"As a responsible manufacturer, we are regularly inspected by the Animal and Plant Health Authority (APHA). We have complied with all of the necessary requirements, and consequently APHA have confirmed they are satisfied all standards have been met by us.
"Even though we no longer manufacture and sell the Venison cat product, we are continuing to work with Food Standards Agency as part of the investigation into the Venison cat food product."
The big question is what broader implications this incident has for feeding animals with raw diets.
Professor Danièlle Gunn-Moore from the Royal (Dick) School of Veterinary Studies, a co-author of the paper, said: "With this outbreak, the problem has been feeding wild venison – the law states the stalker must have their Deer stalker level 1 qualification, but this is only a 3-day course with just one day of disease recognition etc (apparently).
"Natural Instinct apparently sourced their deer from stalkers in the Edge area re TB risk. The stalker is supposed to inspect the gralloch (innards) wild ‘on the hill’ then leave it there for wildlife to eat. They only bring the carcass in skin back with them – which means significant pathology can easily be missed.
"Do we need to strength the law? Either that, or only feed raw venison from Scotland or other areas with no M. bovis (I am ignoring all the other potential infections here).
On the broader issue of feeding cats commercial raw food, Danièlle added: "In concept I think raw food can be far more environmentally stimulating – especially for housecats.
"But that is only safe if we can master 2 things: 1) be nutritionally sound – this is now possible with good companies doing this, and 2) be free of infectious agents – and this is a real problem, especially where the meat has been minced – which they need to be to get the minerals and vitamins correctly mixed in. So I don’t see how to square the circle at present."
Conor O’Halloran et al. Tuberculosis due to Mycobacterium bovis in pet cats associated with feeding a commercial raw food diet. Journal of Feline Medicine and Surgery, 2019. DOI: 10.1177/1098612X19848455