The Royal College of Veterinary Surgeons (RCVS) Practice Standards Group (PSG) has this week published the results of its comprehensive five-year review of the Practice Standards Scheme (PSS), with updates to a number of its requirements that have a particular focus on clinical governance, staff health and wellbeing, and the role of veterinary nurses.
The PSS, a voluntary quality assurance scheme for veterinary practices which is run by the RCVS, undergoes a widescale review process every five years to ensure that the standards it is asking its practices to meet reflect the latest in best practice, whilst keeping up to date with legislative, technological and clinical developments, and the current priorities of the profession and its stakeholders. The review, postponed for 12 months due to the pandemic, encompasses all accreditation levels for practices within the Scheme (Core Standards, General Practice and Veterinary Hospital), across all species types (small animal, equine, farm) and across all of the RCVS award categories.
The review is carried out by the Practice Standards Group which comprises representatives from various professional bodies including the British Veterinary Association (BVA), British Veterinary Nursing Association (BVNA), the British Small Animal Veterinary Association (BSAVA), the British Equine Veterinary Association (BEVA), the Veterinary Management Group (VMG), the Society of Practising Veterinary Surgeons (SPVS), the British Association of Emergency & Critical Care, the British Cattle Veterinary Association (BCVA) and the British Veterinary Hospital Association (BVHA).
RCVS President Mandisa Greene, who also chairs the Practice Standards Group, said: “I am very grateful for my colleagues on the Group, and all those who inputted to the review, including colleagues at RCVS Knowledge and the Mind Matters Initiative, for their hard work throughout the last year in getting the new elements of the guidance together and ready for publication.
“Although the Scheme is constantly being updated in light of, for example, changes to legislation or RCVS guidance, the review we carry out every five years gives us the opportunity to take a much more root-and-branch look at the Scheme and make sure it reflects what both the public and the professions expect from a high-quality veterinary practice.
“For example, these changes have a strong emphasis on making sure that practices take mental health and wellbeing of the team into consideration with clear policies and support mechanisms in place for staff that need help and ensuring that members of staff take sufficient breaks and annual leave. This reflects the increasing focus there has been on mental health and wellbeing over the past few years and the recognition that a healthy workforce provides a better service to its patients and clients.
“Likewise, the enhanced status and role of veterinary nursing is recognised in the update with expectations that practices should have sufficient levels of nursing staff and that, at Veterinary Hospital accreditation level, all patients should have a nursing plan.”
Some of the other major changes to the PSS requirements include:
- Clinical governance: PSS practices accredited as General Practice level will need to demonstrate the use of clinical audit, significant event audits and the development of guidelines and protocols around clinical governance.
- Infection Control: at all accreditation levels there are new requirements on the provision of infection control, including risk-based deep cleaning and the minimisation of cross-infection.
- In-patients: animal owners will have to provide signed consent to demonstrate they understand the level of overnight care that will be provided for their animals as in-patients. Practices at Core Standards accreditation level will need to have provisions to ensure the welfare of patients if left unattended overnight while practices accredited as Veterinary Hospital level will need to have sufficient team members, including an RVN during all normal opening hours, on site at all times and provide protocols and checklists for handovers between day and night teams.
- Medical Records: General Practice accredited practices will need to have a computerised Practice Management System, with records being accessible from and transferable between all branches. They will need to provide written discharge instructions and show regular recording of bodyweight and Body Condition Score.
- Nursing: At least one RVN will need to be employed at General Practice level.
- Surgery: there are several enhancements to surgical facilities and protocols in the update, including the need to avoid any outdoor clothing or footwear in the operating theatre for practices accredited at General Practice level. There are further requirements for the investigation of surgical site infections, including the use of bacteriology for General Practice and Veterinary Hospital accredited practices. Surgical lighting is required for Core Standards practices, and must be directable for General Practice level.
There are also a number of changes to the requirements for PSS Awards, which are designed to highlight specific areas so that practices can demonstrate the areas in which they excel. Examples of these changes include a requirement under the Client Service Award for practices to carry out client focus groups to monitor client perceptions and feedback, and, under the Nursing Award a requirement to have a 1:1 ratio of veterinary nurses to veterinary surgeons.
The full list of changes to the Practice Standards Scheme, together with the new module and award documents, can be found at: www.rcvs.org.uk/PSSreview
David Ashcroft leads the team of PSS Assessors responsible for undertaking practice visits and assessing if they meet the required standards. He said: “The changes will come into force later in the year, at the same time as we are planning to return to in-person assessments, and so timings will be subject to government guidance on coronavirus and the easing of lockdown restrictions.
“As the PSS returns to in-person assessments, practices will have the usual three-month period between booking the assessment and the assessment taking place with which to familiarise themselves with the changes and the modules documents relevant to their accreditation.
“If anyone has any questions about the changes then please make sure to contact the Practice Standards Team on firstname.lastname@example.org and we will be happy to help in any way we can.”