Week 50 and counting….down!

Congress is only just around the corner.  I’ve been scrolling through the programme penciling in all of the sessions that I’d like to attend.  Although having said that I think that David Mountford will already have put paid to any plans that I might have with the meeting schedule that he will have already created.  However, there’s always the Encore Room to catch up with lectures afterwards.

Dave Rendle (Congress Chair) along with the Congress Guardians has chosen such a varied array of topics and speakers that it’s hard to choose.  It’s great to see all of the familiar faces but also refreshing to see individuals presenting at BEVA Congress for the first time – not to mention their apprehension, which strikes a chord.  It reminds me of the first time that I presented at Congress back in 1998.  I was presenting during the final session on the Saturday afternoon in Birmingham and had been working back at the practice throughout that Congress and was on duty up until lunchtime on the Saturday.  I remember getting a slightly panicky telephone call from Stuart Thorne, a then student steward who’d seen practice with me that summer, at about 1pm enquiring of my whereabouts because the “Speaker Preparation Room” boys were getting a little twitchy.  I was still in the bakery in Tewkesbury - I suppose that I have always been a bit lastminute.com.

The main reason for my reference to this is the fact that the session Chair back in 1998 was John Hird, who is also chairing a session at this year’s Congress.  For those of you who don’t know him, John qualified in 1970 and became the first holder of a Diploma in Veterinary Anaesthesia four years later.  He then practiced in Halifax (Hird & Partners) up until the mid 90’s when he retired from the partnership and joined the VDS.  During his tenure at VDS he was author of their notoriously entertaining Newsletter.  Following his recent retirement from VDS he is now back at the practice as a consultant providing his anaesthesia expertise.  He also acts as a consultant for Abbott Animal Health. In fact it was via this connection that I met up with John last week.

We’ve had a fairly torrid time in our anaesthesia department recently having experienced more complications than we’d like to have and definitely more than we’re used to.  This trend has focused our minds and has lead to a review of our protocols. I know that Hird and partners have been using sevoflurane since the early 2000’s when it was first introduced there by Ian McCormick when he was there. I’ve used it on a handful of occasions and have been impressed with it and thought that we should trial using more of it.  However, none of the other anaesthetists at TCEH have used it so I thought I’d arrange some in-house training – enter John Hird courtesy of Abbot Animal Health.  My experience is that the recoveries aren’t any quicker but are generally smoother…. but there’s always the one that bucks the trend!  Another feature of sevoflurane is that it is eye-wateringly expensive, which will need to be justified to my partners.  However, when considering the cost / benefit ratio – what price can you put on an unexpected fatality?

We had a full day at TCEH with John and four very enthusiastic anaesthetists.  It was uplifting having everybody huddled around the head end chatting away, whilst a surgical procedure was being undertaken somewhere else on the patient, almost as an after-thought!  John’s enthusiasm was infectious and it was really inspiring to see him back in a clinical setting full of energy and passion about his subject.  At the end of the day I probably had more questions than answers but it’s comforting and re-assuring to hear of other people’s experiences good and bad, some similar and some dissimilar.  It makes you realise that it really isn’t an exact science.  There are no safe anaesthetics just safe anaesthetists.

John modeling some laser-safety glasses with his entourage

Another striking feature of our anaesthetic regimen is that, along with most other practices / hospitals / clinics, we task the responsibility of anaesthesia (one of the most important jobs in the theatre – but clearly not as important as the surgeon, lest I forget) to probably the most junior member of the veterinary team.  We train them up and then after 18 months to 2 years they move on and the process starts over again.  Also, as with driving, anaesthesia needs flare and empathy, almost a sixth sense; you can teach somebody to drive but it doesn’t necessarily make them a good driver – I should know!  Is that right for the patient?  Is it fair to burden a recent graduate with that level of responsibility?

I’m eagerly anticipating what light Eddie Clutton can shed on this subject in his Plenary lecture at Congress next week – “Anaesthesia in Horses: illness, pain, broken legs and death”.  I suspect that he will probably also ask more questions than he provides answers.  The anaesthesia sessions on Saturday morning will be another chance to hear about any lessons that we’ve learnt over the years.  There is also a chance for those of you who are relatively new (and old) recruits to attend the later morning session, “Anaesthesia for Dummies” chaired by John Hird – you are all most welcome into the fold; surgeons need not apply – maybe that was the reference to Dummies.

Back to Civvy Street…almost.

There have been no BEVA days away from TCEH this week, which has been different, enlightening, refreshing and not to mention…hard work!

I was on call on Tuesday night this week.   I’d swapped it with David (Blakey) so that I could be off on Thursday night.  As always seems to happen whenever you initiate swap, it was a bugger of a night on call.  A medical colic early evening followed by 2.30am, “…old horse down in stable, can’t get up…”  Who looks at their horses at 2.30am?  On arrival at the yard the yard owner, a 60ish year old farmer who’s diversified into a livery yard had arrived back at 1am with a load of straw and had found the horse down in the stable.  After 90 minutes the horse was still down and yours truly was summoned.  As soon as I arrived I recognised the unfortunate patient as one who’d made an appearance at the BEVA Geriatric Medicine Course, which we’d hosted at the Hospital in 2013 and 2014 because of his severe bilateral carpal DJD.

In his attempts to stand he’d now managed to scramble onto the concrete corridor outside the stable and was in lateral recumbency.  It was obvious that we needed to get him from the unsure footing of fresh straw (which had been provided by the farmer before I arrived) on concrete (a place of danger) to the dry paddock adjacent to the barn (a place of safety).

“Shall I get the tractor?” said the farmer.

“Er, no!” I replied.

“Do you think he needs putting down?” he retorted.  I suppose that might resolve our problem, I thought - my bed was still calling.

“Ian, I know we might be feeling strong but I think we need some muscle.  I think we need to call the Fire & Rescue Service to help”.  My suggestion induced a predictable searing pain in the farmer’s wallet, “What will they charge?”  I’d worked with and knew the local FRS crew on several occasions in the past and had recently asked that very same question to which the answer had been, no.  I let the farmer call 999 in order that the appropriate station was mustered.  They arrived within 20 minutes and were absolutely “bloody brilliant”.

We all knew our jobs and worked quietly, quickly and efficiently.  Within 40 minutes and after plenty of sedation, cotton wool filled ears, the perfect roll over onto the rescue glide and a lot of grunt we dragged the gelding into the paddock and left him to his own devices to stand when he was ready; which he did some 3 hours later.

The point of this story is that without the help of the FRS I’d never have managed to achieve the rescue.  To me it was the fruit of almost 10 years of labour developing Large Animal Rescue coming to bear, which made it such a pleasure to be part of it.  What concerns me though is that if this incident had occurred in an area serviced by North Wales FRS, no such help would have been available.  From the 1^st April this year, North Wales FRS decided to discontinue Large Animal Rescue and Rope Rescue both of which are deemed to be non-statutory services - http://www.nwales-fireservice.org.uk/large-animal-rescue/frequently-asked-questions-large-animal-rescues-and-rope-rescues.aspx.  What would I have done? – the farmer’s tractor may have been deployed; euthanasia may have been the only “humane” option; more importantly one of us could have been seriously injured attempting the rescue.

The farmer’s request about charging is also very relevant.  At the most recent Chief Fire Officers Association (CFOA) Animal Rescue Practitioners Forum there was much discussion about North Wales FRS decision and although all of the other FRS present at the meeting declared that they had no intention of withdrawing the service, a handful of FRS’s were starting to charge for it.  Upon enquiry the approximate figure mentioned was £300 per appliance (which may include up to 8 people) per hour, which I think is extremely good value for money.  However, it is something to bear in mind if you do call for their help.  Furthermore, I’m not clear in my own mind whether deployment of this kind of assistance would be covered under a Vets Fees Insurance Policy.  Maybe that’s another job on the list!

I was back home by 6am but by then sleep was never going to happen again that night!

Incidentally the owner was not present throughout.  The farmer said she was difficult / impossible to contact at night – thank heavens for small mercies.  When I met her at the yard the following morning I did enquire with my unsurprising sardonic humour, whether she’d had a good night’s sleep. 

The unfortunate victim of the previous night’s drama was none the worse for wear other than some fairly large abrasions on his dependent side.  I did recommend to the owner to try and avoid stabling him at all again in the future in order to prevent a repeat of the crisis.  He is a native after all and is far less likely to come to any harm well rugged-up in a field than he is inside on a straw bed on concrete.

But finally a massive thank you to the Hereford and Worcester FRS Animal Rescue crew from Pershore, you were great - keep up the good work; even the farmer was full of praise for you the next day.

Week, “I don’t know what” and counting …down.

Just over 1-month to go to Congress in Liverpool.

** STOP PRESS – YOUR LAST CHANCE FOR EARLY BIRD REGISTRATION FOR CONGRESS **

Everything is falling into place, which isn’t by good fortune but is due to the hard work, commitment and coordination of the staff at BEVA HQ.

The Scientific Programme that Dave and Lesley have devised has maintained if not surpassed the exceptionally high standards of previous year’s Congress’, https://www.beva.org.uk/congress/Sci-Prog. 

New for this year is the Practical Dentistry Demonstration Area running throughout Congress in the Commercial Exhibition Area.

In addition, calling all physios, chiros, osteos, etc. etc. – on Saturday we are running a full day of 4 sessions on the Veterinary / Physiotherapy Interface and we would like as much engagement as possible with Equine Physical Therapists to enable us all to see things from the “other side”.  Although in the interests of horse welfare, which has to be our priority, we should always be working on the same side - this may be a good starting point for our discussions.

Luise & I are both off this week.  We’re heading up to The Lakes for a couple of nights and en route we’re calling in to the caterers we have engaged for the Annual Ball who are based near Manchester to do some food and wine tasting.  We haven’t had the conversation yet about who’s driving the second leg of the journey!  I think it’s a good idea to have Luise, Tom & Lucy there to balance the menu otherwise we’d be having something like Calamari to start followed by Steak and Chips.  Tom (Hollow Legs) Harrison is extremely excited about the prospect of a never-ending supply of food to sample.  If you have any comments to make about the menu on the night please feel free to discuss them with Luise?

To book your place at the Early Bird Rates please click here - http://www.beva.org.uk/congress/booking/form  

Post Number 24.... And Counting!!

Just on my way back from our Annual Strategy meeting held at the RVC, Hawkshead Campus.  We were in the Conference Rooms above the main restaurant.  The campus looked stunning, probably helped by bright sunshine, clear blue skies and over 20 degrees.  There were students relaxing on the lawned areas “studying”, just as we used to!  I did have a text conversation with Prof. Josh Slater who said, “The sun always shines on Potters Bar”!

In keeping with tradition, our incoming President, Mark Bowen chaired the meeting.  There were a few absentees due to other commitments and unforeseen problems, which is understandable but we were lucky to have Paul Jepson and Michael Sadlier who were both attending their last Council meeting.  Michael Crane from the Donkey Sanctuary who couldn’t be there is also approaching the end of his term on Council, which means there’ll be places for some “new blood” to join in September.

Joining BEVA Council

https://www.beva.org.uk/aboutus/MeetTeam/Council/JoiningCouncil

Nominations to join Council in September are now open.  Last year the number of nominations exceeded the number of places and therefore an election took place for the first time in several years.  A common accusation we (Council) hear is that BEVA Council is considered by some to be “an old boys club” (beer drinking, rugby playing, sexist etc.).  My shoulders are broad enough to weather that kind of stereotyping but I think that Vicki, Lucy, Gayle and Hannah (see photo of Council Members) were particularly affronted about being referred to in that way!  If you really think it’s like that, which I agree isn’t representative of the profession in 2015, then please step up to the plate and make a difference.  BEVA is a truly democratic organisation, which strives to provide what its members want…it’s your choice.

One of the main topics for discussion and review at the meeting was the results of the recent member survey.  Over 550 people completed the survey, which I understand is an excellent response rate.  Those who didn’t respond missed out on the chance to win free Congress registration.  The feedback we get is vitally important to improve the services to our members.  It is really re-assuring to know that over 90% of our members are either “satisfied” or “very satisfied” with the Association – we must be doing something right!  But could we always do better – “the enemy of good is better”?

One of the funniest responses we had was to the final question, “Is there anything you’d like to tell us about?”.  The answer was, “I think that I may have Superhuman powers but I haven’t been able to tell anybody until now….”.  Great to see that the profession still has a sense of humour…. I assume!

During the meeting I was also chastened about the lack of my Blog over the last few weeks and months…. I really have been up to my eyes in it recently both with BEVA and the practice.  This included a difficult foaling in the middle of last week, (legs back and a small colon prolapse / intussusception), which resulted in a (very strong) orphan foal L…with attitude.  What was also amazing was the response to our posting on Facebook for a foster mare; within 48 hours we’d had 120,000 hits.  We found a mare quite promptly and after lots of seriously hard work by the nursing team over 4 days they bonded and are due to go home soon.  I believe the foal has now got her own Twitter account!

Week 23... And Counting

This has been a week of vet school tours.

On Monday I visited Vienna Vet School, https://www.vetmeduni.ac.at/en/, as part of BEVA’s vet school tours.  This was our first time visiting Vienna as part of the Vet School Tours.  Our point of contact there is Edmund Hainisch, who many of you will know.  Edmund is a larger than life character, both physically and as a personality.  I know I’m not “man mountain” but I’m not small either and he totally dwarfed me (see below).  He (eventually) graduated from Vienna, which is close to his hometown, in January 1996 after a prolonged undergraduate career (his choice), which was interspersed with some long distance lorry driving to fund his studies!  He explained that as an undergraduate he had stumbled across a copy of Equine Veterinary Education in the university library.  He was immediately struck by the quality of the publication and it enthused him to find out more about EVE, EVJ & BEVA.  He arranged to visit the UK and to see practice at Fellowes Farm with Peter Green, stopping off in Newmarket on the way to watch the horses work on the gallops.  He was enthused by equine practice in the UK and was also struck by the close network and camaradery of UK horse vets through BEVA (Peter Green was a BEVA Council member at the time).  Following graduation, he successfully applied for an intership at Liphook (Jeremy Mantell was the BEVA President at the time), followed by a surgical residency at Liverpool, finally returning to Vienna in 2005.  During his time at Liverpool he was coerced into Sarcoids by DCK and is now doing some fantastic research work in the lab at the vet school investiagting immunotherapy for the prevention of sarcoids, with some really exciting results.

In the foyer of the hotel with Edmund – my kids thought we looked like father and growing son!

I left Vienna early on Tuesday morning to do a full round of calls followed by a colic referral that night…..

The following day I drove to the University of Surrey to visit the new Vet School http://www.surrey.ac.uk/vet.  Chris Proudman, the Head of the School, who still commutes weekly from Merseyside had invited me as BEVA President.  I’ve known Chris for years as he was a Resident at Liverpool with Luise back in the early 90’s; I’m sure there are a few embarassing stories to tell on both sides.  Although the new buildings for the Vet School, the Pathology labs and the Large Animal Teaching unit are still under construction the first tranche of 45 students are about halfway through their first year.  They are due to take possesion of the new buildings later this summer.  The whole project is costing in the region of £60 million with a business plan to break even in about 10 – 12 years.

Chris was explaining that the rise of Surrey University has been driven by the “newish” Vice Chancellor, who pledged, when he took over some 8 years ago that he would elevate the University of Surrey into the top 10 of the University league tables within 10 years (it was lying in about 60^th place at the time).  Remarkably, he achieved 7^th place in 7 years.  I do have concerns about the number of veterinary graduates, which the British University system is producing.  However, there is obviously still a need for them and more besides; there was an equal number of non-UK RCVS registrants in 2014 as there were UK registrants, i.e. new graduates.  Therefore there is an argument that we should be filling the UK job vacancies with graduates trained to the exacting standards of the UK vet schools.  Furthermore, I think that with somebody like Chris at the helm at Surrey Vet School I am very confident about the quality of the end-product and I wish them well.  

Chris with his new company car

Week 22?! and counting....

Most of March so far has been pre-occupied with trying to sort out the £227,000, which was stolen from the practice bank account, through our Internet banking, at the end of February.  I don’t mention it with any hint self-pity but bring it up to try and warn you all about the devious methods used by the fraudsters.  It’s amazing how much you learn, once you’ve been a victim.  The front page of one of the Sunday Times supplements, which went to print just over a week later was entitled, “Why Friday is the most dangerous day for fraud.”  The reason being is that after about 4 pm on a Friday the majority of banks’ fraud lines are closed until Monday morning.  This gives the fraudsters all weekend to move their ill-gotten gains from the bogus account to which it has been moved from the victim’s account, without the fraud department being available to be contacted to freeze the aforementioned account.  http://www.thesundaytimes.co.uk/sto/business/money/Consumer/article1527879.ece?shareToken=19135c367b19ac3a111d31237f45ea92

User beware - if you get any exceptional phone calls from the bank on a Friday afternoon, especially from a man called Peter, who duped us, (a name he uses regularly, we’ve now been told) it could be a hoax.  I’m sorry to tar all “Peter’s” with the same brush but I’m still smarting (a lot) about it. 

We are currently in negotiations with the bank, which have offered to refund half of the loss.  I will elaborate on this scam at a future date, once we have reached a settlement.

At the beginning of March, I went down to London to attend the National Equine Forum (NEF), which was held at the Institute of Mechanical Engineers at 1 Birdcage Walk, which is just a stone’s throw from the Houses of Parliament.  My trip coincided with one of my colleagues, Becky Wall, having to go to the RCVS to sit the practical and theory part of the CertAVP examination in Diagnostic Imaging; so I chaperoned her to and from the venue.  Obviously it involved a trip on a Boris Bike and we did a bit of sight-seeing, passing Buckingham Palace en route, which I think put Becky in relaxed mood for her exam.

Obviously at the end of the day, when we met up again it was all death and destruction from Becky…she’d done really badly, couldn’t answer any of the questions, it wasn’t at all what she expected, nothing she’d revised came up, she was going to fail, bla, bla, bla!  She received confirmation the following week that she’d passed, with flying colours…but in her opinion didn’t deserve to!  That is such a girly thing to do….I remember well that if I said I’d failed…I’d failed and deservedly so.

Back to the NEF; it’s the 23^rd time the event has been held and it is growing year on year.  The aim of the forum is, “To host an annual assembly of individuals who reflect every area of the equestrian industry, to hear presentations from experts on diverse and topical aspects of the industry and allow them to share their views.”  Effectively, the who’s who of the horse-world…. and Monty (David Mountford our CEO) and me.  High profile attendees included the NEF president, HRH the Princess Royal and Lord de Mauley TD.  The main topic of discussion for the day was the need for the “industry” to implement a robust and workable equine ID system, which has been pinpointed as the cornerstone for equine health, welfare and management in the UK.  There was a debate, chaired by Roly Owers, which included representatives of the Chief Veterinary Officers of the four UK countries.

Full report about the NEF: -

https://www.beva.org.uk/news-and-events/news/view/716

Incidentally, I had arrived at the NEF fashionably late, at the same time as Celia (Marr), who is always great value, which meant we were seated together.  The catering wasn’t what we were used to in that the mid-morning and mid-afternoon breaks were “comfort breaks” with water only and no coffee, and no coffee at lunchtime either – WTF, no caffeine!  At the mid afternoon break Celia and I sloped off to Café Nero, which was just around the corner for our fix.  I was fine with an Americano but Celia ordered two double Espressos’ – even the guy servings’ jaw dropped.  Respect – I bet she can eat 3 Shredded Wheat too….  No wonder she achieves so much in a day; with that much caffeine who would be able to sleep?

Week, I’m not sure what, but still counting….just.

One of the reasons for my failure to write Blogs is that the interval between my weekly hospital visit for my “bee desensitisation injections” (mentioned in Blog 8) has been extended to every 4-6 weeks, which means that I have no longer got 2 – 3 hours to kill every Monday morning.  I was very sceptical about the whole process of the desensitisation injections but I have to say it seems to be working.  The first injection I received was equivalent to one hundredth of a bee sting, which stimulated a really marked reaction over the first 36 hours, which remained for 3-4 days.  The dose increases weekly; my most recent injection was equivalent to 2 full bee stings, which induced a minimal short-term reaction.  In a perverse kind of way I’d say I’m almost looking forwards to being stung during this season’s hive inspections.  If I don’t appear for sometime it could be that my optimism about the success of the treatment is somewhat misguided. 

February was a really hectic month.  It started with the tail end of a weekend in Stockholm at the Nordic Equine Veterinary Conference (NEVC), mentioned at the end of my last blog, www.nevc2015.se.  This is only the second time this event has been held, the first one was held 3 years ago in Denmark.  It is a collaborative venture between the Scandinavian countries Denmark, Norway and Sweden’s Equine Veterinary Associations, which is hosted in rotation between the countries every 3 years.  The format is very similar to BEVA but just on a smaller scale. There were approximately 400 delegates and 2 sessions running concurrently.  There were several International speakers including Andy Durham, Patrick Pollock and Caroline Hahn from the UK.  The Conference organisers were extremely welcoming and hospitable, for which I am most grateful.  I am no linguist but understand that the Swedish, Norwegian and Danish languages are quite markedly different and for that reason the respective nationals will often communicate in English…they really do put us to shame.  Furthermore, all of the lectures were delivered in English – and a bit of Scottish. 

At their formal Congress dinner on the Saturday night, one of the highlights was that each countries delegate’s had to get onto the stage and sing a song or rhyme from their country as chosen by the organisers.  Fortunately, by the time that it was the UK’s turn they were all too legless to remember or had lost the will to live and therefore we didn’t have to sing “Old Macdonald Had a Farm”.

En route to the Conference, between the airport and the hotel, approximately 40 miles by train at 0100hrs, I managed to lose my mobile (I promise that alcohol did not play a role).  It did cause me a lot of angst initially but by the following morning I accepted my fate and the following 5 days, without a mobile, was quite a liberating experience – you should try it sometime.  However, there were numerous missed calls, voicemails and texts, when I was finally back on air.  My period of radio-silence coincided with the airing of my BBC Countryfile interview about West Nile Virus (WNV) & African Horse Sickness (AHS).  Not surprisingly, most of the voicemails were mocking, disdainful and derisory – I would expect nothing less!  I also received several sardonic emails; the one from Dave Rendle (Congress Organiser) was entitled, “I’ve just choked on my supper”

The following weekend involved a trip to Pisa to SIVE (the Italian Equine Veterinary Conference).  Again the hosts were extremely welcoming and hospitable, for which I am extremely grateful.  The Congress size and delegate numbers were very similar to Sweden with 3 sessions running concurrently.  A familiar face presenting was Michael Schramme and also Karen Richardson from The Donkey Sanctuary.  Again the majority of presentations were delivered in English with simultaneous translation available.  Talking to other delegates it was clear that the economy in Italy is struggling with the inevitable effect that will have on the equine sector, including vets.  In addition to that Italy has a staggering 13 vet schools.  Unsurprisingly, the economy is currently unable to sustain the number of graduates entering the profession and a large number seek employment elsewhere in Europe.  The number of new RCVS registrants from outside the UK (predominantly Europe) is approximately equal to the number of registrants from within the UK, i.e. new graduates.

On my way back from Pisa, I stopped off in Paris (as you do) and met up with Renate (Weller) to attend a, “Radiographic Expert Veterinarian Meeting”.  That’s why I took Renate, I was definitely the monkey; but there was relevance to the membership about harmonisation amongst European vets about the significance of radiographic findings at PPE.

Week 20 and counting…

I attended a joint BVA / RCVS meeting on Monday afternoon to do some brain- storming for the Vetfutures initiative.  As a profession, where are we going to be in 2025?

The Project Manager, Sally Williams and colleague, Hannah Jordan provided a literature review, which highlighted six forces that are likely to shape the future for the veterinary profession:
1. Demographic Changes
a. Feminisation and the impact on part-time working – in the 2014 RCVS survey the number of vets working part-tine was 19% an increase from 11% in 2000.  Most striking is the proportion of men undertaking part-time work, which has more than doubled since 2010.
b. Women tend to gravitate to SA, equine and mixed practice, whereas men lean towards to farm and equine
c. Socio-economic background of veterinary students: 24% of vets responding to the 2014 RCVS survey had been privately educated.

2. Economic Forces
a. Supply & Demand – where the US leads the UK often follows.  An American Veterinary Medical Association (AVMA) survey indicates a surplus capacity of vets of between 11% and 14% between 2011 and 2025.  Pet ownership in the UK remains strong (46% of households have pets) but this is not necessarily an indicator of the number of vet visits with owners utilising the Internet for advice!
 
3. An increasingly Competitive Market
a. Increasing number of corporates versus private sector practices
b. Internet sales of drugs
c. Human pharmacies moving into the pet marketplace.

4. Client Behaviour
a. Convenience culture – clients are “increasingly digitally sophisticated” and “time constrained”.
b. Farmers increasingly want proactive vets who are “part of the team”.
c. An RCVS client survey indicates that veterinary services need to change from a model of what vets are prepared to offer, to one that is driven by the needs and wants of existing and potential clients.  The UK healthcare sector uses the end user as it’s starting point – it’s about “empowering patients”.

5. Food Supply and Global Imperatives
a. Issues such as climate change, bioterrorism, antimicrobial resistance, food supply & security and trans-boundary disease.
 
6. Mental Wellbeing
a. Research suggests that vets are no longer at greater risk of suicide compared with other professions.
b. An RCVS survey found that nearly 90% of vets found the job stressful but 80% reported job satisfaction.
c. 1 in 7 vets reaches burnout within the first 10 years post-graduation; 1 in 5 female vets meets the criteria for burnout with the first 5 years post-graduation.

Two days later I was back in London speaking at the AGM of the Royal College of Chiropractors where I spoke to it’s recently formed Animal Faculty on the very topical subject of the Vet / Therapist interface.  Obviously this was from an equine perspective and was an opportunity to share with them some of the outcomes of the recent survey we undertook for the RMPR project.  The return journey to Euston on a Boris bike coincided with a torrential downpour; it was going to happen one day!

On Thursday I attended a joint meeting of the Veterinary Policy Group (VPG) and Ethics and Welfare Group (EWG) of the BVA at Mansfield Street on the contentious issue of the “badger cull”.  I attended at the specific request of the BVA President, John Blackwell but I’m not sure that it’s right that we (BEVA) should have an official view; that’s surely the job of the specialist divisions.  If you’d like to voice your concerns about the cull, I’d encourage you to contact the BVA directly.

Following this I caught a late flight to Stockholm to attend the second Nordic Equine Veterinary Conference, arriving at 0100hrs.  Between Stockholm Arlanda Airport and the hotel, I managed to lose my mobile…..

Week 19 and counting……

I just spent a weekend on call, which I swapped with one of my partners, Mark Georgetti, whilst he went on SkiPD, organised by the Mayes’s and Henry Tremaine.  Regrettably, we haven’t been for a few years because it’s always during term time.  Although it’s probably not fair to blame it on the children this year…. I do have quite a lot on my plate already!

At the end of the week I participated on a discussion panel at the joint Veterinary Practice Management Association and Society of Practicing Veterinary Surgeons (VPMA / SPVS) Congress, which was held at the Celtic Manor, Newport.  It’s the second consecutive year that it’s been held there because of the sheer size of venue needed to accommodate delegate numbers.  It was also really convenient for me being only an hour away from home.

The Keynote speaker for the Congress was Monty Hall, http://www.montyhalls.co.uk/about-monty, who was captivating for the full hour or so.  As some of you may know he’s an ex-Royal Marine Officer, although by his own admission he’s never seen active service.  He gave a really entertaining and sometimes self-deprecating talk about constantly setting new challenges for yourself, getting out of your comfort zone and not letting age be a limiting factor; which is quite appropriate when you’re my age.  He described how he’d spent several weeks filming with Discovery channel for the programme, “Lost Worlds” where he’d had to climb (accompanied) a 1000 feet vertical face to film some wildlife and he’s petrified of heights; by my standards that’s definitely out of your comfort zone.

This year the Congress organisers had included an Equine Specific Business Stream, which attracted 50 – 60 delegates and generated lots of lively discussion.

Julian Samuelson of Bell Equine deftly chaired the panel discussion with my fellow contributors Chris Pearce and Wendy Furness, neither of whom needs any introduction.  The title of the panel was, “Equine Practice is Different…” which may be true but different to what; I have no experience of running any other type of practice… 

But it seems that a lot of concerns are common to all of us:

-          Feminisation, which is currently less pronounced in equine practice.  Statistics from the RCVS show that of the approximately 20,000 registered practicing veterinary surgeons, 57% are female and 43% are male.  The BSAVA shared their membership statistics with me, which are approximately 63% female to 37% male (the lions share of which are less than 45 years old – are the older ones retired already?!), which compares with the gender split of BEVA’s ordinary members which is 45% female to 55% male.

-          Increasing graduate numbers both UK and foreign; however, there were comments about the dearth of experienced (approximately 3 year qualified) vets in the marketplace.

-          Corporatisation – to date there are only a handful of corporate-run Equine Practices and it’s difficult to predict if this is going to change.

-          Succession – have you got a plan; is your practice affordable / saleable?

-          Work / Life balance - have we got it right?  Have your chance to join the debate “Does Equine Practice need to be more compatible with Family Life?” at BEVA Congress in September.

Talking of BEVA Congress, I am delighted with this year’s logo (see below), for which I was keen to have a racing theme and that image is iconic for the Grand National (Aintree) as the only start where you see the runners from behind.  The personal touch, which Joss has allowed me to include, is the colours of some of the horses which have been under the care of my practice, namely Mon Mome, Monbeg Dude, State of Play, Cappa Bleu and Alvarado all of which have run in the Grand National.  Those racing enthusiasts amongst you will recall that Mon Mome won in 2009 starting at odds of 100-1.

I’m most grateful to both Helen Sanderson (the outgoing VPMA chair) and Colin Thompson (the outgoing SPVS chair) for inviting me to participate in the VPMA / SPVS Congress.  It was also very kind of them to invite Luise and I to the banquet on the Friday evening, which was “black tie” with a hint of Scottish.  I assume that the reason for this was that it was just 2 days prior to Burns Night and also because of Colin’s ancestry; Colin didn’t disappoint with his word-perfect address to the haggis.

Week 18 and counting.....

On Tuesday David Mountford (CEO) and I went to DEFRA and met up with Richard Drummond and Siobhan Taylor to discuss the results of the Review of the Minor Procedures Regime (RMPR) project surveys mentioned in last week’s blog. BEVA have undertaken 2 separate surveys as part of the evidence gathering for the review, one on the subject of Musculoskeletal Therapies, including small animals (Survey 1) and the other one about Equine Dental Care (Survey 2).  Survey 1 was targeted at musculoskeletal therapy associations (12 responses), individual musculoskeletal therapists (623 responses) and horse owners (5,796 responses).  Survey 2 was targeted at the equine dental associations (1 response), individual equine dental care providers (378 responses) and horse owners (5,796 responses).

Both surveys make for interesting reading:

Survey 1

-          25% of horse-owners would not contact a vet if they thought that their horse had a musculoskeletal problem, nearly 50% might contact a physiotherapist and just over 40% might contact a chiropractor.

-          Some therapists report vets being unwilling to engage/liaise

-          Better regulation is desired

-          Minimum educational standards of a Degree or Masters are supported by the majority of therapists

-          Current regulations are considered to be impractical and ill-defined and there is poor enforcement

-          There are currently no minimum standards / qualifications for therapists

-          Therapists consider that there is veterinary indifference and ignorance.

-          Estimated number of therapists offering musculoskeletal therapy to horses in the UK – 1120.

         Survey 2

        

-          Vets are often not the owner’s first choice for equine dental care

-          Word of mouth/reputation is the primary differentiator used by owners

-          Qualifications are important to owners but are not checked

-          Association membership is important to owners but is not checked

-          The majority of qualified EDTs comply with “accepted practice”.

-          BAEDT members appear to be slightly more compliant than others

-          ¾ of unqualified EDTs do not comply with “accepted practice” or the VSA

What a fantastic piece in last week’s edition of In Practice under “A Practitioner Ponders”.  It mentions the outcome of the Injury Survey we commissioned in 2013 and discussed the use of Personal Protective Equipment (PPE).  Key facts worth consideration are that according to the Kentucky Trauma Registry, “50% of horse-related fatalities of riders were from incidents on the ground,” and that the wearing of a safety helmet, “confers an 80% increase in the chance of survival in the event of a head injury”.  I would urge you to find a copy of the journal to read this article (In Practice: January 2015, Volume 37:1), http://inpractice.bmj.com/content/37/1/48.full.pdf+html

Week 17 and counting…..

Yes, I know the last blog was my 14^th but I did have 2 weeks off from BEVA things over the Xmas and New Year period and therefore no blog was forthcoming!  2 weeks off, except of course for the continuous influx into my Inbox; although it was reduced to about 30 a day.  But sadly not 2 weeks off from the practice and the Xmas & New Year Rota, which included the first Point-to-Point fixture in the area for the 2014/2015 season.

New Year and new resolutions: to answer emails by return and not just let them sit in my Inbox, whilst I ponder them; to only read texts, when I’m in a position to respond to them rather than read them whilst I’m driving with the intention of responding when I’m stationary and then I invariably forget.

The first edition of the year of the Horse and Hound included an article on the hopes of a number of vets, including myself.  I’m surprised that there hasn’t been more fallout from my concerns about some rider’s weight compromising their horse’s welfare.

It was straight back into it at the start of the week with a trip down to the British Horseracing Authority (BHA) headquarters in London on Tuesday for a meeting of the Veterinary Committee.  The implementation of their Anabolic Steroid Policy has been delayed until March 2015 because of the difficulty in defining who is deemed to be the “responsible person” either prior to a horse entering training or during those periods of time when the horse is “out of training”.  No further information was available at the time of the meeting but it is hoped that these loose ends will be tied up by February after further consultation with the National Trainers Federation (NTF) and the Racehorse Owners Association (ROA) …watch this space.

I tabled a paper about equine dental procedures being performed on BHA licensed premises.  This is part of our ongoing campaign to inform all horse owners / trainers / carers about the legislation surrounding “the horse’s mouth”.  One of the things, which has become apparent to us over the last few months both from the BEVA e-Survey of our members and the survey, which we undertook for the Review of the Minor Procedures Regime (RMPR) board on Equine Dental Care is the surprising amount of ignorance about and understanding of the subject.  The RMPR survey included dental care providers, including vets, and horse-owners.

BEVA has been trying to promote the regulation of “horse dentists and dentistry” for years in order to protect animal welfare.  Achieving this goal is currently being hampered by the fact that anything other than Category 1 dental procedures are considered to be acts of veterinary surgery.  However, we are still condoning / supporting the practice of Category 2 procedures by “suitably qualified” non-vets.  This is an anomaly and until there is an exemption order in place, which we are working on with DEFRA, it will remain theoretically illegal for non-vets, suitably qualified or not, to perform Category 2 procedures.  However, in the meantime, I think that we should recommend that only “suitably qualified” dental technicians should be performing any (Category 1 or Category 2) procedure in a horse’s mouth.  I think we’ve all seen the results of the damage that a non-qualified individual can do using a set of rasps, albeit legally - whose idea was it for unqualified people to be allowed to rasp sharp enamel points anyway? 

At the meeting I requested that the BHA take a lead on this and recommend that only suitably qualified EDT’s or vets be undertaking any form of equine dentistry on BHA licensed premises.  Obviously it will be difficult to implement this with immediate effect but I suggested that those individuals working on BHA premises who are not qualified are allowed a period of maybe a couple of years to gain suitable qualifications in order to retain the work.

I have a meeting with DEFRA next week to discuss the RMPR survey where I hope we can progress the subject of equine dentistry further.

Week 14 and counting……

Fortunately the weekend on call, although reasonably busy, didn’t result in me losing too much sleep and so I was able to shake off the jetlag quite promptly.

The main BEVA item this week was the Council Review Meeting, http://www.beva.org.uk/aboutus/MeetTeam/Council, which was held at Trinity Hall in Cambridge.  As a Liverpool graduate I am unfamiliar with the City of Cambridge and its collegiate system.  My only visit to Cambridge as an undergraduate was on a rugby tour and all that I can recall is the pub, the kebab house, the rugby pitches and the fact that we won…. which was a surprise as the players who appeared on the pitch on the Saturday afternoon were definitely not the ones we were drinking with the previous night; I think we’d been entertained on the Friday evening by the 1^st XV “drinking team”.

However, what a remarkable scholastic city, steeped in history and tradition.  Although not all Council members shared my enthusiasm – “There’s nothing makes me want to vote socialist more than f…..g Cambridge,…” exclaimed in the best Lancastrian accent – guess who?

We welcomed 4 new members onto Council at the meeting, namely Gayle Hallowell, Ben Sturgeon, Hannah Yeates and Jon Pycock, who’s doing his second stint on Council – his first one being about 10 years ago.  It was really encouraging in advance of Congress in September that we had sufficient people who applied to join Council that an election was required – did they all think, “If Harrison can do it then anybody can”.  For those of you who weren’t successful this time or others of you considering Council, I strongly encourage you to apply next year – you really will get a lot out of it.  I urge more practitioners to apply, particularly female ones - after all that’s the vast majority of members, which the Association represents.  If you think Council’s full of “old, male, tweedy farts” (see Blog 7), put your money where your mouth is:

http://www.beva.org.uk/aboutus/MeetTeam/Council/JoiningCouncil

Topics discussed included:

The Association’s Operational and Financial Reports

-          The total membership stands at 2678, only a fraction up on last year.

-          Membership subscriptions can now be paid by monthly direct debit.

-          There is a NEW concessionary rate for those earning < £15K or on parental leave or studying full time for a full time veterinary related qualification.

-          The Scientific Programme for the 2015 Congress is almost completed.

-          The BEVA Database and Website are being re-built

-          The BEVA offices at Fordham are undergoing some renovation works in 2015.

The Role of The BVA

-          The BVA have asked for feedback from the divisions on its structure and governance.

Do we want to be Doctors!

-          I’d rather “vet” something than “doctor” it!

Following the meeting, we had our Christmas dinner, again at Trinity Hall, which included all Council Members and partners and the BEVA Office Staff and all had a late, great night.

The following day I attended the Winter Clinical Workshop at Duxford Airspace, Cambridgeshire, http://www.iwm.org.uk/visits/iwm-duxford, what an inspired choice of venue.   The meeting covered predominantly “Regenerative Medicine” and its use in orthopaedics – New Treatments for Lame Horses – Do They Work?  It was a really informative day and was fully subscribed with over 75 attendees.

Over Xmas – the BEVA offices closed down although I’m lead to believe that DM is “beavering” away behind the scenes! 

However, no such luxuries at TCEH – although this year Luise and I are both off over Xmas as we both worked Xmas Day and Boxing Day last year.  We were both out till early evening on Christmas day and the kids were Home Alone.  They said it was the best Christmas they’d ever had – they watched the television all day.

Compliments of the season to you all and I’ll catch up in the New Year.

AH

Week 13 and counting……

A quarter of the way through my year already – “Is that all?” I hear David Mountford cry.

Our trip to Toronto airport did involve a stint on the wrong side of the road as I left a “gas station”, which did cause much anxiety for the other driver and my passenger.  So onto Salt Lake City (SLC) via Chicago for the 60^th AAEP Convention – “Howdy!”.  I thought that I wasn’t very well travelled but approximately 70% of Americans don’t have a passport.  But why would you need to in just a huge and diverse country?

Our hosts could not have made us feel more welcome.  On the Saturday night we were entertained at the President’s reception and met up with the outgoing AAEP President, Jeff Blea DVM and his wife, Annie also DVM.  His is an interesting career; his career as a flat jockey of a few years was curtailed after he was involved in a serious riding accident where he was “slammed” into the running rail, which left him with a totally paralysed left arm.  After this he re-trained as a vet and is a now a practitioner who does racetrack work - with effectively only one arm.  I am truly in awe of people like Jeff who conquer serious disabilities to succeed – respect.

The weather was unseasonably warm with clear blue skies and temperatures above freezing.  The Convention format is very similar to BEVA Congress with an opening ceremony and plenary lecture, which most delegates attend, followed by multiple streams running concurrently, but as you would imagine it was a lot bigger.  Also I’ve never seen so many Stetsons or cowboy boots in one lecture theatre.

The plenary lecture was delivered by Marvin Beeman DVM, an 82 year old practitioner who still works a 4½ day week in the mid-west and hunts twice a week during the season.  He gave a very thought provoking and inspiring insight into his work ethic both as a professional and a businessman.  He invited us to join him and his family at the Convention dinner on the Tuesday night - what an inspiration and he fully deserves to be wearing the crown!

There were a handful of UK delegates including Nenad Zilic , from Barn Equine, Sue Dyson, Lynn Hillyer, Tim Mair representing Equine Veterinary Education (EVE), Roger Smith, Chris House & Jane Jackson, Rob van Pelt and our very own David Mountford.  Even Gavin from BCF made an appearance in the trade-stand area (which as previously mentioned was a lot bigger) and managed to lure me into buying one of their new DR systems – it’s ok the deal wasn’t clinched in the bar and my partners do know.

There were several opportunities to collaborate with the AAEP – for example, there was an evening meeting of their Internship Awareness Program (sic).  This involved approximately 60 equine clinics, usually called hospitals, advertising their wares in an informal setting to undergraduates and recent graduates.  Their programme is far more advanced than BEVA’s Internship Awareness Proogramme but gave us some good ideas as how to progress ours.  David and I also had an informal meeting with a company who are keen for BEVA to collaborate in an Equine Veterinary Conference in China in the latter part of 2015.

 

SLC is another 2 hours behind Toronto causing even more disruption to my sleep patterns.  Every morning I was wide-awake at 3 am regardless of the time I went to bed.  Understandably, I vacated the room and was in the “lobby” by 3.15am doing emails etc..  It’s not unusual for me to be in the hotel reception at 3.15 am at BEVA Congress but not usually doing emails!  The return journey coincided with my body clock having finally adapted to the SLC time zone.  It was an overnight flight arriving in Heathrow at 11am and then straight back to work and into a weekend on call….