The NHS and vets: sharing good practice
Prof Oliver's experience with out of hours vets led him to consider the comparisons between vets and NHS doctors.
“I think NHS doctors could learn from the way vets communicate proactively with owners, from the near patient testing and from bringing on-call rotas “in-house”, including at the weekend,” says Professor David Oliver, consultant geriatrician and acute physician.
A recent encounter with out of hours veterinary care prompted Prof Oliver to contemplate the service offered by the veterinary profession, compared to the NHS.
At 8pm on a Thursday evening, his three-year-old calico cat Tilly suffered acute kidney injury caused by gastrointestinal upset. Prof Oliver, who is a visiting fellow at The King's Fund and president elect of the British Geriatrics Society, contacted the out of hours vet.
The four vets he dealt with were “extremely professional, conscientious and thorough and clearly knew their stuff,” he says.
“They all had excellent communication skills, clearly loved animals and were very good communicators with us, the owners.”
Prof Oliver says he was impressed by the way the out of hours team communicated with his regular surgery, the frequent updates he received on Tilly's progress and near patient testing, which limits the amount that has to be referred to “secondary care”.
“Even without asking, we were given proactive regular updates about the cat's recovery - which to be honest wouldn't be the norm in the NHS given current pressures - by the fact that small surgeries had near patient testing (better than most of the NHS) e.g. for imaging and bloods, that there was an on-call rota through the weekend and evening (not subcontracting to a private out of hours service) and that follow up and discharge were easy to arrange”.
The experience led him to consider the parallels between they veterinary profession and his own.
“Both professions require lengthy professional training, both require the use of applied physiology, anatomy and pharmacology as well as skills in end of life care.
“Both require good communication skills (for example when dealing with children, severely demented patients, people with communication difficulties or those who are critically ill/unconscious). Communicating with and reassuring the carers, relatives or owners, as well as getting key history from them is really important.
“Where vets trump us doctors is they have to be both physicians and surgeons and also we only have to know about human anatomy, physiology and pharmacology across the life-course whereas vets have to know this for several species - truly impressive.”
Of course, the impressive care Tilly received came at a price, unlike NHS care, and while she was insured Tilly's owner says having to stump up the initial £1,500 for three days' care came as a shock.
The fact that veterinary practices charge for their services could be one reason for the different levels of service provided by vets and the NHS, according to Prof Oliver.
“I can't be sure whether the workload of vets in small animal practices is lighter than NHS doctors and that might influence their morale,” he says.
“Also because they are operating a fee-for-service model there is bound to be a focus on customer service”. The cost of services may also encourage owners to use them more responsibly, he adds.
However, following his experience with emergency veterinary care, Prof Oliver believes NHS doctors could learn from vets – in terms of actively communicating with patients, providing near patient testing and bringing on-call rotas in-house.
RCVS Knowledge has called on vet practices to audit their post-operative neutering outcomes.
