Ratcheting up the PSS requirements - Veterinary Practice
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InFocus

Ratcheting up the PSS requirements

Veterinary Practice hears all about the changes to the Royal College’s practice standards scheme.

THE RCVS has set the bar higher for the owners of veterinary surgeries wanting to meet the requirements of its Practice Standards Scheme.

At the BSAVA congress, the RCVS announced the launch of the new edition of its Practice Standards Scheme manual, giving clear guidance on what the scheme’s inspectors will be looking for when visiting a practice.

The manual, which can be downloaded from the Royal College website (www.rcvs.org.uk), sets tougher targets for many elements of an inspection and will in some cases require mainstream practices to aim for the same standards achieved in the bestequipped hospital premises.

The college’s senior vice-president, Jill Nute, explained the rationale and nature of the changes in a special RCVS session at the meeting in Birmingham.

She noted that the only modifications to the requirements made since the scheme’s launch in January 2005 had been those necessary to keep pace with legislative changes. But the intention had been to carry out a thorough overhaul of the system after five years once it had become properly established.

Time to act

Mrs Nute emphasised that practices would not be expected to comply immediately with the new standards. Any practice due to be inspected over the next three months would be assessed according to the requirement of the earlier version of the manual. But those with inspections scheduled from July onwards would be expected to familiarise themselves with the changes and act upon them, she said.

The new manual was developed by the Practice Standards Group, which includes representatives of each of the major veterinary and VN organisations. She reassured colleagues that the new system was not expected to significantly increase the administrative burden on senior veterinarians or practice managers.

“There is nothing hugely different or hugely complicated here. What it does is to consolidate a lot of the proposals made during the consultation process. Hopefully, it puts practices in a much better position to meet their clients’ expectations.”

One significant change is the decision to end the classification of veterinary premises into tier 1, 2 and 3 practices. Mrs Nute acknowledged that many veterinary clients did not understand the system, believing that it defined the quality rather than the type of practice – and there was also widespread confusion within the profession itself.

So under the new classification there will be core practices, general practices and veterinary hospitals. The manual also identifies the services, facilities and operational structures that will be expected of small animal, farm and equine practices, respectively.

The document includes a combination of legal requirements, instructions under the Guide to Professional Conduct and advisory notes leading practices in the direction of those requirements which may become mandatory in future years. Among the latter is the advice on the employment of registered and listed veterinary nursing staff.

The Royal College realises, Mrs Nute said, that with the current shortage of qualified VNs that there can be no compulsion for practices to employ trained staff. But it expects all general practices and veterinary hospitals to have made good progress towards that goal by the time of the next review in 2015.

Practices were warned to respect the distinction between qualified VNs and untrained staff and to restrict the use of the term “veterinary nurse” to the former group.

Indemnity

As a result of the increasing professional responsibilities of VNs, it was vital for them to be included under the practice’s professional indemnity insurance. Those practices covered by a Veterinary Defence Society policy had automatic cover but the estimated 5% of practices that are clients of other companies should check the details of their policy, Mrs Nute advised.

Another area where practices should expect tighter control was in the area of clinical governance. She noted that the veterinary profession was lagging far behind human medical colleagues in addressing this issue and she hoped that most practices could at least begin the process of carrying out more detailed analysis of the outcome of clinical procedures.

Any practice with computerised records can ensure that cases producing unexpected outcomes are listed in a specific file which can then form part of the agenda for the regular meeting for clinical staff, she suggested.

The RCVS will also be ratcheting up the standards for the educational attainments of veterinary staff. During future inspections, practices will be expected to provide evidence of a written policy on CPD and more will be expected of those practices registering for hospital status under the scheme.

By 2015 it is expected that any small animal hospital should be employing at least one certificate holder in an appropriate clinical discipline. Meanwhile, it is likely that equine hospitals will be required to employ at least one diplomate in equine surgery before the next revision of the standard comes into force – “So if you are running a hospital practice you should start that training process soon,” Mrs Nute said.

Stretcher required

Many of the new requirements in the manual relate to the equipment and facilities provided by practices listed under the scheme. In some cases it should be relatively easy for practices to satisfy the demands of the inspector team – for example, all core practice will now be expected to have a stretcher or some other method for moving heavy dogs during a general anaesthetic.

Other changes, however, will require planning and regular attention: there will, for example, be a much greater emphasis on biosecurity issues and preventing the transfer of infection from patient to patient or patients to staff.

Small animal practitioners should not assume that biosecurity is only important in farm animal practice, given the significant zoonotic potential of those pathogens responsible for avian influenza and salmonellosis, she warned.

In addition, there are some changes which reflect the RCVS’s role in protecting the public reputation of the veterinary profession. The college already advises practitioners to provide clients with an estimate of the likely costs of a course of treatment.

“The new manual insists that clinicians do everything they can to keep clients informed of any developments that may significantly alter the figure quoted.

“There have been problems in practices failing to update those estimates and so there is hell to pay in the Preliminary Investigation committee when the client complains because they have received a bill for £2,000 when the original estimate was for £200,” Mrs Nute said.

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