May we live in interesting times

While the past few weeks have been very interesting for observers of politics (and great for political journalists!) I imagine that for many veterinary surgeons, veterinary nurses and veterinary practices the excitement may be mixed with a fair bit of uncertainty.

Some 27 per cent of those on the Register of Veterinary Surgeons are registrants from elsewhere in the European Union and they make up around half of all new registrants every year. Meat hygiene and public health are heavily dependent on veterinary surgeons from the EU and I am sure that most veterinary surgeons and veterinary nurses will have colleagues from one of the other 27 states. The input of these vets has been invaluable and I would like to both recognise and applaud the positive impact they have had on the veterinary industry and animal welfare.

The Brexit negotiations have yet to begin and while we may want to give absolute certainties to our EU colleagues that they will continue to be able to live and work here unimpeded – it is very much dependent on the agreements the Government makes regarding freedom of movement and the single market. What we can guarantee, however, is two things. First, that their status as Member of the RCVS is sacrosanct and that, as long as the annual fees are paid, any current registrant will be able to remain on the Register of Veterinary Surgeons.

Second that along with the British Veterinary Association, we will be lobbying and working with Whitehall’s Brexit team and the Department for Environment, Food & Rural Affairs to ensure the transition is as smooth as possible and to take into account the best interests of the veterinary professions and the public. I would personally like to congratulate Andrea Leadsom on her appointment as Secretary of State and look forward to working with her and her team in the coming months and years.

To this end we have set up a Presidential Taskforce to consider the impact of Brexit and which aims to report its conclusions to Council by March 2017. The Taskforce will have several objectives including:

  • Considering the EU regulations that currently impact on our regulatory responsibilities and make recommendations as to which should be maintained.
  • Looking at the issue of the mutual recognition of veterinary graduates in Europe and make recommendations for how we might deal with applications to join the Register from EU countries post-Brexit.
  • Considering manpower requirements and the implications for new systems of immigration.
  • Understanding how Brexit might impact our current priorities such as governance and the review of Schedule 3.
  • Considering our role as an accreditation organisation and how we can contribute to and influence international affairs outside the EU.
  • Studying the financial impact of Brexit on the College.
Nick Stace's speech at RCVS Day

‘change might not always be comfortable or easy, but we cannot resist it and we need to embrace it..’ (RCVS Day 2016)

Brexit is very much a fact of life now and while some may be disappointed with the outcome of the Referendum, the Taskforce will very much be concerned with scoping out new opportunities and engaging with the way the world is changing. As I said at my recent speech at RCVS Day 2016 in respect of digital disruption – change might not always be comfortable or easy, but we cannot resist it and we need to embrace it, work out what it means and take advantage and control of the situation.

There will be many interesting and tough discussions over the coming months and years – and that will just be in our Presidential Taskforce – but we will continue to keep the profession updated on our progress and how the negotiations may affect EU-qualified veterinary surgeons.

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!