RCVS Workforce Ambitions Revisited

Afternoon everyone. We've just started to admit everybody, so hopefully this will be filling up very shortly.

We're really excited to welcome you all. We've had such a large number of people, over 200 have signed up for this session, so hopefully everyone can squeeze in. It's a good job that we're in a virtual space, not a physical one, that's for sure.

We've got a really big variety of vets, nurses, practice staff and people working across different species and specialisms all represented here. So we're really glad to hear from you all, and hopefully we can have a great discussion this afternoon. I will just introduce myself. I'm Angharad and I am Director for Advancement of the Professions at the RCVS, and I am very delighted to welcome some great speakers here today. Before I get to them, I'm just going to start with a few bits of housekeeping, as we welcome a few more people with us. So, we are going to get Slido up and running.

Hopefully most of you are familiar with Slido. If you're not, then all of the instructions will be hopefully very clear. As you can see, there is a number on the side and you can join in. What we would love to do first is ask you about your feelings of working in veterinary or animal health. We're considering that there are a lot of people who might not work clinically, but you might be in very different roles, so we would really, enjoy hearing from you about what you find the most satisfying. But then also we're going to ask you about the workforce ambitions and which ones of these are the most important to you. So you can pick the options, but just be mindful, there are 7, so have a good look through and think about what might be the most meaningful to you.

Now, in terms of housekeeping, as those of you who have joined us from the start, I said we had over 200 people who've signed up, so we had a lot of questions that were submitted in advance, which has meant that we've had to try and group the questions and theme them so that we can get through as many as possible. What we have tried to do, is make sure that these have already been woven in into the format of the event. Vicki, who is going to be presenting shortly, we put some to her about the workforce modelling, but then we've also got others that come through. There were some really great specific questions, so great that what we've decided to do is, put them forward into other sessions, on the specific ambitions. So things like, the client communication challenge questions, vet nursing and Schedule 3, return to work, we are going to put those to our experts in the next couple of sessions. So your questions will be answered just in a variety of different formats and hopefully this will mean that we get through a lot more. Now, on the subject of a lot more, the last time we did these when we first launched the Ambitions, we had feedback saying that 60 minutes wasn't enough.

We needed more time for Q&A and for general chat. So we've extended this session to 90 minutes. So hopefully that will be enough. If we still run out of time at that point, we will consider that that's been a success, and if we finish it a little bit earlier, then you will get that time back to yourself.

We won't just keep going just because we've said that we'll do it in 90 minutes. We will make sure that we use this time effectively. Everybody is very busy, so we are appreciating that you're sharing your time with us. What we are going to do is Vicki is going to present the workforce modelling, and then we'll have a brief Q&A related purely to that, and then we'll go into question time with Linda and Sue, with the pre-submitted question themes, and then, having general questions, at the end of that. So,

it's great to see the Slido is being populated. If you've just joined us, make sure that you, take a moment to contribute to that. We are recording this session, so that people can either watch it back if they've not made it today, or if they didn't sign up for it, then they will be able to get to it. So if you can keep your cameras on, then we'd love to see you. It's always nice to talk to real people, but if you could remain muted so that we can hear the speakers, that would be super. If you want to ask any questions, then please use the Zoom chat that will come through to us, but equally, if you want to pop anything in the chat, then please feel free to share anything that way about resources or, where you're from, those sorts of things we love to hear from people. We will be putting resources into the chat, as the topics are discussed. So these will be links to, this might be documents, it might be content that we have, academy courses, etc. So do keep an eye in the chat for things where we can actually show you what we've been doing. So I'm now going to try and take a look at your answers for what you love about working in the veterinary sector, and this is really great to see. So working with people seems to be one of the most popular, especially talking about the team helping others, thinking about potentially the patients as an extension of that team.

There's lots in here about having that challenge, and helping and improving animal welfare. So this is all really positive stuff and not all of it is purely clinical. I can see that these answers might have come from people that work in all sorts of different organisations, so that is a really positive start to this, and hopefully this has given you a moment to reflect on the impact that you have, whatever your role is within veterinary or animal health. Deb, are we able to take a look at the ambitions now just to see what people have said? So, this is the next question.

So, if you're able to tell us, which of these is the most important, then that will give us a little bit of a hint as to where you're all coming from, and then we'll head over into Vicki's talk. So please free to populate this - oh, this is starting to move quite significantly now. You've got 3 options, so there's plenty of opportunity here to have your voice being heard.

I think this is going to move all over, but confidence, culture and recognition that seems to be staying at the top for the while, which is good because we are going to be talking about culture, for quite a considerable part of this. So I'll let you finish, writing that up and I'm going to introduce Vicki. So, Vicki Bolton is our research manager who joined us at the college last year, and we are very grateful to have her with us as part of our organisation because, she's able to answer some really tricky questions and do some very clever modelling and give us lots of insight as to where we should be going next with some of our research and supporting us in how we do that.

So Vicki, we're going to hand over to you so that you can share with us the overview of the workforce modelling and the data and what it may or may not tell us. As I said, we've woven in some of the pre-submitted questions, we've shared those with Vicki, so hopefully you'll hear some of your questions being picked up in that. But we will have a brief time at the end, for asking a few questions about this. So Vicki, I'm going to hand over to you and we will be in your hands. Thanks so much Angharad.

Hopefully you can now see my screen. Excellent. So,

nice to see so many people here. as Angharad said, I've been at RCVS for not quite a year. I joined last summer, before I arrived, I worked for a really big market research company doing really large scale government surveys and before that I was at the University of Southampton, looking at a cancer cohort. So I've got quite a varied research experience and it's been a lot of fun to come and learn about you all and your profession. Today I'm going to talk about the data that we have access to as the college and as a profession, and I'm going to talk a bit about how we can understand that data and how it can help us understand some of the claims that we often hear about the veterinary workforce.

I'm gonna show you the bathtub full of vets, or indeed nurses, for those of you who are nurses, and I'm going to talk a bit about the fantastic modelling that the Institute for Employment Studies did for us. I mean, as I said, I've only been here for just under a year, so I really feel as though I've been goal hanging on this one. It's a very cool model that we published at the end of last year, and I'm gonna show you some of the data and projections from that. So,

what do we know and what don't we know? The data that you can see on the slide that figure for 30,632 UK practising vets, that's the Register data, and it's actually last week's Register data. I think there are two additional UK practising vets, if you check it today. And similarly, 25,120 Registered Veterinary Nurses, pretty sure that's now 25,123.

And so the numbers fluctuate ever so slightly week by week. It goes on an annual cycle, so there are more of you as new graduates come on board over the summer and fewer as people drop off in renewal season. So we have what an economist would call perfect supply data.

Every veterinary surgeon and nurse is registered, so we know exactly how many veterinary surgeons and nurses are supplied to the veterinary sector. The Register has really fantastic information, it's great on gender, but there are, pretty decent sized gaps in our data on ethnicity and species specialism, and there's no information at all in the Register on your plans and attitudes. No information about your working hours, no information about qualified vets and nurses who aren't registered, so people who could be, but aren't. So, we know that, vets are 67% female, and nurses 97%, and we know about the growth rate - 4% growth in vets per year, 7% growth in nurses per year, but what we don't know, is about the people who are not on the Register.

However, we know things about people who used to be on the Register, people who depart. So, on the slide, you can see the figures for 2024 for the vets who left the, RCVS Register altogether or left the UK Practising category. So these numbers are out of about 30,000, and you can see that the biggest categories are those leaving the category UK Practising, rather than leaving the Register altogether. And of those leaving the category UK Practising, the biggest group have moved to practise outside the UK and this matches the information from our 2022 paper: Recruitment, Retention and Return, which had 41% of those voluntarily removing or changing category, 41% were going overseas, and that's actually pretty much the same percentage that you can see here. 11% were retiring, 9% on a career break, 9% heading off on maternity or paternity leave, and who are we kidding? This is basically maternity leave, and only 2% were leaving the industry permanently. So when we talk about the RCVS Register figures and we talk about people leaving, usually we're talking about people leaving a category and not people who are leaving the profession altogether.

Yeah, that was some highlighting I could have done with about 4 sentences ago. OK, so that data from the Register, in fact, data from 2017 to 2023, was fed into a fantastic piece of modelling, by Matt Williams at the Institute for Employment Studies, and the aims that we gave him were please forecast the likely supply of vets and vet nurses, and he used trends in retirements and trends in other exits, so the exits that we talked about, people moving overseas, people going on leave, and we asked him to look a decade ahead, so up to 2035. And then the really tricky bit is the analysis of the gap between the current demand and supply. And for that, he used vacancy data, and then applied, an economic trend number. And so that's what I'm going to talk to you about today. OK,

I promised you a bathtub, here's the bathtub. Welcome to your profession, a bathtub full of vets or nurses, but not both together. The model is, well, it's actually two separate models, one model for vets and one model for nurses. So sometimes I think we hear the profession talked about as a leaky bucket, but, I think it's really more like a bathtub, and I'm going to explain why I think that. So a professional career starts with qualification and registration, and that's the flow into the tub. And then at the end of a career in the veterinary profession, vets and nurses retire and they flow out of the tub. And in between, they sit in the stock in the bathtub of vets or nurses, and the tub can be topped up with overseas qualifiers, or - could everybody make sure they're muted, please? Thank you. - And the, so that the stock of vets or nurses, it's the bulk of the profession, people getting on with their professional lives. And, just like in the bucket analogy, there are leaks, but I think the bathtub puts the leaks into perspective. Leaks are relatively small in numbers compared with the size of the stock. So when we looked at the 2024 figures, we looked at a stock of 30,000 vets, and only a little over 1000 were drifting away. So, the leaks are small compared with the size of the stock. But, the leaks are where we focus a lot of our attention, and I think that's why the bucket was an attractive analogy, because the leaks are really important in personal and policy terms. So nobody wants or needs to intervene when a vet or nurse joins her profession, builds her professional life, or retires when she has a big enough pension pot. Those things aren't a problem. As a profession though, we do care about and want to intervene, when people leave if they feel undervalued, or if they burn out or, because they struggle to get back in after a period of leave. So those leaks are things which are very significant in personal terms and in policy terms. And I think that's one of the reasons why some of our workforce myths have been so persistent, so there is a persistent but mistaken idea that almost half of young vets leave the profession within 5 years. And I think those things take hold because when we see somebody leaving a profession that they loved and fought to be a member of, we can imagine how much that decision to leave has cost them, and it looms large for us the way that it does for them. So, this is another reason why I'm saying, think about the tub more than the bucket. So, by the way, that myth, that myth, half of young vets leave within 5 years. I, we worked out the other day where it came from. It was born from the original Recruitment, Retention and Return paper, which kicked off this phase of the RCVS workforce programme. And so in that, I'm going to quote from it, in that paper, it says 'In 2021, 45% of leavers had been in the profession for 4 years or less.'. So that's 45% of leavers. So that figure is telling us that, nearly half of the vets who leave are young, doesn't tell us that half of the vets who are young leave. OK.

Bathtub. Who is leaving? So I said that there's a persistent myth. This is going to help us dig into what's actually happening, and it's true. So I think at the bottom of every myth is a truth. Recent graduates are more likely to leave the UK Practising Register than mid-career vets. So mid-career vets, vets in their 40s, they're the really stable group. Only 3% of them move a year, and that's not surprising. They're established in their careers, they are established in their communities, they're established in, they've probably got a family. They've, they're established for their family's sake, so they're less likely to move in or out of the profession. And the recent grads are more likely - it's still only a 5.8% outflow, so it's much smaller than you might imagine. So on average between 2017 and 2022, 356 vets aged under 30 left the UK Practising category each year. And of those, by far the biggest chunk was heading overseas to practise. And that's something that's evidenced both in the 2024 Register data and from Recruitment, Retention, Return in, at the from the start of this, workforce phase. I'll also put in a plug now, look out for our exit survey results, which should be coming out in November. 2 years ago, we introduced an exit survey for all of those coming off the UK Practising Register or voluntarily leaving the Register altogether. And that, we hope, will give us a much more detailed insight into what people are doing and why they're moving away. By the way, we know from Recruitment, Retention and Return, that the most common destination is Australia. So if what we're looking at is young graduates using their excellent qualifications and skills to be internationally mobile and perhaps enjoy the better weather, it might not be a policy problem that we urgently need to solve, but if there's something about, for example, practise in Australia, which we could emulate here in the UK without hitching a rope around ourselves and dragging us 1000 miles south, we'd like to know. And that's one of the reasons why we're having these, this series of sessions.

Nurses, by the way, look quite different to the vets, don't think I've forgotten about you nurses. So, for nurses, it's still a very young profession, both in terms of the age of the average nurse and in terms of registration. So, looking at the nurses, you can see that outflow is very low and increases with age. So, outflow is 4.6% of nurses aged 50 plus compared to under 1% of the 18 to 24 year olds. So nurses, as you qualify and join the profession, you tend to stay. That's what we can see in the, in the data. And we're only, because nursing is such a young profession, we're only now coming up to a time where we can look back at a cohort which has had an entire career as RVNs. And so this is another reason why this is such good timing to do these workforce webinars. OK, the model.

So, the workforce model constructed by IES uses the Register data that I've been talking about, as well as some data from the survey of the professions. And Matt, the economist, divided the veterinary workforce into 252 categories. So it's a really detailed model, using age, gender, ethnicity, country of nationality and residence. And that all of those categories multiplied together, gives you 252. And then he moved the model on every year for 10 years. So the model is then adjusted every year for the percentage of each of those 252 categories who leave on average for age band moves. So over 10 years, people will move up an age band. It's adjusted for new joiners, so you get new joiners in the youngest age groups as people graduate into the profession, and you also get new joiners as people are internationally mobile. And it's also adjusted by the numbers who restore, so that's people who leave the Register, perhaps they go or leave the practising category. They perhaps they go overseas, spend 2 or 3 years in Australia and then come back. Perhaps they take some caring leave and then come back. And so the model is 252 categories adjusted 4 ways over 10 years. It's very complicated. The model for nurses is slightly less complicated. For example, there's no gender split because such a high proportion of registered nurses are women. So there's just too few male nurses to make that distinction across other groups. So when I talk about the methods, I'm going to talk about the vet model because that's the complicated one, but, in a moment, I'll present the results from both, and if you've got any questions about the differences, I'm really happy to take those at the end. OK, so, a

couple of points to note. When the IES modelled joiners from the universities, they were measured as joiners, not graduates, so taking care not to make the mistake of assuming that every single UK graduate joins the UK profession, we know that that isn't so, the model takes into account the new universities. And it takes into account average restoration rates. So this is vets who drop off and come back, from the practising register, for the years between 2017 and 2023. In terms of demand, so I, I said that the, the hard part of the model, the difficult thing to do is to model the gap between the supply for which we have really, really good data and the demand for which we have less good data. So the demand data we got by asking very nicely, large employers, please, could you tell us about your adverts for vets and nurses and how much trouble you've had filling them. And for excellent commercial reasons, we've had difficulty getting enough information for categorisation, and we're really hoping that when the major employers have seen and had a chance to digest this model, they'll be willing to share perhaps a little more information, because they'll hopefully be able to see how useful it is. So we will be coming back, and asking for more demand data. Both for vets and for nurses from the major employers. And then once you've collected information about demand now, you have to project it forward. And this is really an economic question.

So the long term growth in demand for veterinary services has been estimated in this model at 2.5%, and it was calculated by using PDSA data, PAW data on the growth in the number of dogs owned, but it's also a perfectly reasonable figure for economic growth. The ONS calculate the growth in vet services at about 3% a year. So it's not, it's not an outrageous figure at all. I will just take a moment to show you the PDSA PAW data though, cause it's quite fun. So the data on the screen shows you the cat population between 2015 and 2024 in the heavy black dotted line at the top, the dog population in the blue smaller dotted line, and the rabbit population trailing there along the bottom. And the reason that this is such cool data is that the methodology is unchanged since 2015, so we'd expect the numbers to be broadly comparable. So PDSA also very kindly gave us some other information around preventative healthcare and wellbeing. They gave us detailed data about population and ownership and preventative healthcare and how they've changed over time. So I think their key finding is that there actually wasn't a significant change since the pandemic in pet population or pet ownership. And it's not the same message that we hear from members, which is that their lists are full, that they're getting inundated with client requests post pandemic. And PDSA have speculated that perhaps that's because many of the pets purchased in COVID were by first time owners who perhaps had different behaviour towards veterinary care and preventive medicine. So the other thing I'll say while I'm busting myths is, I had a look into the data for why we all think that there was this huge boom in pet ownership in COVID when it doesn't show up in the PDSA data, which is really the best data that we have. And I think, although I'm not sure, I think it comes down to some survey data from the Pet Food Manufacturers Association. It's actually really good data. They're asking 2000 people - It's a perfectly sensible methodology, but their method changed during the pandemic. So they were asking face to face, it was a face to face survey, asking about the numbers of pets. And then during the pandemic, they switched to an online methodology, and there was a big increase in their numbers, which has continued to sort of be level. So there was a jump from 9 million pre-pandemic to 12 million post-pandemic. And that was published as a huge jump during the pandemic, but I think at least some of that, if not all of it, is a methodology effect. But I mean, I'm a researcher, I probably would say that. Anyway, cool, and I love doing a bit of digging into, data. So back to the model. I said that the model uses, registration data, but it also uses data from the survey of the professions. And this is what it uses it for. It uses it to account for full-time equivalents. So, the model uses data from both 2019 and 2024 to estimate what proportion of each of the groups of vets and nurses is working full time.

The projection, by the way, is that there will continue to be an increase in part-time working, but the increase will slow. And that's the same for most of the assumptions in this model, that they're made quite conservatively. And it's important when you think about a model like this to remember all of the assumptions that are sitting in the background, all of the assumptions that you have to make to get a final number. OK, so with that warning ringing in your ears, results. The projections, first for vets. So the number of vets on the Register is projected to increase by 52%, by 2035, reaching 44,800. So that's a growth rate of 3.5% a year, which is slightly lower than the 3.8% rate between 2017 and 2023. And taking into account a full-time equivalence, that's an increase in 42%.

With the average full-time equivalence falling from 0.85 to 0.79 in 2035. Now, looking at those projected figures against demand.

So what you can see here is a projection of supply as a percentage of demand. And I'm going to suggest that you start looking at this graph at the right hand side, the clump of pretty coloured bars with total underneath. So that's the, total, the whole of the profession not broken down, and it's supply as a percentage of demand. So, as the bars approach the blue line at 100, supply equals demand and there's no shortfall and no oversupply. So if you look at that, clump of bars on the right hand side, you can see that the model is projecting that there will be, an improvement in the gap between supply and demand, so that, supply will more closely approach demand towards 2035 than it does right now.

You can also see that, if you look further over towards the left, for clinical practise, which is by far the biggest group, that's going to be even closer, than for the total. And for charities, using this modelling, we'd expect to see a very small oversupply. It's important to remember that this is a mechanistic, demographic model, and it's based on the 2023 vacancies projected for and it doesn't contain any additional information. So, using the data we have now, we estimate the shortfall at 2600 full-time equivalent vets, projecting that shortfall to fall to 1700 full-time equivalent vets in 2035.

The Excel files which hold this model are very cool, and can be, I can adjust them. So I can look at adjustments to the predicted in and outflows of vets and nurses. I can model a shock, what would happen if there was a sudden international policy change which pulled more graduates to Australia, for example, and I can add in future graduation years. So this is, really just a step in the process. It's a very cool step, but we'll, we're going to be using this model, to Look in more detail and to look further ahead as time goes on. Now, I've promised nurse results as well. The number of vet nurses on the Register is projected to increase by 78%, a much bigger increase than for the vets between 2023 and 2035, reaching 41,200.

So like I said, the growth rate will be higher, roughly 5%, so higher than for the vets, but we're projecting that it'll be a lower growth rate than it has been between 2017 and 2023. And similarly, we're predicting that there will be an increase in part-time working, but the economist Matt, who did the study has made the conservative assumption that, the rate of increase in part-time working will slow slightly. So, similar graph for the nurses.

Once again, start on the right hand side, look at the total. The line at 100 is where supply is 100% of demand where supply equals demand. And you can see that we're projecting an oversupply. Once again, I'm going to stress it's a very mechanistic model. It doesn't tell us anything about the economic behaviour of nurses or nurse employers. So it doesn't tell us how employers will react to there being more nurses available. It doesn't tell us how nurses will react to that. Once more vet nurses are qualified, more are available to work, we might expect a greater take-up of nurses among employers and potentially a change in the way that nurses are used in practises. And I will show you, so one of the reasons that I say that, I can use the model to look at projections of the ratio of nurses to vets. So what you can see on the screen is the data followed by the projection of the ratio of nurses to vets. So the heavy black line in the middle is the total, but the, the lilac line at the top, that's charities. So you can see that right now, there is a higher ratio of nurses to vets in the charity sector than in other sectors. And it's possible that that is to do with the way that some of the big charities do their work. Perhaps with a safari model where you have, nurses running a clinical practise room and a vet moving between them. So I've used the full-time equivalent supply figures for vets and nurses to show these ratios, and you can see that the projections suggest that there will be a higher ratio of nurses to vets in clinical practise, moving up to meet the ratio in charities right now. Again, this is a static demographic model. It doesn't tell us what's going to happen. It doesn't tell us how vets and nurses are going to react or how employers are going to react to these changes, but I think it's, it's just one of the very cool things that we can do with the model and the projected data. So to conclude, I've

shown you The RCVS Register data and talked a bit about the survey of the professions and how it can feed into our understanding of workforce. I've talked a bit about how we can use the Register data to understand the workforce claims that we hear. One of the things, when I've given parts of this talk to a university, one of the things that I remind the students is always ask about your denominator. Ask about the method, ask about the denominator. Who is this figure out of? How did you get the figure?

If you don't like the methodology, don't even read as far as the conclusion.

I've also talked about how we've used that data to build a model of the bathtub of vets, of the flows in, the stock, the flows out, and the leaks, which are so significant to individuals, but relatively small in terms of numbers.

And I've talked also a bit about next steps, what we're going to be doing with the modelling, the additional data that we're going to be requesting, and how we're going to be pushing that projection forward beyond 2035, 1 year at a time, 2036, 2037. And while I've got you, just for my final 30 seconds, although I'm pretty sure I am running over, apologies Angharad. I'll also say that, we'll be starting a cohort study next year. So a cohort study is a study which follows people through time. This follows the graduating class of 2026, the veterinary graduating class of 2026, follows them through time for five years to see what happens as they join their profession. To see what experiences they have and how they feel about it. And I'm really looking forward to coming back and doing a 3rd phase of this in 5 or 6 years' time when we have the results coming in. Thank you so much for listening. If you have questions about the model or the data, I'd be really happy to take them. Thank you, Vicki, that was, that was really helpful. There are lots of questions in the chat, which you probably haven't seen because you've got your slides up, but, there are some, there are some good ones in there.

What I might suggest to stay on time is, just a couple of questions. A few people have commented on the less than full-time working or how that might be a leak. I know you touched on it briefly, but would you mind just talking about the information that we do have around what veterinary work constitutes. So the figures that we have on 'less than full-time working' are from the survey of the professions. So this is not the perfect data of the Register, this is survey data and the response rates are average. We get better response rates than some regulators and royal colleges, but, not so good as others. Pretty mid table, let's say, a mid table response rate of 19% for vets and 16% for nurses. And the other difficulty with the survey of the professions is that, those of you who are older are much more likely to fill it in than those of you who are younger. So please, please, please, all of you who identify as younger, next time you see a survey come out, please fill it in, you are underrepresented. But, because of the way the data was used, that's less important because, the workforce model looked at different age groups separately.

Actually, full-time working is more common among younger vets and nurses, and part time working is more common as vets and nurses head towards retirement. So, if you interpret it as a move towards retirement, you could interpret it as a leak. It's not how it's modelled here. It hasn't been modelled as a leak, and I'm sort of reluctant to think of it as one, because all of the people who are working part time are working and they're part of the veterinary workforce. Fab. Thank you, Vicki. Would you be kind enough to respond to some of the questions in the chat, please, because there are some specifics around numbers of animals registered with vets and those sorts of things. So, if you don't mind that would be super. And then we can move on to bringing in Sue and Linda and get to some of the other questions. So I've got is the leaks figure 1000 a year? Roughly, so, it's roughly 1000 change Register category.

And then roughly 200 remove altogether from the Register, and then another 200 aren't voluntary removals, they stop paying. So we don't know what happens to them. They just stop talking to us. And actually those are the people that I'd love to talk to because, we have no information about them at all. We don't know whether they're retiring and I just decided not to talk to the RCVS anymore. We don't know if they're burnt out and don't want to talk about their career anymore. We don't know anything about them at all. So those 200 I'd really like to know about. So it's not, it's not quite 1000, it's more like 1500. Lovely.

Right, well, thank you, Vicki. I am going to move us on and then we might come back to some more of those questions at the end. Sorry. No, no, no, I just, I can see this is clearly fascinating to people. I'll do some in the chat. Would you mind? That would be super, thank you. Lovely. Now let me move onto introducing two of our other speakers, and I promise you there will be more time for Q and A at the end. We are very lucky to have joining us, we have, Linda Belton, who is the current RCVS president and also, a GP in practise in Gloucestershire. And then we also have Sue Paterson, who is a past president of RCVS and current chair for Advancement of the Professions Committee, and is a dermatologist. So we've got, we've got some good insight here from different parts of, the vetting world, but, both Linda and Sue, have been very involved in all sorts of different projects across the college, so we're very pleased to have them here with us. So we've, as I said at the beginning, we've themed the, the questions that all of you have submitted in advance. And what we're going to look at is, looking at different career stages. So we are going to start, with looking at the beginning of the journey, getting into vet school, curriculum in vet school, a couple of questions have been raised about the role of universities in educating vets and, widening participation. So Sue, might you be able to just give us a bit of a flavour, about people who are heading into vet school and what has been, what has changed, and also the accreditation, changes that have, that have taken place for vet schools, please. OK, I'll try and make sure I'm fairly brief so people actually get to leave at a decent time. So there's a huge amount being done, Angharad, and I think the first thing we have to say is that there are policies in place for the vet schools around widening participation. But the vet schools would say to you, you know, they can't offer places to students from widening participation backgrounds if they're not having students from widening participation backgrounds actually applying. So the first step in the whole process is there's a lot of stuff going around engagement with schools. I'm delighted that College has now got an outreach and engagement officer who's made a huge difference, and she's been working with BVA and some of the really fantastic people who are part of Animal Aspirations, which for those of you who don't know, are veterinary students who are spread across all the different schools who go out in their own time to schools from widening participation backgrounds to actually talk to school children about careers in veterinary medicine. We also went to the New Scientist exhibition last year, Linda and I both went. We had a stand there and again, we spoke to loads and loads of people who were unaware of all sorts of things. They're unaware of the fact that there are gateway courses where people who aren't, you know, A* scholars can actually get into vet school by taking gateway courses, and that's something they weren't aware of. We spoke to lots of boys about the profession, because again, lots of them said, 'Well, no, I don't want to be a vet because I want to do eye surgery or open heart surgery', and, we said, well, actually, you can do that if you're a veterinary surgeon as well. And we also spoke to lots of boys again about careers in veterinary nursing, because again, there's a real misconception about what that actually involves, and people don't realise that veterinary nurses are professional people who have really useful, meaningful, rewarding jobs. They're not just people who sort of clean out kennels anymore, although we all clean out kennels from time to time. So there's a huge amount that's being done. As part of College's recreation of new accreditation standards that came in in 2023,they actually insist that all vet schools have widening participation policies. They monitor those policies, and what is also really, really important for me is they actually monitor the progression data for the vet schools. So they're not just making sure that people from widening participation backgrounds are getting entry to school - and when we're talking widening participation, we're talking people from different ethnic backgrounds, we're also talking about people from different socioeconomic backgrounds as well. So it's not just them getting in, it's making sure they get the support when they're there to make sure that they have the same opportunities to go through their course and come out the other side. So there's a massive amount of work that's being done around that as well. The other thing again, which I hear a lot is this misconception about the educational standards at schools. And again, a lot of people don't realise that with the new accreditation standards came in the requirement that 70% of teaching has to be in a primary care context. So our undergraduates are taught about primary care practise, they're not allowed to spend the majority of time sitting in referral hospitals looking at, you know, very specific and specialised surgery, they have to be able to do the stuff, the bread and butter stuff that that vets do when they actually go out into practise. I think probably 10 years ago, vets could identify adrenal glands more easily than they could actually identify anal glands. It's now completely the other way round. The other thing that I also hear a lot about is contextualised care, and that vet students are taught gold standard, and that is not the case, if we should ever even be using that term. They are taught contextualised care at vet school now. And one of the other stipulations from our accreditation standards is that although something like charity practise is really, really valuable, because they see a wide range of staff, they're given the opportunity to practise, it doesn't involve talking about money. And so one of the things again that they have to do is they have to be confident in having those conversations with clients around costs and prices and actually personalising treatment plans for animals. So everything's changed enormously over the last 10 years with the new with the new accreditation standards coming in, with the amazing amount of work that the schools are doing around widening participation. So I, I think this, it's really positive, the stuff that we're seeing coming, out of our schools and the work that's being done. Thank you, Sue. That that is a whistle stop tour but hugely comprehensive. So hopefully that's given people a bit of an idea as to what we're now starting out with. So, thinking about those people who are qualified and who are out in practise or who are who are working, more broadly, talking about practise culture, we know that this is a topic of, it's at every conference, it's always something that's being discussed. If we start with leadership, especially thinking about the CMA, and legislative reform, Linda, are you able to share with us a little bit, about the latest interactions with the CMA, and what this might mean, and then we can move on from there to talk more about leadership. OK, I think in terms of what it might mean, that is an unknown. So we have the, the potential remedies paper that came out at the beginning of this month. There was an awful lot in it. I don't think it's an expectation that everything in it is going to be implemented as a remedy. And I think I want to look at this. There's a, there's a lot in it that they're asking the RCVS to do, but I think today we want to look a little bit more at the things they're asking the profession to do. The things that I think clearly are going to come out are around the transparency pieces around ownership, and being clear about pricing. Now, obviously being clear about pricing is something we should be doing anyway. It's not about the same as what the price is, it's just about being clear.

You know, if something's going to cost X, we need to say so, whether or not it should cost X is a different conversation.

That's in there. There's a lot of push around choice for, clients, and I think that's a really difficult one because it's a complex market. It is not about shopping for things and that value of relationship and continuity. And the contextualised care that Sue was talking about, it does get difficult, and I think if we start to fragment things as well, there is actual potential for overall to the client, for things to not improve for them, just because we're moving things around. So I think there's a lot we need to think about as a profession, but undoubtedly, being clear, being confident talking about money, understanding why things cost what they cost. And I think in some of the early stuff going into the CMA, it was clear as a profession, we need to remain connected with the commercial realities of what it costs for us to do our work, so that we understand our value, and can really communicate that effectively. Thank you. And we had lots of questions about the role of vet nurses, and we've got the ambition session, that's coming later on this year, talking about vet nurses specifically. But, are you able just to give a couple of sentences about legislative reform and potential timelines that we might be looking at for this, please?

A lot of, there's definitely a crystal ball on that one. I think a lot of the things that are mooted as changes without a timescale are because for them to happen, legislative reform is required. So people often say the college has decided this, but there's no timescale. Well, actually the college can't decide. The college is making recommendations potentially, but the decision sits with government and legislative reform. And a lot of the things around the world of nurses depends on that as well. And in particular uncoupling the work of nurses from the exemptions that exist under the current Act. There's been work going on for years around legislative reform, lobbying both the RCVS and many other organisations as well, BVA and other stakeholders. And anything like this is slow. However, DEFRA have now publicly said they are actively engaging in this, and a huge amount of work is going in every week into looking at this. So we think we're closer than we've ever been. However, even with the best case scenario, we are talking by the end of this par-, this sort of election cycle, so it's not tomorrow, and it is a maybe. So I think that there's an awful lot we should be looking on what we can do differently now under the current legislation from a nursing perspective, and there is quite a lot, rather than always looking at the things that depend on legislative reform. Angharad, can I add to that too? I, I think when we get changes in our VSA because we will, we will get changes, it's just when we actually get them. I would dispute whether those numbers are, will still stack up because I don't see how we'll have an oversupply of nurses, because once we actually start to use nurses to their full potential, because these are driven professionals with you know, who contribute enormously to the veterinary team. I actually think they will start to do jobs that they're more than qualified to do, that they'll be able to do under the new legislation. I think they'll be supportive to our vets, and I actually think we'll see a change in the way that practises work, and I don't see we'll have an oversupply of nurses. I think what they'll do is they'll help bolster the veterinary workforce so that actually, they help support the vets in practise. So I actually see this, that's going to be really, really positive. And the sooner we get a change in the VSA, I think it's going to help our workforce absolutely enormously. It will help with retention of nurses who can be rewarded more generously, get better work satisfaction, and I think it starts to support our veterinary workforce in a much better way. Well, that leads us quite nicely into the next part, Sue. So thinking about that leadership, culture, delegation, all of those different areas, we know that everyday leadership, as well as official leadership, will set a set a large tone. Sue, can you share some of the highlights that you've observed from your RCVS work, and hopefully give people a bit of a flavour as to what else is going on that supports that everyday culture. Yeah, I think people recognise College as being a regulator, and of course, College is a regulator. And people seem to think that that's one of the few things that that college does. But the, the true Royal College component of it working under our charter, there's huge amounts of stuff that's there. And as chair of APC I've been able to see an awful lot of that. There is so much great stuff on The Academy. The Academy has really been created to help people comply with their regulatory requirements. So there's all sorts of really great courses around leadership courses, which people can do and there's courses have difficult conversations with clients and the like. So if you've not had a chance to look at, look at The Academy yet, I think it's a really great resource that's there, but is that I think it's very underused at the moment. And of course, it's CPD and it's free CPD and we all like a little bit of free CPD. So certainly I think it's something that we should look to use in a a lot more if we possibly can. Absolutely, we've also had questions about vet GDP. Are you able to just give a little bit of a flavour of that one as well, please? Yeah, of course I am. VetGDP. So VetGDP for me has got two aspects to it. One of the, one of the component parts of it is the fact it supports our new graduates, and we know that support for new graduates is absolutely essential to help with our retention, and we know without that support, we will lose more of our new grads. What it helps to do is it helps to build their confidence and competence to develop into really great vets. The positive things about it is that whereas the old PDP was not part of code, the VetGDP is part of code, and so what it actually stipulates is there has to be a senior, appointed senior veterinary surgeon in the practise to oversee the process. They have to give the graduate and their mentor protected time in order to be able to work through their portfolios and actually gain the confidence that they actually need. The other thing which people perhaps don't know perhaps so much about is the fact that as part of the whole process, we are getting huge amounts of really rich data going back into College. If you look at the sort of surveys that were put out by the vet schools looking at feedback from employers and from new graduates in the past, the return rate of those was sometimes less than 10%. Whereas we're getting data from pretty much every single new graduate, and also from every single new graduates employer, because they have to complete that as part of VetGDP. So we're able to look at where the strengths are of the different programmes, where potentially there are components of the programme that may not be as good. So whether it might be, I don't know, equine diagnostics or something, and that data that is fed back to the schools are part of this continual quality improvement that college is now promoting. So the nice thing about it is, you know, there's been previous criticisms that students come out, graduates, and they're not fit for practise, and they've got all these airs and graces, because they've been taught in referral practise. It's far from that now, because not only are they being taught in a primary care context, we have this feedback to the schools where they can actually improve their own programmes. So I think it's great, and we certainly looking at the very, very early data, it does seem to be making a difference to our retention rates. Indeed, and a really positive experience for those that take part. We've had some questions in the chat and some discussion, looking around, working times and chronic illness and those sorts of things, so I might just take this opportunity to flag, the chronic illness survey that we undertook. So this was a groundbreaking survey, that looked at chronic illness, disability, neurodiversity and mental health, not just within qualified vets and nurses, but also looking at the student population as well. So there's some more information on that, on the website, but also the Let's Talk Adjustments campaign that we're currently running. So this is enabling people to think about what reasonable adjustments might support them and help them within their workplace. And we are also just about to launch a Vet Return course, into The Academy. So this is to help, vets who, might no longer be in practise but would like to return, and this is aimed at helping them and their employers. So just a quick plug for, for that one. So, continuing on this theme of culture, and we have that everyday leadership thread running through. If we bring it down to the individual, and think about career progression, I don't know how many people here have seen the VCCP or perhaps even know what it stands for, but Sue, might you be able to just give an overview and then Linda, from your GP perspective, think about the positives that it could bring, please? OK. So, the Veterinary Clinical Careers Pathway. There are 3 different components to it. One is looking at the creation of the specialist GP if this, if you can use those two words in the same sentence. A specialist GP qualification, and that's actually a piece of work that's really very advanced to the point that in education committee today, we were looking at the outlines of the curriculum for that. And I think that's really, really exciting. The second work stream is looking at trying to define more clearly the different qualifications, because there's a huge misconception from the professions and also from the public about what an AP is, what a certificate holder is, what a specialist is, and so there's a real need to try and redefine those terms, and it may be we need to change those names to produce greater clarity. And then the third thing which I'm particularly passionate about is having flexible routes from primary care practise to do specialist qualifications, because we know that the sacrifices that people have to make through residencies and internships are sacrifices not everybody can do. If you've got a partner who's got a fixed place of work, you've got dependents, whether it's elderly relatives or children, you can't always up sticks and disappear off and do a residency. So we're looking at working with the European boards to look at flexible ways for people to do specialist in clinical subjects, so ophthalmology, dermatology, etc., to actually increase the diversity of our, of our workforce. So 3 really, really great stuff. And it all boils back to one of those ambitions around, you know, career progression and a and a sort of Rewarding pathway for people. I think at the moment, general practise, people do their APs, and then they hit a bit of a brick wall. And I think one of the reasons why potentially people might consider leaving is because they don't feel satisfied. There's more that they want to do. There's more they want to give. And I think our specialist qualification will hopefully, hopefully help contribute to improve that state of affairs. Excellent, thank you for sharing that with us, Sue. Hopefully, ,you've had a moment to to take that on board. But Linda, as as a GP and somebody who's had, you know, a fantastic career as a GP, what might this have meant to you or what do you think this could mean to those who are who are newly in GP practise at the moment? I think you've got to look at it in different ways. There's what it might mean for an individual. My own development, my own sense of reward, and that side of the work. And then there's looking at it from the impact you can then have in practise, and what that impact is, also coming back to your earlier comment, does depend on the workplace culture. As to what you can bring in and certainly, you know, we've seen people, you know, go through, as you say, AP and really bring great differences to not just to their own work, but to the wider piece, but it does require that flexibility within practise. And I think one of the things we're seeing is where there's some inflexibility in practise and maybe structures are designed not by the people who are gonna work in them. And there's a bit of a disconnect there, and that limits people's abilities to bring that through. So I think as well as doing all this work, we've got to think about how it's going to translate into the workplace, and it can bring real benefits across the whole team rather than just for the individual involved. So, you know, you look at the CMA stuff going back to that and they've got this idea that a 'FOP', as they call them, a first opinion practice, doesn't do much. They don't seem to understand that veterinary hospitals can be first opinion practices, whether that's you know, a different species. So I think there's a lot we can, we can bring in, but the workplace culture needs to be part of the success of this for where it can go. Absolutely, and it's something that that we will be discussing in more of the ambitions over the next couple of months. So, thinking about modern ways of working as you've referenced there, the flexibility, the different ways in which people might choose to engage within a workplace. And also recognising that lots of people are taking very different career routes. They might be doing clinical work, but that might only be some of that their working hours, they might be doing all sorts of different things. So I think it's really interesting to see how this will this will develop. I'm conscious of the time, and we haven't actually got too much time left. So before I come to the next question for Linda, I'm just going to ask if anybody's got any questions for Linda or Sue or Vicki, would you mind popping them in the chat, while we get to the next question, then we can come back to them towards the, towards the end. So we've had a bit of a, bit of a run through, admissions, through to curriculum and then thinking about practise culture. So just some small topics. Moving onto the future, we've had questions come in, as part of the pre-submissions, about technology, AI, and that's the artificial intelligence AI, not, not anything else. So, Linda, what are your thoughts, because we had a round table last year and there's been a lot going on in the background. Can you share a bit more about that please? There's obviously really different views and feelings around the use of AI in veterinary education and veterinary clinical practise. And there's a real range. I think we've got to think about it, that, yes, there are risks, but there are also risks with not using AI as well and not reaping those benefits, arguably, you know, being, being negligent not to. There's no way we can regulate AI. That's, that ship's definitely sailed. we don't really have the ability to regulate the devices either. It's a global situation and we don't have the equivalent of the medical situation. But what we can do is regulate how we use AI. And I think we want to look at this from that sword and shield perspective of regulation. So that we can give people the confidence to embrace it and get the benefits whilst mitigating the risks. And so what we're doing is looking at all sorts of different areas where it's got applications, and many people will be using AI already, possibly even more than they realise they're using it. And there are some areas where it's pretty safe to be working with it. And I think we are looking at still needing a human in the loop, and ultimate responsibility sitting there, but where can we provide some assurance? And some of that may well be around a voluntary scheme looking at sort of kite marking of particular devices where we understand the quality of the data that's going in. And remember, it's such a fast moving field that if you set things up in a very rigid way for today, they'll be irrelevant next month. So lots to think about, but I think as a profession, it's something we should be looking to get the benefits from for animal health and welfare and, huge potential, and working with it, but look to some regulation to give us some assurance and support. Absolutely. So there's a, there's just a few small things to tackle there, but there's more information in the report that Tash is going to put into the, in fact, she's already put it into the chat, so if people are interested in learning a bit more about that, then, then please do take a look. So, thinking then about final reflections on leadership before we get to a couple of questions in the, in the chat. Both as your time as leaders so far, within your, your day to day clinical work, but also as the RCVS, anything that you're particularly proud of steering or having involvement with, and how might people be able to use any experience that they have to generate a more positive culture? Either of you can go first, whoever's the most enthusiastic. I don't know about the most enthusiastic, but I'll start. I think one of the things that's really, really valuable is to sometimes step outside of our own profession for our learnings. There are always cross learns, and it bringing in wider perspectives is really, really helpful, and this idea that unless it's sort of come from within veterinary, it has no relevance to us, we're missing tricks there. And I think there's enormous value in bringing in some outside perspectives and us stepping outside and learning, not just with our, our colleagues from practise, but more widely. Thank you. Sue? I think they've probably had enough from me already, haven't they? So I suppose my, I suppose the thing that I'm very passionate about is that we reflect the society that we that we serve, and we are very un-diverse as professions. I mean, look at the nursing profession, 97% of the nursing profession is female, and that doesn't mean to say that, you know, females don't make fantastic nurses, but we need more, we need a lot more boys to be there. It was really interesting, you know, if you go to a big congress like BSAVA or any other of the big congresses and you look around. A lot of a lot of females and they are predominantly white. When we went to the New Scientist exhibition, it was a very much more mixed audience that was there, a real variety of different people from different backgrounds. And it just struck me when we went to the New Scientist exhibition that actually we need to be a lot more diverse. We really do. And so I think the more we can do around widening participation. I, you know, I would like to think I've played a small part in helping college to drive, produce better career material, which I think is absolutely key, because I think so many of us as parents or involvement with schools go into schools and do career talks and can, you know, give our share our experiences, and our enthusiasm for the profession. I think having career resources and stuff that's there is really important. So I think that's probably one of the things that I will value the most when I leave college, which I will do probably in about another 15 months as I come to the end of my 12 year term. I think widening participation for me is absolute key. I think when we have kids entering the profession who are driven and determined and really want to be vets, and some of these have struggled to reach vet school. Those are the ones that are going to stay, you know, when I went to my inauguration speech Royal College Day, talked about how I didn't make vet school first time around. I didn't, like a lot of people of my generation, I didn't get my physics A level, so I had to stay on another year to get my qualification, and it was because that's what I wanted to do. And so many other people have come up to me, who are perhaps been qualified for quite a long period of time, have said, do you know, I have exactly the same story. I didn't get in first time and I went back and, and I think those are the people who've perhaps had to fight a bit who are perhaps a little bit more resilient. Who perhaps are the ones who've stayed in the profession. And I think when we're getting those people from those sorts of backgrounds, I think they're much more likely to stay, because they really, really want to be vets, and those are the ones I think that are going to stay in the career and contribute to the profession. So for me, widening participation has been something that I would hope I've helped drive College and encourage College to do more on. Thank you, Sue. And I think it, you are, you are right in terms of thinking about the diversity of, the communities that that vets and nurses and practises serve. It's important to see that reflected. There is a question that's slightly tangential to that, looking at overseas vet students within the university, and whether we know the percentage of university places offered. I might, I might ask Vicki if you, are able to pop in the chat some of the information that we have about that because we did look at this as part of the workforce modelling the assumption of those who who don't join the Register, but as far as I'm aware, there is no cap, unless, Sue, you can correct me on that, because you've worked closely on this. But, are there, is there a cap for universities on how many overseas places they're allowed to offer that you're aware of? I think the biggest problem, Angharad, is funding for our schools, and it would be lovely to see that they were funded properly, so they didn't have to rely on foreign students coming in. Not there's anything wrong with foreign students coming in to contribute to our workforce, but many of them come in because it's a lower cost education than it is perhaps at home, and then many of them will go back afterwards. So the schools admit them really to make ends meet, and so they are subsidising our own homegrown students. And I would suspect that if funding was better, then actually we would be able to provide more places for people to study from the UK and therefore, potentially we might keep more vets in the country. Interesting, thank you. So we have got one more question that's going up on Slido in just a second, so if you could check that, and then I'll ask Deb to share the results with you on that. We've had quite a few questions that have come through. There's a lot of comments on, on the cost of, of living essentially, and for many people, saying that it's not that they want to leave, because they, it's rather, it's not that they, they don't want to be a vet and that's why they're leaving, and it's more that they are struggling to stay in and keep themselves afloat. So I don't know, Linda, if you have any, any immediate reflections on those sorts of comments and potentially some support for thinking about people who might want to come back when they're ready. I think in terms of, it's a bit of a difficult one, isn't it? We've got a situation into, one sector of the veterinary market talking about the costs and that there were all sorts of debates about the impact on veterinary wages and how it hadn't been a cause and it had been a cause and real mixed messaging around that. And, you know, remuneration, isn't, you know, it's not a particularly highly paid profession at all. And the structure of the industry is part of that and maybe something we need to think about. And then there's the bigger societal issue around the cost of working when you have dependents, and the burden of looking after dependents, and we need to be thinking about this not just from a veterinary perspective, but, you know, society as well. When is this going to change? Absolutely, it's a it's a really difficult one and one that is also being discussed across many other professions and career stages as well. So I would agree with you it's one that unfortunately we don't, we don't have the answer to immediately. But we should certainly be part of the conversation. Absolutely, absolutely, and I think this is one where with the later ambitions we can start to explore, especially thinking about ways of working and leadership, how we might be able to enable these conversations to take place so that people can still do something that they that they love. So, we've asked you the question 'If you had to name one thing that has kept you or would keep you in this field, so stop you from leaving, what would that be?' And what I'm seeing here coming through is that there's, there's a lot of very similar content to the question, at the start when we asked you about what do you love. So, there's a large sentiment here around animal welfare, love for animals, passion for helping animals, person centred employers, the people, family. I'm not sure if that's thinking about the wider relationships that you might have with your team and how you might describe that or whether that's the ability to work with family members, but relationships with colleagues and clients and patients, all the different people, and this is all this is all really important I think for us to reflect on and to take a moment to think about. Why do we all do what we, what we do? But then also from an everyday leadership perspective, how can we ensure that there is more of this? I don't know Sue or Linda if you're seeing this, and if there's anything that particularly resonates with either of you, is there anything in here that matches as to why you on those, on those bad days went, I'm going to stick at it.

I suppose for me it's making a difference. I suppose, you know, people's pets are part of their families, and I think it's still a pleasure and a privilege to be able to help people when their animals come to you. So for me, and I still get a buzz out of it. I think when I stop getting a buzz out of making something better or helping someone, then that's probably the time when I will, will, you know, pull up sticks and go, but I just think all of us, it's a way of life I think for most people. I don't think it's a job. I think it is what we are, it's part of our being as vets and as vet nurses that that that's why we, that's why we do it. Thank you, Sue. Linda. I think it's how bad days impact you. I always believe there's good days, you know, tomorrow's a good day. And that sort of thing is in understanding that not everything is going to be as I'd like it to be in veterinary. It just can't be. There is risk, and I think probably a little bit, one of the things to to think about is what is our attitude to risk, as a profession? And I think that's an area we could explore because it might make a lot of things, a little more palatable sometimes. I think that's a really good question for all of us to consider in terms of the risk appetite and how that changes as your as your career develops and the different experiences that you have and your appetite for risk might be might be very different on some days to the other. So, good food for thought there, if I can say that correctly. So, a huge thank you to, to you for sharing your thoughts and your experiences with us. Hopefully, for those of you who've joined us, you've been able to see that there is a huge amount that is going on in the background, and, all of the teams across our organisation, whether they are more regulatory, in their, in their day job or whether they're more upstream regulation and Royal College, that there is, there is stuff that's going on every day that's impacting, across every different, every different group and community. And we're, we're very proud of all the different initiatives that are coming through. Some are very nascent and, and we haven't seen their impact yet and some are growing and developing and have been established for a long time. I mostly also want to say thank you, to our delegates for sharing your thoughts and some very personal thoughts and feelings within this chat. It's really great to hear from you and to help us understand a bit more about, where you're at right now. And what might, what might need to change or what might need to be to be different, but also, from the thoughts and feelings that you've you've shared with the Slido and in terms of how we might, how we might learn from from what does go well and imbue a bit more of that into the, into the day. So we've covered a lot of ground, and there's more to come. So the purpose of this session, as we, as we said at the beginning was to, to think about the workforce and its in its current sort of form, give you some of the data, some of the insight, a little bit of a flavour, across the, across the activities and, Sue and Linda have been made to work quite hard, I think, to share all of this with you. But if you're interested in joining us for more sessions, we have got, we have got 7 more, so it's, it's not too late to sign up and and be part of those. As I said at the beginning, some of the questions that were submitted for this, have been allocated to very specific sessions, where we've got experts, and they will, they will be answered in those, so make sure you do come and join us for those. This has been recorded, so we will be able to share this hopefully within the next week or so, once we've made sure that it's all, all neat and tidy and ready to, ready to go out to you. It will be something that's available for everybody to watch. It will go up on the website and you'll get an email with that link, but also the resources. We are going to share a survey with you as well, immediately. I will apologise for this, but I also won't because we would love to have your feedback. This is a very different type of session to ones that we've run previously, so we would welcome your thoughts on this, and what we can, what we can learn from this. What type of information or projects that you might be keen to have another similar session on, so that we can, we can learn from that. So there's, there's all of that, in there, it will be coming to you. The one question, that we were asked, that, I'm going to be a bit cheeky here and say that we're not going to answer it just yet, and we're not going to answer it in the next sessions in its entirety. We're going to run it throughout. One of the questions that were submitted was 'What do you see as the biggest challenge and potential barrier to achievement of the ambitions?', and the person has commented that there's many considerations, the professions are very complex. So this is something that we are going to continue to talk about because, when we, when we talk about the workforce ambitions and when we engage with different key stakeholder groups, so whether that species divisions, vet schools council, HE and FE institutions, we're always very conscious that we're all working towards the same goal. We're all trying to make sure that the workforce that we have can be healthy and thriving, and that they can have a positive impact on animal health and welfare and also on public health. So, this question will, will run its run its course. So thank you to whoever submitted that. It is a it is a good question. So in terms of the, the challenges and the barriers, I'd urge everybody to consider how we can all contribute, but also if you spot barriers, think about how we might be able to overcome those hurdles, and I'm going to try not to use too many analogies with hurdle jumping and limbo dancing and, and all sorts of different things as to how we're going to have to navigate round some of these. So, thank you all for joining us. We are 4 minutes before the end, so hopefully, you can use that 4 minutes to have a moment, not staring at the screen. For those of you who are coming to BVA live, we will be there and we'll be running a session there on the Friday afternoon. We've got the last slot, so if you're, if you're still standing, and if you're still ready to talk about workforce and practice culture most specifically, then we would love to meet you in person, come and join us, and if not, we will hopefully see you online at one of these. But thank you again, Vicki, Linda, and Sue for being part of this and feeding us with lots of information. If you do want to get in touch with us, please do, we're always available, the email addresses are in all of the links. So, with that, I will let you all go and hopefully see you all soon. Take care everyone, bye-bye.

Welcome, everybody. So this is the RCVS Workforce Action Plan Ambitions revisited series, and we are in ambition number six. We're going to be talking today about an attractive career for everyone, including those who have left. I'm Louise Allum. I am going to be chairing this session today.

So, a little bit of housekeeping to start with, if you've remembered your zoom etiquette. We're are gonna be recording this, so I hope that's OK with everybody. If you can stay on mute while the session's going. We're gonna put resources in the chat. I think we're gonna put questions in the chat as well. So if you've got any questions, then put them in the chat, and there's gonna be time at the end for questions as well.

So I've got a fabulous panel with me here today and um we've got um the panel of stakeholders to share their thoughts and experiences on this topic and I've chatted to them beforehand, they've got a lot of really interesting things to say. So we're gonna go through, I'm gonna introduce myself to start with. So, some of you might know me, some of you might not. I'm Louise. I'm head vet at the shelter medicine programme at the RVC. So, I do work with kittens quite a lot at the moment and work at animal shelters. I have a fantastic role, really. I am also part of the RCVS Council, which is why I got asked onto this today, I think.

Now, let me introduce my panel and I'm gonna get them to give them a very short intro on why they're excited to be here today. So, can I maybe start with Tim to start with?

Tim: Thanks, Louise. yeah, Tim Parkin, chair of RCVS Education Committee, I'm Junior Vice-President of the Royal College, also head of school at Bristol Veterinary School. I think reflecting on what I'd like to say here is thinking about what I say to graduates at admissions day when they're admitted to the Royal College, and ensuring that, they recognise that their degree is their own degree to do what they want with, and actually I deliberately told them not to look at their parents who may be expecting them to go into clinic, and actually to think about what they want to do and actually potentially take a risk. I myself, never went into clinics, I went to PhD and stayed in research, but it works in the opposite way as well, and I always ask students to keep in touch and think about what they're going to do with their veterinary degree and recognise quite how flexible it is. And actually they may spend time out of clinics and may then want to come back into clinics, and that sort of thing. So I try and encourage them to take the risk and when the opportunity arises, do something different with their degree, and that might include coming back into clinics, I would say as well. Thanks, Louise.

Louise: Thank you. I think, Tash has put in there, if you've got any questions, do pop them in the chat. We've got some of the team from the RCVS here. So, we've got Tash, Deborah, and Angharad joining us as well today. Right, Kit, tell me why you're excited to be here.

Kit: Thanks, Louise. So, I'm Kit Sturges, I'm a clinician and have been qualified for 40 years but I've had quite a squiggly career and when I qualified, I was going to be an equine lameness person, and it became clear to me over time that I really didn't enjoy it and wasn't particularly good at it, along with cattle medicine, and that's the one thing that I've really learnt through my career that if you want a fulfilling, or for me, if I want a fulfilling job, I need to really believe in it and and feel that I um recognise that the things that I'm good at and the things that I'm not good at. And I guess for many of us who have been quite high achievers, we feel we should be good at everything, and it's hard sometimes to admit that actually you're really not good at something and they don't give me sharp cutting instruments anymore because I'm not a surgeon.

So that's a little bit of me. I've done many other things. I have what people would describe as a portfolio career now, so I do a lot of charity work, committee work, and some clinical work, so that really, you know, is great, floats my boat and I really enjoy it. The other angle is my wife is a vet as well, and she had a career break through health issues and having children, and we're older parents and we didn't have any sort of parental support, so we had to do it all our own. And she did try to come back and eventually she just found it got too difficult and decided not to come back and that's before all the wonderful resources that have recently been created, so we have a little bit of personal experience of how hard it is after a break to come back and the challenges that presents.

Louise: OK, I'm gonna move on to Sally next, who I have to say has made me feel quite inadequate in the past when I've heard what she's been up to. So Sally, give us some highlights.

Sally: I'll try and cut it short. So I started off, I qualified as a nurse in 1987 with the little green book. And then I became a Head Nurse, then a Practice Manager. Then I had 7 years out of nursing. I became a foster carer for challenging children. Then I had 3 years with my own delicatessen, selling my own homemade food and British cheeses. Then I came back to nursing. I was a veterinary nurse, then I became a Head Nurse, then I became a nurse clinical manager, then a Practice Manager for a veterinary referral hospital. Then I went to work for the College of Animal Welfare as an IQA. And then recently, at the age of 58, I've come back full circle to nursing. And, yeah, I've had a break and I've had, I just want to be, I would just want the simple life now, really. I've got pressures at home, I've got children, I've got a grandchild, I've got, uh, ageing parents. So I know the pressures of working and having outside pressures with family and supporting them.

Louise: Thank you, Sally. That's. That's amazing. That's, that's great. Right, Lauren, another inspirational person. Tell, tell us, you know, tell us a little bit about you as well, please, Lauren.

Lauren: I mean, I'm, almost a professional returner, at this stage in in my career. So I mean, I lived abroad for a bit, early in my career, moved back to a first opinion position, having had 6 months out. I had maternity leave and came back to a technical position, so still in an industry role, salaried, but coming back to do something different, and I left the profession entirely, and then came back and set up my own business in the veterinary space. So I'm like, tick tick tick tick on the leaving and returning box in a in and out all over the place. I'm really passionate about talking about it because on none of those three occasions did it feel easy. And all times when I kind of gathered my courage and went for it, it was never as bad as I thought it was gonna be, but there's always strategies to make it easier. And any way that I can help anyone with any of those challenges, I am here for it.

Louise: Fantastic, thank you. So, that's our fabulous panel for today. So we'd love to find out a bit about you as well, who have joined us here today, and we have got a lovely, Slido poll, if you're used to doing those, I think Debbie's gonna put that up for us to have a little look at. There are, I believe, 3 questions, and there'll be a 4th 1 at the end, so um if you can add any comments on this. How do we join? So we join on Slido, so onto your mobile phone or on your laptop if you can and um put that hashtag number and see I'm not down with the kids, am I? That's great. Well done.

Hearing a little bit more about everybody, that's great. Feel free to add anything in the chat box as well if you're struggling to do the Slido. Considering my options, I'm liking that.

and Debbie, when will you be able to tell us when a fair number of people have voted. None of these options, that's fine, Jenny. I can move it on to the next slide. OK, let's go. Let's move on to the next slide.

So what do you love about working in the veterinary sector? So, one of the other reasons I'm here today is that I've just employed my vet who is returning after 15 years, out of practice and has just come back to the animal shelter that I'm working at. And so it's been really interesting seeing that return to work through her eyes. What do you love about working with the veterinary sector? I have to say the thing that she said she really liked is that she can now describe her job title a lot quicker again in, in parties or wherever she is, she said for her it was about having her professional identity back again. She said people have stopped blanking out when she described her job. Yeah, I love that working with people is so high up on the list, actually, because I think, a lot of, I'll talk to Tim about this later, but I don't think a lot of our graduates maybe go into it, thinking about working with people, but it's such a huge part of it. Working with animals, helping people, community, love that, helping others, it matters, sense of purpose. Yeah, I have to say that sense of purpose is a big one for me. Making a difference, it does feel like you're getting up in the morning and making a difference.

Working in science, I think that's a great thing, and teamwork. I think that's the other thing. I haven't tried working in a one man practice before. I've always worked in a team and I do love going in and seeing people in the morning, who've got the same sort of sense of purpose as me. Making an impact, it matters. Passion that the vets and nurses have, love all that.

As everybody participate. Thank you very much, everybody. And again, if anybody wants to add anything in the chat, we're gonna add resources to the chat as we go along as well, so do feel free to, and you'll be able to look back at those another day as well. Then a final question, have we, Debbie? I think that's for the end of the session. Fantastic. That's great.

So, let, let's move on then to have a bit more of a chat with our panel and dig into this a bit better. So, my first question to the panel is, how do you make the career attractive to people who have left it? What are we gonna do maybe with the really talking to Tim as well with the younger members of the profession, sort of trying to make sure that people feel that they can maybe stay in the profession for longer. Do you want to, Lauren, you were last to start with. How do you think we We can make the career more attractive. So, so why did you come back? What, what made you leave and why did you return?

Lauren: Well, what made me leave was, I think I was quite disillusioned about what I wanted. I felt a bit lost. I tried various different careers. I've been in tech, I've been in clinical content writing at Vets4Pets head office. I'd done a variety of different first opinion practices. Because I threw my toys out the pram and decided it must be the profession that was the problem, rather than me. I left and discovered that all of those problems exist in jobs all over the place, and actually the problem was probably me, in the end actually. And then the real crunch point came as I was the commercial director of a healthcare mattress firm and we were turning over 23 million. So you know it was a big deal. Somebody I didn't know ask me at a networking event, what's your job? I said, well, I'm a vet, but now I sell mattresses. And how long, when reflected on that, how long am I gonna spend saying I'm a vet, but? It's just, you know, 10 years, 20 years. Actually, what that really showed me was that I think when you're in the profession, it's really hard to actually really leave. You always end up with that, I'm a this, but now I. And it was that that really dragged me back. This kind of realisation that the grass isn't greener, there are challenges in all of these professions, and learnings and being able to bring them back is really cool. So that was me.

Louise: Yeah so how do you think we can make this career more attractive than Lauren what so second part of that question really. So what do you think we can do as a profession to say, look, you know, this is a good career, come back to it?

Lauren: Yeah, I think one thing we're not really very good at is kind of shouting about what we need to those people who've gone. You think about, let's take Australia, right? Australia's well known for being like, right, come in because we need these people who can do this, we need people who are this, and we need people who are this, and we want to create a really great environment for you to if you've got all those things. and I think us going out there and saying, actually, we're looking for people with great communication skills. We're looking and you might have, maybe you didn't have that when you were here before, but now you probably do. You've you've kept communicating, that hasn't. And that the skill set that you might feel that you're missing is actually negligible. It might be a couple of new drugs, some updated. You might used to have known the Metacam drug dose on the top of your head and you don't anymore. I think we're gonna get over that, right? For your years of experience. And kind of trying to communicate that actually that what you don't know is infinitesimal really compared to the wealth of experience you're bringing back in.

Louise: Yeah, that's really interesting. Kitt, do you want to jump in on that, actually, because I know you were talking about your wife's sort of return and failure to return, well, not failure, but, but opted not to. How do you think we could have made the, this career more attractive? What were the barriers, do you think, to her returning?

Kit: I think there was no structure. So I think vets generally like a plan, and vet nurses too. I, you know, I think those are the sort of people we are. And just to sort of have this, I want to return, but how do I do it? I think that was really difficult and she went to some local practices and did a bit of work, but there wasn't anybody sort of really supporting her to do that, and I think to Lauren's point, people tend to overthink the things they don't know and underthink what they really do know and the things that are rusty, yes, they're gonna take time to come back. My wife had been out for like 16 years, so a long time, but they do come back and I guess it's also probably accepting that you're a different person from when you left, so what you might do now may not be exactly the same as you could do when you left. So I think those are the things, it's trying to build that structure of how you actually do it and for some people it's, and I think definitely for my wife, she's quite a process person, it's the nuts and bolts of of how it all fits together and I think the resources now facilitate that.

And just to sort of Lauren's point, my impression is that most people who leave the profession are sad to leave because they've failed to find their happy place in the profession. And for me that comes back to really understanding what you like and again as Lauren said, it's being honest with yourself rather than saying, oh it must be the profession or the corporates or or the Royal College or whatever it is, that's probably not the issue. The issue is that you haven't perhaps been as honest with yourself as you might be about what the things are that really get you up in the morning.

Louise: Yeah. And I think that's a really interesting point, Kit, and thinking about the flip side, why have you kept in the profession for this long? And I think that, that squiggly career, that portfolio career idea, how do you think you've, how do you think you've done that? What has been your techniques or tips for navigating that? would you say?

Kit: It's a good and a bad thing, and it does come bite me at times, but I say yes. When people ask me if I'm interested in doing something, I tend to say yes. Now sometimes that leads to overload and there have definitely been times in my career where I've been really close to compassion fatigue and just not managing. But there have been some great opportunities when people said, are you interested in that? And I think, actually, yes. And so now, to, what your career is, Lou, you, I, you know, I'm chair of trustees of a large animal charity and, you know, governance and finance and things that I'd never thought I was particularly interested in, but, doing that for the impact that it has on cats is brilliant. So, you know, I think, being confident in yourself enough when somebody asks you something that you may not have done before to say yes, if it's something that, that you feel actually that could be really interesting, really helped me. Sometimes people ask me for sort of opinions on something, I think I know nothing about that, but I actually really enjoyed going out and finding out about it and keeping, just keeping engaged, that's, I think a big thing for me.

Louise: Lovely, thank you, Kit, that's great. I'm gonna move on to Sally then. How do you think you, I mean, what were your reasons for coming back, Sally, you talked a little bit about it before, but how do you think we can make um the veterinary veterinary nursing career attractive to to people who've left? How, how can we improve what we're doing?

Sally: I think flexibility is important from practices and also understanding that when you are coming back and you're a little bit older, that you have medical conditions that you need adjustments for, you know, it's not a failure to have a medical condition. But it just needs understanding in practice. You know, I have medical, a long-term medical condition, which means that I get vertigo every other day. So, by explaining to the practice what my needs are, you know, I need structure and I need routine. I work Monday to Thursday, 9 till 5. And you know, it's really important for me because when I left nursing before to go into different roles, I had burnout, I had compassion fatigue, and COVID and not being furloughed and being the only nurse doing practice management and nursing and reception finished me off. And COVID was just one of those things that, you know, I didn't find difficult at the time, but after COVID, and going back into practice, I thought, no, I don't wanna see another client. I don't wanna see another pet. So, I went into management side, which has its own challenges. And now, you know, I'm getting to the age, I'm 58, I want to go down into retirement at 67, doing a job I love again. And that's why I've come back to clinical nursing, and I'm now in a small practise where I'm the only nurse, and there's one vet and one receptionist, two receptionists, and, and one kennel assistant. But it means that I can go back to my basics, you know, I was worried about going back to nursing because of all the fancy equipment that's out there now. You know, which I was really daunted by. I think, oh my gosh, you know, I've got to learn all of these things again. But, in fact, you know, because he's only just set up by himself, he hasn't got the money for all the fancy equipment. So I can go right back to basics, to what I learned, as a nurse on how to monitor anaesthetics. And yes, we'll get there. We'll sort of learn together. But, yeah, I'm just really enjoying, the flexibility of doing hours that suit me. And, you know, if I do any overtime, which there's a little bit covering other people, if I do overtime, I can take it off in time. Which time is more important to me now. You know, time being at home, time if my parents need support, I can just take an hour off and he lets me go an hour early. And then, you know, I might make it up by doing a little bit of overtime when someone else is on holiday. So I think flexibility and adjustments for any medical conditions you have, is, you know, the key to me coming back into clinical practice.

Louise: Yeah. That's great. And I think we've just put in the chat actually about the Let's Talk Adjustments campaign by the RCVS because I think this, as you say, is a really important, it is an important barrier for some people. And interestingly, you know, looking at my team now, I think I'm the only one that works full time. Everybody else is working part time, not just for childcare or for health reasons, but, some of it is for mental health, you know, it's saying that I actually, I can work 4 days a week in this profession, but I can't work 5. I need some time to myself to manage that. Kitt, you're an employer. How do you find, is it easy? Are you finding that you're having to give increased flexibility to team members now? I know it can be quite challenging as an employer, but is it something that you've been looking into?

Kit: To be clear, I only employ me, and I'm as flexible as I can be to myself. I have, I did set up a referral practise, and was an employer of 60 people, and certainly. There are competing issues for practices because you have to maintain a certain level of cover, and how do you manage that, with reasonable adjustments to for people's medical health, but also their mental health, the number of days they want to work. How do you build systems in, because to ensure you have good handover of cases, because people aren't there full time, those things I think then become really important. And the one thing that really struck me was Trying to ensure the team understood that it was for the team's benefit to do this well, rather than somebody who was getting a bit of a favour because they had shorter hours or school time or whatever, which I felt really started to create some resentment amongst some staff who felt, well, everyone else is getting something, why aren't, you know, why aren't I being given something rather than understanding that this was building a team that worked rather than individual favours.

Louise: Yeah, that's why I think it's really important to really have this out in the open and start talking about it. Tim, yeah, sorry, I hadn't forgotten about you, don't you worry. So, we were talking about how do you make the career attractive, but do you want to jump in on the flexibility of working, before we go to other things.

Tim: Yeah. Yeah, we have a couple of hundred staff at the vet school, obviously, and then vets, you know, a couple of hundred plus individuals. And more and more of them clearly want to work flexibly. The routine in Langford Vets would be sort of 8am till 6pm, four days a week, doing compressed hours. I think the one thing that I want to comment on that is that we now try where as best we can to match the student experience when they're in a clinical rotation to the experience of the practitioner. So if they go to a practice for a rotation where actually the routine is for the vet to be doing 4 days a week, 8am till 6pm, that's what the student will do. And I think it's really, really valuable because our student body is so different to what it was 5, 10, 15 years ago. We have so many more individuals who come with other calls on their time. And I think the pressure that most feel in the veterinary profession is that you are doing your job, but you know you've got so many other things to do in your life and actually if you don't have the time, if your job is all consuming and you don't have the time to do everything else that you want to do that you may need to do, I think that's where I see a lot of issues come in and, you know, we are all so much more busy than we ever used to be, whether that be within work or out of work, and actually you have to then decide that actually what is more important, life or job. And you need to get that proper work life balance, and I think the profession is getting better at recognising that, but I still would say that I still have employers in clinical practice who come to me and say it's really disappointing that the first question a new grad might ask is: "I don't want to do out of hours, what's your on-call rota, I can only do 4 days a week". So there is this mismatch in what graduates might expect, but also what some employers might still be demanding, and I think it's important to have that conversation and recognise that the graduates that we're taking in now are very different, and we are deliberately, you know, trying to get a group of individuals who leave university who are much more reflective of the society that they are likely to be serving in the future. And that can only be a good thing, because then I think surely they will stay um in the profession in clinical work or whatever they happen to do much, much longer.

Louise: You know, and that was, that was the other question I was going to put to you, Tim, a slightly different spin on the question I've asked others is, um, not how do we make the career more attractive to people who have left, how we are preparing our students to really make sure that they're aware of the different types of roles. Because as we see with Lauren, actually, there's a number of different roles that we can be doing in this profession. So, is there anything more, do you think, that the vet schools can be doing to prepare our students to go into the realities of the profession today?

Tim: Well, I mean, everyone, on the call probably has either been a vet nurse or a vet student, knowing that it's a pretty heavy programme, there's an enormous curriculum, we are accredited, you know, many vet schools are accredited by up to three accreditors, having to sort of meet multiple challenges. So it's forever the case, trying to add something to curricula that is already overflowing is really, really difficult. But we do, you know, try to have as many, you know, we engage with the Royal College, we get our students in the Royal College, and the Royal College comes and talks about the different roles of the profession. We deliberately talk about that at admission ceremonies. We have a professional track that runs through the whole programme, and throughout that we make sure that our students recognise the broad range of roles they can take with their veterinary degree, or veterinary nursing degree. And it's really, really important that we push that as much as possible. And I think the opportunities that are available in 3rd, 4th, 5th year. through a variety of EMS is really, really critical and being as flexible as we can so that, students can get that flavour of what it might be like to go and work in an office in DEFRA or whatever it happens to be. And I was literally, two days ago, I went to go and speak to the 49 students who are now qualified OVs from Bristol, final year students who were doing the OV programme. And I said, look, you know, I just said, we talk about you guys a lot because, you know, you're really critical. And one of them happened to be my tutee, they emailed me straight afterwards and said, can I have a quick meeting? This person is now deliberately, they're not going to clinic, they don't want to do that. They've decided that's not what they want to do, but they are seeking many, many different roles, you know, and actually, allowing them to think in that way is really, really important, so that they can genuinely be brave enough and not feel that there's any shame in doing something different with your veterinary degree, and you know, I love what Lauren says about I'm a vet, but you know, we all, I think as soon as you get MRCVS, you're forever gonna call yourself a vet, whatever you end up doing, 'cause it's so, it's so much part of you, isn't it? That's what's so good about it.

Louise: Yeah, a really interesting from comment in the chat here: Work across society increasingly seen as a means to support life outside of work, rather than the other way around. This is really impactful for roles traditionally seen as vocational, as the vocational concept of work is increasingly being rejected. Yeah, I think that's a great comment.

Right, so let's move you on panel. I've got another question for you. So how can we help improve the veterinary profession's workforce situation? So how can we support those who want to return? Sally, do you want to start me off on this? How, I mean, you've said about flexibility of working. What what else would have, and what else could have helped you? Is there anything else that you can think of to improve the workforce situation?

Sally: I think it's important to be honest with what you like and what you dislike, because there are a variety of roles out there. I used to work with a vet who couldn't stand seeing clients. And so she used to come in and do 5 days a week just operating. So I think it's, you know, the the traditional role of vets and nurses is blurred now in practice, especially, I think, since COVID. Because when you come back, the last few years, if you want to only do consulting, then be upfront and say it. You know, because there may well be a consulting role out out there, especially with you know, the recruitment of vets and nurses being quite hard these days. You can actually say I only want to work this many hours, or this shift or that shift, and I only want to do this, and I only want to do that. So, I think employers when I was a manager, I think as a manager in a large practice, you have to look at, maybe job sharing. So if a vet or a nurse wants to come back for 20 hours a week and you've got another one who wants to come back for 20 hours a week, that makes a full-time equivalent person. So I think it's a matter of employers recognising that to solve the, the recruitment crisis in both vets and nurses, you need to be flexible in what you are offering and also it needs to be from the other side, honesty in what you want from your job. And there's nothing wrong with aiming high and then compromising as you get the offers in. So yeah, I think that's, that's really important, is to be honest on both sides.

Louise: Sally, that's great. How do you, I think for me, it's having the confidence to do that as well. How did you, did you have a mentor, Sally, that helped you? Cause I think, there might be people sitting at home thinking I'd love to do that, but I'm not sure I've got the confidence to push myself out there like that. What advice would you give to somebody who's maybe struggling with that confidence?

Sally: I think did have a lack of confidence coming back to nursing, definitely, but when I looked at other jobs, you know, on the recruitment sites for in other professions, actually nursing now is very well paid for what I was looking at online. I mean, I was happy to go and work in a supermarket. But the money, you know, minimum wage compared to what I was getting in nursing made me come back to nursing and just gave me that little bit of extra push to say, right, well, what do I want? So, my contacts within the veterinary industry, I sort of put it out there that I was thinking of coming back to nursing. And then it just so happened that, you know, somebody who I knew from many years ago who was setting up by himself said, well, you know, come and work for me. And since then I've actually grown in confidence. Yes, I was very reluctant to begin with and, you know, the kennel assistant was teaching me things. But I went into practice saying, look, I've got a very rusty knowledge, so please bear with me, and I will learn from you and then maybe I can teach you something. And we have this, sort of, unwritten agreement that we are equal and we can teach each other things. So I think you, you don't have to go in there with the impression that people think you know everything, cause none of us know everything. You know, we just have to refresh our knowledge sometimes.

Louise: Yeah, that's great. Lauren, from you, how do you think people can get the confidence to go back? any tips you'd give to sort of try and get people thinking about going back into the workforce again?

Lauren: Yeah, 100%. So I think, you think about when we talk about maternity and things, we talk about KIT days, don't we? Keeping In Touch days. So when you're on your roll back to going back to work, come in and do a couple of days, see what it's all about, catch up on whatever, sit and read a vet times with a cup of tea on your lunch break, rather than running around doing nappies or whatever. I think that is, it's not enough, but it's a good thing that we do for especially maternity leaves. What we're not good at is keeping in touch with people who have, like I did when I was off making mattresses for 5 years, I had very little contact with the veterinary profession at that time. I think where we can really help is trying to help people keep in touch days, things that can help me encourage people to still come to London vet show for a day. You don't have to be working in veterinary practice. Come meet up with your old guys from university, have a mosey round, listen to a couple of lectures, and I think the more that people get re-immersed and you think, well, I went to that lecture and actually, all right, librela has been invented, but actually fundamentally all that's the same. Actually there's a confidence in that, isn't there? And also, as Sally was saying when you start connecting with people, suddenly someone says, what, you'd be great for this job. They can hook you back in because you would actually be brilliant at this. And sometimes those conversations are much more fruitful than trolling job sites, which can feel, I think, very anxiety inducing, especially for women who always have to meet every criteria on the jobs listing, don't we? We're known for that, you know. That can feel like a real thing. But actually if some mate you've known for 10 years goes, "come on, come on, come on, come and join my practice, please", because they've spotted you at BVA Live or whatever. That is completely different. So I think, how do we get, keep in touch days or experiences for people who've left, I think that would be a fantastic thing to do.

Louise: I love that, Lauren, love that. I'll go to Tim then Kitt. Tim, what do you think? How can we, have you you got an idea for fixing the workforce situation? And how would you support somebody who wants to return to work? I don't know if you've had this situation at uni?

Tim: Well, we have, I can talk from our particular situation and we have a number of different, I think looking at flexibility of roles and within the university, for example, at Bristol, we have Langford vets who see the cases, but we, we now employ a vast range of very experienced primary care practitioners who come in, they don't want to be seeing cases anymore, but they are there now to be that intermediary between the clinicians who are seeing lots of cases in Langford vets, and the student. They are clinical demonstrators, essentially, they don't see their own cases, but they work in the hospital, and they are absolutely adored by the students, because they have so much experience about what it means to be in first opinion practice. So actually trying to understand that and looking for those niche roles that may take the pressure off from actually seeing cases, but actually understanding that you can do a lot of other things with your veterinary degree that might actually be great for the next student body, the next, group of professionals coming through. It is one thing I would recommend. Think about going, you don't have to be an academic to be working in academia anymore, you know. I would say out of the 15 or 20 veterinary clinical demonstrators we have, a few of them will have certificates, but they don't have master's degrees, they don't have PhDs, they've done limited research. But there's enormous amount of opportunity for them in in that sort of role and, you know, we genuinely get inundated with applications for those roles every time we put them out. They're fantastic opportunity for people to continue to. Be connected to clinic, and many of them, they do a morning of locuming at work just a week just to keep up with their own sort of clinical skills and that sort of thing, and to keep a little bit up to date. But you know, there are so many different opportunities out there, I think it's really, really important.

I just say something about Lauren's comment about getting people back into going to veterinary congresses and that sort of thing. I wonder whether there's an opportunity here for having a particular registration stream for those who are out of the profession. Actually saying a returner stream that is a fee that is lower than the veterinary fee, just to genuinely push those people back, you know, pull them back in. I think it's a great idea and you could almost have a stream of the session, you know, a registration fee that's dedicated for them, but a stream of the session that is dedicated to that particular, aspect of the role is a great idea.

Louise: Love it, love it. And then finally on to Kitt. So, improving the veterinary profession's workforce situation, Kitt, how are you gonna fix it?

Kit: So I think it's about showing that variety of role that's available because my experience in cats protection, for example, rehoming cats, we get people come in and say 'I want a ginger cat'. And our approach now is to get the right cat for the right person, and I think there's a lot to be said for getting, you know, getting the right right vet and the right vet nurse in the right job. So I think it's having that flexibility and getting people to understand that that flexibility exists. And coming back to Sally's point, it is a negotiation. So, you know, there is that bit of I want this, I want that, but I think the one thing that I would really strongly say to people who are coming back is just take a moment and think about all the skills that you have developed, so you can say I want this, but I can offer...I can manage 5 children, get them off to school, give them lunches. That is an absolutely amazing skill and and could really benefit practises in terms of the workflow, how things can be managed, or else I've done a job where I've got some really good financial skills or I've had a lot of client relations management that, you know, everybody hates the the letter that comes in saying, 'I brought my dog to your clinic, you know, two days ago and I'm not happy'. You know, maybe that's an area that that person can really take on because they have the empathy and the experience to respond to that letter appropriately. And perhaps they'd be less anxious about it than maybe somebody who's really busy in clinics and and has put that off for two weeks and the owner, the client's just got more angry. So I think, I think there is that element too of, really sitting yourself down and saying, well, what skills have I developed in my time of doing something else or becoming a parent or whatever, because those are all really good transferable skills into practice because as the Slido really highlighted a vast amount of what we all do is working with people and the skills that you develop in doing all these other roles is is usually people skills, which are so valuable to practice. So recognising that there is a huge plethora of roles and there is a role somewhere that will suit you, and then when you go for it, as Sally says, asking for the things you want, but also being clear about the things you can offer, so that that the negotiation is a two-way street, so that they may have somebody who doesn't work quite as many hours, but the value they get from their life experience is huge.

Louise: Thank you, Kitt, that's great, and looking at my experience with my vet who, as I say, had 15 years out of practice, actually completely smashed the interview, but just wasn't expecting to get the job, cried when she got the job, you know, just so emotional when she got the job. So, I have to say, I found it really exciting to have somebody, sort of come along who was coming back into the profession and being able to support them has been a real privilege. So we're gonna move on now to, Charlotte, Rodia who is going to give us a little bit of, you know, nuts and bolts of what it actually looks like to return to practice. There is a slight change. You can't just sign back onto the register again. There is now more of a formalised support system to get back onto the register to help people returning to practice. And Charlotte's gonna give us a little bit of a talk through how the RCVS is supporting that. So, over to you, Charlotte.

Charlotte: Hello. Thank you so much for having me today. so I'm just gonna share my screen, and just show you, a couple of the courses that we offer on the RCVS Academy. So just to introduce myself, I'm Charlotte Rodia. I'm the digital learning content writer at the RCVS Academy. I'm also, an RVN as well. So I'm just gonna share my screen and then I can just walk you through.

[Technical discussion about screen sharing]

Right, hopefully everyone is familiar with the RCVS Academy. If you're not, feel free to ask any questions. So, this is the landing page. So if you just log in using your 'my account' details. Again, if you've forgotten any of those, then just give us a shout and we can help get you in. So, the academy now has two courses to support vets and nurses returning to clinical practice after a break. So you'll find them in the career support category. I'll go to nurse return course first, 'cause that's the first course that we did. So, nurse return was launched last October, so it was quite good timing. We went to BVNA Congress with this kind of under our belts, so we could sort of let everyone know about it. So as I said, it launched last October, it's been developed with the RCVS VN Futures Project Lead, Jill McDonald. It's a 5-hour course, and it's split into 6 modules. These can be done at learners' own pace. They can log in, kind of do a module, come back, do another one. You don't have to do the whole lot all in one go. So you can do it as and when it suits you. What we've done with this nurse return course, obviously the aim of it is just to provide support and guidance to veterinary nurses returning to clinical practise after a break. And what it does as well is it incorporates the PSP, so the Period of Supervised Practice is interwoven throughout the course. So should nurses need to do that, if they've been off the register for a period of 5 years or more, and it's mandatory for them to do their PSP, this course can help support them through that process. So throughout the course we've got these pink boxes, for PSP nurses.

Louise: That's really helpful, actually, because, obviously, there's quite a few bits of paperwork and stuff for those nurses doing PSP to complete. So, it just helps guide you through that, what bits and pieces you need to submit. So it's quite helpful.

Charlotte: On the other hand, if you, if you're a nurse that doesn't need to do your PSP, just sort of ignore those pink boxes and, just do the course as normal. So, just a little walk through then. So, module one is a welcome back, so we've got a nice video there from Julie Dugmore, the Director of Veterinary Nursing, sort of welcoming nurses back to practice. We've got, a little reminder here on regulation. So we've got a nice interaction there on just reminding basically about how nurses are regulated. Just a little refresher there. We've also got some information on Schedule 3 as well, and definitions of supervision, just as a reminder. Some nurses might feel a bit nervous going back into practice and not remember exactly what can be delegated to them, etc. So that's just a good reminder there. And then we've got a section on confidence and self-esteem, and an activity there.

So, module 2 - this is all about mentorship. So if you're doing a PSP you need to have a mentor in place. But even if you're not, it's a really good idea to kind of identify someone in the practice that you're going back into, to be your mentor. So, we've got some really great resources there on, mentorship and also some communication and teamwork as well. That's a really useful one.

Module 3, so this one is got some great downloads and things in that you can use. So, basically, even though none of our courses on the academy are clinical, they're all non-clinical, but what this will do is this will help you, kind of identify those areas that you need to kind of get up to speed on. So, for example, for me, I haven't been in practice for 7 years. If I was to go back now, I'd be a bit nervous with anaesthesia and things like that. So, yeah, it's just kind of identifying those areas and planning your development. So we've got some good downloads and things that you can use to facilitate that and work with your mentor.

Module 4, this is just a reminder about CPD, so CPD requirements, reflection, and we've also put a bit in there about evidence-based veterinary medicine and QI as well.

Then we've got Module 5, which is the well-being module, so a very important topic for our professions. There's some nice resources in there, some MMI resources as well and just some tips for kind of maintaining that, work-life balance.

And then the last module is a sort of summary module, so this kind of guides you through the next steps. So if you're doing a PSP, what you need to submit, completing that and then for nurses not doing the PSP, we've just got some information on 1CPD, and just some final thoughts there. So yeah, that's our nurse return one. We've just got some additional support and further learning resources there as well. Any questions about nurse return before I move on to our vet return course? No?

OK. So, Vet Return is actually not quite launched yet. It's launching early next week, so you're gonna get a little sneak preview of Vet Return. Vet Return, obviously, as the name suggests, is for vets, our vets returning to clinical practise after a break. There are also some aspects in there that might be relevant for non-clinical roles as well. And we've also kind of interwoven the VetGDP, into this as well. So, VetGDP is mandatory if you've been off the UK practising register for a period of 5 years or more. So this does touch on that. It gives a bit more information about VetGDP in here. Then we also have our VetGDP graduate induction course on the Academy as well. So, should that be relevant, to any vets that are returning.

So, as I said, this one is brand new, launching early next week, and this was developed with Tash in the Advancement of the Professions team. This one is 3 hours long and it's split into 6 modules. So the framework is essentially very similar to the nurse return course, but obviously, targeted for our veterinary surgeons.

So, we've got a welcome back video from Linda Belton, the President of the RCVS. We've also got some information on VetGDP should it be relevant to that particular veterinary surgeon. We've got some really good practical tips for returning, so yeah, just some tips there to have a look through. Again, a bit on confidence and self-esteem. And this is probably my favourite part of the course - we have got these videos. I can see Rob on the call has contributed to this. So thank you again, Rob. Some videos of vets who have returned. And the two vets that we have on here returned after quite a while. I think one was sort of 12 years, the other 14, something like that. So, quite a while out of practice. And then their mentors as well. That's really useful and it gives some really good kind of real life stories about people returning, so yeah. So that's really good. And I think quite inspiring for vets that are returning.

On module two, again, this is similar to the nurse return one, so it's all about your development, and whilst there's no clinical information in there, it does, you know, give you those resources to help kind of plan what you need to sort of brush up on planning your development, and using smart goals, etc. So that's really useful.

Module 3. Again, mentorship, so if a vet is completing the VetGDP, they will have a mentor, in practice, obviously their VetGDP advisor, or even, like I said, even if you're not doing VetGDP, it's good to have that person in practice to to support your return.

Module 4, again, is just some information on wellbeing there, sort of achieving that work work-life balance and some good resources in there.

Module 5 is, basically just a reminder about the role of the RCVS, a reminder about regulations, Schedule 3, so what you can be delegating to your nurses, and also quite useful, some updated prescribing guidance. So, if you were last in practice before September 2023, the new 'Under care' guidance, so we've summarised the key changes in there. And also some information about the Cascade as well.

and then the last module is just a reminder about CPD and next steps, and then we've got just linked to some other courses on the Academy that may be useful for vets who are returning. So yeah, that's about it. If anyone's got any questions, let me know, or we can pop it in the chat. Or you can always email us. I'll put our email address in the chat as well, [email protected] if you've got any questions. And as I said, Vet Return will be launching early next week. We've got some communications to put out around it on social media and things like that. If anyone has any questions, feel free to reach out.

Oh look, there's one in the chat there actually, which I think Tash just answered so so how do people who are not on the Register access the course. Is it open access?

Yeah, so if you're not on the Register, you can I think, Tash, did we say to contact the Registration, team? Or you can contact the academy and we can sort out access for you. It's not a problem.

Louise: Yeah, that's great. And I have to say, very excited about the vet return, course, that looks fantastic, and I will be pointing my vet in the direction to have a little look at that. So thanks very much for that. And just to say, I have to say, I had a great experience with the Registration team as well. They've been, you know, my vet was, we were both very unsure about how easy this process was gonna be, and the Registration team really helped support us through it. And, it was a little bit daunting to start with, but actually, it just seems to be a really nice way of structuring the return to work. So I think any good boss would be wanting to put some stuff in place so that you have, you know, some, some aims and some goals, but this really helped us just structuring it. It it was more of an aid than a sort of hurdle to get over, which I thought was fantastic. So, yeah.

Charlotte: OK, great. And something else, sorry, I forgot to mention is, obviously these courses are great for the mentors that are supporting these vets and nurses back into practise as well. So yeah, not only the returners themselves, but the mentors supporting them.

Louise: Yeah that's great. Well, thanks very much, Charlotte. That's really helpful. if anybody else has got any questions, but we're we're gonna have a few minutes now, just for some general questions and answers. So, if anybody has got any, questions I don't know if Rob, I can see you in the interview there. Do you want to say anything, any feedback that you've got from this point of view. I'm afraid your face is on my screen, so I'm gonna ask for, any feedback you've got, you know, about this, return to work.

Rob: I'd agree with everything that people said. I particularly think, the the discussion about honesty, so people on both sides of the employer and the potential returning person, being honest about what they need and what they can offer. Having a grown up conversation about what's possible and what's not possible. I think sometimes where it goes wrong is people have a really long list of requirements. And that never works. You can have probably one or two things realistically, that you can insist on and after that you've got to be willing to flex. I think that's sometimes where that goes wrong. Yeah, but people are, I think increasingly people are really keen to try and make return to the profession, particularly clinical practise work. So they're a lot more minded to be supportive, and encourage people to come back and it is a really great thing. I've personally experienced quite a few and it's amazing watching people come back. It's a really, really satisfying thing to be part of.

Louise: Yeah. Thank you, Rob. No, I completely agree. I think, you know, for me, I got a really super experienced vet out of it, which, you know, I definitely benefited from. It wasn't me just being benevolent and kind. I got something really good out of it. And it's really interesting. One of the flexible things that my vet asked, they were still doing a sort of financial job, and they needed the first, one day off every, the, at the at the beginning of every month to do some financial stuff. So I was like, I'm sure we can make that work. So that's a really interesting one. We've got another one in the chat. Thanks very much for your contribution there, Rob. Do vet returners have to do all the modules on the VetGDP if they, if they use it? So does one of the RCVS team want to reply to that or do you want me to reply to that?

I was gonna say, I probably need my colleagues from VetGDP to answer that one. Obviously, it's not a specific Academy one.

That's fine, I'm happy to answer because I looked at that with my vets. So when you're doing so the VetGDP has a series of EPAs, which is entrustable professional activities, and what we did with my team member is there's a whole long list of them, but you go through and pick out the ones that are relevant to the job. So, I work in a shelter setting, so there was gonna be certain things that weren't relevant to my shelter vets. So we picked out the ones that that were relevant and used those as the EPAs that we're going to go through and that we're going to focus on. That's great. Anybody else got any other questions on that?

So a vet who wasn't operating could just do medical EPAs, that's absolutely correct, yeah.

And then Letitia's asked, do the vets from outside the UK that just registered with the RCVS also have to do the VetGDP module. I have to say, Leticia, I'm not really sure on that one. That's not my field of expertise. Is anybody from the RCVS able to answer that one? If not, then we can we'll make sure we reply to you offline on that one, Leticia, if that's all right.

I'm quite happy to come in on that as a former member of the Registration team, looking at the registration of overseas vets was not within my remit, but, but within the remit of my colleagues, and to my knowledge, that's not a requirement if you are coming in as an experienced vet, from your home country. But certainly we can get formal confirmation from the appropriate people and have that sent over. Very happy to do that.

Yeah. Looking at that resource as well, that that return resource, I think it would be useful for other people coming in. I feel that I probably want to look at it as well and just see it. It sounds like it's got some really good refreshers on there of what, what people need to know at the moment.

Can I just come in there? I think the thing to remember is that the VetGDP, whatever form you take it, it's about having an honest conversation about which EPAs are appropriate, but als don't regard it as a barrier to get across. This is something that is there to ensure that you're more successful when you do return, and that you're more likely to stay in the profession when you're there. So, it's certainly not, this is not like another exam to get passed, so that you can then start practising again. And this is something that is there specifically designed to help you and be more fulfilled and be more successful when you do return.

Louise: Yeah, thank you Tim. Any other questions out there? Feel free if anybody wants to put a hand up and ask a question as well, we can go old school on this if you want.

That's great. With that, then, what I'm gonna do is ask, the panel just to give me a sort of take home. So, you know, why do you think people should return to the profession? What would be your top tips for returning? Kitt, do you wanna start us off? What would be your, your final words of wisdom on this? Thank you.

Kit: I would say there is a, a role out there for you. If you came into the profession, if you did your degree for the reasons of that most people are here for working with people, working with animals, doing, helping people, there is a role for you. And it's being honest with yourself about what that role might look like, and then kind of making the, making that search to find that role and I think people have far more skills than they often realise and and actually taking that moment to reflect on what skills do I have. Also, depending on where you are in your life, what stress can I cope with? So it may be for the start, that you want to do a role within the profession, which is, doesn't really push you outside your comfort zone very much, but as you come back and other things change, you want to push yourself outside your comfort zone and and grow. But I think again, having that self conversation, knowing what you're trying to achieve is so important. I'm talking, not from because I do it, I feel I should do it more, but I think as I think Lauren came in with saying, you know, that this is a really important part of getting to the place that you want to be doing the role that you that really suits you.

Louise: Lovely, thank you, Kitt. Lauren, give me some final words of wisdom then.

Lauren: Well I think for me coming back into the profession isn't something you can do on your own. So it's always about finding your network, and that is, yeah, your mentor in practice, but it's sort of just reconnecting with people that you graduated with or people you used to work with to to trade horror stories and all that dark humour that we all, we all exist on, don't we? It's about attending some events, picking up some CPD. The more that you can, the more that you invest in the profession, the more you'll get back. And I think we should, yeah, the more we can get people to do that, even when they're thinking about coming back, the more success people will have.

Louise: Fabulous. Love it. Sally, final words of wisdom. And we've also got a Slido up here as well for you to join in. So what's the one thing that you would always bring back to you back to this field? So, Sally, give me some final words of wisdom.

Sally: Well, I've absolutely loved coming back to nursing, and I've got my enthusiasm for just. The client relationships and doing a job that I loved from many years ago, and I would encourage anybody to come back, especially, you know, if they are coming even towards retirement age, you know, I don't have the enthusiasm to go back up to doing management or anything like that. I just want to enjoy my job again, and that is the most important thing to me.

Louise: Yeah. Thank you, Sally. And Tim, for you, final words of wisdom on this one, please.

Tim: Yeah, I mean, I don't like going last because everyone said kind of what I was gonna say, but, but I mean it's fundamentally flexibility and actually just recognising that perhaps, whether it's going back into clinic or just coming back to the profession more widely, understanding that. The range of jobs, the role, different roles could be quite different to what they were when you left. And that would include, you know, what your clinical role might look like, but equally, as I said before, think about other areas that you might not have thought about in terms of academia, etc. where there are so many different roles. There's so many opportunities for those of us, you know, we all became vets because we're so passionate about doing the right thing for animals and that sort of thing, and trying to remember that and think back to your teenage self and think, right, how can I use what I've learned, what I've gained over the years in a slightly different way, because there are going to be many, many different ways you can do that now than there might have been 10, 15 years ago.

Louise: Great. Thank you, Tim. I'm not sure, going back to my teenage self, I wasn't very well behaved then. So that's yeah, it's a good thing. Thank you, everybody. If there's any further questions, what's the best place to go to if we've got further questions on this, Angharad? Is it the VetGDP email address or is there any other places where you'd like to point people towards to contact us?

Angharad: Absolutely. So if you are a vet or an employer or potential vets who are looking to return, then the the vetGDP email address has gone in the chat a couple of times, but we'll send it out on email afterwards. And if you are a vet nurse looking to return, then we've also got the the vet nurse information there. And Charlotte has also put the Academy email address in there as well so that you can have access to all of that information. If you've got any other queries, then the Registration team would be more than happy to help. And if they are not the right people, then they will find you the right people to, to answer your question. They're all wonderful individuals who are really keen to make sure that you get the right information and that you can be supported to come back or to support people to come back. So please do talk to them. They don't mind even if it's a I'm not sure just right now, but what might I have to do in sort of 6 months' time, they will give you all of the information and they'll talk you through all of the bits and pieces. On the website, there are some really useful flow charts and FAQs, so there is that information there if you prefer to do that, and equally, if you just prefer to communicate over email, if there's a time zone difference, or, time zone due to to small people difference, then, then that's also an option. And those email addresses are always monitored and people come back very quickly to you. we will have presence at all of the major events, so we'll be at BVA Live in a couple of weeks and then throughout the autumn we'll be at the autumn shows. So if people do want to come and have a chat with any of us, then you're very welcome to do that. But equally we can take your information and get people to contact you directly if that's also something that you would like.

The long and the short is talk to us, we'd really love to help. I don't know if many people know this, but once people come off the Register, we can't contact them. So as much as we would love to keep in touch with you, we can't. So, please keep in touch with us and then we can, we can make sure that you've got the latest up to date information. But we hope that this has given some people a bit more confidence to think about returning, and we would love to hear your feedback on the new vet return course, as that one is brand new, and, we're hoping that that will really, really help.

Louise: Angharad, I think there's a Workforce Ambitions revisited, Eventbrite page as well, if somebody is able to put that up in the, the chat if people want to go back and look at these. Are there any other events coming up at the moment, Angharad, or was this the last one in the series?

Angharad: No, we're actually doing them slightly out of order, because we, we wanted to make sure that we did some of the topics that were a bit more seasonally appropriate, we thought we would do this one earlier, so this is actually the first one. of the actual ambitions, so next week we've got GP looking at at the value of the GP career, which we hope will be quite an exciting one, mostly because we, we want people to consider all of the different routes that are available because I know our speakers here today have really extolled the different options that are vailable to to those people who want a different career route or just want something different right now, something that will suit them. So the GP session will be coming up. We've got our dedicated vet nurse one, so all of the details Tash has put there on the Eventbrite page, so you can sign up to one, you can sign up to all, but they will all be recorded, so if the time isn't convenient to you. Don't worry, you'll get the email from us but also it will be on the web page. And I will just take an opportunity to plug the fact that we are at BVA Live, in a couple of weeks, and Tash and I will be running a workshop, looking at workplace culture. So do come and join us for that. It's the last slot on Friday, so, we might have to bring some chocolates in to to persuade people to come and join us.

Louise: Thank you very much. Thanks very much to the RCVS team for organising this. So, really wanted to thank everybody who's turned up today to all my lovely, panel members. And thank you very much. Is there an post event survey that will be sent out as well? We love a survey, don't we? So thank you everybody for attending. I'm off now to go and run a kids club. So, this is, portfolio career, as you can see. So, thank you very much, everybody, and, very nice to see you all. Take care. Thank you. Bye.

Good morning everyone, we're just letting people in. There's quite a few people to admit, so as you're coming through, then we will get this session started. It's really lovely to see so many people who've turned out to come and join us, and we've got a great panel for you today, and a presentation as well. So, we've got a lot to get through, as always with these. So just a quick rundown, if this is the first time that you're joining us on this series, and then I will go through some housekeeping shortly, but I'll just do a quick review of what we've done so far. So we've had two sessions so far, although the keen eyed amongst you will recognise that there are seven ambitions, and that would bring our total sessions to eight when we have completed all of these. So, we decided that it would be a really great idea to do an update on the workforce modelling project, which was one of the commitments that we made in the workforce action plan. So a couple of weeks ago, we presented that, well, and I say we, it was our wonderful research manager Vicki who took everybody through that, so that we could help, sort of look at what the potential might be from a workforce perspective, because it is a very large piece of work and needed a good amount of time dedicating to it. So we did that one and then last week, we talked about returning. So this was both for vets and nurses, but thinking about coming back, that could be into practise, it could be into a non-clinical role, but how we can make life easier for people who want to come back, and also for employers who were interested in welcoming people back and what we might need to do from a support perspective. So this was a really, really well valued session and lots of positive feedback and interactions with that one. So hopefully today, we will also get lots of interaction from everybody. Many people have submitted questions in advance, so what we are going to do is, I've collated a couple of very similar questions to ask the panel, and there's a couple of questions, that we will respond to individually, because they are more specific to certain situations, and there are others that we're going to share with other panels where we've got the appropriate experts on those.

So, be assured that your questions are being looked at, but we'll make sure that they're responded to in the right way. We are going to be recording, in fact, we are currently recording this session, so, please just be aware of that. The chat is open, so if you've got any questions or comments, then please put those in there. Again, be mindful of our colleagues that are reading them, and please, please use a positive intent when interacting with everybody. We will also make sure to share appropriate links, resources, etc. in that chat. So these will be items that are available that are evidence-based, that are free of charge, etc. from us and from other organisations. So Tash will be, will be putting those in there. But equally, if you've got other resources from your organisations, and non veterinary resources are also welcome, then please feel free to share those. It's an opportunity for people to, learn from everybody else here. And the reason that we're here today, is to celebrate the life and work of general practitioners within the veterinary sector, there is no one size fits all for GP practice. So this is a great opportunity for us to consider what a GP career actually is. How does that work? What are the benefits of doing it, and how do we describe being a GP? Because we've got people here today who will have very different lived experiences of that, including from the human healthcare side as well. So this should be quite a good rounded discussion. So we've got a quick Slido that we would love everybody to participate in just so that we can get a sense of how people are feeling in the room. So Deb, if you'd be happy to share that, and while people are filling that out, then I will ask our panel to introduce themselves. So the question is going to be about what do you love about working in animal health, veterinary, whatever your role might be, we're very conscious that not everybody in here might be currently working with animals, or might not want to work with animals, all of the time. So, please, please make sure that you put your fullest opinion in there. And while Deb is sharing that Slido then I'm going to come to our panel. So Jenny, I've got you first on my screen if you'd like to introduce yourself.

Jenny: Yeah, so I'm Jenny Millington, so I qualified in 1999 from the RVC. I initially did a year of mixed practise in North Wales and then since then I've been working in far more general practice. I got my CertAVP in General Practice a good 10 years ago, and I opened, my own practice 15 years ago, which is now a big successful 24 hour hospital. I still work as a GP vet, so I, I combine some management role and some clinical hands-on role, and I've been asked to kind of come and share my experience of being a GP vet, in my role.

Lovely, thank you. We're delighted to have you with us. Nick, you're up next on my screen.

Nick: Oh, hi everyone. I'm Nick Cooper. I'm probably the only non-vet here. My background is general medical practice. I'm a GP in a semi-rural practice in Devon, so, you know, obviously dealing with, with families who also deal quite heavily with vets, with farming families, etc. So quite a lot of cross experience. I also have numerous academic roles, and I'm president of The Academy of Medical Educators, which is a supportive role for educators, not only in dentistry and medicine, but also veterinary science as well. And I'm currently Chair of the Veterinary Clinical Career Pathways group as a non-vet.

Excellent. Well, we're delighted to have you with us. Thank you, Nick. Ami, you're up next.

Ami: Thank you very much. My name's Ami Sawran, I graduated from Liverpool in 2011 and have since then sort of worked in and around farm practice, through academia. I did a PhD and an internship at the RVC, but I have always maintained wanting to be in practise despite doing lots of different things with my career. For example, I'm currently the SPVS president, and the secretary of the British Veterinary Camelid Society. But, as well as being a clinical director, at the heart of it, I still see, all of my farm species. I should probably admit to being an advanced practitioner, in Camelid practise. But again, it, you know, it's such a niche thing. It's very unlikely that I'm going to be spending all of my time doing just that one thing. So yes, at the heart of it, still very much seeing absolutely everything from cows to chickens.

Lovely, thank you, Linda.

Linda: Hi everyone, I'm Linda Prescott-Clements. I'm Director of Education here at the RCVS. So within my team sits the Veterinary Clinical Careers Pathway that Nick Cooper has introduced and is leading, and various other things, so nice to be here.

Thank you, Linda. And, Laura.

Laura: Hi there. Hi, I'm Laura, I'm a student. I'm a 4th year student at the University of Liverpool. I had a varied career before becoming a student, so I did about 10 years from college to actually becoming a vet student. And I worked in a mix of sport developments and also some commercial farming as well. And I'm here because, well, my career aspirations lie within first opinion practise. Certainly at the beginning, it's very early days yet for me, so, I have a lot to figure out, but I have done most of my placements in first opinion, and I am really, really enjoying the work in it. So, yeah, here to join you today.

Excellent. Well, thank you, Laura, and I appreciate that you're busy on rotations this week. So it's a good thing that we've been able to steal you away for a short bit. And hopefully the conversation here today will inspire you to continue thinking about that career pathway. So the Slido we've had a few technical errors with, but Deb has, managed to make it work, so well done on that. So it is now up, if you go to Slido.com or if you take a picture of the QR code, then that will take you through. I can see a couple of people who are already on there. We've been asking this question every single session, because we are really curious as to as to what people say. Most of the comments are coming through very, very similar, so I will hope that we will see some good stuff coming through. I think all of these are going to be topics that our speakers cover here today and, yeah, please continue going with that. Catherine, I'm just gonna ask you to introduce yourself because we are going to have an overview of the RCVS Academy up next from Catherine. So, if you want to just introduce yourself while people finish populating the Slido, and then we can get you to share your screen, if that's OK.

Catherine: Yeah, of course, no problem. So good morning everybody, thank you very much for inviting me along to speak briefly this morning about The Academy. My name's Catherine Hemingway, I'm currently Head of Academy at the RCVS, but also a vet, so it felt important to point that one out. I graduated from the RVC 2006 now, and spent quite a long time in first opinion small animal practise first, so definitely can relate to the conversation that's going on here today. And then moved into teaching, so I was a programme leader, at a college and university for 10 years, and and now I'm doing what I do here. So yeah, I'm intrigued by everything that's coming through on the Slido. It's interesting, lovely to see that 'people' are on there so many times.

It is, and I think that is going to be a core element of what we talk about today. So, for those of you who are joining us, if you do want to tell us a little bit more about who you are in the chat, a couple of people already have, then please feel free. Free to do so. But Catherine, shall we dive into your, into your presentation?

Catherine: We can absolutely do that. Yeah, Debs, are you alright to share the slides for me, please? Yes, one second. Yeah, we're asking you to do a lot with Slido and slides this morning, aren't we? Sorry, no, it was doing an update! How inconvenient of it! There you go. Fabulous, I'll just give us a second to load. Thank you, Debs.

Yeah, so, as I just mentioned, I'm currently working as Head of The Academy at the RCVS. Hopefully, some, or if not all of you have heard of The Academy, but for those who haven't or are a little bit less familiar, there's just a few slides about what The Academy is about, and then I'll just be talking very briefly about how The Academy can really support those working in sort of GP vet roles. Next slide please, Debs. So, we launched the RCVS Academy back in June 2022 now, so we're celebrating our third birthday this summer, which is very exciting. So keep an eye out for the birthday celebrations that we're just working on. It's a digital learning platform that was developed by, or is developed by the RCVS to offer CPD to vets and veterinary nurses and those preparing to join the Register to really help veterinary professionals to meet the standards that have been set by the RCVS. So there's no clinical CPD on The Academy at all, it is purely non-clinical, focusing on professional development and meeting standards. Go to the next slide please, Debs. So the bonus point really about the RCVS Academy, it's completely free, which is always nice to have a bit of a free CPD out there. And because it's online, you can access it at any time or any place. All the courses work, on normal computers, on tablets or mobiles, so you really have got lots of options if you want to log on at lunchtime at work or sit down in the evening, or if you're anything like me, I'm sort of sat there at the soft play while the kids are running around, having a coffee and catching up with a bit of CPD as well. So all of those options are absolutely fine and open to you. We spend a lot of time and effort in the background, in trying to make our courses as interacting, interactive and engaging as possible, and we do have a feedback form at the end of each course, so please do give us your feedback. I promise you we read it, and we do act upon it as well. We've got 30 plus courses now. We just launched a course yesterday, so we launched at Vet Return yesterday. So keep an eye out for social media posts and things coming out about that. And I got my calculator out earlier on in the week because I was intrigued, and we've got 90+ hours of CPD now sitting on The Academy, so there's plenty for you to log on and explore and complete as well. If we could nip to the next slide, please, Debs. Thank you.

As well as the courses that we have on The Academy, we're out and about doing lots of other things, so please do seek us out and engage with us. We'd love to hear from you. We launched Academy Live sessions this year, so we're doing webinars very similar to what we're doing, today, now. Oh Debs, we just, yeah, that's lovely. So webinars similar to what we're doing now, based on The Academy courses that we offer, we're out and about at all the congresses, so do pop along to the stands and say hello. Charlotte, one of the team, spoke at VMG the other week. I'll be at BVA next week doing a talk, so do pop along and say hi. And we spent quite a lot of time and effort filming, doing filming and photography at real veterinary practises, to make our courses as authentic as possible. We've got lots of vets and vet nurses on our pilot panel as well, who pilot our courses. I'll give you some information to get involved with that if you'd like to, and we work with all of the departments across the College to bring these courses to you. If we go to the next slide, please Debs. So Academy Live, we launched this year, so they're free again, live interactive sessions. We run them on Zoom like this session. We run them at lunchtime, and they're based on the Academy courses that we offer. And they give you a chance to log on, and interact with the, with the panel of experts that we have and ask any questions that you have. So you could perhaps do the Academy course, come along to the appropriate Academy Live session, and ask any additional questions, or equally do it the other way. So do an Academy Live session and then go and check out the full course. So please do keep an eye on emails and social media for details of those. If we go to the next slide, please, Debs. And this is the full list of everything we offer at the moment. I had to update this this morning because of Vet Return launching yesterday, but all of the courses are on there now. We've categorised them into 6 categories, and there really is something for everybody on The Academy, whether you're a vet just starting out, or you're a vet much further on in your career, or you're a student nurse or whoever, there, there really is something for everybody. So I would encourage you to log on, and have a little look and decide sort of what would, would work for you. So for example, if we look at our Leadership and Coaching category, which is the bottom left of the screen. If perhaps you've been a GP vet for a little while and you're moving into perhaps, a more leadership type position or role, and that might be with a formal job title that goes with it, or it just so happens to be that you're in the practice now and you're one of the more experienced people there. We have some courses for you in this category. So it might be that you're a VetGDP advisor and have been asked to take on that role, and in that case, you have to do the course. And, you know, that course sits in that category. We have a course on delegation, and it's not on Schedule 3 delegation. We're talking about delegation more broadly, about how you delegate various tasks to various people, which is clearly quite an important skill, in management and leadership roles. We have a course about leadership and management which really introduces those concepts and the fundamentals of that. So you might want to nip into that course, do the course, and then perhaps take your learning further with a formal qualification in that area, perhaps, and then a Mentorship course as well, I think which is useful to anybody who's helping to mentor perhaps those less experienced, or newer to their place of work. Debs, if you could nip to the next slide, please. And I'm just going to speak a little bit about Communicating Cost, which we launched, earlier this year, a couple of months ago now. I'm hoping everybody's heard of the CMA review that's going on at the moment, so it's quite closely tied in with that. Clearly communicating cost is a really important part of what we do, in general practise as vets. And doing, it's never, if we're honest, it's never an easy conversation to have. It's a conversation that I'm sure some of us would like to avoid at times, but it's a really important conversation that we do have that with clients, and clients are aware of what things are going to cost, so there's no nasty surprises later on, down the line. So we developed this course in combination with the Standards Team, and we've also got 3 really experienced vets being part of videos during the course as well. So we really, delve into the guidance and the Code of Conduct, so what's in there that we should be doing, and we bring that through in the course in a really easily digestible way, and make it relevant to what everybody's doing out in practise. We've got some information in the course about prescription costs, we've got knowledge checks dotted throughout so you can check that you've understood the course as you're going through. We have some scenarios that really help bring the content to life for you, and as I said, we've got those three really experienced vets, being videoed and sharing their tips on how to communicate cost effectively. It's only a 45 minute course, so it really doesn't take out too much time of, you know, out of your day. If you can sit down and do it in one go, brilliant. If you want to do sort of 15 minutes a day, then that's equally fine. If you want to do the course and dip in a few weeks later, and remind yourself, we would actively encourage you to do that. So please do go and take a look at that course. Go to the next slide please, Deb. And we'll just leave these QR codes up just for a second for anybody who wants to scan them. The one on the left of the screen, takes you to our Academy brochure, which lists all of our courses on the website, and as they launch, we add details, obviously for new courses, and then the QR code on the right will take you to The Academy itself. And you log in with your My Account details, so the details that you have to update your details on the Register and pay your fees. It's the same details, and they'll take you straight through to The Academy. And if we could just go to the next slide please, Debs, and this is the last one. So I would encourage you to start learning with us really, so please do join us and explore The Academy with your login. If you can join an Academy Live session. If you're out and about at events, pop along and say hello, tell us what you like about The Academy, please feel free to tell us what you don't like as well and what we could perhaps do in terms of launching new courses. And if you do have any questions, then do drop us an email, and contact us, and we'd be happy to help you. Thank you. If there's any particular questions then feel free to pop those in the chat and I can answer those perhaps as well.

Lovely, thank you, Catherine for sharing that with everybody. Hopefully, some of you have already used The Academy, but if not, I would actively encourage you going to take a look, and I will put a plug in for our Vet Return course as well, that has literally just launched. If you want to know more about it, then Charlotte did an overview of it in last week's session, which has been recorded, so, that will be going up very shortly, but part of our focus is on recruitment, retention, return, and return is one of those ways in which we can, we can bring people back. So, let's now move on.

We had quite a few questions about GP, careers and planning and qualifications and those sorts of things that came through. So what we thought would be a good idea, is if we combine all of that, and Linda, if you're able just to give a bit of an overview on the VCCP or for those who don't know the acronym, the Veterinary Clinical Careers Pathway, which is a bit of a mouthful. But if you're able just to tell us what's new, what's going on, then hopefully that will, that will give everybody a bit of an update and we'll also put links in the chat for people to do a bit more reading, and then, hopefully that will answer most of the questions.

Linda: Yeah. Thanks, Angharad. Yeah, hello everybody. Yeah, so the Veterinary Clinical Careers Pathway project started, it was launched about the beginning of last year. And this came about following a number of areas really throughout the College, looking at retention in particular, but also listening to GPs that really the options around clinical careers were somewhat limited and so we decided to explore these further. It's a large project, that really is taking place in 3 separate work streams. So, Workstream 1 is to develop specialty training curriculum for GPs. So that's a very ambitious project in its own right. And it's to develop the whole curriculum, from the aims and purpose statement, right through to the syllabus, how it might be implemented. So a full proposal, if you like, that then the aim is to get that, if approved by our education committee, would go up to council and subsequent consultation with the profession because obviously that's a significant new change. So that, so that's the first one. Workstream 2 is really looking at the role titles, which is a little bit different, but, that we've heard that it's sort of very confusing for people. So we've got a lot of titles and names that are very similar. So this is a bit more of a public facing intervention as well. So things like what is an Advanced Practitioner? And how does that differ, from a CertAVP Certificate, Advanced Veterinary Practise? We did a piece of research that showed that, you know, even the profession itself often gets these things mixed up, and it's not easily understood. So, certainly, the public would find that confusing. So we're, again, being blue sky, nothing's off the table at the moment, so exploring new names, both for it might be for CertAVP, it might be a new name for what is an Advanced Practitioner, and we're liaising with stakeholders, particularly for that piece of work. Workstream 3 is around exploring flexible training routes. So these exist already. EBVS have got some modular pathways and various different flexible routes that are getting off the ground as well. So, sorry, they've got the alternative pathways that are very well established, but also modular pathways are coming on through, although they're being taken up a bit more slowly, and other - in America, there's other flexible routes as well. But we really want to explore how they're working, if there is a gap, if there's something new that we could do to really open up specialty training for those that would like it. So this is about all clinical specialties, not just the GP.

So, Angharad, I think for today's session, Workstream 1 is probably more relevant, but I'm happy to talk about the others, if anyone has any questions or if you want to email me separately. So, Workstream 1, exploring specialty training for GPs. So very new, very exciting. We have started really by, a huge amount of stakeholder engagement, and whilst we'd always planned a lot of stakeholder engagement, we extended that. So pretty much most of last year was spent speaking to the profession about this. The aim of this is to increase the opportunities and the choices for GP vets. This is not going to be a mandatory thing. This is not an expectation for everyone to do. It will not be for everybody, but for those that would like to enrol on a structured period of training that would give varied experience and might perhaps give the same variation and depth and breadth of experience that a typical GP vet could get over 20 years, just through sort of naturally working, then this could be structured into a programme. We know that it would be the same level and duration as other specialty training, so this isn't going to be the poor partner of the specialties, and it's about recognising general practise or primary care, and at the moment we're using those terms interchangeably as a specialty within its own right. We've made quite a lot of progress, but there's still quite a lot to do. So in terms of where we are now, our working group is led by Nick who who's on the call today. We have the full purpose statement that's been approved, and that's gone up to Education Committee. So the purpose statement for curriculum is quite detailed, really. So it, it's not just your vision, although it does include that, but it includes the specific aims and objectives of this training. It describes what benefits it would bring to different stakeholders, so what benefits it would bring to you as an individual GP, what benefits it might bring to your employer, which was important, particularly in our context, because obviously it would need to be funded somehow, and it, and what benefits it would bring to clients, to animal welfare, etc. And then as the purpose statement as well has gone on, and we've now worked on the specific overarching learning objectives for the specialty training programme. They've been reviewed by our working group and Education Committee just in the last few weeks and approved again. So the next step is to build the actual syllabus. Now our stakeholder engagement last year, we had many events online, in person, all around the UK. And we did focus on this, ideas of what GPs would like to see, what they'd like to learn in this. And I think one misconception is, is that, 'Oh, it must be professional skills, because if you're a GP vet, you can't enhance your clinical skills, you know, to that level.' It's not that, it's both clinical skills and professional skills. And so we have all the information from the profession on what topics and what content would be appropriate and wanted. What we need to do now is build that into a structure that might be core modules, flexible modules, so that it's, it could equally be taken whether you're a companion animal vet, whether you're farm, whether you're equine, whether you're a mixed vet and want to mix and match. So that's what we're working on at the the current moment. Thank you, Linda. I'll probably leave it there, Angharad, otherwise I'll waffle on all day.

Well, it's not waffle, it is really interesting, but we do need to march on, I'm afraid. But I think it's important to share that update and hopefully if people have got more questions then please feel free to either put them in the chat or email the Education Team. And this is just one of many projects that you're working on at the moment and one of the work streams that that you oversee within Education. So let's not forget the 1CPD, EMS, VetGDP, etc. So there's a, there's a significant body of work that all supports GP and wider practitioners as well. So, a really good shot there. So thank you, Linda, for that. So let's get to our panel discussion, because that's probably why most of you are here. You want to, you want to hear what's going on. So, we've got, we've had some really interesting questions, but I think one of the ones that sort of stood out is, why are you a GP? What made you go 'Hmm, this is the one for me.'? So, Ami, could we, start with you please, and tell us why? What made you become a GP?

Ami: You can do. I mean, I think in farm practise where I am, it's sort of a necessity, really, because whilst specialisms exist in the Small Animal realm for something as small as an eye, you can only really become a specialist in like an entire cow in farm. So, you know, you do have to be a bit of an all-rounder and a bit more, not a bit more, but you have to be quite intuitive and work within your means on farm. So, being a GP appeals to my sort of practical approach to things, and the sort of sentiment that, like, I might not be the best in the world at doing something, but, you know, I've got a problem, I'm the best available person to fix it, so I'll give it a good go. I also like variety. I think if I did the same thing day in, day out, there may be a bit of professional ennui about it. And I enjoy being on a constant learning pathway. So I'm always going, I'm never gonna know everything about everything. So it's nice to, to have that bit of variety and keep learning new things. And I think also, like, it's the romanticism of it all, really. Like it's being, you know, being the traditional vet that I saw on, you know, a TV programme or, you know, that I thought practise would be. And I think it's fun, basically, to really enjoy a bit of that.

Absolutely. We all need to enjoy what we do. Jenny, what about from your perspective as a Small Animal Vet?

Jenny: Yeah, so some similar aspects to Ami. So, I love being a GP about just because, like, even today I'm on consults this afternoon, I don't know what I'm gonna see, and I really enjoy that variety. It's not the same every day, and when you're specialise, you tend to just focus in on your area. You know, I enjoy doing medicine, and I did think at one point about going down the medicine route, but I enjoy surgery, I enjoy consulting, I enjoy a bit of, a little bit of dermatology, so for me, being a GP gives me, I can dip in and out of my areas, and actually that's changed over the years So, I'd say, I used to really enjoy medicine and I kind of thought I'd go down that path. Actually I'm enjoying the surgery more now, so being a GP means you can also change what your interests are over your career, which I think's quite important 'cause once you go down a specialist route, although you can change, you kind of feel a little bit pigeonholed. So I think a GP vet gives you that ability to have areas of interest, but equally dip in and out of other areas. I'm also a GP vet because I think it gives you a lot of flexibility. I really like that, and I think a lot of the team that we have here enjoy the flexibility of the different shift patterns or different rota patterns that you can kind of, probably a little bit more availability in GP practise rather than specialism. And also, personally, I love the, just the client side of it. You know, I get to see 20 clients a day, and I, as a specialist you're kind of doing longer, but with only a few clients. So I actually enjoy that real mix and that variety, and I think seeing all the different characters and all the different people you meet in general practise, I really enjoy that aspect as well.

Yeah, it sounds like a great opportunity to explore lots of different things, and I guess from thinking about, you know, staring down the barrel of you know, a 20, 30, 40 year career as a vet, this then gives you the opportunity to do lots of different things as you change and grow and want to do something different. Do you think that that is true?

Jenny: Absolutely, and I think, you know, I got to the stage firstly where I was kind of 9, 10 years qualified. I kind of felt clinically I'd, I kind of knew what I was doing. I was confident sole charge. I was quite happy doing whatever came through the door. I was able to kind of problem solve as Ami said. So I kind of thought, what's next? And actually being a GP, I thought actually I'm gonna have my own clinic. And that gave me another thing to focus on and grow in and learn about the business side of it and learn about managing a team and learning all that aspect, and I think, it enabled me to go off down that aspect as well. And I've got some of my team that really enjoy mentoring and coaching, we've been able to do that side of their GPs, they're looking after the grads and they're developing that side of their careers. So I find being in GP practise, once you get to that stage where you clinically feel, I'm OK, there's lots of other aspects you can dip in and say become a mentor for someone else and then grow with that side or take on the auditing side of practise and learn more about that. So I think it does enable you, as you go through to learn different aspects and in different areas, kind of, yeah, challenge yourself.

Absolutely. So I think we probably need to talk about sort of early career and setting yourself up for success based on some of the questions that we've got, but before we get to those ones, Nick, I was just wondering, have you got any reflections from an NHS perspective on what's just been said about GP work? Because we know it's not the same, but there are some similarities.

Nick: I think that there are huge similarities actually, I would say the similarities are the flexibility, the work-life balance, many are, those coming into general practise now want that work-life balance. It's not just female, it's also male as well. They, they have a very different view, and there's newer generations coming through all the time. They're much more, you know, in in that way, feeling, which was very different from when I enter general practise, people were full-time partners and, you know, you were on call at night and etc. etc., so it's very different what people want. So ,first of all, I think medicine is very different in a sense that general medical practise is completely different from hospital-based practise, in the way it's organised and therefore, I think people in hospital they don't feel they have that flexibility. So first of all is that. Secondly, I think as we've heard already, I think it's around knowing people working in a community. Certainly we've got a lot of good evidence now from Exeter University that continuity of care produces better healthcare outcomes. So it's that continuity, I think, which is a benefit both I think for the practitioner, and for our patients as well. So, so there's that side of it, I would say. In terms of the training, I, general practise went through this issue about 45 years ago. So formal GP training came in in 1982, and there was a lot of opposition by established profession at that time, but it wasn't necessary, etc. But now, I mean for us it's mandatory, so you do have to do 3 year programme, but I think people do get value out of that because they think about the differences of working in the community, they think about perhaps they would like to develop special interests as they go along, and as we've heard from Jenny, that might change as well, the opportunities and also about the generic skills, because some now will become partners, but we have less working as partners now, we have more working as salaried GPs. So what their role will be particularly, but also that they can develop those special interests, I think, and I think sometimes it's portrayed in undergraduate medical education that GPs unfortunately, you know, it's still portrayed in some universities that it's a bit boring, and samey and anybody can do it and a lot of it's talking and, etc. etc. So I think it's getting that myth out of the way as well.

Yes, we have had in in some of the, the, you people here today that you've sort of commented on the fact that you feel as though a GP is often looked down on by hospital specialists and it's seen as a bit less than. So, hopefully this session will help remind people of why that, why that's not necessarily true. So, moving on to sort of early career and setting ourselves up, Laura, we're gonna come to you in just a second, but first, I'm just wondering, Linda, f you would like to talk about the positives around thinking about planning your CPD and how to get the most out of those early career couple of years when you're newly qualified and you can, you can start to think about what type of practitioner you might want to be.

Linda: Yeah, sure. I mean, so the first, for the first couple of years after graduation, actually they'll be doing VetGDP and that counts as all your CPD, so you don't have to double up at all. And it's in a similar structure. It's very much, self-directed, although in VetGDP it's, that's alongside your 1 to 1 coach, your VetGDP advisor. And it's around a portfolio, gathering as much experience as you can, you know, through the support of your adviser, ensuring that, you know, if something in an area that you do want to get more experience of, you may be not as confident in, they can maybe help you get those cases your way, or you can observe or scrub in or whatever and it's reflecting on that and recording it, until the point where you feel much more ready for independent practise and feel you can tackle anything that can come through the door really. So, that counts as all of your CPD. After that, it's very much again self driven, and we have the cycle: Plan, Do, Record, Reflect. But you can jump on that cycle any way and it's really just a guide. So, you might reflect on a really difficult case and think, actually I'd like to know more about that, in case, you know, I see that again. And then you, so you might plan after that and then do that. I think the reflection is a really tricky one. I think we're still battling with the misconception that reflection involves sitting down for hours after the event that, evening when you've already had a hard day at work and writing an essay, and it really couldn't be further from the truth. So we do require reflection. It's an important part that shows the impact of CPD, but the use of our app and the online platform 1CPD is mandatory now, and that includes, it's up to you how you reflect. You can use the prompts, you can type in notes and bullets. You can write an essay if you want, but I'm not sure there's many who really feel the need. But you can also use voice notes on your phone and just talk for 30 seconds, and that's your reflection. It's done. It doesn't have to take a long time. And yeah, it doesn't have to be complicated or lengthy either, so hopefully that's helpful.

Yeah, absolutely, and a good way of sort of thinking about how you could apply those, those mechanisms. So for the queries that we've had around choosing CPD and thinking about what you need to do in that early career phase, then that's a really solid way of thinking about it. And also for anybody who's not going through VetGDP, that they can also adapt and think about those processes and learnings there. So Laura, coming to you then, thinking about, you know, stepping out into the, into the wide world soon as a new grad, there'll also be those sort of nerves as to what am I doing? Why am I, why am I here? But thinking about the more positive elements, you've said previously on, on calls that you're really considering, GP practise and what you might do. How do you think your journey is going to start? What are you, what are you looking forward to?

Laura: So yeah, you're absolutely right. There's a lot of nerves as well. But I am looking forward to it. I think, and like I've said before, you know, finding the right team, the right people to support you is the most important aspect of it. The right area, the whole balance of work and life and what, you know, makes you happy in the long run. That's, you know, that's what I'm looking for. I am considering first opinion practise. I think it's a really valid, long career path that we probably don't talk about enough at Uni because we're exposed to so much referral work, so much hospital work. But I've done all my placements in first opinion practise on EMS and I've absolutely loved it for lots of reasons that other people have spoken about. I love the clients. I love the community aspect. I love, the variety and it's fun. It's really good fun. So, yeah, I'm looking forward to it, to be able, yeah, just to continue my education and find somewhere very supportive to kind of help me along that journey. And, yeah, it's, it is very daunting, but like, my experiences so far, touch wood have been, have been really, really great on placements.

Thank you. So I think we're hearing a lot around finding the right person, the right practice and and those sorts of things. Jenny, I know that you've spoken previously about feeling quite passionate about those early couple of years. Is there anything you'd like to add? And also potentially as a sort of part of your career development in that that mentoring role and how you can bring people on, and find satisfaction through that.

Jenny: Yeah, so I think, I think the good thing about GP practise is a wide variety in GP practices. So I always say to the students on placement, it's really important to think about what kind of suits you and what kind of thing you might be looking for, and actually one environment doesn't fit everyone and our practice doesn't fit everyone. So I think that's a really key point of going into the GP route. There's lots of variety within GP practices. And if you start at a practice or a young place and it's important on placement to have a look around and think about, go to some big practices, go to some small practices, go to rural, go to urban. I think that's a good tip, and when you start out, if you feel you're not in the right type of practice, you'll find that, and there's lots of chance to move and move to a different type of GP practise. And then I think we have, yeah, once, you know, quite a lot of my team really enjoy mentoring, and they, 2-3 years out, they're quite keen to help share their experiences and what they found useful on placements, and they feel they want to help the next generation already. So I'm working with, you know, those vets about, OK, well, let's see about doing some CPD on how to teach. You might think you know how to do it, but, you know, over the next few years, if you want to go down that route, let's look at that, your CPD rather than being clinical CPD being more about some leadership or some mentorship, about, and, you know, one of my, the vets on the team's actually starting doing a certificate in teaching. So there's lots of ways you can develop and you know he said I never thought I'd get into this, but I really enjoy it and I've found my niche, and that's all while he's still doing his general practise work as well.

Yeah, I think that's quite a good, a good sort of finding, isn't it, because we all grow and develop when we, when we're in our careers, don't we? And what you think you might want to do and what it turned out to be are sometimes very, very different things. Ami, I'm gonna come to you next because I think you've obviously forged a really specific pathway, and you're now a Fellow, which I'm going to guess as a student, you probably didn't even think about fellowship in those days. So what's been great for you in terms of planning, or did you plan? How did it, how did it work out?

Ami: No, I think, you know, you always get that interview question, it's like, where do you see yourself in 5 years? And I'm just like, I don't know because I know that I'm the sort of person that likes to have, like, fingers in loads of different pies and do loads of different things. And what I actually really love about my career is I've never really had to say 'No, I can't do that anymore because I am X Y or Z'. And up until recently, I had like other jobs as well. Like I was, part, you know, part of a, a team running a media company, for a few years just for fun. So I haven't been solely, invested in the veterinary profession until like fairly recently. And I was nodding away at what Jenny was saying there because, you know, you start off thinking, 'I'm gonna be a vet, I'm gonna see animals all day, and that'll be the end of it'. And I speak to so many members of my team that say, 'Oh, I couldn't possibly teach', or, you know, like, 'I'm not good enough at my job to show someone else how to do it'. And then suddenly one day they'll walk in and they'll be like, 'Hmm, I think I want to do more about teaching', you know? And I love being able to give them that because I've been afforded that too. I think a lot of GP vets can potentially feel like they've stagnated, especially if they don't have, like, a linear career path. And what I hope to demonstrate through mine is like, I'm not on an ownership ladder. I work within a corporate structure, and I'm very, very happy with it. But I'm never gonna own a practice. But what I love is being able to be like, oh, you know, I'm actually quite good at this aspect that's non-clinical. Can I use that and then use it to help my practise or help my colleagues. So I actually work in the, in the marketing team within Vet Partners, just because I found it interesting and they've kindly funded a more Master's training for me so that I can do that from an evidence base. And it's lovely that, you know, we, we're teaching with an evidence base as well. Other things that I've done is just getting involved in various clinical passions, or wider profession issues. As I've, you know, as I've seen these opportunities come up. You know, some people are like really good mentors, and they will come in and say I think you'd be really handy working on this working group, say, or, I could do with a little bit of your skills here. And that just opens doors for you. And I think it's really important as a profession, that what we do that for other people too. Like, we notice like gaps in, you know, how our practice is running, and then we think, oh, well, one of my teammates will be really good at that, so I'll bring them up and they can help me do the less desirable aspects of my job. So, as I move laterally in what I'm doing, I want to give an example to my team that they can do that too, so they don't feel like they're stuck on this sort of linear trajectory that that they're gonna hit a ceiling on. So that's sort of what I do. I mean, I find myself in a lot of situations, mainly by accident, to be honest. But you roll with it, because you can, because you've got time.

Yeah, absolutely. I think it's, it's really interesting to hear how you do so many different things, but all of it adds value to your sort of normal day job, I guess. We talked a lot about this on the, on the Return call last week, thinking about the different skills that people pick up when they're not in clinical practise or not in wider veterinary work, and the value that this brings, that just because somebody hasn't been a GP or a surgeon or whatever it might be for the last 5 or 10 years, doesn't mean that they can't still be an amazing nurse or vet. It just means that they bring something different and it might take them a little while to get up to speed because drugs have changed and..

Ami: Well, yeah, and you've got to future proof yourself as well. Like, I, I'm not stupid, I know there is potentially a sell by date for me in farm practise, like chucking, you know, cows around. So, if I were to be like temporarily injured or whatever, you know, God forbid, I've got a skill set that I can use and still contribute to my job. I don't have to leave my job just because I'm not doing one element of practise. And I enjoy affording that flexibility to my colleagues as well. So we never know what's gonna happen with us, but we're as upskilled and tooled up as we can be, for those eventualities.

Yeah, absolutely. And Laura and Nick, you've both mentioned about flexible working, and sort of defining how you want to work. One of the things that came out of our most recent survey, the professions, was looking, and that was a census survey that hopefully most of you on the call participated in. Everybody who's on the register was, invited to be part of that. And there is very much this misconception that it's only the women and mostly for childcare reasons that, it's women who are asking for flexible working and actually looking at the generations coming through from vet school now, there's just as many men who are also wanting that that flexibility because they want to do other things, they want to explore other passions or training or different roles. So, that's something just to sort of remind ourselves, I guess, that it's equal, in terms of who might want it to be flexible, but Laura, to give you some confidence, people are asking for it and they are doing it. So that's a good thing for us to consider as to, you know, when we're employing somebody, what might they do and how might they work. Nick, just to come to you, as an outsider, and not a vet, there are a few of us, don't worry. What do you think of the flexibility within veterinary work? Have you observed much of this conversation happening? Or how people are thinking about it?

Nick: Yeah, I think the difference probably compared to medicine is the flexibility. You've also got the species flexibility as well, you know, you're a farm vet, or you might have a skilled small animal vet, or whatever it might be. So, I think there's even more variety potentially for veterinary practise in general veterinary practise, if you like, than there is in medicine, in that respect. Plus you can also, you know, we're quite limited now on what surgical procedures you could do. I used to do minor surgery when I first came into medical practise, but none of the current generation do that anymore. Whereas obviously, in general veterinary practise, you know, you still do operative procedures and that sort of thing, so you have that practical element, perhaps a little bit more, which is been taken away from general medical practices. Mainly around fear of litigation, which is the biggest thing. But I think it's that flexibility and having time, I think, because they want to work flexibly, it also gives them opportunities to do other things, and as we've heard, you know, a lot of people in general practice to go off and do courses in education, because education training is important for the next people coming through around mentoring, as you said, so the generic skills as well as specific skills, if they want to develop specific skills in certain areas like dermatology themselves, because a lot of dermatology can be dealt with at the primary care, first opinion level, rather than going to expensive secondary care, which it is in terms of the NHS. I mean, the mantra from the NHS at the moment is moving stuff into the community, but we'll wait to see what that actually means when the workforce plan comes out later in the year. But, you know, there's a lot that can be done within the community, if people are getting that support and skillset. So I think it's getting those opportunities, and I think there's a little bit of fear there isn't there, from people when they're in their early 20s, are we going to be doing this same thing in 40, 30, 40 years' time. But having the idea that you've got those opportunities for career development, doing different things, you might change tack, etc. And I think in medicine you don't get that flexibility in working in secondary care in hospitals. You're very much on a steamroller of what you're going to do, and then you get super specialised, most people now are so super specialised, so, you know, for a lot of people that's not, not very interesting after a while.

Well, as you say, it puts you, puts you in one particular route that's harder to move out from. Although as you say, I think it's probably a salient point around the species widening out the choices, and and what people could do and the, the power of the vet degree, one of our speakers last week was also thinking about, you know, what doors this does unlock for you, and I think that's also quite important to remember that, whatever your extra qualifications might be, that that MRCVS or RVN qualification is so important to thinking about what ticket that that gives you.

So we've got some questions coming through, but we're heading towards that stage that we need to, we need to start wrapping up in about 10 minutes. So, if anybody else has got any other questions for the panel, then please put them in the chat now. Tash has also just put links to the Reasonable Adjustments campaign, because that is something that we're running at the moment to help people think about, the tools and the resources, when we might need to think about reasonable adjustments, which is based on the research that we commissioned over the last two years and did in conjunction with the BVCIS team, thinking about this groundbreaking study on how people are and how people are at work. So that's, that's a, it's an interesting read for those of you that are interested in it, but there is a, there is a short version as well as a longer version, so please don't, please don't miss it just because there's one long one, there's, others as well. So one final pre-submitted question, which perhaps is a bit of a summary, but how can we encourage more graduates to think about GP careers? Is there anything from the panel, I don't know, Ami or Jenny, if you'd like to sort of do a bit of a pitch as to why you need to bring more students and grads into GP practise and sell them that career.

Ami: You know what, I think you've spent so long at vet school and pre vet school, trying to be something. You've gone through an awful lot of transitions in pursuit of your ambition and I think some people are really set in their ideas and what they want to be and what they want to do, and that's totally fine. But I think you would be remiss to not sample the joys of the veterinary profession and the huge spectrum and breadth that you can see and be involved with before you make a decision that could potentially just take you down quite a narrow pathway. I mean, of course, your qualifications are always gonna be there. You're always gonna be an adaptable, flexible person because of the nature of what you've gone through to get here. But you know, really go into your first job with your eyes open to all possibilities because, you know, your situation might change, you yourself might change, and the veterinary landscape is constantly evolving. So I think tool yourself up with as many different experiences as you can, before you really commit to something, if that's what you want to do. But just know that this sort of narrowing of your day to day, if you will, isn't actually a necessary thing. It doesn't necessarily gain you more respect. In fact, most, you know, people that I meet, members of the public are just fascinated about the variety of things that we see, you know, that they, they don't want to know exactly what's going on in like an adrenal gland, but they're like, what's the weirdest thing you've seen, you know, they're absolutely fascinated by all of the different things that we get up to. So don't do it because you think you're going to be perceived as a more respectable professional if you just go down the one road. So if you want to, that's fine, it's your life. But I just think you can have a lot of fun and have a lot of varied experience before you settle on one thing.

Thank you. Jenny?

Jenny: Yeah, and I think for me, you know, when I was a student, I wanna be, I wanted to be a farm vet, you know, because I enjoyed that part of EMS more. I perhaps enjoyed that part of the teaching a little bit more. And I think I would encourage you to just try different aspects and not, it's you're in a really kind of bubble environment when you're a student, either on EMS placements or in your Uni environment, and I think, don't close yourself off and think, oh I enjoy surgery or I enjoy equine because you enjoyed it, cos I actually changed completely what I enjoyed from as a student and seeing practise to working and it was really different. So I think, please try being a GP vet and even different species, you know, move from one to the other and see what you enjoy, and don't feel disheartened because you feel I haven't enjoyed that, it's not what I thought it was gonna be as a student. Really, then try a different species, try a different type of clinic, go from a small to a big, big to a small, different parts of the country as well, we've not really touched on that. Be a GP vet's enabled me to work all over the country. There's much more opportunity in different locations as GP vets because there's, there's many more practises that are doing GP work. So I think for me it would be, don't close yourself off and assume what you like in the first few years of your career, is what you're gonna like later on, and being a GP vet gives you that option to change your mind very easily and quickly move into a different area.

Yeah, I think that's a really good point to make, because we're very UK centric right now on this conversation in terms of what type of practise looks like, but, one of the biggest myths that we that we come across is 45% of new grads leaving within the first couple of years, which isn't true, there's a there's a slightly longer part of that sentence, that looks at 45% of the leavers are new grads, it's a very small pool, but the majority of those, under 5 years are actually going overseas, so they're looking to explore the world and use their veterinary degree to go and do that, and it's predominantly in GP practise from what we've been told, that they're looking to go and live in different places. They've worked very hard for their degree. So, they want to go and enjoy it in in different ways. And I think that's another element, Jenny, building on what you said, to think about how you can make the degree work for you, and whatever age you're at, whatever life stage, there are always those other opportunities. So we've got, we've got a couple of questions to get through. Linda, I think this one might be for you or maybe for Nick, but the first one is, looking at the specialism pathway. So I'm just gonna read it out so that I get it in full. Is this specialism as a GP, or is this access to approval of a specialist from a practice which does advanced procedures, but cannot currently be recognised for what it does? GP specialism is not what my senior team want, but training and acceptance as specialists in their own areas without the European Diploma Pathway is what they want to be developed. Does that? Do you need me to read that again or you -

Linda: No, no it's fine, I've got it as well and I think it actually is a little bit similar to, there's another one, and it's about recognition of people that are already working at a high level. And this has been part of the discussion and I think it will continue to be, in terms of grandfathering rights, if and when this pathway does get off the ground. I hope it does, but that will ultimately be up to council following consultation. I think, I think there are obviously a lot of very, very experienced GPs out there who are working at a very high level, and any new training would need people to help teach that training. So, the recognition of existing ones is definitely part of the conversation. What I would say though, is rather than an automatic route, it would need to be demonstrated, because the role of specialist, just like the role of advanced practitioner, has certain criteria because unlike a qualification, which is something that you achieve, and then you've got your certificate for life, the role is our way of ensuring that people are working at that level and continuing to keep up to date at that level and demonstrating that competence. So, recognition is definitely part of the conversation, but it may well involve them demonstrating that via various means. It could include a diploma, it could include a different mechanism, a portfolio, but it would need to show parity, to be fair to everyone. So, and I think that there's one, sorry I'm jumping down below, but there's one on diplomas as well. So, so I'll just check, so is it Anthi? Could I just check, Anthi if that answered your question as well? Do shout out, Anthi if it doesn't, it didn't, and you need more from me. Roberto, you've asked about the diploma, so yes, you've obviously been at one or maybe more of our stakeholder events that we held last year. And the main driver for the VetCCP work wasn't to reintroduce the RCVS diploma, however, we were really blown away by how many people during those stakeholder events from all different areas asked for that and wanted it. So we are definitely looking into it. It's on the table. And like I said, with everything, it will be up to consultation. I wasn't at the RCVS when we got rid of the diploma, but I believe part of the reason was it needed a total revamp to bring it in line with international best practise, which was possible, but as a single country, and many, many clinical species, the numbers of specialists wanting that assessment can be very low, depending on the specialty. So actually to make a really good exam, quality assurance, standard set it, implement it, takes a lot of resource. And if you have one candidate every 3 years, that's really difficult to manage across the breadth of veterinary practise. However, I do think it's possible. I do think things have changed now. First of all, we have AI, which may help with writing exam questions. Obviously that needs oversight and very clear quality assurance, but we have the expertise in the department to do that. The other area though is something that we are looking to, very tentatively to explore. It's actually collaboration, so the EBVS and the European colleges have their questions and diplomas. The American boards, will have the same. So actually, if is there an opportunity for larger collaborations around question banks, which could also ensure parity across them - now this is very Blue Sky. We, it hasn't been quite announced yet. We're working on the comms, but we are going to host the first sort of international postgraduate veterinary education conference in November. And we do have international speakers coming across, and I am really keen to look at this. So, Roberto, I've nothing solid for you right now, but it was very clear from the stakeholder meetings that there is much more interest in us doing this than I had really foreseen. So it might be something. And we're definitely gonna look at it.

Yeah. Thank you Linda, for taking those questions. We did have a few people who joined after you did the introduction earlier, so are you just be able to remind us about timelines or rough timelines just to help people situate this?

Linda: Yes, so the original timeline was 2 years, starting from January 2024. That's when council agreed the funding and timeline, it was 'Shall we go for 2 years or 3 years?' 2 years was always recognised as being extremely ambitious for this work, given the 3 very, very ambitious work streams in itself. 3 years though, things, as you all know all too well change really quickly. So we decided to go for the 2 years and try our best. We'd already planned for 6 months stakeholder engagement that turned out to be a year, and there's been a few little things like CMA in the middle. So it's safe to say, we are making good progress, genuinely. I, whether we'll be finished at the end of this year, beginning of next year, as in 7 or 8 months' time, I doubt it. But we are keen to finish as soon as possible. I, this isn't something that's you know, going to roll on and on, so I'm keen to get the proposal for it. And Nick Cooper, who's on the line, will make sure I do that, Nick. So, yeah, probably not expect a full proposal January, but I'm hoping by summer next year, certainly we can get everything to the committees and council.

I think sort of reiterating Linda, the stakeholder sessions, I think it's just so important because the problems we've had, and it's slightly different than involved in the physician associate programmes coming into the UK 10 years ago, and the problems that all arisen out of that, looking back is there wasn't enough stakeholder engagement at the beginning. The challenges it would bring, and then you get all the problems coming on later which are far more difficult to unravel.

Linda: Yeah, and you know, the stakeholder engagement we did was extremely lengthy, but actually so valuable. I'm really glad we did that. So I do feel now that I've probably got all the bits of information that we need out there in all the recordings from the stakeholders, it's pulling it, all that together in there. And of course we'll be going back out to stakeholders with this the consultation after it's been through committees, so that's definitely not the end of it.

Indeed, so people need to keep an eye out for emails, social media, any of those opportunities to get involved and, as attendees here today, then, we will make sure when we start to wrap up these sessions later this year, because we're running until October with these ambitions, that we will send periodic updates to people, if you've opted in on the the Eventbrite so that you can hear the latest from us. So we'll make sure to to help spread that message as well. But we do really welcome people getting involved, whether it's smaller sessions like today or sort of full day events, whatever that might be. So we have got 6 minutes left, which is not very long. So, just a final sort of round from our lovely panel here who've very kindly given up this time to be part of it. But I think you've absolutely sold a GP career and the different, the different elements that can, that you can bring, the different routes you can take, and the different levels of satisfaction. I guess thinking about the future, because when we started this conversation, we were sort of contemplating early career vets and thinking about where they might be in sort of 10, 20, 30 years' time. I guess for you guys thinking about, you know, sort of 20 years' time and reflecting back on, you know, large parts of your careers, what would you, what would you love to be proud of from a GP perspective? What's the one thing where you'd go, I'd love to be able to say this is what I have, I have done, or this is, this is what's given me the best sense of satisfaction. And Laura, I'm gonna ask you to look at a slightly longer time frame as somebody who hasn't yet finished vet school, so I'll come to you in a moment. But Jenny, what would you love to say?

Jenny: Well, I think I can already kind of say it now a little bit in that I am so proud of the difference I've made to so many animals and so many families and so many people. You know, every day, what might seem as a little, you know, just a cat bite abscess or something straightforward, it means so much to those patients and those families, and I'm so proud of all the number of patients that I've helped, the number of families and how I've supported them through their life with their pet. I think one thing perhaps not touched on, being a GP: I love seeing them from when they get that pet right through to the end and then the next pet afterwards, and it makes you so proud to have helped that family and that pet or that client all the way through their life, and that is, you know, that's something that never goes away no matter how long you've been a GP vet, you just have more of those clients and those cases.

Absolutely, I think that's, yeah, that's a really important thing to consider is that that community and coming back to our Slido at the beginning, the impact that you can have on local community and the people that you work with. Ami, what about for you?

Ami: This is a really hard question. I don't have an exciting answer for it because like, because I do so many different things, like I'd like to say that, you know, I contributed to making the profession in general like more livable, more accessible, and, you know, in- like, you know, 'inspired', but you know what I mean, like encourage someone, who wasn't thinking about that, you know, that they were capable of doing instead of GP farm practise, that they could do it, you know, I look around my practice, we're not from farming backgrounds. We're a predominantly female practise, and certainly across Vet Partners practices, you know, we've got a fairly even gender split when it comes to to farms. So I want to make sure that people don't come into it with preconceptions that they can't. That would be a good achievement. But you know, fundamentally, it might be really, really basic, but nothing really beats a good clinical outcome for me. It doesn't really matter how complicated the case was. Like, when I get a text a day later and the cow is standing or the, you know, the calf is better or the leg is fixed. I like that. And I don't think that's ever gonna get old. You know, that sort of element of our workmanship is always going to be the thing that I think we're most proud of because it's really what we, what we started doing this for. And I've never lost sight of that, and I don't think you do as a GP.

Absolutely. No, thank you. I think it, it is really important. It doesn't have to be anything grandiose. I think the everyday is what we show up for, isn't it? So, yeah. So Laura, the question to you in thinking about, you know, where your career might end up, who knows what you might be doing in, 20, 30, 40 years' time, but, what would your thoughts like to be?

Laura: Oh, great question. Yeah, really difficult. I've been so lucky that I've met so many amazing vets on placements. And in first opinion practise, and they've all had such amazing varied careers that have been really inspiring. You know, there's vets there who are teaching at the university part time, doing PhDs and it's because it's mixed practise. You've got people who are amazing at large animal surgery, and then someone who's done loads of CPD in animal behaviour and dog behaviour, so it's, it's just such a huge variety. So I really do feel at the minute that the world really is my oyster and everything I do on rotations, I go, I love this, this is amazing. This is what I wanna do. But at my core, what I'd be really proud of would be if I could, I, it sounds like it's gonna take a really left wing, but I love sheep. I absolutely adore sheep. I have a, I have a small flock of sheep at home. And, if I could be a really good first opinion sheep clinician and advocate for, sheep not being stupid and advocate for good sheep welfare, I'd be really proud of that, and advocate for smallholders. So if I could look back in 20 years' time and say, I've changed a few, changed a few perceptions along there, then I'd be really, really proud. So ,yeah.

I have a sneaking suspicion that we are likely to see that from you, based on what we've seen so far. So, yes, we'll have to check in, we'll set a reminder to come back and ask you. So, Nick and Linda, some final words from you. What would your hopes be that we can see changing around, GP careers in general? What would you, what would you love to see in sort of the next 10 years' time? Nick, can I come to you first?

Nick: I think pulling all the things we've just heard together, isn't it, to emphasising to people that it's got such variety, such possibilities, and what Ami was saying about making a difference. I think we forget what a difference it makes, just one encounter with individuals and I certainly think in medicine people lose sight of that, in hospital medicine. And you know, what I'm looking back at, you know, is seeing families having treated their, you know, somebody now treated their grandmother or treated their parents or whatever. And, and having that relationship which you can't develop in other aspects of care, I think. So I think that fits in very much what Ami was saying about taking it through, you know, the life of an animal or how you were looking after them, etc. and also all the things Jenny was saying about that variety as well.

Lovely, and Linda, over to you.

Linda: Yeah, I suppose I'm an educationist, not a vet, so I'll reflect on the VCCP work which unsurprisingly, I just think it's really exciting and it's not without its challenges. There are major challenges to that. But I think if we, you know, the whole point about valuing GPs, and what's really struck me in writing some of the learning objectives and reviewing what the stakeholders said, is there is a real art to being a GP actually. It's not just about first opinion practise. There there's a real art to it. And I think to give options, to give flexibility to facilitate all of these different pathways would be fantastic, if we can do that.

Yeah. Absolutely. Well, let's leave it there because we have gone one minute over. Apologies for that, but important to hear from everybody. So, thank you to our wonderful panel for giving up your time to be part of this. I think it's been a really positive experience for everybody. And thank you to all of our delegates who've joined us here live today and for your questions. It's been really, really good to hear from you, and this conversation will continue. So what we will do is make sure that we send out the recordings of this, but also with the links to the resources so that you can share these with your colleagues. It will all go up online. We've got another session, on the 20th, which is looking at client communication, so, again, we've got some, we've got some great practitioners who are coming to join us. Linda Belton, our chairman, who's also - chairman? - is chairing the session, and she is RCVS president, but she's also an equine GP in practice, so, thinking about all those difficult conversations, and communicating cost and expectation management, etc., as well as more broader communication skills as well. So I think that that will be, that will be a really, fascinating session if you can come and join us for that. But they're running all the way through to the autumn, the list, Tash has put in the, in the chat as well, so do sign up for them, we'd love to see you and we'd love to hear your questions. And hopefully you've also had a good time today, and learnt something new, but perhaps been inspired to be full of pride as to what GPs do because, it is very clearly coming through that it is amazing, and we're very excited to look at our vet nurse session as well, which I think will be equally full of pride and excitement for vet nursing careers as well. So, I hope you all have a wonderful rest of your Fridays, and we will see you all soon. Take care everyone, bye-bye.

We've been joined today by a panel of stakeholders to share their thoughts and experiences on the topic and I will in a minute to ask them all to introduce themselves but I'd just like to ask everyone, there are two questions being placed by Tash in the chat, which we'd be really interested to if anybody would like to pop some Responses to these two questions into the chat. and if you want to include your role in in practise with a clue sort of for perspective. So they are what do you love about working in the veterinary sector and we're actually asking this at the start of every one of these series of webinars and then a specific one for this one, which is what do you think is the biggest cause of complaints in practise now. This webinar is about more than complaints, it's around increasing quality of communication and client interactions. However, we all know, and we need to acknowledge that one of the drivers for this is to reduce or even avoid even better complaints from happening and we know from data that communication is one of the biggest issues cited in in complaints. So we're a little bit grabbing the elephant in the room and saying yep this is an element of this is around complaints, and we will be also including Today a session from Simon who'll introduce himself in a minute, with some myth busting around the RCVS complaints process as well which often worries and concerns people. So we are going to look at the complaints side, absolutely, but we are dealing with much more than that in this webinar today. So, our panel we have today with us are Alison, Grace, Louise, and Max, and I'll like to ask each of them to introduce themselves and to answer those two questions for us as well please if you would. So, if I could start with you in a second, Alison, and then go with Grace, Louise, and Max, that would be great. So, over to you Alison.

Thanks Linda. So my name is Alison Skull, and I am currently Resolution Manager at the Veterinary Client Mediation Service. I have been there around three years prior to that, I worked within The Queen Mother Hospital at the Royal Veterinary College for over 20 years as their Client Liaison Manager there. What I love about working in the industry is just the variety and no two days are ever the same and still working with that family of colleagues, no matter where you work it always brings us together. What I feel drives complaints in, in practise is can often be down to that communication, either inappropriate communication or poor communication. Looking at how we can get our clients to understand us better and use those skills is what I thrive on. Thank you, Linda.

So, I'm Grace. I'm a Client Care Manager at a Referral Specialist Centre, also on the BVRA Council. What I love about the role is, again, no two days the same, the variation of the role, but also the client satisfaction side of things. I'm heavily also involved in the bereavement side. What our biggest drive for complaints again would be keeping clients updated along the Way regarding costs and estimates.

Hi, I'm Louise. I am a Lecturer at The University of Nottingham and I lead the communication skills teaching there. My interest experience is I've worked in clinical practise, and then I've gone back to do a PhD in small animal communication consulting, so that's my in terms of the things I love most about the veterinary sector, it's the people, the veterinary staff, but also the clients actually, I think they're the real fun bit and the real value added bit of the profession. Obviously, we love the animals and then the biggest cause of complaints, I would say mis-matched expectations. So, what we as a vet expect this is what the client is expecting and that all comes down to communication.

Hi everyone, I'm Max, thanks for having me today. I'm a General Practitioner swan vet in the sort of Wiltshire, Gloucestershire area. What I would say the best part of the job is that I think it very much echoes what other people have said already, but I think it is the people. I think we're exposed to some amazing people, both as clients, but also as owners. and I think that makes for really interesting conversations and great exposure in terms of where I think we see most complaints. I would say it's when people don't think they are heard.

Brilliant, that's great, thank you, thank you all very much for the intros and absolutely it's all echoing through looking at the comments in, in the chat, very common themes there around people and yes, animals do, do come in too, but very much the emphasis on that communication, talking about money as well, and I think that's an important part of that communication piece That we know we need to probably uh take consideration of and we will look at today as well. So, we'll keep moving on because we've got plenty of things to discuss and we do want to give time for a general Q&A, as well as discuss the pre-submitted questions. So I'm going to start please by handing over To Simon Wiklund. Simon is Head of Legal Services and Assistant Registrar at the College, and he's just going to really start to give us a little bit of a look and do a bit of myth busting about the complaints process and talking about the requirements that are in our guidance and carried around communicating of cost, but also where we do and don't have influence. So, Simon, if you want to come on through and make a start.

Thanks very much, Linda. I'm just going to share my screen because I have a a short presentation just outlining the RCVS concerns process. So we generally don't talk about complaints, we talk about concerns. There is a reason for that but we can discuss that. So just bear with me as I hope the tech will work for me. Right,so, the starting point in any concerns or complaints process is an understanding that everyone is human, apart from our patients, of course but that means that we all make mistakes, and mistakes happen on both sides. Complaints Made on a mistaken basis, but also mistakes by professionals that give rise to concerns. Veterinary nurses and veterinary surgeons are regulated professionals. They're regulated by the RCVS and that means there needs to be a way to raise and address concerns. It's a standard part of regulation for all professions in the UK. What that Means however, is that the RCVS has a legal responsibility under its statute to investigate concerns if they're raised about individual professionals. Now that's important, I'll talk about that a little bit more, b our legal responsibility stems from the Veterinary Surgeons Act 1966. The date's important because you'll all understand that the way veterinary services are delivered has changed considerably since 1966. But the key shortcoming I would say is that we, the RCVS, don't have statutory authority to deal with through a disciplinary process, complaints about practises. So as you can probably Imagine in 1966, the majority if not all veterinary practises were owned, operated by veterinary surgeons who were individually registered with the RCVS. So it meant That De facto, the RCVS had control over the way veterinary services were delivered through the professionals that were registered with it. That situation has changed. So it does leave a rather large hole where concerns are raised by members of the public about practises or unidentifiable individuals. The third point to really make about from the start about the complaints process is that because of the way the legislation is drafted, we can only deal with the most serious concerns. So most professional regulators will now talk about things that may impair or affect fitness to practise in. Actual fact, the language in 1966 legislation talks about disgraceful conduct in a professional respect. I always think it's really important to go back to that language because it helps people, I Think to understand just how serious the behaviour has to be in order to attract disciplinary action by the RCVS. Disgraceful conduct sounds something truly, truly terrible and generally, implies some kind of intent, bad intent, things at the most serious end of the spectrum. it's always helpful, I think as well to compare with the doctors who had in their legislation of the same date the legal test for action was infamous conduct in a professional respect. I'm not sure I understand the difference between disgraceful conduct and the infamous conduct, but hopefully the point, it's clear that it's something very, very serious before the RCVS can take disciplinary action under its statutory disciplinary powers.

So what are we really talking about? And we translate this disgraceful conduct or this impairment of fitness to practise. Normally we're talking about serious professional misconduct. That's behaviour that's fallen far short of what is expected of a veterinary surgeon. And those three examples on the slide are by far the most common um concerns raised with us that result in disciplinary action. So where we're talking about clinical things, it's very poor professional performance where there are serious departures from the code. And that's in plural on purpose, because in most cases, a single departure from the code, unless extremely serious, is unlikely to reach the threshold. the second example there, fraud, dishonesty or false certification, for obvious reasons, I Hope people will understand that anything that undermines the integrity or honesty of a professional whose relationship with patients and clients is based upon trust is really serious and has the potential to impact on the wider profession. So anything of that nature tends to be treated very seriously. And again, it implies that aspect of intentionality. You've been dishonest, you've done something wrong. It's not something that's happened accidentally. and then finally, criminal convictions I would say quite a large proportion of cases that end up before the disciplinary committee relate to convictions for serious matters. Again, criminal convictions are likely to impact on public confidence in the profession as a whole and that's why they're treated seriously by not just the RCVS but other professional regulators as well. So that's what we do look at as part of the concerns process.

It's probably helpful though just to limit or to describe what we don't deal with. So, there's some real understanding about the coverage that the RCVS disciplinary process has. So I talked about sort of accidents. We are not looking at difficulties or problems that occur routinely in practise and are nobody's fault. So, the example I've given there post-operative complications. Professional regulatory disciplinary processes are not designed, and they're not there to punish individuals. They are there so that people learn from their mistakes and so that they don't happen again. In the vast majority of cases that can be done without the need for any disciplinary action by a professional regulator. Just to say the legislation from 1966 doesn't provide the College with many options when it comes to taking action about concerns. At the moment we have the ability to suspend or strike someone off, remove them from the register. We don't, for example, have the ability to impose conditions or, or other actions that might be designed to help remediate and prevent recurrence. It is one of the short shortcomings of our current legislation. We also don't look at mistakes that are not serious and don't affect fitness to practise. So, I said at the outset, we're all human, professional regulation understands and acknowledges that we're not looking at negligence. Obviously, members of the public, clients, have the ability to take civil action against practises and veterinary surgeons where there's a damage as a result of negligence. That's not a matter that will normally meet the threshold um for our RCVS concerns. And finally, again, I'm referring back to the individual nature of the RCVS jurisdiction. We can't deal with complaints about practises or unregulated individuals. Just to note, we obviously look at illegal acts of veterinary surgery by unregulated individuals. That's by way of criminal referral or investigation, but in terms of our process, our disciplinary process, we can't look at members of practise staff who are not veterinary surgeons or registered veterinary nurses. It is important to point out though and we're helpfully joined by a colleague from the VCMS, there is a route for individuals with complaints about practises. Sometimes the nature of those complaints will cross over into matters that address individual fitness to practise or serious professional misconduct by an individual veterinary surgeon, but often not. And there is a Route for those complaints to be dealt with through VCMS.

I also want to point out that although it's not part of our statutory function, through our college, charter, we run something called a Practise Standards Scheme and while that doesn't involve a complaints resolution process, it does require practices who are members of the practise standards scheme to have a practise complaints process. And also we do have the ability to take on board concerns raised about practises when we're carrying out our assessments which take place on a four-yearly basis as part of PSS, Membership. But it's not strictly speaking a disciplinary process.

So the outline of the process on this slide shows that first stage when a member of the public or a veterinary surgeon contact us to raise a concern so it's essentially a triage stage. And the arrow going off there to the left with ADR which is alternative dispute resolution, is essentially VCMS which is one of the ways in which concerns that don't, or are excuse me, or are unlikely to raise issues of serious professional misconduct can be directed to VCMS for possible resolution. So if that inquiry or triage stage establishes that it's about an individual and that there's a matter which might raise um a serious professional misconduct issue, it goes to that stage one assessment and investigation. And essentially what happens there is evidence gathering to establish whether or not there is a realistic prospect of a finding of serious professional misconduct. That's all very legalistic, but it's essentially there a basis on which a decision could be reached that this person has behaved in a way which is serious professional misconduct. At the conclusion of that stage one investigation, a matter is referred to the preliminary investigation committee. For veterinary surgeons, it's very likely that until that point the referral they may not know that a complaint has been made to the College, and that's for very good reason. The vast majority of complaints are either closed at that initial inquiry triage stage or are directed to other sources of advice or assistance. The College's position is that it's really important not to unduly alarm professionals where there are complaints that are closed at an early stage. Certainly we understand the impact that complaints can have on individual professionals. So we contact Veterinary surgeons and registered Veterinary nurses at an appropriate point where a complaint is in the process, the more formal stage, which is preliminary investigation committee and then disciplinary committee.

So the PIC, there's a separate PIC for vet nurses is made up of individuals that receive cases, receive the evidence, and they make a decision about whether or not that case meets the realistic prospect test i.e., is there a realistic prospect that the disciplinary committee will make a finding of serious professional misconduct? So you can see there 20%, that is 20% of complaints that come In, reach that preliminary investigation committee stage and I'll give you some numbers at the end so you can put that into context. So if the PIC conclude that a referral is necessary, it goes on to DC Disciplinary Committee. But the PIC does have the ability to close the case, it does have the ability to impose warnings about future conduct as alternatives to that referral. I think it's also important to point out that until stage three, this process is confidential, the only the parties involved know about it. The reason I say that is as a legal professional who's practised in the courts, the disciplinary committee hearing is very formal, very public. It's akin to and on a level with any other judicial proceedings. There is a huge difference in approach. All the parties will be represented by lawyers. And it's only fair then that it's 2% of complaints we receive that we're talking about that arrive at that final stage. So to put that into context in terms of complaints that we receive on an annual basis. We get about 600 concerns raised with us, so 2% of those, we get about 20 hearings on average a year before disciplinary committee. It's a very, very small number. I think it's important for veterinary professionals to consider, and I'm just talking about vets in terms of numbers on the register, but there are 30, there are over 30,000 that are practising. And when one considers how many interactions there are with clients on a daily or even hourly basis. The fact that that results in only 600 concerns being raised with the college year, I think is important to keep in mind. The vast majority of veterinary services are provided by vets in a manner which does not give rise to concerns or complaints. And even then, we're talking about 1 to 2% reaching that final serious stage of a disciplinary committee hearing.

I'm just going to come out of that now, and then just touch on a couple of points that have come up recently around communication and consent. I've already talked about why we have limited tools at our disposal, given the age of our legislation, and I think it's a situation that's common to many professional regulators that consumer priorities and terms of business have not traditionally been part of the remit of professional regulators. Many of our brethren professions have regulated with much more up to-date legislation, and some have clearly uh focused on the consumer aspect of services they deliver. So I have in mind financial and legal services. But if we compare with say more similar professions, those in particularly in human healthcare, the reality is they do not Address in a way that I think the CMA has indicated it would like the RCVS to address issues around consumer, concern, communication, particularly of treatment options and prices. This isn't anything new, we've had real difficulties, I think, because we just don't have the powers beyond putting things in the code of conduct and then taking disciplinary action in those very few cases that meet the threshold in our legislation. So I think what that means effectively is, although something might be in the code, a single departure from the code, particularly if it's not a particularly sorry, I've used particularly twice there, but if it's not something that is so serious, it's very unlikely to pass that initial threshold at PIC meaning there's no realistic prospect of a finding of serious professional misconduct. And that's partly influenced by the fact that that the outcome. In our disciplinary process is removing someone from the register, and for obvious reasons that appears disproportionate if we're talking about a failure to communicate effectively a price. I'm not saying that's never something that might end up before disciplinary committee, and multiple examples of failure to communicate have and could be matters for the disciplinary committee. But perhaps you can understand that there are very few cases um around communication and consent. On their own that are likely to wind up before the disciplinary committee.

Just on what we do already do about communication and consent, there are three fairly chunky chapters in supporting guidance to the code of professional conduct that address communication and particularly communication around costs. chapters 9,10 and 11 of the supporting guidance go into some detail on how members of the professions. Should comply with the code obligations on communication and consent, they're quite in depth and they're comprehensive. It's important to say though, what we don't do is give you a prescription for how to communicate, what should be on a price list, if there should be a price list. In common with many professional regulators, we have. Continued on the basis that the way professionals communicate with their clients is a matter of professional judgement, and if they adhere to the principles set out in the code, then that's appropriate that is something that may well change depending on the view of the Competition and Markets Authority about potential harms in the veterinary services market. That's a really, really quick, super quick and slightly superficial overview, but I hope at least it puts everything into context and I would be really, really happy to contribute more to the, to the cost and communication point as the discussion goes on.

Brilliant, lovely. Thank you, thank you very much Simon. I just want to just ask you those figures that you put up around the concerns and the difference between complaints and concerns, obviously a lot more complaints than that 600 come into the College. So when a client says I'm going to complain about you to the RCVS, it's not 2% of that time that end up there. It's when it goes to a concern level, a lot are weeded out because they don't come under the remit as explained so yeah, So, keep that complaint and concern, difference to mind. Couple of other really, different angles on what they love about being in the veterinary sector have come in, one commenting on that role we have around being able to influence things at a global level, global health and wellbeing through our involvement, particularly obviously currently in the livestock sector, but that increasing understanding of the importance of the veterinary voice in the one Health agenda is a is a really key one, and also the comments around, time being a factor in complaints and that if we don't have adequate time with our clients, and I think that's something else we will look at today.

So moving on now, to two members of our panel who are going to just talk a little bit about the positive effects of good client communication and considering client perspectives. So if I hand over to Lou and Alison for that please.

OK, so, just a few slides here. Some of you I realised I will be preaching to the converted on this one, but I thought it'd be really helpful on this webinar to just have a look at what we know from scientific research about communication. So we know, and all of these things have come from research papers, and if anybody wants the original source, then pop it in the chat and I will try and direct you in the right direction. but we know that if we get communication right with our clients, our consults are more effective. And what we mean by more effective is we're likely to be more clinically accurate we are more efficient. There is more trust between vetting clients, and there's an improved vet-client relationship. So there's some great reasons to start why communication is so important. We also know that good communication, getting it right is really, really important for coordinated care. So we no longer work as you know in necessarily tiny teams, often actually, there are a whole load of paraprofessionals and, and other professionals involved in the care of animals. And if we, if we communicate well with them then that animal is getting better and more coordinated care, which is a really good thing. We also know that actually we get better medical outcomes if our communication is right. So the research shows that if we communicate well, our clients are likely to be more satisfied with the consult with their experience, but also actually as vets, if we're communicating well, we are more satisfied with our consults, and that's a really, a really, really good reason, particularly in light of you know, our well-being, concerns within the profession, actually. Learning how to improve our communication can actually make the job a lot more satisfactory for us as that's and that's really, really important. We also know that if we do it well, our clients are more likely to understand what we've said and remembered it after the fact. And all of this feeds into the fact that that means our clients are more likely to adhere to the recommendations or the treatment schedule or whatever it is that we reach at the end of the consult. and that's really, really important because if we have recommended. A course of antibiotics, actually, that patient receiving the full course, is a really, really important thing in order for that animal to get better as an example. We also know that good communication improves the quality of care. So we are safer practitioners if we're communicating well and we're less likely to make mistakes, which is obviously really, really important. We're also less likely to receive complaints and malpractice claims, which obviously we've just heard a little bit about. And if I still haven't convinced you, there is one really interesting paper out there that looked at using something called a relationship centred care approach in our communication, and that's relationship centred care, a lot of overlap with contextualised care, which we're hearing a lot about at the minute but they found that if you use this relationship centred care approach, which is understanding that clients are an expert in their own right that pets are very, very important and there's an important relationship there that we need to take into account. We use that approach, consults are on average 1.5 minutes shorter if we take the time to build a relationship with our clients. So just to sort of pick up briefly, and I'm really sorry if you can all hear the bin lorry outside of my house. Actually taking those approaches, we know that we are time pressured and that can massively affect communication, but taking a little bit of time to work on that relationship and to understand what that animal means to that person and get their perspective on things actually can help us with that. It's not something that's going to necessarily make our consults take longer. like I say research has shown it can actually reduce consult lengths. So, just a few reasons as to why all of these things are really, really important, to get right. can we have the next slide please, Chloe?

OK. So This figure here is something that came out of my PhD which I mentioned at the start was on small animal consultations and what does good look Like and that was good in terms of for the client and also for the patient and also for vets. And one of the big things that came out of it was that we as vets/ veterinary professionals more broadly are really good with animal behaviour. We spend a lot of time studying that at university. we can read dogs and cats and horses and all of that jazz, but what about the person on the end of the lead rope, leaning over the gate, you know, at the end of the lead? and this figure came out of lots of conversations with vets, clients etc. and hopefully this will sort of help you see a little bit more and feed into the discussion later. I think as professionals, we're very, very focused on a particular animal and its disease. So you'll all have had you look on the practise management system and it says dog with lump. OK? And this is a fictional example running alongside. OK, so this isn't a real dog. So you know that you've got Alfie, he's coming in, he's 13 years old. He's a Labrador, and he's got a lump, OK. And already in our heads as, as professionals, we tend to pattern spot and we're probably already thinking, oh well, you know, all the Labradors probably a bit flabby, might be a lipoma. We're already starting to have those thoughts in our heads because that's the way human brains work. And I guess using a relationship centred care approach and understanding of the human side of things is actually there's a waterline. So we've seen those two things at the top of the pyramid. Underneath that waterline attached to the end of the lead attached to Alfie, we have a client, OK. In this example, it's Mrs Smith, and she has a family situation. So she is married, she has two grown up kids. The dog is the remaining of offspring still in the nest, OK. He really is part of the family. she's got a little bit more disposable income because the kids have moved out, and have got their own lives, careers, Jobs etc. So, there's a little bit more money than they were when, you know, when the kids were small and then she's got other stuff going on in her life. So in this example, her father has recently been diagnosed with cancer, and she believes that Alfie is a firm member of the Smith family, OK? Understanding that there are all of these other things going on under the waterline allows us to have better conversations with our clients allows us to understand their perspective and it allows us to make better individual decisions as to the advice we give and what might be best in this case for this patient OK, it's I'm not in any way saying you need to go out and say OK Mrs Smith are you married? Do you have any children? How much spare cash have you got lying around? Absolutely Not but by taking the time to talk to our clients and picking up on the little cues that they drop in conversation it may be Like oh you know we have the kids around for Sunday dinner, for example, and you go, oh, that's great, you know, do they come often? It's a real opportunity. we pick up on these cues from our clients to build some rapport. And by doing that, we're building trust, we're building a relationship. And if you remember from the slide before, we're hopefully making our consults run a little bit smoother, and a little bit quicker. OK? All of that said, we are all individuals, OK? And that's vets, that's clients, that's everybody. We all come with our own situations. We all come with our own beliefs and values and biases. OK. And it's really, really important that we try and account for those, try and understand what our owner, put them to one side and really listen to what it is, the clients are telling us, because that's our role, to advocate for animal welfare, and to help the clients when they've brought their animal to you. And ultimately, they have presented their animal to a veterinary practise, because, they are concerned about them and they care about them. And I know it's very, very easy if you've had a really tough day, you might be feeling a little bit burnt out to forget that. But ultimately they come to veterinary to seek veterinary care because they care, and it's our job to work with them to help improve that welfare of the animal.

Alison, if you've got anything you want to come in on at this point, I keep talking. Yeah, so when we look at the iceberg um effect, we can also look at how that can drive behaviour. So it can come that Mr Smith comes into the consult with Alfie. And if she's displaying a behaviour, maybe that she's overanxious or really concerned, is it because she's worried about that lump being cancerous, bearing in mind what's going on in her home life? And there's so many times where a behaviour can be driven by something that's going on completely irrelevant to that situation. And by getting to know our clients more and communicating well and passing on that information within practise, we get communication skills better and we get the best outcome ultimately and sharing that information within our practise you know, if Alfie's coming back next week to see a different vet or coming in for a weight measurement for example sharing the information that you've learned about Mrs Smith will help your colleagues going forward.

OK. So, we've talked about how important the client's perspective is and this relationship centred care, contextualised care approach but how could we actually achieve that in practise, because it's all very well saying you need to do it or we recommend that you do it but the reality is how do we do this? OK. So number one would be listening. Often actually humans, clients, you know, we drop cues to how we're feeling often. So it may be in our body language you know, if a client is there with their arms Folded actually perhaps they're feeling uncomfortable, they're feeling defensive if we can Pick up on some of those body language cues, then we can start to sort of think, OK, perhaps they need more from me or I need to find out what else is going on. Ok, So number one, listen to what they're saying, also listen to what they're showing you. OK. Empathy is a massive, massive one here. so actually, it's really stressful living an adult life, put it like that but we've, we've all got stuff going on, you know, MATs that need to be booked, children's appointments that need to happen, you know, bills to pay, mortgages, etc. etc. And just understanding you know, these people, like I was saying earlier, they do care, and they do want to do something about that, the pet and just being empathetic to actually life is tough for a lot of us and understanding that, you know, say you're prescribing eye drops 4 times a day, the reality if you've got young children, is that that's going to be really actually extra hard and it's bearing those factors in mind and having a conversation with the client that actually, is this going to be workable for you and your situation? Or do we need to come up with an alternative plan? Sometimes there aren't alternatives and we are sort of pushed down a particular route, but certainly, there are options, understanding and empathising with the client and what it's like to have to live with an animal with, say, diabetes or an animal that's getting older and is incontinent in the house. Actually, you know, that's not easy. It's absolutely not. and showing them a bit of empathy can go an awful long way.

In terms of what you can say to maybe try and draw out some of the disinformation there's something called ICE or ideas, concerns and expectations, and it's talked a lot about in medicine and it's perhaps not talked so often about in veterinary medicine or is starting to come through and that's understanding that clients will come in with an idea. It may be that they have Googled It or they've been on a forum and got some information. So understanding what it is they think might be going on can be really, really helpful in guiding your conversation. If,for example, they come in and say, I'm really worried that my cat's got Cushing's because X,Y, Z,and you go, OK, right, I understand why you think that but Perhaps something else may be a little bit more likely. It shows them that you've listened to their concern that helps you drive the discussion away from that. If you don't ask them what they think might be going on, then potentially they may leave the consult and think, well, That you know, I still think it's this because you didn't address It OK. So it's understanding you know why are they here? What do they think's going on. If they in for something and the classic one is the nail clip, isn't it? They come in and you find something else on physical exam. If you don't address the fact that they wanted their pets' nails trimmed, even if that's not particularly important, you know, clinically compared to what you find on the exam, unless you sort of say, I think we need to get this bit sorted first, and then we can look at getting him booked in to get his nails sorted, then actually they may leave and think well, You know, I still didn't actually get what I came in for. And it's not that you as the have done anything wrong, you've picked up something more serious that needs dealing with more urgently, but it's about managing those client expectations and letting them know I have heard you and we will get that sorted. But right now my worry is this and for the sake of fluffy, I think we need to, to proceed with this bit first it is certainly, a really, really important thing today. It's also really important to try and find out what they're most worried about. So thinking back to Alfie, our example, like Alison said, you know, in this example Mrs Smith's father is ill with cancer. It may be that she is really, really worried that this lump is something nasty. If we,you know,as vets, we see lots of lipomas and it's not something that we would necessarily worry about unless it's huge or causing the animals significant issues but actually, if you know that the client is worried about that then saying you know what are you most, giving her the opportunity to say I'm worried it might be cancerous, may guide your decision as to when to do more diagnostics sooner than potentially you might have chosen to do otherwise, OK? actually, if you say, well, the only way we're going to know is to take a sample of this lump, then actually you can progress things on the owner feels heard and you've made a decision understanding a little bit about that context and they're going to leave feeling like you actually listen to them, OK? Another one in terms of expectations is what do they hope you will be able to do today. So we've had I've certainly heard of complaints about you know, the client wanted an X-ray. And unfortunately, for example, in terms of busy, it may not be possible to do it on that day for all but you know, dire emergencies. Understanding what the client has come in expecting, you know, I was hoping you would be able to Start the tests or get something booked in, etc. If you understand what they're expecting, then you can either meet their expectations or you can help discuss, you know, sort of reframe their expectations. So I agree with you, for example, that an X-ray would be a great next step. We're Currently it takes about a week to get those organised, so we will certainly organise them for you. Again, the client is going to feel like you've taken their concerns seriously. Assuming an X-ray is warranted and but also you're not, you know, basically always never going to be able to help them with that, if that makes sense. So, it's understanding what they want from you. And then the final thing, and then I will stop talkingis understanding what the client's starting point is OK? And that's really, really good for everybody say you have a newly diagnosed diabetic. If you speak to them and say, have you got any knowledge or experience about diabetes, they may tell you that they have it, their family member had it, they've had a cat with it before etc. They may be a human endocrinologist, OK? And understanding that's going to save you a lot of time in terms of you can then, formulate your discussion and information to their level. Equally, say, have you got any knowledge or experience of this? And they Say none at all. And you're right. So you know that you need to start back with a little bit more basic information before giving them more info. So those are really, really in a nutshell important and good ways to try and get the client's perspective. Alison, if you've got anything else that's fine.

Thanks, Lou. Great, thank you very, very much, both of you. Lots in there, Lou, which will take us very nicely on to our Q&A for the panel. I thought you, you had great points in there, you know you made that lovely point about our everyday, it's probably unique situation for that client and we need to remember that, and those sorts of things, and lots and lots of comments around understanding the human. So if I move on to the pre-submitted questions which you sent for this webinar, we've grouped them into some themes that have come through and I'm going to go to the panel and ask for them to sort of give their um experience and thoughts on these questions. The first one is really around um learning um from our perspective as, as vets around um human behaviour, human psychology, to improve that that. Communication style and skills and getting in there at that early stage, and you obviously talked quite a bit about that there, Lou. But what resources can we guide people to where to start, what's helpful, how should we think about this sort of thing, and what have we learned in our time? so perhaps if I can start with Alison, your thoughts on this one, and then if you'd hand through onto the panel if they've got anything more to add, that'd be great.

Yeah, I think there is so much learning out there at different levels and about understanding the client, the client's behaviour and psychology. It's sometimes that we oversee, certainly at vet school level, where if you can just understand a little bit more about how clients think and their expectation, it really supports down to the basic consults of, being able to address that and communicate better.

Thank you, Alison, that's great. Grace, any thoughts from your perspective? Yeah, so I think it really dips into the client journey and active listening. So really thinking about the peak end rule, where the client will always remember the most intense moment of their journey, and then the very,very end. So, when you are at that investigation level of a complaint, really investigate. where that intense moment was, whether that's good or bad and then when you are at the complaint level and resolving it, really dipping into the very end and making sure that they walk away feeling listened to and heard and part of the outcome.

Absolutely, thank you very much, Max. Yeah,I really enjoyed that. I was actually taking notes throughout what Louise was saying then. And and it's sort of a few points sort of resonated with me a little bit, because at work I get sort of a lot of alot of stick for, for having lots of conversations completely irrelevant to the patient. So, you you're asking how they're doing, how their holiday was, you know, has their son, daughter graduated from university? And Actually I think that side of things is really interesting because you do learn things about people. And then that then helps to inform how we communicate with these people and the outcomes. and worst-case scenario, if you learn nothing you've then just possibly had an interesting conversation with someone. I think also there was another point that resonated in that. I remember someone once said something when we were dealing with a a postoperative infection. And that it was that this may be 1 in 100 or 1 in 1000 for us, but for this person at this time, this is their one in one. And I think it's us trying to relate to people and trying to put ourselves in their shoes that I think is really relevant.

Absolutely, thank you. Lou,if I can ask you to come in again on that, and maybe, comments coming in around the impact of the fact that there is money attached to our conversations with people, and we make a charge and there are costs and the impact that that has, and how we work on getting those um conversations had and how we can learn to get better. At doing that and the not losing that positive side to it to go forwards, and another question is coming around how much is being done in the education world around this and you're obviously based at Nottingham.

OK, so I'll answer the second question first, if that's OK in terms of what's being done in the education world, I can only speak for what is is at Nottingham, but certainly our students are Getting training on you know, client expectations, relationships and to care, etc., from year one. So certainly our graduates, are definitely getting it. but certainly, there are also excellent communication skills programmes at other universities too and certainly every school does teach communication skills, and professionalisms. Throughout their course now at UK universities, it is part of the course. So that is that is question two answered. Question one around how do we communicate cost or how do we learn understanding the impact that You know, the fact there is money involved, and we're going to make a charge, and there's payment considerations and the impact that has on the relationship building, and where we can work on our confidence with that and understanding what we need to do Yeah! in terms of what clients expect, there's been some very interesting research into this. mine is very much, oh, there's paper on that. And actually, they spoke to clients and they expect the vet to raise the cost, discussion, OK? I think the other thing that's Really important to remember is that clients are expecting to pay something. OK? I know we didn't necessarily go into this because we wanted to charge people money to look after their pets. but unfortunately, you know, it is a business, and it does have to function as that. I think understanding that you know, clients are going to, they don't expect this for free should hopefully give us some confidence in talking about it. In terms of how we can talk about it in a way that we feel comfortable withI would always advise let's talk about value, OK, rather than price. So, We say you recommend that an animal needs some, a blood sample doing because you're concerned. Actually,if you say the blood sample is 100 pounds, although I realise that actually it's probably going to be significantly more than that, depending on what we're sampling for but let's go with 100 pounds, OK? It's 100 pounds. Do you want to do it? and the clients like, oh well, 100 pounds is a lot of money. Lots of people don't just have that lying around. If we talk about its say I think a blood sample would be good in this case because actually it's going to give us some information. About Rover's kidneys, about how his liver is functioning, about his red and white blood cells, which is going to tell us how you know, it's going to tell us some more things about what's going on. It will help us rule in or rule out some things you know, some of the big diseases that we're worried about, the cost for that blood test is 100 pounds. That is going to sit a lot better with a client because they understand what that money is being spent on and the value it's going to give to the discussion. If they then say, Well actually 100 pounds is more than I can afford, then you can talk to them and say, OK, well, actually we could do a urine test, which is a little bit cheaper. It doesn't give us quite so much information but it can still tell us about a little bit about what the kidneys are doing, if there's any sugar in there and then you can start to negotiate you know, as to what is affordable for them and tend to use that language as well or would recommend using that language. So you know is that affordable to you? without judgement I realise that that is a lot of money. you know, is that affordable at this point, and it gives them that opportunity to say yes, actually,I thought it's going to be more than that, and you don't say that to the client or you go, OK, right, I understand, right, let's talk about another plan. You Know how else can we move this forward, because they're coming to you. They don't, they would love you to fix that pet instantly in a consult, but in reality, they want to leave with a plan. OK. That's we like diagnosis, we like to fix things, but the clients are actually looking for advice for progress. and so it's understanding that I could talk for hours about this. I know.

No, you, you again around that expectation meeting. That we did talk about, and I think there is that real value in us as as veterinary professionals, getting a focus on our non-clinical learning, doing that non-clinical CPD, seeing it as valuable, we've popped a couple of resources in the chatter as a start off to kind of point us in the right direction. There's a lot of provision out there, but it's quite hard sometimes to engage clinicians in spending their time and money on doing this sort of learning and development we, we tend to be keener on clinical CPD, but the value, it enables us to use our clinical skills to better effect, when we also improve our learning in this area. So just going to go on and talk before we open it to the floor for questions from today. We may not get through all the questions that we had pre-submitted, but there's one around how we can most effectively prepare the client from the point of um making the um initial appointment, their arrival in the practise, and then their arrival in the consult room. so there's different stages of the journey and how we can work together with the people involved in the different parts of it so, Grace, do you want to talk a little bit about um how you start from that?

Yeah, definitely. So obviously I'm at referral level, but you can apply this to local as well. So obviously for the client's journey, their first impression and their first start of that is on the phones at point of booking. So at a referral stage, we will run through a checklist and actually the first question that we will ask the client is, how is your pet, the vets? Do they get anxious? Are they nervous? What's their temperament? And then touch onto the client needs and what they need. and I think that's really important because straight away it sets up a positive client experience and they feel that they have a say in their experience already. A point of arrival we will make notes on the file of that telephone conversation. So if the pet is anxious, we ensure that we've put the time into taking them straight into a room, so they have that private space. and then throughout their journey it's just all about making sure that they're happy, they're kept updated and that they feel that they are part of the decision making so you know, it also touches on the medical terminology that's used, and sometimes they don't understand that and it can be quite confusing for them especially at a specialist level so we have fact sheets that we can give to clients based on conditions. And it's just really making sure that they feel involved in the journey and the decision making.

Thank you very much, that's great. Max, any comments around that preparation piece and how they arrive with you in the consult room? Yeah, sort of just echoing, echoing what Grace has said, you know, I think that the first telephone conversation is, is so vital because it's where you start to build that trust as a practise. And I think often it is, it is, undervalued. And sometimes it's really tricky, isn't it, you know, if you've got multiple phones going off at the same time but ultimately you know you need to prioritise the people that are in front of you at the time, and again, understanding what their expectations are, because they may be going to you because they've had a bad experience elsewhere and it could be something that could be avoidable for the future. So, for example, like one thing that we do if we've got a, puppy that's coming in is that sometimes the one of the nurses will come out and just spend a bit of time with the puppy in the consult room just build a bit of trust,you know,and try and get a bit of a gauge for the relationship and, and what they're expecting of that. And then obviously then when they come into the consult with, with one of us on the vet team, then we're just building on that and it's a continuation that makes us feel like we're all part of a team, hopefully working towards 11 thing.

And that's actually a really good example of that, investing a bit of time to reduce time needed in the future to get good outcomes where you've built that trust and started to build that relationship from very early on in the in the client journey. Thank you. I'm gonna keep going with um some of these pre-submitted questions. We,we had a big piece around understanding the client's concerns and motivations for being there, which I think you covered really well Lou, in your presentation. So, hopefully those have been answered. Another theme was around our use of language and the types of language that we can use to get, good responses and compliance from clients, especially when talking around I use the word slightly advisedly here, sensitive subjects, the classic one being around the conversation around insurance and is the pet insured and whether we've got any comments from the panel about constructive use of language to help us get good responses in these situations and tackle these situations with more confidence.

I think Louise covers some quite nice information there about how pre-framing the subjects, and I think the insurance is a big one because you ask it too early and you can see in your complaint letters all they were interested in money because they asked me if I was insured. And if you ask that question correctly, it can be used so much better in the sense of you know, what contextualised care options we, we offer can depend on what finances were available. So using that conversation and pre framing that in you may have spoken to our administration team this morning and just To check that they covered um your insurance documents, Etc, you automatically get feedback then well we're not insured or what we told her we only had this sort of um budget. So it's not asking that straight question, are you insured? Because they automatically think that the treatment level you're going to offer them is either within their insurance limit or is having an effect being driven by costs.

Lovely, thank you, Lou, did you want to come in with something on that, please? Yeah, totally agree with Alison, if you come straight out and say, are you insured, and there is definitely, and this came out in my PhD as well this preconception that vets have a different price insured versus uninsured, which is really sad, to be honest in terms of when to bring it up it can sometimes be helpful if you lay out the options and then potentially say something like this would be something that would be covered under pet insurance have you, have you got any or you know, are you insured at that? Because then you're saying it after you've given them the options, there's not like this is the option, this is how much we cost, it would be covered if that is something that you had, can just kind of, it's a different way of approaching it, and can sometimes soften it a little bit and not leave them thinking that you've given them different options because you ask them that question first, that makes sense.

And is that power. Which,you know, and if you're insured, it will be more than your excess, so you might want to make a claim. Well most people will give you a lead then as to whether or not they are insured. And as you say, you've laid out the options irrespective first, but you are still going to talk about money because as we said, there will be a a bill attached.

Max,any sort of thoughts from your perspective in the consult room? Yeah, it's a really interesting, isn't it, cos I think we make an assumption that if an animal is insured that we will be able to offer more treatment plans. And sometimes that's not the case. you know, sometimes people don't need insurance or don't believe in insurance or insure in a different way. So I think that that's one key thing is it's not assuming that someone, because someone is insured, they will want to do something, cos some people are insured, but ethically don't feel that chemotherapy would be appropriate, for example, and that I guess comes back to us understanding the client and the way that they behave. I think it is important to a degree to know that they're insured because some people on the flip side also. Are unaware that they would be able to be covered on insurance.um, and then that's interesting cos then possibly people are more reluctant to pursue an option cos they're not sure if that will be covered under insurance. So I think it is the elephant in the room, and I think it's appropriate to have a conversation, but equally we have to be careful that we don't make assumptions according to insurance.

Yeah, assumptions, absolutely always a problem. Grace, can I ask you sort of reactions you tend to, to see when you're doing that preparation work with clients, and I appreciate your talking from a referral set up, and there are some differences there, but you've got wider experience and connections. Yeah,so definitely there can be some negativity towards um insurance questions, financial questions, but I think um it's key just to manage that expectation and when you are as Alison was saying, it's all about the wording so when you are asking about finances and insurance, it's making sure that you word it in a positive light, showing them that actually we're asking because we want to help, we want to make sure that we manage throughout the journey, the correct treatment plans for them. And I think as well within that, it's important that all team members are aware from client care through to the nursing team, through to the clinicians.

Brilliant, yeah, thank you very much. We're never ending talking about communication, and there's one question in the chat about recording that contextual information which you referred to in your, your iceberg model with um Alfie and Mrs Smith. In a GDPR compliant way, and I think one of the things to start off is animal information doesn't uh come under GDPR, but obviously, we're thinking about our contextual information about that person at the end of the lead as well. Alison, have you any comments on that question please?

Yeah I do, clients who ask of and they're absolutely entitled to see their clinical records for their pets sometimes come to us through mediation and really upset and offended by what's been written and I think we need to just remember whenever we're putting clinical notes out on that out in practise that the client can absolutely read those, and we need to be really sensitive to that. I think Grace's journey initially is our receptionists are our eyes and ears and to you know what's going on and the passing that information on, also putting it in clinical records. And as long as we keep it factual, we're absolutely covered. And I think it's fine for a client if you obtain something that's quite personal to them. There is no harm in asking the client, Is that OK if I put that down on the computer system so that Max, your vet knows that when you, when you come to see him? And you're just showing empathy to the situation that they've shared with you, but you're covering yourself by that being OK, put in the clinical notes.

That's it, isn't it? Being confident to ask that question, showing that empathy, being clear and transparent about what we're doing it's the sort of common Themes coming through this and we've got something similar coming through in the chat, and this is actually lands very positively with clients and exactly as you're talking about it's empathetic and helping them and it is supportive. Thank you very much, that's good. We've had another question around dealing with situations where the client is very emotionally charged. We addressed this when we looked at the iceberg model, we don't know what else is going on but are there any sort of particular advice, languages that we can talk about? I I appreciate we need to be a little bit mindful of time, but I think this is a good one. To help us manage those conversations when we're, we're dealing with clients where perhaps their rational brain is not the dominant uh part at that time. anybody got any sort of comments around that that they'd like to bring in?

I, I can help, maybe, I think that the key one in this is, is whether or not they're emotive through anger or just through stress I think the key thing is to try and relate to that and to try and hear what they want you to hear and then to try and pick out from that, because sometimes people can, can wave for five minutes and you think, oh, I don't quite know. What I should be taking from that. So almost what I try and do is I, I almost, I give them the opportunity to for me to listen and for them to put across their point and then I try and pick out a few key points and ask them if they think that that is a fair assessment or synopsis of, of where we're at and then again if it's not, then it gives them an opportunity and then we can go back to the drawing board and start again but yeah, I think as I said, it comes back to just giving people your ear and an opportunity for them to be heard because sometimes people just want to be heard because they're not being heard elsewhere in their lives, or they don't feel necessarily that they've been heard by one of the other people in the team or vice versa.

Thank you, absolutely. And that's that real technique of coming back to them and showing that you've heard what they've said, even if it can be quite difficult to pick out and de-escalating situations as well. And that's a skill. you know, you'll watch people in other walks of life who it is their bread and butter, and it is a is a skill we can learn. Is it possible to make a comment ? It literally, we're getting to the end, but please do, if you can be brief or pop it in the chat. Yeah,if I can be brief, I mean, one is I'm impressed with the client interaction, that is you're promoting Louise's stuff is absolutely fantastic. And I wrote in the chat, what about the 10-minute time that is limited in many of the corporate vets? How do you fit all this into the 10-minutes of getting answers of what you're doing? And the other thing is, nobody has mentioned the receptionist. The role of the receptionist is obviously becoming uh critical er to cover some of these highly talented person at the front desk who's going to do a lot of this interface, OK, that's all I wanted to say.

That's great, thank you, absolutely, I think my, my takeaway from today has absolutely been the one around time and how we can actually shorten our consults with better conversation. But we'll, we'll just very quickly ask the panel to do that for literally a minute. And in terms of the role of the front of house, absolutely we are focusing on that and we do have Grace here who's representing the BVRA and in her role at front of house. Can I ask for one short comment around the 10-minute time factor, that's not universal, not everyone is working on 10-minutes, but the concept of working in, and maybe an inflexible time slot situation of however long the duration is.

Yeah, I guess it comes down to clients are hoping for a plan and some progress. They don't necessarily want you to fix everything in 10-minutes, so it's understanding their expectations, what is the agenda, what is the list of problems that they are coming to you with, and then prioritising and agreeing a priority level, and some things have to come back for a review. or another appointment and, and it's just being open and honest about that, from the start in a nutshell.

And with our better communication skills, maxing out what we can achieve in the time with that lovely smooth, I think there's that comment isn't it? I think I get it wrong every time but, smooth is, no, slow is smooth and smooth is fast, and getting that that nice frictionless consult,so I'm gonna sort of wrap up today, aware that we are approaching one o'clock, and a huge thank you, to all our attendees for joining today, and in particular to our panellists And Simon as well for, for your bit earlier.T hank you all so much. It's a big part of improving sort of everyday life and the care we can offer our clients and I hope some of the resources have been put in the chat are useful and that we can really urge that sort of willingness to learn and really focus on this sort of skill set, that we need in our roles as well as all our clinical skills as well. We have more sessions coming up in this series so please do um join them if they are of interest and helpful to you or encourage colleagues to do so. there will be a post event survey being emailed out. We really, really do value feedback on these. We try and do our research to find out what is needed and then deliver in response to that, but we do want to know what is landing and where we could improve and what else might be useful for it. and we will send resources by email to all attendees, and they'll be available on the our CVS website as well. So thank you all very much indeed. Enjoy the rest of this lovely day, in whatever way you can subject to work and hopefully we will see you on future webinars too. Thank you all very much, bye bye.