Our quarterly Board and Policy meetings were last week at BEVA HQ in Fordham.  These meetings are vital to the work which BEVA undertakes and that came on the back of a trip to lantra in Stoneleigh to discuss the national occupational standards for EDTs.  For some time, we have championed the efforts of the BAEDT in providing professional dental services within the context of a proposed exemption order to deregulate some dental procedures to non-vets and the current work with lantra is a step in that direction.

I am currently at the AAEP congress in California.  The AAEP is an important commercial and political partner for BEVA.  Their congress has a similar in scope to BEVA congress and has coexisting clinical streams for general practitioners and a vast commercial exhibition.  Breakfast meetings at 7am for international attendees or those of a strong Christian faith, with lectures from 8am are novel and would certainly be a struggle for most attendees at BEVA congress given our extensive social programme!

The RCVS forewarned us of a letter they are sending to the Vet Times regarding orthopaedic firing, this week.  Whilst we didn't agree with their decision to publish, they did ameliorate the letter on our advice.  Firing has been a contentious subject for some years now and, even with the RCVS 'ban' in-place many of members feel that this therapy has some merit.  We defend veterinary surgeons' right to use the treatment they feel to be in the best interests of the horse, whilst also recognising that there are a range of therapies for the treatment of tendonitis, some of which have a greater claim of efficacy.  What was apparent today, at the World Horse Welfare conference in London, was that there are greater equine welfare concerns out-there, other than tendon firing which merit our attention.

Congress 2013 planning is marching on at full pelt.  Sandy Love is the chair of the congress committee and is putting together an excellent programme for our annual congress in Manchester.  The organisation of congress has evolved over the years, as BEVA itself has grown and changed.  Each subject area at congress now has a 'guardian' and these guardians suggest session chairs and speakers under the supervision of Sandy.  On a lighter note we've also been reviewing the band for the annual BEVA dinner and the venue; we've even lined up a few venues to look at when council meets in the city early in December.

It was refreshing to meet the Head of School at the University of Edinburgh this week, David Argyle.  David has had an exceptionally successful career and he has a strong vision for the profession and veterinary teaching.  Clearly a very busy man, I was afforded exactly 60 minutes of his time at his smart new top-floor office at Easter Bush.

Great to be home after BVA congress.  It's clear to anyone that this congress needs to change, although, personally, I just don't feel comfortable with the BVA linking up with the London Vet Show, when there are species divisions and its own member organisations which could have provided this service equally well. This was discussed at a meeting with the presidents of the BCVA, SPVS and BSAVA where we discussed how best to deal with this pressing issue amongst others. 

The annual BVA dinner was a opportunity to bend-the-ear of the RCVS president and make some plans.  Jacqui was very positive and helpful - such a breath of fresh air.  At my table was the CVO for England, the BVA president, the RCVS president, an ex-CVO and the Lord Trees; which all felt just a bit too much as the wine took its toll on my already tired and overcooked mind.

MacBeth. Give me your favour: my dull mind was wrought with things forgotten

The difficulties faced by younger members of the profession was brought home to me by a BEVA member who reported that she had had conversations with a group of recently graduated members working in equine practice.  The young vets (2011 graduates), once so full of excitement and optimism about their chosen careers were now down-at-heel and one was even looking to leave the profession.  No one has ever said being a vet was easy, particularly in horse practice, but this particular group of youngsters were specifically complaining about lack of support, changes in contract terms and clients complaining and then not being backed up by their employers.  Veterinary graduates don't just face careers issues or challenges with day-to-day work in equine practice at the early stages of their career and we mustn't ignore that.  There's no magic bullet to help but BEVA did run our first careers session at congress 2012 and we're hoping to expand on this further in the coming years.  The issues surrounding vet-graduate support (or lack of) are very complex and its difficult to know where to direct our limited resources.

We're always keen to hear from members and I am grateful to the individual who raised this again this week, just before our Board of Management and Policy Committee meeting on Monday.

It was a pleasure to be with World Horse Welfare today, in Deeside for the Royal opening of their farm, Belwade. Whilst Belwade has been in their possession for sometime, the charity had redeveloped their indoor facilities such that rehabilitation of horses can occur all year around, rather than stopping over the winter months. A short tour was followed by presentations from their field officers and an official opening by the Princess Royal and Roly Owers, their chief executive. It was an opportunity to continue to keep the profile of BEVA high and involved at the highest level within the welfare & equine charitable sector. 

Keith Chandler 19th September 2012

Just finished at the extremely useful BVA medicines-group meeting at the BVA headquarters in London.  The link here outlines the group's terms-of-reference and membership.  Medicines control, dispensing and prescribing are topics which are going to become more and more important to the profession as a whole and it's vital that the BVA takes a central role in discussions with the governments in the UK and the EU.  The meeting began with a discussion about the potential reclassification of monapantel, an ovine anthelmintic, which is currently POM-V.  Clearly, reclassifying this medicine to be more widely dispensed via merchants, would result in a more rapid development of resistance and BVA has written to the VMD to encourage them to maintain the status-quo.  A wider debate then occurred about the overuse of anthelmintics and resistance to these products; I made the point that this is not a problem restricted to farm-animals and that we would also support a tightening of the rules and that the vet is best placed person to prescribe wormers.

Antimicrobial resistance is a huge threat to our right to dispense these medications and the BVA is really keen to see our guidance on the responsible use of antimicrobials which, along with our medicines smart phone app, should be available to BEVA members shortly.  Lastly there was a debate about the cascade and it's effectiveness and protecting the position of vets in the UK. There will be a draft proposal on amending the cascade coming from the EU in the first quarter of 2013 and we will await this with interest.

Keith Chandler 18/09/12

Politics, politics.....NED and CEM

The long summer (?) political recess is over and the party conference season is upon us.  I look forward to seeing you at Congress, where the Firing, Insurance and Paraprofessional debates should provide the intrigue, passion and stalemate that British politics provides. Meanwhile, the analogy continues in that a couple of hot potatoes were served during the holidays.

The National Equine Database (NED) had its funding withdrawn unceremoniously and somewhat suddenly by defra. There had been a tendering process in place for NED and we had been awaiting the results of this, not the complete abandonment of the project...

We are all aware that NED wasn’t quite fulfilling the roles required but the general feeling was that it just needed to be better supported, financially and with data input. Knowledge of where the horse lives would be the primary requirement in the advent of a disease outbreak and this information is sorely lacking in the database. Also, compliance with the registration of change of ownership, horse death and horses with foreign passports has been woefully inadequate. However, a paper written by Newton et al indicated that despite its flaws the database certainly has its usefulness for epidemiology, population statistics and so on. Furthermore despite this and known difficulties in access, emphasis on the wrong data and many other issues, NED  is the only equine database we have. We can’t just abandon it.

Interestingly, it appears that defra  were advised to abandon NED on the advice of the Animal Health and Welfare Board for England, (AHWBE) seemingly without consulting the equine industry “sector council”. Despite some inevitable teething problems, since the formation of the AHWBE the equine industry has been quite organised in putting a sector council together, a confluence of the Equine Health and Welfare Strategy Group and the British Horse Industry Confederation, so consultation would not have been difficult.

BEVA has been involved in the defra passport expert group since its beginning. Utopian plans for a single Passport Issuing Organisation were unrealistic, but the 80 PIOs have organised themselves into a public interest company and are keen to take the system forward. The British Equestrian Federation is/was the sole shareholder of NED and BEVA is supporting them in plans to salvage the database, secure funding and develop it into a more useful tool for disease surveillance and contingency.

Meanwhile, questions are being asked in the House of Commons as the Members return.....

The second hot potato is CEM, outbreak and how to handle them and the future of its notifiable status. BEVA is a strong supporter and advocate of the world-renowned HBLB Codes of Practice for Equine Diseases. There have been two extended incidents of CEM this year, one involving an untested stallion in Gloucestershire and the other, imported semen from Germany. Defra’s Core Group of contacts have been kept informed, and this includes BEVA. The outbreaks and extensive investigations that have followed and that are still ongoing, have proved costly to government and defra and the AHVLA have made it clear that this is not acceptable.

BEVA are fully supportive of CEM’s and other diseases’ notifiable status, but accepts that the cost of treatment and surveillance must be borne by the owner and/or the industry – not government. Having notifiable status, i.e. enforcement, is essential to ensure that such diseases can be controlled. Under the “sector council” system described above, BEVA have a lead role in coordinating changes that defra will bring in as budgets are cut.

Roly Owers, BEVA Treasurer and Chief Executive of World Horse Welfare, chairs the Disease Coalition, a small group of experts from across the industry. The Disease Coalition is the advisory group for the equine industry sector council and I urge all sectors of our disparate industry to appreciate this and to use it. Defra is aware that the high standards set by the HBLB Codes of Practice are often not adopted by non-TB parts of the breeding industry. BEVA, working through the Disease Coalition and feeding into government by the Animal Health and Welfare Board for England, has a very important role to play here.

 Equine veterinarians, whether working with hobby horses, competition horses, thoroughbreds and even travellers must show a measured, coordinated and professional approach in these hard and changing times. We should continue to support the recommendations of the HBLB Codes, which will include updated measures for AI, and commit to educating our clients about the importance of disease control in the UK and its relevance to them.

that was the week that was

The first BEVA practice management course on Tuesday and Wednesday (26/27th June in the Midlands) was a resounding success! there were some 25 delegates (we did come and go a bit). The Pfizer VetPlus Suport team's Nic Steel took the first sessions on teamwork and leadership - using the Dead Poets' Society for inspiration. and Amy Rook bamboozled us with the science of "client understanding" - from the Recession Exposure Matrix, use of surveys and focus groups, and some other graphs as well. Andrew Gillespie - former marketing director at Barclays (I bet he's glad he's quite that one) and Standard Life - gave us an inspiring talk on finding, acquiring and retaining valuable clients, that is MARKETING. Again, the use of feedback, customer groups and so on is essential - listen, don't talk - and then act on it. each practice should work in 4 or 5 segments (e.g. breeding, livery, emergency care, vetting, inpatients etc) and build services for these core audiences. know your segments!
Above all, the message that the RECEPTIONIST is the key cane over oud and strong from all. can your reception give you 3 reasons why the enquiring client should be with you......
After lunch, the ladies hit the spa - and some of the chaps. The more intrepid of us hit the Forest of Arden championship golf course. It was not for the faint hearted - the elements were in evidence and it was a wee bit tricky. Andrew Gillespie revitilised us all in the evening with wine tasting of some of the best wines from NW Italy  -where his company, Montforte Wines, specialises. Thank you again, Andrew.
David Mountford took over from me as Chair the next day as I headed to London for another meeting. Adam Auckburally from Glasgow Vet School gave some great CPD on dispensary management and Julian Samuelson got stuck into the challenges facing equine practice - and the solutions.
I understand that there was great feedback and demand for more targetted practice management. There will be sessions at Congress and I hope that this is the first course of many, perhaps with a more inclusive activity break.

The story so far...

BEVA continues to go from strength to strength.  But it isn’t resting on its laurels. Many issues are looming, especially as the economic downturn continues, with double dip recession and no growth in the national economy for several years yet. Many practices, including my own, are using this period to regroup, streamline costs, develop marketing strategies and generally review their position. Most equine practices are experiencing good and bad months, but, overall, fee income, competition from online pharmacies and competition has hit less than envisaged. Much of this is due to improved, and more attention to, management: from HR, forecasting, and savvy purchasing to zoning, pay-at-time and debt control.  BEVA sojourned into practice management CPD with a two day management course, in the luxurious surroundings of a luxury hotel in the Forest of Arden with golf, spa, wine tasting and course dinner included. Similarly, there will be a practice management afternoon at Congress on the Friday, a taster for partners, directors, senior assistants, budding entrepreneurs and the increasingly specialised equine practice managers.

As BEVA president, I attend the Congresses (well at least the dinners and awards’ ceremonies) of our fellow BVA specialist divisions. This includes the BVA (London, September), the BCVA (Southport, November), the VPMA (Kenilworth, January), the BSAVA (Birmingham, April) and the SPVS (London, May). In addition, I have attended the AAEP (Texas, November) and CEVA (Bologna, February). BEVA immediate past president Deidre Carson had a great trip to the Cape for SAEVA Congress. Sadly I felt it prudent to turn down the Bane Fallon Australian equine congress invite to Brisbane in July. I would like to thank the presidents of these Associations for their generosity and kindness during their hectic schedule at these events. I look forward to seeing many of them at the ICC in Birmingham in September where BEVA will host international, specialist division and past presidents meetings – to discuss and act on the state of our profession on a national, European and global scale.

Liaison within our small, threatened profession is essential. Perhaps the veterinary politicians do talk too much when action is required! BEVA officers have had joint officers’ meetings with the RCVS and the BSAVA this spring and liaison with the BVA is frequent. Since the RCVS’s confusing stance on “thermocautery” in their November newsletter, BEVA Council has debated firing and we have taken our views to the RCVS. We await their response. Similarly concerns about sports/leisure horse insurance have led to meetings with brokers and underwriters. Detailed vet and client guidelines will soon be available to download on the BEVA website. Insurers have often made losses in the equine market and the enforcement of exclusions, compliance with history submission and other policy criteria is now strict – vets, and particularly their clients (the insured) need to be aware of this. However, the insurers need to understand that £5,000 vets’ fees don’t go far in 2012, and that it is not due to increased fees, but increased veterinary technology, knowledge, capability as well as owner expectations.

Meanwhile, BEVA has submitted responses to RCVS consultations on Specialisation, Performance Protocol, and Northern Irish ones on the DARD equine welfare code and the (agricultural) status of the horse. BEVA regularly meets with defra, AHVLA, the VMD. We have excellent input into the new government “Big Society” Animal Health and Welfare Board for England through the executive Board members (the Chief Veterinary Officer and his deputy) and the non-execs Tim Morris and Mark Tufnell. BEVA is an observer at the British Horse Industry Confederation, attended by David Mountford, and the Equine Health and Welfare Strategy Group (chaired by Paul Jepson and attended by me and Roly Owers). James Wood, Roly, Paul and myself also attend a government/industry liaison group – the Disease Coalition. BEVA has also met with representative of the allied musculoskeletal professionals to determine their criteria for our “approval”. Defra is setting up a Project Board on Exemption Orders for paraprofessionals under the Veterinary Surgeons’ Act – and there will be steering groups on EDTs and AI technicians led by BEVA and the BVA.

In Scotland the Rural Affairs Cabinet Secretary is pre-consulting on livery yard, dealer, stud and sanctuary licensing and/or registration. This has been driven by the Equine Establishment Working Party, a joint industry group chaired by BEVA to look into such secondary legislation enabled by the Animal Welfare Act 2006 (Animal Health and Welfare Act (Scotland) 2006). All Scottish BEVA members (over 100) have been asked to respond directly to the pre-consultation. Inspection of “commercial” livery yards, dealers and sanctuaries can only benefit equine welfare, in a similar way to the current riding establishments, but with earned recognition. However, it is unlikely that the majority of inspections will be carried out by approved bodies’ trained inspectors on an earned recognition basis. Registration of all equine premises is already law in Ireland and France, however, enforcement is an issue. Although this would be of massive benefit in endemic and exotic disease control, we must be wary of other implications.

One of the issues that is drawing a strong (and varied) response from all BEVA members is that of death, injury and euthanasia in racing, eventing and competition. The live TV death (from a CV catastrophe) of Beijing Olympic champion Hickstead in the ring of an international showjumping competition Italy, then five fatalities at Cheltenham, and, above all, the loss of Synchronised and According to Pete in the Grand National has made this a developing, major and complex conundrum. The Competition Catastrophe Spring Workshop in Newbury, attended by 60 members, helped concentrate the mind on this matter. BEVA have discussed whether a network of media-savvy vets should be developed – like the renowned AAEP system in the USA. However, the British media are somewhat more critical and seek controversy more than in the USA. Meanwhile the racecourses and large event organisers are acutely aware of the importance of media liaison and have their own systems in place. BEVA member Chris Proudman did an excellent job at Aintree, but even the racecourses can’t dictate who the producer puts in front of the camera. No-one is criticising the excellent, immediate and expert veterinary care that is given to horses trackside, ringside and afterwards. Meanwhile, BEVA and the Association of Racecourse Veterinary Surgeons (ARVS) are jointly talking to the racecourse owners’ association, the BHA, the FEI, the BEF and others to assure them that we are here if needed. I did a radio interview on the two horse deaths at Bramham only this week. After presenting “a jump too far” at the BVA Animal Welfare Foundation Forum (attended by MPs and journalists) in London last month, I realise the level of concern with our sporting practices even within our own profession. It is important that equine vets concentrate on what they can do – deliver extraordinary veterinary medical care - whilst considering how this appears to others in this multimedia, instant comment, public-sees-all world.

All these issues are significant and important to large swathes of our membership. Daily Current Affairs sessions at Congress will include debates on firing, insurance and the current situation with respect to paraprofessionals. Naturally, Congress will primarily be about science  – with 3 days of 5 streams of world class CPD to educate, stimulate and inspire you – along with the biggest trade exhibition yet and the opportunity to socialise and, indeed, party with friends and colleagues. I look forward to seeing you there.