Following the recently updated advice to Veterinary Surgeons and the wider vet professional team AHPR wish to provide updated advice to our registrants about working practices. We recognise that this is a very difficult time for you all, both in relation to the worry and anxiety you may have in relation to you friends and family and your businesses and employment.
Firstly we would like to give you the background to our advice.
The RCVS issued new guidance on 9 th April. The link is copied here and should be read in its entirety, the flow chart is very useful for decision making https://www.rcvs.org.uk/setting-standards/advice-and-guidance/coronavirus-covid-19/
The reason for changing their guidance was further information issued from the government. The guidance provided on 25 th March came into effect following the initial lockdown period where veterinary businesses were not listed as essential businesses; hence the guidance was to see only emergency or urgent cases based on professional and clinical judgement. In the interim the government has provided advice that it is important for businesses to carry on. The RCVS needs to follow government advice both in this aspect and also government advice in relation to public health and social distancing, and Public Health must come first.
The new flow chart the RCVS developed was in relation to the above and in consideration that the lockdown may last for several months, and what may not initially be considered an animal health and welfare problem may well become so over time.
However they have emphasised the following:
- It is NOT business as usual
- Prioritise public health of clients and the team
- Professional and clinical judgement must be used in each individual case
- Social distancing rules must be followed strictly
- Communication with clients is important to alleviate their worries and expectations
RCVS are going to provide updated client advice on their website.
BVA guidance becomes effective from 14 th April and a guide for veterinary practices can be accessed here: https://www.bva.co.uk/media/3430/bva-guidance-for-veterinary-practices-on-covid19-from-14-april-2020-final.pdf?dm_i=3VUQ,14CR9,1ZAB3L,3XXGW,1
This must be read alongside the RCVS guidance. BVA have also emphasised that it is NOT business as usual. The RCVS guidance is based on what Vets CAN do, the BVA guidance is based on what Vets SHOULD do; and they have given the advice that “Just because we can do it, doesn’t necessarily mean we should do it”.
BVA provided the following advice; unless there is a definite, and not nominal, animal welfare benefit or it is work related to maintaining the food chain then the work should not be done. Decisions should be made on a rolling 2 month period (this is based on the government’s shielding of vulnerable people guidance).
BVA have acknowledged that the language used on their traffic light guidance was not clear enough; and the green “go ahead” section should be viewed as “go ahead only if veterinary clinical judgement means it can and should be done”.
It must be remembered that any treatment that goes ahead will put people at risk, whether this is part of the vet team or the client, or other people you may come into contact with whilst working or travelling. Nothing is 100% risk free.
BVA emphasised that the most important principle at the moment is to slow the spread of Covid-19 and if work can be done remotely it should. They also emphasised the reputational risk to the profession if they were not seen to be doing everything possible to play its part in controlling Covid-19. These are the same principles on which AHPR are basing their advice.
At the BVA webinar today (12 th April) a specific question was asked in relation to complementary therapies, the response was;
- the treatment should have a real and not nominal benefit
- each case must be considered individually
- clinical and professional judgement must be used
- Can it be done safely?
Therefore our advice to registrants has changed little from what was sent out on 26th March but has been slightly modified (point 1):
- You should only attend an animal if it has been assessed by a vet who decides it needs urgent treatment, this will include new cases and possibly new clients; or you should only attend an existing client’s animal if consideration of the case by you and the vet results in a decision that physical therapy treatment is required at this stage. You must get either scenario confirmed in writing.
- You should check with your insurance company that you are covered to do this during Government advice to stay at home as you will not be classed as a critical business and your insurance may not cover you.
- Make your own professional judgement in each case.
- Assess your own safety and that of the client you are going to see. Have they been self-isolating, is there anyone ill at the premises, are they classed as vulnerable?
- Make sure you follow strict biosecurity and social distancing as advised by the Government.
If you do go and treat an animal following veterinary guidance please consider the risks to yourself, your family, the client and the client’s family and anyone else with whom you may come into contact. We reiterate nothing is 100% risk free. Wear gloves as animals can act as fomites of transmission, but remember PPE is in shortage for NHS staff at the moment, and wearing gloves does not remove the need for hand-washing thoroughly and frequently. If you are treating horses consider the risk of sole working due to social distancing – are you going to be safe? If you are seeing companion animals outside of a clinic situation you have no control over cleaning and disinfecting the environment in an owner’s home and is probably a very unwise risk to take. Use your clinical and professional judgement at all times. Remember Public Health at this time is the priority.
The advice government is providing in this unprecedented time is under continuous review and as such we will continue to monitor the situation and our advice will also be reviewed, updated and communicated to you.
As usual if you have any questions please do contact us.