Veterinary Development Council Veterinary Led Team Working Group

1. Veterinary Development CouncilVeterinary Led Team Working Group Secretariat:- Catherine Lawrence Rachael Gledhill Members:- David Catlow Neil Cutler Bob Moore Catherine McLaughlin Peter Scott Bill Reilly

2. Terms of Reference To identify the range of services that could be supplied to the farming community by a veterinary led team Those services that could be undertaken by non veterinarians Those specialist services that could be delivered by the veterinarians Those services provided by others with which vets need to integrate/co-operate Those typical Official Veterinarian services that might be delivered as part of a veterinary-led team To identify how these services are currently delivered To describe the benefits of bringing non veterinary services into the team e.g. increased profitability, appropriate treatments, and veterinary contact To assess the desire of vets and non vets to work together to deliver the services

3. General Points • Priority is animal health and welfare • Overlap other groups – different models/shared staff

4. WHO? • Clients • Farmers • AHVLA • Practitioners • Technicians

5. Farming perspective Examples Foot trimming Blood samples for other than notifiable disease Vaccinations / injections Removal retained after-birth Uterine irrigations Scanning for pregnancy Mobility scoring Sampling for health screening e.g. bulk milk samples Welfare monitoring Body Condition Scoring Disbudding Calving

6. Farming perspective • Who should? • Who does? • Who could?

7. Farming perspective • most appropriate and cost effective • Vet (generalist/specialist) • Technician under “supervision” • Technician

8. Acts of veterinary surgery • Only veterinary surgeons are permitted in law to carry out such procedures, although animal owners or their employees may undertake certain acts such as disbudding. • Other lay persons (however trained or supervised) may not undertake such activities.

9. Acts of veterinary surgery for which an Exemption Order is in place • These are confused. For example testing for tuberculosis can be carried out by suitably trained lay testers employed by AHVLA but not lay persons employed by veterinary practices. Lay persons employed by veterinary practices can blood sample for brucellosis but not for other diagnostic purposes such as metabolic profiling. • Lay persons carrying out activities for which Exemption Orders exist have little or no regulation or supervision. • Most of the Exemption Orders do not require direction or supervision, of the lay person, by a veterinary surgeon.

10. Activities that are not deemed to be an act of veterinary surgery • For example cattle foot trimming. • These be carried out by lay persons over whom there is no statutory control.

11. Farming perspective • Wide range of potential activities • Undertaken by appropriate people and charged accordingly • Veterinary team includes technicians, “generalists” and specialist veterinarians • Potential for “veterinary led team”

12. AHVLA • Farmers “need access to quality assured, affordable services” • Lay TB testers: “would consider amending the legislation” if support from the profession • Blood samplers “exempted for specific purposes” change “could increase the workforce available to us” during disease outbreaks • “Some tasks are not acts of veterinary surgery such as inspections…we would not expect to prescribe who did it provided they were suitably trained and competent”

13. AHVLA • Support for the development of a veterinary team that included non veterinarians • Appropriately trained

14. Veterinary Perspective Survey Monkey Targeted at farm, mixed and equine practice 269 responders

15. Veterinary Perspective Does your practice currently employ any technicians? 26% Yes 74% No

16. Veterinary Perspective What technicians do you currently employ? Equine dental technicians 3% (2) Scanners 10% (6) Foot trimmers 24% (16) Others 63%

17. Veterinary Perspective Has your practice considered employing technicians? 36% Yes 64% No

18. Veterinary Perspective Does your practice have an agreement with self employed technicians? yes 12% (28) no 88%

19. Veterinary Perspective Are you aware of your clients using technicians not provided by the practice? yes 67% no 23% not sure 10% Dental technicians Scanners Foot trimmers AI

20. Veterinary Perspective Would you employ technicians in the future as part of a veterinary led team? yes 67% no 13%

21. Veterinary Perspective • Potential for the development of a veterinary led team • Need to be confident about training and supervision

22. Technician’s Perspective

23. The Equine Podiatry Association Independent evaluation of the level of training undertaken by barefoot trimming organisations within the UK, enabling a mechanism whereby “approved” practitioners can be recognised by the veterinary profession In the interest of continuing professional development we are keen to promote shared learning across the veterinary-led team.  “would encourage a more open and transparent relationship between client, hoof care provider and Veterinary Surgeon”

24. National association of Cattle Foot Trimmers • Welcome any opportunity to improve links with the veterinary profession. • One major problem faced by the foot trimmers is a lack of interest and engagement by some local vets. In some instances a lame animal will be referred by the local vet. This is not desired by the foot trimmer, who would prefer to be dealing with routine preventative trims. • Improved communication will help fruitful partnerships develop between vet and farmer. • We would agree that better partnership between the vet and trimmer would benefit the farmer in many ways. • We do not believe the foot trimming technician under the employment of the local vet is the preferred way of working. Instead, we would welcome any initiatives that would encourage all trimmers to engage in on-going CPD and that trimmers should be working towards, or attaining, a 'category 1' status While licensing of some form is not wanted. we realise it may prove necessary to encourage trimmers to attend professional development and check days.

25. Technician’s Perspective • Work more closely with the veterinary profession • Partnership rather than employed • Training and regulation

26. Principles for the Way forward • Better partnership working • Technicians employed by veterinary practices • Improved regulation, training

27. Recommendation 1 The British Veterinary Association should undertake a consultation and opinion poll, which captures the views of the UK veterinary profession, to establish the appetite or otherwise with regard to allowing technicians to undertake specified veterinary service activities (such as blood sampling, disbudding and tuberculin testing) under veterinary direction.

28. Recommendation 2 • The Royal College of Veterinary Surgeons should consider the best course of action to establish an acceptable process of training for, and regulation of, technicians who undertake activities under existing or new Exemption Orders. • This should include a clear differentiation between veterinary direction and supervision. • In addition the assurance of competency and appropriate approved training, accreditation and registration must be clearly identified.

29. Recommendation 3 Defra should consider the necessary further legislative changes that would allow suitably trained lay persons to carry out minor acts of veterinary surgery (such as disbudding) under the employment and direction or supervision of a veterinary surgeon.