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Practice Standards Scheme review - final stage consultation

 

Please note: this consultation has now closed.

 

Introduction

We are consulting on the revised Practice Standards Scheme and would now like your feedback on some of the fine detail.

The background to this review, aims of the revised Scheme, details of the changes and the consultation process itself are all set out below.

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Review of the Scheme

The RCVS Practice Standards Scheme (PSS) is a voluntary initiative to accredit veterinary practices in the UK. Through setting standards and carrying out regular inspections, the Scheme aims to promote and maintain the highest standards of veterinary care.

The Scheme was launched in 2005 and has been a success, with over 57% of UK veterinary premises currently accredited.

In June 2013 RCVS Council gave approval for the development of a new structure for the PSS.

The new structure has been designed to address issues that were raised in response to a Concept Note (consultation) we issued in 2012 as well as extensive feedback from the current members of the Scheme and the wider profession.

Specifically, the new Scheme provides:

  • A more ‘behavioural’ approach to inspection and a movement away from ‘box-ticking’.
  • Greater flexibility, which would allow all types of practice to join and progress.
  • A pathway for improvement and a means of recognising practices which are striving for excellence.

The redevelopment of the Scheme has been led by the Practice Standards Group, which comprises representation from RCVS and VN Councils, a lay representative and members from the following representative bodies:

  • British Association of Veterinary Emergency and Critical Care (BAVECC)
  • British Cattle Veterinary Association (BCVA)
  • British Equine Veterinary Association (BEVA)
  • British Small Animal Veterinary Association (BSAVA)
  • British Veterinary Association (BVA)
  • British Veterinary Hospital Association (BVHA)
  • British Veterinary Nursing Association (BVNA)
  • Society of Practising Veterinary Surgeons (SPVS)
  • Veterinary Practice Management Association (VPMA)

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Aims of the Revised Scheme

In redeveloping the PSS, the Practice Standards Group worked to ensure that the Scheme would:

  • consider those behavioural aspects that have an impact on the veterinary care of animals and not just facilities and equipment;
  • provide a pathway for practices to improve and show what they are good at; and
  • be clear and understandable to the public.

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What stays the same; what changes?

Recognising the range and variety of veterinary practices, the accreditations recognised under the existing Practice Standards Scheme will remain as:

  • Core Standards: comprising standards relevant to all veterinary practices.
  • General Practice (GP): (Small animal; Equine; Farm Animal) reflecting the requirements of a primary care practice. A GP must meet all Core Standards as well as specific GP standards.
  • Emergency Service Clinic (ESC): reflecting the requirements of a designated out-of-hours provider. An ESC must meet all GP standards as well as specific ESC standards.
  • Veterinary Hospital (VH): reflecting the requirements of a general practice allied with additional facilities and protocols for the investigation and treatment of more complex cases. A Veterinary Hospital must meet all Core and General Practice standards as well as specific VH standards.

The requirements for accreditation in each of these categories will remain essentially the same, broadly covering equipment, facilities and services offered.

 

Modular Format

The layout of the requirements for these accreditations, however, has been reorganised into a modular format. This ensures greater clarity by showing what is required on a topic-by-topic basis and allows practices to approach accreditation in a more manageable and logical way. 

The complete PSS modules are outlined below. However, some of these modules do not apply to Equine or Farm Animal Practices:

 

Anaesthesia

Clinical
governance

Client
experience

Dentistry

Diagnostic
imaging

 Emergency and
critical care

Infection
control

In-patients

Laboratory and
postmortem 

Medicines

Medical
records

Nursing

Out of hours

Out-patients

Pain
management

Practice
team

 

Premises

Surgery

 

 

Introduction of Awards

The most significant change to the Scheme is the introduction of additional Awards for each practice premises, over and above the base accreditations of Core, General Practice and Veterinary Hospital. Requirements are set out in the Awards section of each module.

Practices can choose if they want to be inspected for none, for some, or for all of the Awards.

The Awards focus on the behaviours and outcomes that have an impact on veterinary care, the veterinary team and the experience of the client.

They will provide practices with a clear pathway to improvement which is not reliant upon significant investment in facilities or equipment.

Moreover, they will allow for greater differentiation between practices and provide them with a powerful marketing tool.

Awards will be available at either ‘Good’ or ‘Outstanding’. This is a similar format to that used by Ofsted in the inspection of schools and should therefore be more easily recognised and understood by the public.

Awards have been specifically tailored to take into account the differences between Small Animal, Equine and Farm Animal practices and will be available as set out below:

 

Small animal

 

Equine

 

Farm animal

  • Team and professional responsibility

  • Client service

  • Patient consultation service

  • In-patient service

  • Diagnostic service

  • Emergency and critical care

 

  • Team and professional responsibility

  • Client service

  • Ambulatory service

  • In-patient service

  • Diagnostic service

 

  • Team and professional responsibility

  • Client service

  • Advisory/consultation service

  • Diagnostic service

 

How will practice premises qualify for an Award?

Each module contains a section entitled ‘Award points’ and within this section there are clauses which are allocated points.

‘Good’ in a module will mean that over 60% of the total available Award points have been achieved. ‘Outstanding’ in a module will mean that 80% or more of the total available points have been achieved.

To achieve any Award a premises will need to obtain ‘Good’ or ‘Outstanding’ in every individual module making up the Award.

To be ‘Outstanding’, however, it would need to obtain an ‘Outstanding’ score across all of the individual modules making up the Award.

 

Small Animal Awards

Team and professional responsibility

Client service

Patient consultation service

  • Clinical governance

  • Infection control

  • Medical records

  • Medicines

  • Practice team

  • Premises

  • Client experience
  • Infection control

  • Medicines

  • Nursing

  • Out of hours

  • Out-patients

  • Pain Management

Diagnostic service

In-patient service

Emergency and critical care

  • Diagnostic imaging

  • Laboratory and postmortem

  • Anaesthesia

  • Dentistry

  • Infection control

  • In-patients

  • Nursing

  • Out of hours

  • Pain Management
  • Surgery

  • Emergency and critical care

 

 Equine Awards

Team and professional responsibility Client service Out-patient (Ambulatory) service
  • Medical records
  • Clinical governance
  • Infection control
  • Practice team
  • Premises
  • Medicines
  • Client experience
  • Out-patients
  • Pain
  • Nursing
  • Medicines
  • Out of hours
  • Infection control
Diagnostic service In-patient service  
  • Diagnostic imaging

  • Laboratory and post mortem

  • Nursing

  • In-patients

  • Pain

  • Anaesthesia

  • Surgery

  • Out of hours

  • Dentistry

  • Infection control

 

 

Farm Animal Awards

Team and professional responsibility   Client service
  • Medical records

  • Clinical governance

  • Infection control

  • Practice team

  • Premises

  • Medicines

 
  • Client experience

Diagnostic service   Advisory/consultation service
  • Diagnostic Imaging

  • Laboratory and Post-Mortem

 
  • Out-patients

  • Nursing/Paraprofessionals

  • Pain

  • Surgery

  • Out of hours

  • Infection control

 

It is recognised that there is some overlap and that some modules may contribute to more than one Award. This is to ensure that all relevant topics are covered in individual Awards.

It is also recognised that, on occasion, there is overlap between the requirements of individual Awards and Veterinary Hospital requirements.

This recognises that some of the requirements of Veterinary Hospital accreditation already go beyond facilities and equipment and look at aspects of behaviours and service.

 

Will all practices be eligible to achieve an award?

The Awards will be open to all practices whether they are accredited to Core Standards, General Practice or Veterinary Hospital.

For a practice accredited to Core Standards, some of the Awards may not be achievable due to the constraints of the premises or the work undertaken.

However, it is expected they would be able to attain Awards in ‘Team and Professional Responsibility’ and ‘Client Service’.

Where a 'Core Standards' practice would like to apply for an Award, they would also need to comply with the ‘General Practice’ requirements within the applicable modules.

 

Inspectorate

The new Scheme places a greater emphasis on the advice and guidance that inspectors can provide to practices to help them along a pathway to improvement.

In recognition of this, we are dropping the term ‘inspectors’ and using the term ‘assessors’ instead.

Assessors will receive professional training specifically in behaviour-based inspections. This will ensure that they provide the highest possible standards and consistency of inspection and that the process is not simply a ‘tick-box’ exercise.

There will also be an employed Lead Assessor tasked with monitoring inspections and providing guidance.

External professional advice has been sought to help recruit assessors and to train them in the new behavioural approach to inspection.

In recognition of the change in approach to inspection, the current inspectors will not automatically transition to the new Scheme. Instead, those inspectors who wish to become assessors will need to re-apply for the position and to attend the same training as the new recruits.

The Scheme will begin to recruit assessors in early spring. In addition to the Lead Assessor, there will likely be around 20 assessor posts available.

 

IT System

A bespoke online IT system is being built to support the new Scheme. This system will allow practices to make applications online and will lead them step-by-step through the requirements of the Scheme.

Practices will be able to upload all the documents they require for accreditation prior to inspection. This will help to free up time on the day of inspection and to allow the assessor to spend more time talking to team members and providing advice and guidance to the practice.

The system also includes a facility for practices to set up reminders for key events (such as when Portable Appliance Testing [PAT] is due) and when documents need to be updated.

The system is designed to be convenient and to save time for practices, by ensuring that all the documents they require for inspections are readily available in one place.

The system will also ensure the faster and more efficient processing of evidence and applications by assessors and the PSS Team.

 

Fees

The Scheme is not run for profit, however, it must be self funding.

If the Scheme were to generate any surplus it would be reinvested for the benefit of the Scheme, including marketing to improve recognition amongst the public and profession.

In order to deliver the new Scheme and its enhanced benefits, it will be necessary to increase the annual fees. It is envisaged that the annual fee will be up to £350 + VAT for principal premises and £100 + VAT for branches.

The cost of awards will be based upon assessor time, which will be charged in half-day blocks.

It is estimated that it would be possible to inspect two to three Awards per half-day, dependent upon the type of practice and the Awards selected. Assessor time is likely to be charged at £175 + VAT per half-day.

It is also expected that there will be increases to the fees for new joiners and voluntary re-inspections.

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Transitional arrangements

Upon launch, practices will automatically join the new Scheme at their current accreditation level, for example, General Practice – Small Animal.

Practices are free to apply to be inspected for Awards at anytime.

Routine inspection dates will not change under the new Scheme and practices do not need to delay or bring forward their routine inspection in order to be inspected for Awards.

The Scheme will endeavour to make assessors available for those practices that wish to apply to be inspected for Awards outside their routine inspection cycle.

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Consultation

The structure of the new Scheme was built upon the response we received to the 2012 Concept Note (consultation), feedback from current members of the Scheme and extensive input from the veterinary representative bodies through the Practice Standards Group (PSG).

At this stage we are not, therefore, consulting upon the new structure or the principle of the introduction of the Awards.

This final stage of the consultation process seeks feedback on the details of the Awards and the weightings attributed to the clauses in the Awards section.

Please note, however, that the 'behaviours' column remains in development as we work with external consultants to develop the behavioural approach to inspection.

There will be an opportunity to provide more general comments on certain elements of the Scheme within the consultation.

At the outset, the PSG gave a commitment to the profession not to make fundamental changes to the requirements of Core Standards, General Practice and Veterinary Hospital.

As such, only minor amendments to the requirements have been made, to reflect changes to legislation or the RCVS Code of Professional Conduct.

We would not, therefore, advise respondents to focus on the requirements.

 

Out of hours

The only substantive change to current accreditation is within the Out-of-hours (OOH) module.

Under the new Scheme it is stated that ‘Practices can only outsource their OOH provision to practices that meet or exceed their own accreditation level’.

The new Scheme also stipulates that within five years Veterinary Hospitals must provide out-of-hours cover from their own premises. There are dedicated questions relating to these changes within the consultation.

 

Equine General Practice - ambulatory

There is also a proposal to add a new accreditation level: Equine GP – Ambulatory.

This recognises there are equine practices that provide a GP level service, albeit they do not have stabling facilities or premises where horses are treated.

More details are found within the module questions and there is a specific question on this change within the consultation document.

 

Download the modules

You can download the complete draft module documents (PDF files) for Small Animal, Equine and Farm Animal practices below:

It is important to note that whilst these look complex when presented on paper, the IT system will lead practices through accreditation in a step-by-step fashion and will only show practices the requirements that are relevant to the accreditation level and Awards they seek to attain.

 

How to send us your views

Please provide your feedback to this consultation exercise via this survey page.

This will ensure that comments are linked to the relevant section of the modules and that PSG can consider all feedback in the context that it was intended.

Please note that once you have begun to respond to the survey it will not be possible save your progress. We would therefore advise you to consider the above modules and any feedback you may have before launching the survey.

If you wish to respond to this consultation, please do so by 5pm on Monday, 23 March 2015. (NB extended by 24 hours to 5pm on Tuesday 24 March.)

 

 

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