Subcontinental shift?

In a previous blog I stated that, while the Brexit process may throw up plenty of challenges for the next two years and beyond, there will also be plenty of opportunities to forge closer links with countries that we, perhaps, have ignored over the years in favour of our nearer neighbours.

One of these countries is India where I, along with the President Chris Tufnell, recently embarked upon a fact-finding mission to better understand their veterinary industry and regulatory system, visiting the various veterinary bodies in Delhi including the Veterinary Council of India and a vet school in Chennai.

It is a pretty well-known fact that India is on track to becoming the world’s most populous country by 2030, but it also has one of the biggest ‘veterinary populations’ in the world (not to mention the largest cow population!) with some 90,000 names on the Veterinary Council of India’s Register as well as 44 vet schools. As we look to expand the ‘global brand’ of the RCVS, therefore, India must be one of our key targets – not only because of the size of population but also its long-standing historical ties to the UK.

Chris and I flew first to Chennai (formerly Madras) in the south of the country where we visited the Tamil Nadu Veterinary and Animal Sciences University, meeting Vice-Chancellor and heads of departments to get a sense of how veterinary education works in India. As in the UK the degree courses are longer than most others with five-and-a-half years of education and training – many of them focused on regional agricultural species.

Over the course of 2017 we will be looking to better understand…how we can develop a framework for a pilot project around accreditation of Indian vet schools.

We then travelled to Delhi where we met with the Veterinary Council of India, the Indian Council of Agricultural Research, the veterinary department of Jawaharlal University and the President of SAPAC (the equivalent of the BSAVA) as well as the British Council and British High Commission.

While it was something of a whirlwind tour there were two overwhelming impressions that Chris and I came away with from our discussions with key people and our own observations. The first is that, understandably, veterinary medicine is still very focused on agriculture – but that, with the burgeoning middle class, there is an ever-increasing demand for companion animal-focused vets. The second is that it seems to be a slightly lower status profession in India than the UK but that, like here, it is highly trusted by the public.

In terms of what we want to do in India, we will be looking to build on the links forged during our visit and, over time, possibly look to the country as a potential source of veterinary graduates, as the medical profession does in this country. There are also opportunities for UK students and graduates and for the sharing of knowledge and best practice.

Although some preparatory work has been done, building these links will not be without challenges – the regulatory system is quite different from ours. For example, registration and professional conduct issues are handled by the state branches of the Veterinary Council of India with only educational standards falling under the remit of the central body. As would also be expected of a country of more than one billion people with 29 states, there is also a dizzying array of agencies and organisations and stakeholders so it is difficult to know who to talk to about what.

Over the course of 2017 we will be looking to better understand where the power lies and how we can develop a framework for a pilot project around accreditation of Indian vet schools. This will involve making contact with those key stakeholders – a task that the British Council in India has kindly offered to help us with.

So – we look forward to seeing how this will develop over the coming years and updating you in due course!

Enhancing reputation through conciliation

In my last blog, I mentioned some correspondence from a veterinary surgeon, published in the Veterinary Record, which was so ‘on message’ that, to the cynical eye, it might have looked like we wrote it ourselves!

In fact, it was a totally unprompted and heartfelt letter from a member of the profession about his positive experiences with our concerns investigation process and alternative dispute resolution (ADR) trial.

John Dinsdale, the author, described a concern that had been raised about the conduct of one of his veterinary surgeons who, after a thorough investigation of the circumstances by our Professional Conduct Department, was found to have no arguable case for professional misconduct against her.

However, the client was not satisfied, and the case was referred to our ADR trial, which is independently delivered by Ombudsman Services, and aims to resolve concerns which we cannot deal with ourselves, through conciliation.

To paraphrase the letter, Mr Dinsdale wrote that there was ample communication throughout the ADR process, including regular updates directly to the vet, and that the whole process was relatively simple and fast. To quote from the letter directly:

 “The ombudsman ruled again in her favour. This system, along with the excellent approach taken by the RCVS, definitely reduced the stress and anxiety to a manageable level.”

Engagement with ADR

However, despite the fact that this letter was overwhelmingly positive about the ADR trial, this sentiment hasn’t quite been reflected in the profession’s overall engagement with and take-up of the trial.

It has long been my mantra that what is good for the public is good for the profession and I stand by that.

In fact, statistically-speaking, the take-up has been quite disappointing, which is partly why the trial got off to a slow start and had to be extended by six months. Out of the 343 cases that have been considered since the trial started in November 2014, 173 cases were not referred because the vet did not consent.

There has clearly been some scepticism amongst the profession about the benefits of ADR and at the College we need to think about how we convince people of these. It has long been my mantra that what is good for the public is good for the profession and I stand by that. With many complaints, public and professional interest may seem diametrically opposed, but the results of cases referred to the trial prove this is not the case.

Of the 62 cases for which final decisions have been made, a large proportion found that the veterinary surgeon need take no further action to remedy the situation – essentially an exoneration of their actions. In one case, Ombudsman Services has found in favour of the veterinary surgeon and recommended that the client settle their bill.

Handshake photo

It is not about apportioning blame but providing resolution.

Inevitably, in some cases, Ombudsman Services has recommended that the veterinary surgeon make amends to the client. Examples have included offering an apology and making a small goodwill payment; being asked to provide documentation to a client with an overview of clinical actions taken; and providing a post-mortem report to a client in language that was understandable to them and without photographs.

I think that, even where the Ombudsman Services has recommended that amends be made to the client, these shouldn’t be seen as negative decisions against the vet. For a start, they are not binding on either party, but, more importantly, they also provide a means of conciliation between the veterinary surgeon and the client, a way to resolve what could otherwise be a protracted and potentially bitter confrontation. It is not about apportioning blame but providing resolution.

However, I think the most important reason to get behind the ADR trial is reputation. A recent Vet Futures survey, conducted by our project partners the BVA, revealed high levels of trust in the profession. This is very gratifying and is reflected in the relatively low number of complaints made about veterinary surgeons and the fact that very few of these end up in Disciplinary Committee hearings.

Nevertheless, this situation is not a given. Back in 2008, and in relation to the fact that the majority of concerns we receive are closed because they do not meet our threshold for serious professional misconduct, a House of Commons Environment, Food and Rural Affairs Select Committee report stated, that ‘allowing such a large number of complaints each year to be dismissed in this way inevitably harms the reputation of the veterinary profession’.

I do not think this is overstating the case. By engaging with dispute resolution the veterinary profession can prove that it is truly dedicated to animal welfare and client care, and that it is willing to engage with and resolve problems in a constructive way. The alternative could be a gradual erosion of these high levels of public trust in the profession.

In his letter, John Dinsdale summarises this point more authentically than I ever could:

“We are already judged by the… public each and every day of our working lives and there is a public perception that Ombudsman Services are fair and open. This should result in an element of trust and a move away from the misguided feeling that we, as professionals, close ranks.”

Next steps

Despite the slow start, the trial is almost two-thirds complete and is set to meet its target of 100 cases by its October deadline. The findings of the trial will be brought to November Council where we will also decide, in the light of our experiences, how we can best implement the EU Directive on ADR.

In the remaining few months it would be great to see some more engagement from the profession in the trial. Greater recognition that an alternative way of solving complaints which we, as the regulator, have no powers to take forward, is vital for maintaining confidence and trust in veterinary surgeons and their art.

If you would like to have a chat with me about the trial, you are very welcome to contact me on nick@rcvs.org.uk. You will find no keener evangelist for ADR than me – excepting John Dinsdale of course!

It’s nice when a plan comes together…

The front page of Veterinary Times on 1 June bore the headline ‘Staff back RCVS as great workplace’. This reflected our coming 30th in the top 100 Best Workplace Awards (medium-sized category), run by the Great Place to Work Institute , beating the likes of Coca Cola, Office Angels and General Mills. [See my previous blog for details.]

This was pleasing news in itself, but it was also particularly great to see that headline in print, because one of the exercises carried out back in 2013, as we put together our 2014-16 Strategic Plan, was imagining the headlines we would like to see on the front page of the vet press in three years’ time: the RCVS being a great place to work was one of them.

Clarity of vision

The moral of this story is that when you have a specific goal in mind, and especially when you can articulate and visualise how it might look in print, it has a much greater chance of being met.

This is why our Strategic Plan is full of very specific goals, which were developed out of a process that involved staff, Council and, through the First Rate Regulator Project, the profession and public at large. Some organisations shy away from specific objectives – it’s too easy to be called on them if they are not met. But plans without bite are inevitably left on the shelf to gather dust.

And so I would like to reassure you that, 18 months into our current three-year plan, we have either met, or are on target to meet, the majority of our objectives. The list of actions yet to be tackled is manageable, and one which we may yet add to before 2016 is out.

Complaints progress

But don’t just take my word for it. In addition to the excellent headline in the Veterinary Times, a further testimonial to our hard work could be seen in the Veterinary Record recently (30 May 2015).

Here, veterinary surgeon John Dinsdale was kind enough to praise our Professional Conduct team, specifically highlighting the positive changes that have been made in our concerns-handling process and improvements in communications. This work has been part of our Strategic Plan objective to ‘reduce the time it takes for a complaint to be concluded in a fair and transparent manner’. Mr Dinsdale also commented positively on our trial of an alternative dispute resolution process (ADR), another of our Strategic Plan objectives.

A third piece of recent external validation came in the form of the independent Chair of our Audit and Risk Committee, Liz Butler, giving our current IT projects, which include an upgrade of our database, a new online Practice Standards system and a new IT system for our Professional Conduct work, a clean bill of health.

You can find a full update on our Strategic Plan progress in my CEO Update to Council, available online as part of the June Council paper bundle.

We will soon be starting the process of developing our 2017-19 Strategic Plan, and I will continue to push for sharp, meaningful objectives of the kind that you can sum up in a positive headline. Of course, by being specific you could set yourself up to fail, but it is better to fail to reach a stretching goal than meet a feeble one. Of course, to set yourself stretching goals and meet them is even better!

Finally, following our very successful journey to Edinburgh the other day to hold the first RCVS Council meeting outside London in living memory, here’s a quick video update outlining the main discussions and decisions from the day…

Looking to the future with an eye on the past

One of the many traditions that abound around this time of year, amidst the carol-singing, over-indulging, panic buying and, in our house, the magic of Father Christmas, the notes up the chimney and the excitement of young children – is the tendency to cast an eye back over the last 12 months and to wonder what the next 12 might have in store.

Now, whilst I would generally consider myself more of a reformer than a traditionalist, this is one tradition that I don’t mind participating in. As the old adage says, in order to know where you’re going, you must know where you’ve been.

Walking the dogs in the snow

In order to know where you’re going, you must know where you’ve been

So what have been some of the key issues and achievements for the College in 2014, and how might these shape our activities in 2015 and beyond?

Listening

As you may well have read on these pages before, a key objective of mine when joining the RCVS as CEO was to truly listen to what our many stakeholders – be they vets, vet nurses, students or members of the public – had to tell us. In 2014 especially, there have been some good examples of where I think we got this right.

Our new guidance on 24/7 emergency veterinary cover – a previously contentious and difficult subject to get right – has been generally well received. This was in no small part due to the comprehensive consultation exercise we undertook in the first part of the year, where we not only called for comments in the normal way, but for the first time also held in-depth ‘Select Committee’- style hearings with many of the key representatives of the vet/VN professions and animal-owning public to identify the real issues and key challenges people were facing.

A 2012 resolution by RCVS Council to remove postnominals from display in the RCVS Register of Members turned out to be an unpopular one. Such was the profession’s unhappiness, in fact, that Council agreed to reverse this decision in June, and then work towards a solution that was acceptable to all. We reported on the new changes in November, which should be rolled out next spring.

Technology provides us with ever-increasing ways to listen to others’ views and gauge opinions, whether that’s through email, online surveys or social media. However, this shouldn’t be at the expense of personal communications – also known as conversations! – whether that’s via formal evidence-gathering sessions like we conducted for the 24/7 review, or, more anecdotally, by getting out and about and meeting people, which I remain committed to doing. I’d like us to continue using all methods at our disposal, whenever we need to consult.

Reform and modernisation

As I said, I’m more of a reformer than a traditionalist, and ensuring that the College is well placed to face the future has been, and will continue to be, a key focus.

Early in 2015 we will have a new Royal Charter – the first in almost half a century – which formally sets out the objects of the College to set, uphold and advance veterinary standards. Perhaps most significantly, the Charter also modernises various regulatory functions, in particular by underpinning the regulation of veterinary nurses and properly recognising them as true professionals in their own right.

In other potentially seismic changes, we are tackling the difficult subject of governance reform, particularly the future function, size and composition of RCVS Council, as well as the structure and membership of our Committees. Council’s discussions in November indicated an appetite for reform, which is hugely encouraging, but there is still more work to do before we reach agreement on what represents the best model for the College to adopt for the future.

Looking ahead

Of course, it’s not just the College’s future that we need to plan for, but that of the whole veterinary profession. To this end, there are now three forward-looking projects underway that should help us do just that.

Together with the British Veterinary Association, we launched the Vet Futures project in November – a major initiative that aims to help the profession prepare for and shape its own future, whilst keeping animal health and welfare at its heart. You can read more about this project on the Vet Futures website, and I would encourage you to join in the monthly debates.

I’m also keen to encourage participation in a trial that could mark a sea change in how the College handles a lot of the concerns raised with us by animal owners. On the basis of what’s good for the consumer can be good for the profession, we’re currently testing alternative dispute resolution as a first step towards settling disputes between users of veterinary services and members of the profession. I would hope the profession recognises the benefits of this trial in helping to resolve long-standing disputes, and would strongly urge members to take part in it, should the opportunity arise.

And then there’s the Mind Matters Initiative, launched in December, which aims to help address the mental health and wellbeing issues that sadly have become such a significant issue for the veterinary profession. A first, very practical, action has been to provide extra funding to the Vet Helpline (0303 040 2551) to enable this confidential support service to be staffed by people, rather than callers having to leave a message and be called back. A vital difference, perhaps, and especially at this time of year.

Thank you

Of course, little, if any, of all these activities would be possible without the tremendous hard work of my colleagues at Belgravia House, and the support and commitment from members of both the RCVS and VN Councils. Their willingness to put the hours in, embrace change, and recognise the benefits that change can bring, has been as inspiring as it’s been encouraging.

My sincere thanks to them and my best wishes to you and yours both this Christmas and for whatever the New Year may bring.

A little speech therapy at RCVS Day

I’ll shortly be battling my way through London’s unforgiving rush hour towards the calm Edwardian surroundings of One Great George Street in Westminster, a fittingly grand venue for us to host our AGM and welcome around 240 guests to our annual awards ceremony.

One Great George Street

A look inside One Great George Street

This will be only my second ‘RCVS Day’, but if it’s as enjoyable as last year, then, together with the invited veterinary surgeons and veterinary nurses, their guests, Council members and my colleagues, I have much to look forward to over the next few hours.

I’m conscious that only a fraction of the profession are ever able to attend this important celebratory event, not least as it’s always on a ‘school day’, but I’m pleased to report that we will be producing a short video of the proceedings, as well as plenty of photos and the usual reports and minutes, so there should be ample opportunity to catch up.

I’ll also be making a short speech, which I thought I’d give you a sneak preview of here on my blog (see below). I’ve tried to encapsulate the significant progress we have made, and continue to make, at the College, without going into reams of detail. In my view, the shorter the speech, the better it’s received, so I hope this hits the right note a little later today!

Some of the business of the day will include the presentation of our annual report and financial statements for adoption by members, and a vote on a motion to submit a new Royal Charter to the Privy Council for approval, which would be the first in almost 50 years.

Perhaps most importantly though, RCVS Day provides us with the perfect opportunity to celebrate the very best of the UK veterinary profession – veterinary surgeons and veterinary nurses alike – and give due recognition for the many veterinary accomplishments and achievements that so often go unsung.

Rush hour aside, it’s going to be a good day.

 

My speech…

It is a great pleasure to be here once again among the good and the great from the veterinary world.

This is a day for speeches, but this one won’t be long. I just want to update you on what we have achieved and what more there is to do.

Last year I talked about the First Rate Regulator initiative, a massive engagement programme with the profession, public and stakeholders. It led to the strategic plan, a programme of work to improve what we do and how we do it.

Just six months in to the plan I’m delighted to say we have achieved a great deal:

  • A new Charter heading fast towards the Privy Council;
  • Ambitious plans to reduce the time it takes to process complaints;
  • Mid way through an overhaul of our IT infrastructure;
  • In November we will trial of a new consumer complaints service;
  • A new status of ‘Advanced Practitioner’ – with applications opening in September;
  • Next year we will have a new Practice Standards Scheme and the transition to an independent disciplinary function will be complete;
  • And the charity partner of the RCVS, RCVS Knowledge is going great guns – a clear purpose and mandate for EBVM and a fabulous new Chair in Jacqui Molyneux.

A lot to be proud of and real momentum for change and improvement.

In addition we have listened and responded to fair criticism from the profession including a very productive evidence gathering session on 24/7 emergency care, which has resulted in important changes.

I believe listening and responding is a sign of strength and confidence. We do not seek to be popular but to be sensible in how we regulate and respectful in how we carry out our Royal College duties.

I continue to visit practices and other places where vets and VNs work every week and will be delighted to accept invitations from any of you to see the work that you and your teams are doing.

One of the areas that I am most excited about is how we are unleashing the talents of our team at the RCVS. In the last year we have been able to promote from within, we have a greater focus on training and development and our levels of staff engagement are increasing significantly.

It is not self serving to say these things, but critical to the service we provide and the success we can have as a Royal College that regulates.

I see our role as a force for good, contributing to the profession being world leading, supporting some of the best veterinary practitioners in the world, doing everything we can to ensure the public feels properly protected when things go wrong.

We are honest about our strengths and weaknesses and determined to be the best we can be. Thank you for your support in helping us on this journey.

A month of celebration, by George!

A year or so on from one of the most spectacular series of national celebrations this country has ever experienced – in the shape of the Diamond Jubilee and London 2012 – and it seems we have all developed rather a taste for celebrating success.

First, the Lions maul the Aussies (and having lived and worked in Australia, I shall never tire of saying that) then, Murray makes mincemeat of the Wimbledon opposition; the England cricket team are confidently carrying on where the Lions left off, Froome finishes first in France and now, while we continue to bask in all this sporting glory and uncharacteristic sunshine, our future King (by George!) is delivered safe and well. Amidst all this, I’m pleased to report that the veterinary world seems determined not to miss out on achieving its own successes, and has itself had much to celebrate over the last few weeks.

For us at least, it all kicked off with RCVS Day on 5 July – our annual general meeting and awards ceremony which we held at the Royal College of Physicians in London. It being my first, I wasn’t too sure what to expect, but what a thoroughly enjoyable and impressive day it turned out to be, surrounded by the good and the great of the veterinary and veterinary nursing professions, together with their friends and family.

You might not need me to tell you this, but the College doesn’t hand out its awards lightly. The achievements being recognised were, for me at least, real eye-openers into the breadth and depth of expertise amongst those in, and associated with, the profession; be they for the large animal vet who first identified BSE in cattle ‘simply’ through careful observation in practice, or the impressive number of VNs gaining their diplomas in advanced veterinary nursing, including three in the equine field for the very first time.

As I said on the day, in my first nine months as CEO I have met many members of the veterinary professions up and down the country, and have found them to be extraordinarily welcoming. It really is a privilege to be leading the RCVS at this time, and I take great pleasure in seeing vet and VN accomplishments being recognised and honoured in this way. My sincere congratulations to all of our award holders!

Pictures from RCVS Day

A few pictures from RCVS Day (click image to view more on Flickr)

Over the ensuing weeks, I switched from commending eminent vets for years of hard work and lifetime achievements to congratulating the very newest MsRCVS just embarking on their professional careers as veterinary surgeons. I was lucky enough to be representing the College at the graduation ceremonies of the Royal Veterinary College and Liverpool vet school (but for a late taxi, horrendous traffic and a missed flight, I would have been at Glasgow vet school, too) and was thrilled to witness so many young people on the cusp of their professional lives. A UK veterinary degree represents five/six years of hard, unrelenting graft (the vet schools and the RCVS rightly strive to ensure that it is just that!) and all our new veterinary surgeons can be immensely and justifiably proud of themselves.

Of course, no period of celebration can be fully appreciated without some day-to-day toil to put it all into perspective, and our work agenda has continued apace at Belgravia House.

We had a seven-hour ‘beauty parade’ of auditors this last week, which was quite the test of endurance for our Audit & Risk Committee, my colleagues and me! A regular review and renewal of auditors is an essential discipline for any organisation that wants to maintain best financial practice, a concept I was interested to note has been recently promoted by the Competition Commission.

We’ve also now had a first report back from our IT consultant summarising the responses we’ve received to our invitation to tender for our new customer relationship database. Of the nine companies invited, seven have submitted replies, which is an excellent response. I will keep you posted on developments as we take forward this eye-wateringly complex project.

Finally, as I mentioned in my previous post (‘Avoiding tunnel vision’), our new Operational Board is meeting for the first time this week. We shall be spending two days in each other’s company at the recently renamed Royal Agricultural University in Cirencester, where I will be steering the Board through the latest draft of our strategic plan before it goes to Council in September. You can find out more about the Operational Board, and who’s on it, via the College website.

And there I shall leave things for a fortnight or so, as I have a couple of weeks’ holiday coming up, camping with my young family in France. At least, if you can call 14 days of unforgivingly hard floors, very early mornings and scrambled egg saucepans a holiday… Perhaps that auditor meeting wasn’t so arduous after all.