council meeting - to be held in committee · pdf filethe president further informed council...

Council Sept 17 AI 00

Council Sept 17 AI 00 – Agenda Unclassified / 2

Council Meeting - to be held in committee Thursday, 28 September 2017 at 10:00 am to be held at the RCVS, Belgravia House, 62/64 Horseferry Road, London SW1P 2AF

Agenda 1. President’s introduction

Oral report

2. Apologies for absence

Oral report

3. Declarations of interest

Oral report

4. Minutes of the meeting held on 15 June and 7 July 2017

Refer to Council minutes

5. Matters for decision by Council a. Alternative Disputes Resolution (ADR) trial Unclassified

(some annexes confidential)

b. Review of Disciplinary Legislative Reform Order (LRO) Unclassified c. Complementary and Alternative Medicines Confidential d. Code of Conduct for Council Members, and Policies for Managing

Conflicts of Interest, and Dealing with Complaints about Council Members

Unclassified

e. Election of Treasurer – process Unclassified f. Medunsa Veterinary School graduates, South Africa Confidential g. Chief Executive appointment - update Confidential h. Appointment of auditors Confidential /

Oral report

6. Matters for discussion a. New Schools Regulatory Review Confidential /

Oral report b. Governance update Confidential

7. Date of next meeting Oral report

Thursday, 2 November 2017 at 10:00 am (reconvening in afternoon 2:00 – 4:00 pm) Thursday, 18 January 2018 at 10:00 am (reconvening in afternoon 2:00 – 4:00 pm) – to be held in committee

Council Sept 17 AI 00

Council Sept 17 AI 00 – Agenda Unclassified / 2

Afternoon session 2:00 pm – 4:00 pm

8. Annual General Meeting of the RCVS Trust All Council members are invited to attend.

Refer to papers sent to Trustees August 2017

9. Presentations a. RCVS Knowledge Confidential b. Mind Matters Initiative

Confidential

10. Any other College business a. Estates Strategy – update

Oral report

11. Risk Register, equality and diversity

Oral report

Dawn Wiggins

Secretary, RCVS Council

020 7202 0737

[email protected]

mailto:[email protected]

Council Jun 17

Council Jun 17 – Minutes Unclassified Page 1 / 14

Council Meeting

Minutes of the meeting held on Thursday, 15 June 2017 at the Hilton Hotel, 4 Lanyon Place, Belfast BT1 3LP Members: Dr C W Tufnell (President in the Chair) Mrs E Acaster Professor R A Hammond* Professor D J Argyle* Professor M E Herrtage Mr C T Barker Mrs L V Hill Mr D J Bartram Mr D C Hutchison Ms A K Boag Mrs A K Jeffery Dr K Braithwaite* Mrs R J Jennings* Professor E Cameron Mr P C Jinman Mr D F Catlow Mr T J King Dr N T Connell Professor S A May Dr J V Davies Dr J R Molyneux* Mr R Davis Mrs S Paterson Professor S Dawson Professor S W J Reid Dr M A Donald Dr K A Richards Mrs J M Dyer* Mr P B Robinson Professor G C W England* Dr K S H Salmon Mr N P Gibbens* Col N C Smith Miss L V Goodwin Dr C P Sturgess Dr C J Gray Dr P B Viner Dr M O Greene Dr T H Witte Professor T R C Greet Professor J L N Wood*

*Denotes absent

In attendance: Ms E Butler Chair, Audit and Risk Committee Mrs E K Cox Chair, Veterinary Nurses Council Ms E Ferguson Registrar Mr D J Thompson RCVS Past President (open session only)

President’s introduction 1. The President welcomed members and guests and outlined the order of the meeting.

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2. Per the President’s request, Dr Gray gave a brief outline regarding the Alzheimer’s Society National Cupcake Day and thanked the hotel for providing Council with cupcakes to have with their coffee at the meeting and encouraged members to donate money to the charity.

3. The President further informed Council that he would be walking approximately 75 kilometres

along the Thames Path on Thursday, 22 June 2017, from Windsor to Westminster and any charitable donations to the Presidential fund would be welcome (the President of each year had a charity, or charities, of their choice that various fundraising initiatives throughout the year would go towards).

Apologies for absence 4. Apologies have been received from:

• Professor D J Argyle • Dr K Braithwaite • Mrs J M Dyer • Professor G C W England • Professor N P Gibbens • Professor R A Hammond • Mrs R J Jennings • Dr J R Molyneux • Professor J L N Wood

Declarations of interest 5. There were no declarations of interest.

Minutes of the meeting held on Thursday, 2 March 2017 6. Council accepted these minutes as a true record of the meeting.

Matters arising Obituaries 7. Council were notified of the passing of the following people:

• Dr Andrew Edney, Ex-President of WSAVA and BSAVA, and past-Chairman of the Blue Cross;

• Mr Ian Hutchinson, veterinary surgeon from Arundel;

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• Lord Soulsby, past President of the College 1984-85. 8. Council observed a minute silence for members that had passed away since the last meeting, and

also for the people who had perished in the fire at Grenfell Tower in London the day previously and in the two recent terrorist attacks in Westminster and Manchester.

Council correspondence and matters for report RCVS Day 2017 9. The President reminded Council of the arrangements for RCVS Day in July and requested that

anyone who had yet to respond should contact Emma Lockley in the Communications Department as soon as possible. The arrangements were:

Date: Friday, 7 July 2017 Venue: Royal Institute of British Architects (RIBA), 66 Portland Place, London W1B 1AD Timings: 09:30 am: Coffee 10:00 am: Annual General Meeting (followed by Meeting of Council) 11:00 am: Presentation of awards followed by: President’s address; Talk from our guest speaker Dr Ebony Escalona MRCVS from the veterinary charity ‘The Brooke’, with a talk entitled: ‘Jump outside the veterinary box: widening our horizon’; and Investiture of new President 12:45 pm: Lunch 15:00 pm: End

RCVS Council elections and appointments 10. Council noted the outcome of the recent RCVS Council elections. One current member had been

re-elected [Dr Tufnell]; and five newly elected members would be formally confirmed to take up positions at Royal College Day in July. These were: Dr Caroline Allen; Miss Sarah Brown; Dr Danny Chambers; Mr Martin Peaty and Dr Cheryl Scudamore.

11. There were no university changes for the 2017/2018 College year, and confirmation was awaited

from the Privy Council Office for the re-appointment of Mr Richard Davis. CEO update 12. The CEO introduced the paper and highlighted: Great Place to Work 13. This was the third year running that the RCVS was in the top 30 employers for being a great place

to work, the new Director of HR, Kim Cleland, would progress this further; Europe and new Secretary of State for Environment, Food and Rural Affairs 14. Following the recent General Election, The Rt Hon Michael Gove MP had been appointed as

Secretary of State for Environment, Food and Rural Affairs. The College had written to him with a request for a meeting to discuss the veterinary profession / EU Exit. It was noted that the CEO

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was to have a meeting with the Chief Veterinary Officer, Professor Gibbens, on Monday, 19 June 2017.

15. The CEO had attended the recent FVE meeting in Talinn and there had been a number of

discussions about what kind of arrangements could be put in place for the future for different countries. The same had happened with EAEVE meetings with the RCVS, therefore continuing to work closely and pro-actively with EU colleagues.

Vet Futures 16. Work was on-going to connect internationally and globally – four countries had taken on Vet

Futures work and number of others had borrowed the Vet Futures ‘tag’. Mind Matters 17. This continued to be an extremely positive venture, with the sense that other countries were

looking at the work done by the RCVS so MMI (Mind Matters Initiative) could potentially become MMI (Mind Matters International) in the future and discussions were on-going.

Concerns process 18. KPIs were starting to be met as a result of changes put in place and how the work was

approached; ADR was also making a difference, so the College was starting to move into a more appropriate place to focus on service issues.

19. There were no questions.

Matters for decision by Council (unclassified Items) RCVS Fellowship appeals procedure 20. Professor Dawson, Chair of Education Committee, introduced the paper. It followed on from

Council’s request to set up an appeals procedure for fellowship applications, and was in-line with the Examinations Appeals procedure where it focussed on procedural irregularities not on the decision of the Panel.

21. The cost of £100 to appeal was queried. It was confirmed this was to cover the administrative

costs of the appeal, and would be refunded if the appeal was upheld. It was further questioned whether ‘irregularities’ (page 3 of the paper, paragraph 7, point 3) could be defined or whether it would be on a case by case basis which could further lead to irregularities. It was confirmed that it would be on a case-by-case basis, which was the same as with other RCVS appeals processes.

22. A vote was taken. Council unanimously agreed the RCVS Fellowship appeals procedure as set

out in the paper. Other awards 23. The President introduced the paper. It had been felt that, as the Fellowship process had recently

changed and Vet Futures work was on-going, it was an opportune time to consider historical and

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potential new awards. There was a paper before Council that proposed three new awards that would be offered for nominations in the next awards ‘round’ that opened in the summer. These were:

• RCVS Impact Award – for a veterinary surgeon or veterinary nurse who had made a

considerable impact that had affected the profession at large, animal health or welfare, or public health – this would fall into the normal awards cycle;

• RCVS Inspiration Award – for a veterinary surgeon or veterinary nurse who had demonstrated

the ability to inspire and enthuse others consistently throughout their career – this would fall into the normal awards cycle;

• RCVS International Award – for nominees who had worked internationally from within or

outside the UK and had made an outstanding contribution on issues that were in line with the RCVS mission; they could be a veterinary surgeon, veterinary nurse, or lay person – this would fall into the normal awards cycle. As agreed at March 2017 Council meeting, the first of this award, the ‘Inaugural RCVS International Award’, would be presented to Christophe Buhot at RCVS Day on 7 July 2017.

24. In addition, the RCVS Innovation Prize was outlined: this would be open to individuals or teams

who had either already developed an innovation or were developing one that had a clearly designed concept; open to all innovations that contributed towards the delivery of animal health and welfare or One Health in terms of ideas around processes, service delivery or business structure; there must be at least one veterinary surgeon or veterinary nurse on the team but other members could be lay people; in the case of individuals it must be a veterinary surgeon or veterinary nurse – this would not be in the normal awards cycle, instead a prospectus would be submitted for judging by a Panel.

25. Re: RCVS Inspirational Award: it was commented that it could be perceived that nominations

would only be for people c. 30 years into their career. It was noted that Nominations Committee would consider the people before them for decision, regardless of length of time in the profession, but it would be made clear in the guidance that it was open to all members. Further, (paragraph 5 to the paper) it was suggested that ‘...or tutor’ be removed as a professional colleague could already include that. This was agreed.

26. There was discussion regarding the number of awards (up to 2) and the prestige accompanying a

limited number. 27. Re: RCVS Innovation Prize: it was questioned whether this included educational innovations? It

was noted that this had been considered, and if an educational innovation had made an impact, then it could be put forward for consideration by the Panel.

28. A vote was taken. Council unanimously agreed the introduction of the proposed awards (with the

slight amendment to the wording of the Inspirational Award), and support for the Innovation Prize.

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Complementary and alternative medicines (CAMs) 29. Mr Catlow, Chair of Standards Committee, introduced the paper. He highlighted that:

• the Committee had met twice to discuss this topic; there had been a great deal of work undertaken and external Counsel’s advice sought;

• following that advice, it was accepted that the existing wording of the Code of Professional

Conduct (CoPC) and Supplementary Guidance (SG) was good and committee did not make any recommendations to change those;

• within the Veterinary Medicines Regulations (VMRs) there was differing treatment of

homeopathic remedies from other medicinal products with reference to efficacy; the committee strongly supported that this should be raised with the Veterinary Medicines Directorate (VMD) for discussion; and

• there was a wish to strengthen the RCVS position in view of CAMs and Council was asked to

comment on the proposed statement in order to feedback to Ops Board on how to move forward.

30. Comments and questions included but were not limited to:

- in the consideration of the position statement on CAMs, had there been any attempt to categorise therapies?

o it was indicated that there had not; the wording was intended to focus on, and to apply

across the board – if Council wanted a new remit of separate categories then it could be considered but this was felt to be unwise;

- Council were reminded that this had come from a specific enquiry around a specific point

about what the College expected of practitioners; and it was questioned if this should be reflected in the statement to put it in context;

o it was suggested that it should include a comment that stated it was a statement in

response to an enquiry around the question of CAMs; 31. Re: the proposed new position statement:

- it was suggested that ‘complementary [and alternative]’ might be removed, and to word the statement to say that the College supported evidence-based veterinary medicine (EBVM);

o it was felt that EBVM would be understood from this statement;

o concerns were expressed regarding ‘evidence-based’ as it might be suggestive only of

clinical trials or systematic reviews when there was a hierarchy; there was a discussion regarding rationale approach that might be tried if nothing else worked. However, if no rationale, it could not be part of the evidence-based paradigm;

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- point one: should read ‘veterinary medicine’, not ‘veterinary surgery’;

- point 3: what is ‘adequate’ and in whose judgement? There was a discussion about collectively accepted practice, stemming from science. Also, if clients sought a view from a veterinary surgeon about a treatment and there was no evidence to support it, if that could not be offered, it could instead be set up by people who were not veterinary surgeons, which should be avoided;

- it was commented that whilst a short general statement was agreeable and should be

considered, it was important not to restrict innovation;

- regardless of what the current or proposed statements said, a veterinary surgeon must make the client aware of what they were trying to do and get informed consent;

- it should be made clear that any position statement (new or proposed) was not changing the

CoPC or SG;

- there was discussion around vaccinations – could prophylactics be included not just have them as a footnote?

o it was noted that there were other claims for prophylactic medicines so it was not just

about homoeopathy – this could be broadened to include unproven claims;

o it should be a core statement, rather than relating to prophylactics one week and another matter the next week;

- it was suggested that points 1 and 2 be combined, and points 3 to 5 be combined; that any

statement should be kept general, rather than specific, as there could be unintended consequences.

32. Council agreed that comments should be fed back to Operational Board in order to produce a

further proposed alternative position statement for consideration at a later meeting. Exemption Orders / Associates of the RCVS 33. Dr Viner, Vice President (Senior) and Chair of the Exemption Orders and Associates Working

Party, (EOAWP) introduced paper. He stated that:

- the report in front of Council was an interim report but one that contained a lot of information; where the EOAWP was currently; that significant external views had been sought, and thanks were given to the people involved;

- Defra had asked the RCVS to undertake this work as current Exemption Orders (EOs) had

built up in a piecemeal fashion; and that they were directly relevant to the Veterinary Surgeons Act (VSA);

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- the Working Party (WP) had looked at: a way to rationalise the EOs that existed now, identify areas not covered, and ‘future-proof’ them. The flowchart at Annex B to the paper provided a visual guide to the steps to be taken when considering if any procedure should be exempted;

- it was stressed as per paragraph 7 in main paper, that all of the procedures considered would

continue per the ‘status quo’ unless, and until, Defra took any proposals forward and amended the current legislation;

- Annex C, Guidance Note 2: confirmed that EOs should only be in place for minor

tests/operations/treatment. Legal advice had been sought as to what clarified as ‘minor’. There was no formal definition. It was, however, felt that by definition to qualify as minor would only require a short period of days of training (i.e. not to degree level);

- thereafter, what was the reason for carrying out that procedure? With subsequent suitable

guidance;

- Annex C, Guidance Note 5, paragraph 17: the concept of over-arching guidance for all EOs should be applied:

o persons carrying out the procedure should be over the age of 18, unless carrying out the

procedure as part of training / under supervision, when they should be over the age of 16;

o rationalisation of people who were suitable to do the procedure(s) e.g. animal welfare offenders would not be deemed suitable;

o there should be re-validation of competence / training / qualifications every 2 years.


- it was acknowledged that this was a significant piece of work and the sooner it was concluded the better it would be;

- the age of 18 was questioned, when there was often younger people working in agriculture

and it was possible to get married at 16;

o the age of 18 was in current legislation, but it could be a judgement call as there was the proposed over-arching principle that if training / under supervision then it could be from the age of 16. Sector Councils had been consulted and to date none had raised the issue of the age of 18, however, should this work proceed to consultation there would be an opportunity to modify it thereafter;

- it was questioned what the proposal for a 2-year re-validation cycle was based on, and what

evidence was there to reflect and justify this, particularly when veterinary surgeons qualified over 5 years and veterinary schools were re-accredited every 7 years?

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o 2 years appeared already in some EOs, so it was broadened to cover them all; it could be a fairly simple re-validation process as the issue was one of judgement and competence in the area concerned;

- it was suggested that when considering harm, that it should be considered similar to work with

risk registers i.e. how likely harm would be and what would be the consequence(s)?

o this suggestion would be taken back to the WP;

- the point was raised that a lot of a veterinary surgeon’s work was the basis of normalcy, that ‘diagnosis of normalcy’ could be done by a lay person but went to the core of veterinary surgery – when did a statement of observed fact, i.e. something you could see, become diagnosis? If examination of a horse’s teeth was not deemed to be an act of veterinary surgery (Standards Committee Report, paragraph 48) it calls into question whether examination of teeth in other animals would also not be veterinary surgery;

o there were differences between recognising when something was wrong, to diagnosis; a

failure to say something was wrong in a horse’s mouth could cause more problems. This point, however, would be taken back to Standards Committee.

35. All of the proposed amendments to, removals of, and introduction of new, EOs at Annex E were

outlined. Comments and questions on this section included but were not limited to:

- re: rectal ultrasound scanning of bovines: it was proposed that Defra should hold a list – what about devolved governments?

o the devolved governments had been contacted and the College was awaiting replies;

- re: epidural anaesthesia in bovines: should this be restricted to veterinary surgeons?

o this was not deemed to be a minor procedure, so not eligible for an EO;

- non-surgical artificial insemination of bitches was not specified and should be;

o this was agreed;

- it was questioned when a person was certified fit by a veterinary surgeon, whether they had

indemnity and who was ultimately responsible, the person doing the procedure or the veterinary surgeon?

o this would be taken back to the WP for consideration.

36. Equine dentistry procedures were highlighted in that:

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- Category 1 procedures: it was understood that Category 1 procedures had been re-considered; that several aspects should be classed as acts of veterinary surgery but that these could be covered under an EO;

- Category 2 procedures: these were procedures carried out by qualified Equine Dental

Technicians (EDTs) / were acts of veterinary surgery but there was an on-going ‘amnesty’ as no action was being taken against EDTs in carrying these out. The WP concluded that those procedures could not be specified as minor and it should be considered whether Schedule 3 of the VSA could be broadened to include EDTs. It was considered that it could open up associate membership;

o the removal of ‘loose teeth’ by Veterinary Nurses (VNs) was questioned, a definition of

‘loose’ was that VNs could only take out teeth when they were loose enough to take out with their bare hands.

37. A vote was taken to approve the WP recommendations in relation to EOs set out in Annex E (with

the amendment at paragraph 35, point 3) in order to be presented to Defra. This was unanimously agreed.

38. Physiotherapy was discussed and it was noted that:

- the RCVS defined ‘physiotherapy’ as including all manipulative therapies, which was different to what the public understood physiotherapy to be;

- there were a number of different industries that had been built up around this;

- there were parallels with EDTs – where significant qualifications had often been gained by

some practitioners, physiotherapists / osteopaths / chiropractors could also potentially become associate members in one form or another;

- it was recognised that to redefine ‘physiotherapy’ and to classify into aspects eligible for EO

and otherwise was a significant piece of work and would be a Council decision whether to go forward.


- was this now the time to create more clarity re: para-professional groups who undertake procedures/acts of veterinary surgery that had a different framework to EOs? – to become an ‘expert technician’ not in an exemption category;

o the issue would be whether, and to what extent it might be possible, to ‘stretch’ the VSA

in such a way;

- would those carrying out any manipulative therapy, regardless of qualification, be breaking the law if not under the direction of a veterinary surgeon?

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o yes, technically they would be breaking the law;

- how would any of the suggestions be enforced and, if it was not enforceable, what could we do within our profession?

o an enforceable framework would be put into place and the RCVS would encourage

authorities to do likewise;

o it was suggested that the onus should be on the different professions (physiotherapists, etc.) and that they should do their own ‘whistle-blowing’;

- it should be noted that regulation of EDTs / physiotherapists under Schedule 3 was a

possibility, not a fact – the VSA stated what vets could do, with certain ‘carve outs’, it was not, however a veterinary services act. Further ‘stretching’ of Schedule 3 still had a question mark over it and changes may eventually fall back into the Legislation Working Party for consideration;

- had zoo procedures been considered as they are a unique category?

o it was confirmed that the WP had received input from the British Veterinary Zoological

Society, and that the VSA applied within the zoo environment with no special exemption – there is usually one, or more, vet(s) that had responsibility.

40. A vote was taken. Council agreed to undertake work to form proposals in relation to amending

the current EO for physiotherapy. 41. The criteria for associate status were outlined. Comments and questions included but were not

limited to:

- if associates were brought in-house, there could be a significant requirement for staff – how would that impact on the current arrangements?

o the initial decision should be regarding associates, rather than informing Estates Strategy,

however with the proposed re-configuration of Belgravia House there should be adequate facilities;

- there were broader considerations with legislation and what could be done within the current

VSA? It was noted that Exemption Orders related to specific procedures and therefore were different to considerations about professional groups; it was suggested that consideration should be given to what would be wanted in the public interest re: the veterinary team for the future?

o it was noted that whilst the idea of a ‘vet led team’ for the future was attractive, it had to

be kept in mind that there were already, for example, EDTs who had direct contact with clients and trying to change that would be extremely difficult;

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- re: the accreditation model: this seemed to assume they would be one large organisation that had current procedures already in place; there were smaller groups that were too small to deal with this themselves – had they been considered?

o it was noted that they had potential to join together;

- if, for example, 10 groups came together, they might as well regulate themselves – why would

they want to come to the RCVS?

o it was noted that RCVS accreditation / associate status would enhance their standing. It would also assist vets in who they should and should not refer to (and increase public knowledge);

- any associate status should not be seen as protectionism of veterinary surgery but rather to

focus on the benefits of the animal; it was suggested that with any associate the RCVS should reserve the right to have observer status on their own governing body.

42. A vote was taken. Council unanimously agreed to approve the criteria for associate status set out

in paragraph 43 to the paper. 43. Regarding the decision of whether both models of regulation described in the paper should be

considered options going forward: there was no clear steer on either model. Council agreed to keep both options open.

VN Registration Rules 44. The Registrar introduced the paper, and explained that it was a straight-forward amendment in

order to disassociate fees from the Rules. There was a similar process for the fee structure for other matters in the College.

45. A vote was taken. Council agreed unanimously to disassociate fees from the VN Registration

Rules.

Reports of committees – to note Audit and Risk Committee Minutes of the meeting held on 23 February 2017 46. There were no questions, the report was noted. (Draft) Minutes of the meeting held on 8 May 2017 47. There were no questions, the report was noted. Annual report of the committee 48. There were no questions, the report was noted.

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Education Committee 49. There were no questions, the report was noted. Standards Committee 50. There were no questions, the report was noted. Veterinary Nurses Council 51. There were no questions, the report was noted. PIC / DC Liaison Committee 52. There were no questions, the report was noted.

Reports of statutory committees – to note Preliminary Investigation Committee 53. There were no questions, the report was noted. RVN Preliminary Investigation Committee 54. There were no questions, the report was noted. Disciplinary Committee 55. There were no questions, the report was noted.

Notices of motion 56. There were no notices of motion received.

Questions 57. There were no questions received.

Dates of future Council meetings 58. The President reminded Council that calendar dates to the end of 2018 had already been sent

out. Dates of future Council meetings were:

Friday, 7 July 2017 (RCVS Day / AGM) Thursday, 28 September 2017 – to be held in committee Thursday, 2 November 2017 Thursday, 18 January 2018 – to be held in committee

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Thursday, 8 March 2018 Thursday, 14 June 2018 Friday, 6 July 2018 (RCVS Day / AGM) Thursday, 27 September 2018 – to be held in committee Thursday, 1 November 2018

Retirements from Council 59. The President reported that there would be five retirements from Council from Royal College Day

in July 2017:

• Dr Jerry Davies (elected) – 16 years • Dr C J Gray (elected) – 8 years • Mr P C Jinman (elected) – 12 years • Dr B P Viner (elected) – 12 years • Dr T H Witte (elected) – 4 years

60. On behalf of Council, the President thanked those members for their hard work and contributions

both to College and Council. 61. It was noted that Dr Davies, Mr Jinman and Dr Viner had all done just about every job in the

building, including being President in 2011 – 2012 / 2010 – 2011 / and 2015 – 2016 respectively and the President would carry out Council’s thanks to them on RCVS Day in July.

62. The achievements of Drs’ Gray and Witte while members of Council were listed, and they were

each presented with a scroll with grateful thanks.

Dates of next meetings 63. The next meeting was to be held on Thursday, 28 September 2017 at 10:00 am (reconvening in

the afternoon) and would be held in committee. 64. The next open meeting thereafter was Thursday, 2 November 2017 (reconvening in the

afternoon). 65. Council thanked staff for arranging the series of meetings in Belfast. Dawn Wiggins

Secretary, Council

020 7202 0737

[email protected]

[PAGES 15 – 22 CONFIDENTIAL TO COUNCIL MEMBERS ONLY]


Council Jul 17

Council Jul 17 – minutes Unclassified Page 1 / 2

Council Meeting

Minutes of the meeting held on Friday, 7 July 2017 at the Royal Institute of British Architects (RIBA), 66 Portland Place, London W1B 1AD Members: Dr C W Tufnell (President in the Chair) Mrs E Acaster Professor T R C Greet Dr C J Allen Professor R A Hammond* Professor D J Argyle* Professor M E Herrtage Mr C T Barker Mrs L V Hill Mr D J Bartram Mr D C Hutchison* Ms A K Boag Mrs A K Jeffery* Dr K Braithwaite* Mrs R J Jennings Miss S J Brown Mr T J King* Professor E Cameron* Professor S A May Mr D F Catlow Dr J R Molyneux Dr D S Chambers Dr S Paterson Dr N T Connell Mr M L Peaty Mr R Davis* Professor S W J Reid Professor S Dawson Dr K A Richards Dr M A Donald Mr P B Robinson Mrs J M Dyer Dr K S H Salmon* Professor G C W England Dr C L Scudamore Professor N P Gibbens* Col N C Smith* Miss L V Goodwin Dr C P Sturgess* Dr M O Greene Professor J L N Wood *Absent In attendance: Ms E Butler Chair, Audit & Risk Committee Mrs E K Cox Chair, Veterinary Nurses Council Mrs E C Ferguson Registrar

Apologies for absence 1. Apologies for absence had been received from:

• Professor D J Argyle

Council Jul 17

Council Jul 17 – minutes Unclassified Page 2 / 2

• Dr K Braithwaite • Professor E Cameron • Mr R Davis • Professor N P Gibbens • Professor R A Hammond • Mr D C Hutchison • Mrs A K Jeffery • Mr T J King • Dr K S H Salmon • Col N C Smith • Dr C P Sturgess

Declarations of interest 2. There were no declarations of interest.

Matters for decision by Council Approval of the Presidential Team and Treasurer for 2017/2018. 3. The Registrar asked Council to approve the appointment of the new Presidential Team and

Treasurer for 2017/2018 as follows: President: Professor S A May Vice President: Dr C W Tufnell Vice President: Ms A K Boag Treasurer: Dr C P Sturgess

4. The Presidential Team and Treasurer appointments were approved.

Dates of next meetings 5. The dates of the next Council meetings were confirmed as:

Thursday, 28 September 2017 at 10:00 am (to be held in committee) Thursday, 2 November 2017 at 10:00 am

Dawn Wiggins

Secretary, Council

020 7202 0737

[email protected]


Council Sept 2017 AI 05a

Council Sept 17 AI 05a - ADR Unclassified Page 1 / 9

Meeting Council

Date 28 September 2017

Title Alternative Disputes Resolution (ADR) trial

Classification Unclassified

Summary Summary of the second ADR trial with Veterinary Client Mediation Service (VCMS), including results and feedback

Decisions required Council is asked to decide whether or not it wishes to continue with the VCMS (administered by Nockolds)

Attachments Annex A: RCVS & VCMS Working Together – Policy Statement Annex B: Nockolds/VCMS proposal Annex C: Nockolds/VCMS proposal with costs (Confidential) Annex D: Written comments from Advisory Panel (Confidential) Annex E: Comments from the Veterinary Advisors (Confidential) Annex F: Options – costs and resources (Confidential) Annex G: Summary (Confidential)

Author Eleanor Ferguson Registrar/Director of Legal Services [email protected] Gemma Kingswell Internal Policy & Senior Manager, PSS [email protected]





Introduction 1. As Council is aware, the second RCVS alternative dispute resolution (‘ADR’) trial began on 3

October 2016 and is administered by Nockolds Solicitors. The scheme is known as the Veterinary Client Mediation Service (‘VCMS’). This paper, together with the annexes, provides an update in respect of the VCMS trial and considers options for the future.

Background 2. The last 10 years has seen a steady increase in the number of concerns submitted to the RCVS.

In the 12 months to the end of December 2016, 983 concerns were registered with the RCVS, (an average of 82 per month). Council will recall in 2016 the difficulties that arose in meeting the target times for completion of stage 1 cases (4 months) and the additional resources that it was necessary to inject to clear up the back log that had arisen in dealing with this volume of concerns.

3. The jurisdiction of the RCVS under the Veterinary Surgeons Act 1966 is by reference to serious

professional misconduct. Historically, around 80% of complaints have not progressed beyond Stage 1 of the concerns process. Within this group there are potential cases of negligence as well as consumer and service type of disputes neither of which the RCVS has power to resolve as they do not cross the high threshold of misconduct. In certain situations ‘advice‘ relating to the Code of Professional Conduct may be given to the veterinary professional at this stage, but the process offers no practical solutions or avenues for redress for consumers who may consider that something has ‘gone wrong’. This can lead to dissatisfaction with the RCVS, a situation heightened as the only alternative is to seek a remedy through the civil courts, (which in most situations would be impractical/disproportionately expensive). According to the Environment, Food and Rural Affairs Committee of the House of Commons in 2008, ‘Allowing such a large number of complaints each year to be dismissed in this way inevitably harms the reputation of the veterinary profession’.

4. In addition to this, the past few years has also seen increasing consumer awareness and

championing of rights in other service areas. ADR has also gained a heightened profile as the alternative to courts for a range of disputes, in a range of sectors and is increasingly seen as the appropriate way to resolve disputes, between consumers and service providers creating an expectation that this will extend to the veterinary sector.

5. In June 2014, Council agreed to trial an ADR scheme and in November 2014, the first trial

administered by Ombudsman Services (OS) was launched. Council will recall that a key feature of the OS process was that cases required first to have ‘gone through‘ the RCVS complaints process before they could be considered. Once this had occurred, if both parties agreed, papers would be sent by the RCVS to the OS. It did not therefore operate as an alternative to the RCVS complaints process. This contributed to a low uptake by veterinary surgeons who were reluctant to embark on another procedure after the RCVS process had been concluded, and as a result was the subject of dissatisfaction from complainants. It was an adjudication system and this also came in for criticism; it was heavily reliant on veterinary advisors input to determine a



recommended outcome, which took time; was seen as a cumbersome process, and was not binding. Different types of recommendation were made ranging from no further action to apologies/‘goodwill gestures‘ and while practices did not on the whole express dissatisfaction with the recommendations, the overall process did not generate wide acceptance.

6. In 2016 following consideration of the results of the OS trial, Council decided that a second trial

with a different process and a different provider was appropriate. Nockolds was selected as the provider and the VCMS came into being in October 2016.

The VCMS trial How it works 7. VCMS is a direct access service, meaning that complainants can access it without going through

the RCVS process in the first instance, it aims to resolve consumer disputes through mediation. It has its own website and ‘presence’ separate from the RCVS see https://www.rcvs.org.uk/concerns/veterinary-client-mediation-service/ In essence, mediation assists the parties to reach a resolution together rather than an outcome being ‘imposed’. The service is voluntary, so that both parties must agree to take part, which is in keeping with the spirit of mediation. As with the OS scheme the VCMS has access to four veterinary advisers: three small animal practitioners and one equine practitioner, although by virtue of the nature of mediation their use has been limited (advisors have been used in a total of 23 cases).

8. At the same time as the introduction of the VCMS, and complementary to it, the RCVS introduced

an ‘Enquiries stage’ to its concerns process. In essence, the Enquiries stage is a triage stage that allows the RCVS to identify early on whether or not a concern is best suited to the VCMS or RCVS process and to signpost the enquirer to the appropriate service. The Enquiries stage involves complainants contacting the RCVS either through a short enquiries form on the RCVS website or by telephone and then discussing their concerns with a Case Manager. The Case Manager assesses the individual’s concerns and either advises them to contact VCMS or asks them to complete a ‘full’ RCVS concerns form.

9. In order to ensure that the RCVS meets its statutory obligations under the Veterinary Surgeons

Act 1996 (‘VSA’), the VCMS and RCVS have devised a ‘working together policy’ (see Annex A). This is particularly important with a direct access ADR scheme. Amongst other things, this policy deals with the circumstances in which VCMS must pass a case directly to the RCVS.

10. In practice, there is an open dialogue between the team at VCMS and the Professional Conduct

Department, which allows both sides to talk through cases in order to ensure they are diverted down the correct route. In addition, a rigorous audit process has been implemented throughout the trial. This process has involved three members of RCVS staff (Eleanor Ferguson, Registrar/Director of Legal Services, Gemma Kingswell, Internal Policy and Senior Manager PSS and Gemma Crossley, Senior Case Manager/Solicitor) working through every case accepted by VCMS up to 13 July 2017 and assessing whether or not the facts disclosed an arguable case of serious professional misconduct (‘SPMC’). Reassuringly, the audit process did not identify any

https://www.rcvs.org.uk/concerns/veterinary-client-mediation-service/



cause for concern and all cases being dealt with by VCMS appeared to be appropriate and fall outside of the RCVS’ jurisdiction.

11. The trial (as for the OS trial) was overseen by the ADR Advisory panel, which, in addition to

RCVS representatives, consisted of representatives of the VDS and British Veterinary Association (BVA) together with a consumer representative.

12. In addition to working closely with the RCVS, VCMS have also worked hard to develop good

relationships with key stakeholders such as the VDS and major veterinary employers through the Major Employers Group. More information about these efforts can be found in Nockold’s proposal at Annex B.

13. Key features of the process were direct access by the public and a mediation process (via

telephone) which focussed on a solution acceptable to both sides rather than the imposition of an outcome. Also key, has been the Enquires system, which allows the RCVS to positively signpost an alternative for consumers to the RCVS concerns process with processes in place to safeguard the statutory obligations of the RCVS. Also key has been VCMS development of relationships with stakeholders, in particular the VDS.

Impact on RCVS concerns process 14. Since the beginning of 2017, the number of concerns received per month by RCVS has shown a

significant decline with the average since January 2017 – 51 per month. 15. It is believed that this reduction is directly related to the existence of VCMS and in particular,

being able to direct unsuitable concerns away from the RCVS at the Enquiries stage. Further, there is clear messaging on both the RCVS and VCMS website about what types of concerns each process can deal with meaning that consumers are able to make a more informed choice about which service they contact in the first instance.

16. Although the numbers of concerns have decreased, the RCVS is receiving a large number of

Enquiries as described in paragraph 8 above. In the period from 1 January 2017 to 31 August 2017, there were 2350 Enquiries (1548 telephone enquiries and 802 email enquiries). As explained, a proportion of Case Manager time is being diverted away from dealing with concerns towards dealing with Enquiries. At present, the Case Managers operate a rota system so that one person is allocated exclusively to enquiries each day, with additional ‘top up‘ as necessary. This means that the Enquiries work effectively requires at least one dedicated Case Manager to cover it. However, with a reduced number of concerns this is manageable with the current staffing arrangements. At the same time, for cases registered since January 2017, target times for Stage 1 have been met in an average of 89% of cases.

17. The impact on the RCVS complaints process has therefore been a positive one; it has meant

fewer cases going through the RCVS process with those that do so being dealt with at Stage 1 in a more timely fashion. The result of this is a reduction in the stress and anxiety that is reported for any veterinary professional involved in a complaint to their regulator. It has also allowed the RCVS to focus on the complaints that it does need to consider as potentially falling within its jurisdiction and to process the early stage more quickly. It has also enabled more positive



interaction with consumers as they can be offered an alternative route for redress for cases that will never meet the threshold for misconduct.

Results and feedback 18. Full details of the outcome of the trial, together with feedback received from participants and the

objectives set by VCMS at the beginning of the trial, can be found (in the proposal) at Annex B. The summary of key points is as follows:

Numbers 19. Since the beginning of the trial, VCMS has received 870 referrals/enquiries. Of those:

a. 297 (34%) resulted in the animal owner being referred back to the practice concerned – this is because it is a requirement of the VCMS scheme rules that clients exhaust a practice’s internal complaints procedure before raising their concern with VCMS;

b. 165 (19%) progressed to mediation; of which 129 (15%) have been successfully mediated;

and in 36 (4%) the mediation concluded without a resolution;

c. 93 (11%) did not progress as the animal owner did not pursue the complaint;

d. 73 (8%) were given advice only, e.g. regarding how best to raise a concern with a practice;

e. 66 (8%) did not progress as the practice declined to engage;

f. 76 were out of remit of the scheme;

g. 100 are ‘live’ and on-going. 20. The resolutions agreed in the 129 cases that have been successfully mediated include the

following:

a. further explanation of detailed response to be provided by the practice;

b. input from veterinary advisor has reassured/satisfied the animal owner;

c. animal owner to remove negative social media postings;

d. animal owner accepted their demands were unreasonable;

e. practice agreed to review processes or initiate training in a particular area;

f. practice to apologise;

g. agreement to reduce fees;

h. donation to animal owner’s choice of charity;



i. agreed payment plan for outstanding fees. 21. The Advisory Panel queried why 11% of animal owners decided not to pursue their complaint. It

was explained that the reasons given for withdrawing from the process included that they had now got the issue ‘out of their system’, they believed the veterinary surgeon should be removed from the register and that they felt that the RCVS process was more appropriate.

22. The reasons why practices decline to engage with the process remain consistent, e.g. too much

time taken up with complaint already; too much stress caused to staff; client has been abusive; already attempted to resolve the issue but client is unreasonable; and so on. However, on the whole, the number of practices declining to participate is very small and a vast improvement on the participation rates seen in the previous scheme where 65% of practices declined to take part in the process.

23. Generally, VCMS has seen increased activity in recent months. In the final 3 months of the trial

there was an average of 115 referrals/enquiries per month in comparison with an average of 55 in the first 3 months. As well as telephone traffic, there has also been an increase in the number of hits received by the VCMS website; currently averaging at 435 per month.

24. The VDS has confirmed that it is not aware of any civil claims being brought against practices as

a result of unresolved concerns raised with VCMS. This was one of the concerns voiced by the VDS when the trial began, however, it does not seem to have materialised.

Timescales 25. At present, the average time taken to conclude a matter is 22 days. However, where mediation is

involved, that figure rises to 63 days. This is longer than the 45 days initially anticipated, it is still less than the industry standard of 90 days (90 days is also the time limit set out in the EU Directive on ADR). As the Committee is aware, the ‘clock’ starts when VCMS receive the animal owner’s signed authorisation.

Feedback from practices and consumers 26. VCMS continues to ask all persons who contact the service (including those who have been

referred back to the practice or given advice) to provide feedback on the service they have received. At present, the feedback rate for animal owners is 29% compared with 19% for practices. It was observed by the Advisory Panel that feedback rates for surveys of this kind are typically low, averaging at 10-15%.

27. In terms of the feedback itself, the key figures are as follows:

a. 8.3 out of 10 animal owners felt that VCMS understood their concerns compared with 8.1 out of 10 practices;

b. 5.4 out of 10 animal owners were satisfied with the outcome compared with 7.9 out of 10

practices;



c. 7.7 out of 10 was the average experience rating given by animal owners compared with 8.1 out of 10 for practices;

d. 80% of animal owners and 85% of practices would recommend to VCMS to others;

e. 80% of animal owners and 78% of practices felt that mediation was a positive addition to the

veterinary sector;

f. of the practices that responded to the survey:

i. 86% found VCMS to be helpful; ii. 82% found the service to be productive; iii. 82% found the service to be efficient; iv. 96% found the service to independent; and v. 93% found the service to be fair;

g. of the public that responded to the survey:

i. 75% found VCMS to be helpful; ii. 59% found the service to be productive; iii. 71% found the service to be efficient; iv. 94% found the service to independent; and v. 82% found the service to be fair.

28. The figure relating to consumer overall satisfaction was queried. VCMS explained that feedback

had been sought from all individuals, including those who had been referred back to the practice/been told that their concern was not within the remit of the service, or where the practice has declined to take part as well as those that had proceeded to a ‘full’ mediation. In terms of those going through mediation satisfaction was noted at 6.4 out of 10 – and the same for those referred back to practices, with those where the practice did not take part recording (perhaps predictably) considerably lower levels of satisfaction. It was observed that, the feedback received in respect of ‘outcome’ was broadly consistent with feedback received by other, similar bodies.

Feedback from the Veterinary Advisors / Advisory panel 29. Feedback from the Veterinary Advisors can be found at confidential Annex E. Feedback from

the Advisory Panel can be found at confidential Annex D. Options going forward Continue the VCMS scheme administered by Nockolds 30. Nockolds proposal containing commercial information, such as details regarding costings, can be

found at confidential Annex C.



No ADR 31. In the event that RCVS does not pursue ADR in any form, there would once again be limited

options for complainants. In that situation, it is reasonable to assume that complainants would once again direct their concerns through the RCVS concerns process. If this occurred it is anticipated that the RCVS would receive, at least the same level of concerns as before (see paragraph 14 above) if not more. The potential impact of this on costs and resources is discussed in confidential Annex F.

32. Costs and resourcing necessary to meet this demand and to maintain current compliance with

target times are, however, only one aspect. It might be anticipated that the same issues and criticisms from consumers highlighted in paragraph 2 above would be reignited and that with increased numbers of concerns a greater number of veterinary professionals would experience the anxiety arising from any matter involving the regulator. These are also factors for consideration.

ADR scheme operated by the RCVS itself 33. This suggestion was considered and rejected in June 2016, Council taking into account a number

of factors, chief of which would be that any such scheme would not likely be perceived as independent by consumers or veterinary professionals. It was pointed out that even with strenuous efforts towards separation (separate premises/staff, etc.), veterinary professionals might be reluctant to participate in ADR if it is administered by the RCVS and even if they do participate, they are likely to be less candid. Furthermore, because this option involves setting up a new team (with all of the associated costs), it would be difficult to trial and so the starting point would be a permanent scheme.

Alternative providers 34. Following feedback to the OS it was expected that they would put forward an alternative proposal

at this time. However, they have recently indicated that they have “decided not to submit a new proposal at this point in time”. They have stated that they are “going through some huge changes at the moment and whilst we have a vision for what our service will look like in the future, there is a lot of work to be done before we’re in a position to deliver it. We do know from your feedback and those who participated in the trial that our current offering isn’t aligned with the wants and needs of RCVS, its members and complainants. We have taken all of this feedback on board.” On the basis of this and recent discussions it is anticipated, however, that they may do so in the future.

35. Mediation in areas such as family disputes, construction and general civil disputes is not

uncommon; likewise, adjudication types of solutions for disputed utility charging, and similar, are also not uncommon. However, the market in external providers of systems complementary to professional services and a regulatory landscape is currently not well developed and at the present time research has not identified other suitable providers for the scope of services sought.

Conclusion and recommendation [from Operational Board] 36. VCMS has broadly been viewed positively by consumers and practices. There have been good

levels of participation by both, and positive feedback with particularly high scores in relation to independence/fairness/and seeing the service as a positive addition.



37. It offers a direct access scheme, providing a real alternative to the RCVS concerns process for suitable cases. This has had a positive impact on the RCVS processes for both consumers and veterinary professionals.

38. There have been 2 trials of different processes from different suppliers, with possible options

considered in June 2016. It is recognised that for a commitment of this nature and value a tender process would normally be followed. However, as indicated above the potential ‘field’ at this time is limited.

39. It is suggested that a 4 year contract with a review at year 2/break clause at year 2 (with one

year’s notice on either side) at the costs set out in confidential Annex C, provides a realistic and pragmatic way forward at this time. It enables a recalibration based on actual demand for the service. A “sliding scale” in the meantime allows for some sharing of risk where demand in years 1 and 2 has been estimated (with such estimates considered reasonable). It also allows for ‘taking stock’ once the scheme has developed, and, with sufficient time for alternative providers to be sought in the event of any issues with the service, and in any event for a tender exercise as required in what it is anticipated by that stage may be a more mature market. The proposal is therefore a ‘step on the way’ rather than a full commitment.

40. The recommendation is therefore to continue with the VCMS scheme administered by Nockolds –

in terms of option 2 of the proposal submitted (confidential Annex C). Decision Required 41. Council is asked to decide whether or not to continue the VCMS administered by Nockolds.

Working Together Policy

Council Sept 17 AI 05a An A

Working Together Policy (September 2016)

Veterinary Client Mediation

Introduction1. The purpose of this statement is to set out clearly, for both clients and veterinary professionals, how the Royal

College of Veterinary Surgeons (RCVS) and Veterinary Client Mediation (VCMS) will work together both generally and,

in particular, when resolving concerns raised against veterinary professionals.

2. The RCVS is the statutory regulator for veterinary professionals. The RCVS’ jurisdiction extends only to allegations of

serious professional misconduct, which is defined as acts or omissions that fall far below the standard expected of a

veterinary professional. VCMS is a mediation service able to resolve all other types of concerns, from customer service

issues to poor veterinary care (see VCMS Scheme Rules for more information).

3. The RCVS’s aim is to set, uphold and advance veterinary standards in the interests of the health and welfare

of animals. The role of VCMS in mediating client complaints contributes to achieving this objective by providing

consumers with a forum to raise consumer concerns or complaints, which do not necessitate investigation by the

RCVS.

4. Both organisations understand that the concerns process can be difficult and stressful for all parties. We believe that

co-ordination between the RCVS and the VCMS will help us to achieve our joint goals of protecting the public and of

investigating/mediating concerns as swiftly and as smoothly as possible.

Hybrid Complaints 5. It is possible for complaints to be made against veterinary professionals that cut across both the RCVS’s regulatory

jurisdiction and VCMS’s mediation remit, for example a concern with an arguable case of serious professional

misconduct that also includes allegations of poor customer service. If this occurs, the case will be referred in its

entirety to the RCVS for investigation. However, once the RCVS closes its investigation, it is open to the parties to

agree that any suitable matters should be considered by VCMS.

Sharing Information6. The service provided by VCMS is funded by the RCVS. The RCVS and VCMS are both mindful of their responsibilities in

respect of the proportionate and secure sharing and storage of personal data.

7. For the purpose of enabling VCMS to carry out its mediation role, the RCVS will share information with VCMS as

follows:

— In cases of doubt, confirming to VCMS the registration status of any individual;

— When requested, confirming whether a veterinary professional is currently subject to an RCVS investigation in

order to avoid duplication of proceedings.

Working Together Policy (September 2016)

Veterinary Client Mediation

8. The RCVS will not share the outcome of its investigations with VCMS as this is not relevant to VCMS’s function.

9. VCMS will share information with the RCVS as follows:

— Regular provision of caseload data (including details of complainants, case files and outcomes) via a secure

mechanism:

— To enable the RCVS to detect possible duplication of processes, identify trends and to evaluate the

effectiveness and value for money of the service provided by VCMS

— For audit purposes to ensure that all matters falling within the RCVS’ jurisdiction are being referred to the

RCVS in line with this policy and the VCMS scheme rules.

10. In all other circumstances, the RCVS and VCMS will apply a public interest test to the sharing of information.

11. Details of veterinary professionals who are involved in a client complaint received by VCMS will only be shared with

the RCVS:

— Where the factual circumstances and the information received by VCMS in a specific concern indicate there

may have been serious professional misconduct

— Where VCMS receives more than two complaints concerning a veterinary professional or, where more than

three complaints are received that relate to the same practice or practice group

— In other circumstances where it is in the client’s interests, the wider interest of the public or the profession.

Signposting and Referrals12. In most cases, when either VCMS or the RCVS receive a concern that is more appropriate for the other organisation we

will advise the client to lodge their concerns direct with the other organisation.

13. VCMS will pass the concern directly to the RCVS in the following situations:

— Where a complaint involves allegations that disclose an arguable case of serious professional misconduct

— When a concern is lodged with VCMS that raises clear public protection concerns

— Anonymous allegations of serious professional misconduct/fitness to practice concerns received by VCMS.

Veterinary Client Mediation Service

Veterinary Complaints Mediation ServiceProposal for a Complaints Resolution Service Funded by

Royal College of Veterinary Surgeons

August 2017

Bishop’s Stortford

6 Market SquareBishop’s StortfordHertfordshire, CM23 3UZ

t: 01279 755777e: [email protected]

London

46 New Broad StreetLondonEC2M 1JH

t: 020 3982 6800e: [email protected]

Council Sept 17 AI 05a An B

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Chapter Content Page

A Contact Details 5

B Introduction 6

B.1. Introduction

B.2. Objectives of the Service

B.3. Glossary of Terms

C Exectutive Summary 10

C.1. Executive Summary

C.2. The Trial Experience

Section 1: Review of VCMS Trial 19

1 VCMS Activity 20

1.1. Enquiries

1.2. Remit of VCMS - Outside Remit

1.3. Professional Misconduct - Referral to RCVS

1.4. Scheme Remit

1.5. Remit of VCMS - Within Remit

1.6. Evaluation

2 Mediated Complaints 23

2.1. Mediated Complaints

2.2. Participation by Veterinary Clients

2.3. Evaluation

3 Engagement by Practices 25

3.1. Engagement by Practices

4 Mediation Process 26

4.1. Veterinary Advisor Input

4.2. Evaluation


4.4. Evaluation

5 Outcomes and Resolutions 28

4.1. Outcomes and Resolutions

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4.2. Timescales

4.3. Proposal

6 Feedback from Service Users 31

5.1. Feedback from Service Users

5.2. Lessons Learned

5.3. Feedback on the Future of VCMS

7 Launch of Trial Service 37

6.1. Operational Review

Section 2: Review of the Input of Nockolds 38

8 Expertise and Experience 39

7.1. Expertise and Experience

7.2. Regulated Status

7.3. Approved Status

9 Engagement 41

8.1. Stakeholders

8.2. Impact of VCMS Trial on the Parties and Stakeholders

10 Complaints and Insight 44

9.1. Nature of Complaints Received by VCMS

9.2. Species

9.3. Evaluation

9.4. Direct Access and Forecasting the Activity Levels

9.5. Forecast

11 Safeguarding 48

Section 3: Future Delivery of the VCMS 49

12 Future Delivery 50

12.1. Complaint Mediation

12.2. Remit of the Scheme

12.3. Engagement

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12.4. Promotional Activity

12.5. Staffing and Training

12.6. Efficient Use of Online and In-House Resources and Processes

12.7. Performance Measures and Targets

12.8. Complaints Relating to the Service Provided by Complaint Service

13 Reporting 53

13.1. Interim Reports - Monthly and Quarterly

13.2. Annual Reporting

13.3. Relationship Manager

13.4. Contents of Reports

14 Interim Period 55

14.1. Interim Period

D Conclusion 56

D.1. Conclusion

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Should you require any further information regarding the proposal or the firm, please contact:

Jennie Jones

Partner / Director

dd: 01279 712580

e: [email protected]

A. Contact Details

CONTACT DETAILS

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B1. Introduction

Most interactions between the 40,0001 veterinary professionals and the 23million animal owners in the UK are entirely satisfactory and often exemplary in terms of the service, treatment and the outcome.

In all areas of society complaints and concerns arise and the veterinary sector is no different. The public’s expectation from professionals continues to rise, dissatisfied consumers are more likely than ever to raise their concerns. Most concerns will be effectively resolved within the practices. Where this is not possible, complaints can escalate and again, expectations in terms of how concerns are handled can lead consumers to seek redress from the regulator or civil courts. These routes can be expensive, disproportionate, ineffective and contentious which can often further aggravate the parties’ and have a detrimental impact on the reputation of the veterinary profession.

To address the difficulties that can arise in the consumer-practice relationship, the 2013/11/EU Directive introduced the requirement for an Alternative Dispute Resolution (ADR) scheme to resolve consumer disputes2.

For these reasons, many professions and industries have established ADR schemes to manage complaints proportionately and effectively.

This summary reviews the trial of a mediation based ADR scheme, Veterinary Client Mediation Service (VCMS) .

The VCMS is an alternative trial ADR scheme which launched on 3 October 2016 for the veterinary sector following an initial trial undertaken by Ombudsman Services from November 2014.

The RCVS Council appointed Nockolds Solicitors Ltd (Nockolds) to launch and conduct the VCMS trial by way of a decision at Council meeting on 2 June 2016.

Nockolds is a firm of solicitors regulated by the Solicitors Regulation Authority who specialise in ADR and in particular schemes for regulated professional sectors.

B. Introduction

INTRODUCTION

1 30 June 2017 was 30,630 vets (however, 3,821 of these are non-practising) and 14,890 RVNs.

2 The impact of Brexit on the requirement for an ADR scheme is currently unknown, however given the impact on the small claims process on the civil courts, the government is unlikely to exclude from the statutory framework.

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The VCMS provides an alternative form of resolution where complaints fall outside the statutory regulatory function of the RCVS (i.e. do not solely involve allegations of professional misconduct or do not meet the threshold for fitness to practise and disciplinary investigation).

This review evaluates and explains the operational methods used during the trial phase. The key objectives of a Veterinary ADR service are:

— Efficiently and proportionately resolve complaints and minimising the time, cost and energy expended by all parties in dealing with escalating and protracted complaints, focusing on resolution rather than blame,

— Reposition the ‘negative’ view of complaints as a constructive element of professional practice which helps to advance standards

— Enhance trust and confidence between practitioner and consumer.

The proposal draws on our experience operating the trial service, engaging with stakeholders and our experience as the provider for consumer complaints in optics (Optical Consumer Complaints Service) and in complaint handling within the legal profession. The process and approach implemented during the trial has been evaluated. This report contains details of the evaluation and the recommendations or options available to Council should the decision be made to continue with the VCMS on a permanent basis. This in no way pre-judges any discussion or decision by the RCVS but is provided to assist and facilitate discussion regarding the VCMS methodology, approach and strategic focus.

B2. Objectives of the Service

The following objectives were set for an ADR scheme in the veterinary sector:

Goal Status

Become an established independent ADR scheme for complaints arising from the provision of veterinary care by RCVS registrants.

Achieved

Resolve such complaints in a fair, time and cost efficient, proportionate and independent manner focusing on practical resolution, and not judgment or adjudication.

Achieved

With increasing resolution rates

To have an effective protocol to refer allegations of professional conduct concerns and allegations to the RCVS.

Achieved

Audit review by RCVS has reassured both RCVS and VCMS that remit assessments have been accurate and appropriate.

Provide a proportionate forum for resolution of complaints that do not involve professional conduct and fitness to practise allegations, and are therefore not within the statutory remit of the RCVS reflecting

Achieved

Only 6% of complaints concluded the mediation process without a resolution.

Analyse and share insight gained in resolving complaints to help practitioners and their representative bodies to better understand why complaints arise and escalate, and supporting improvements in practice standards, communication and consumer experience, resulting in fewer complaints and retained focus on positive business development and management.

Due to volumes, the VCMS has been able to begin analysis and this has been shared with the Advisory Panel. Productive professional relationships with VDS and BVA have been developed over the course of the trial, and should a permanent service be launched, solid foundations are in place to share insight and produce collaborative communications for the sector.

INTRODUCTION

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Reposition complaints as a positive learning tool to further develop excellent animal and client care and enhance practice standards.

Analysis of the data obtained during the trial confirms to the VCMS Team that there will be sufficient insight to produce positive learning case studies and comms to assist the veterinary profession in complaint and dispute resolution.

The VCMS trial differed from initial trial conducted by Ombudsman Services in that:

— Veterinary clients and practices had direct access to the service

— A mediation approach focused on the resolution of disputes and complaints, and moved away from blame and individual fault. The OS trial was based on a written adjudication process

— Key stakeholder interaction and engagement was a priority from the outset.

The VCMS trial also provided for:

— The mediation of consumer complaints falling outside the professional conduct remit of the RCVS and was also extended beyond the Nockolds trial proposal to include complaints involving allegation of negligence which otherwise may have only be addressed through legal proceedings

— A service free to the parties at the point of use

— A service independent of the stakeholders in the sector but engaging with them.

B3. Glossary of Terms

Term Definition

ADR Alternative Dispute Resolution - means of resolving a dispute without recourse to court or regulatory proceedings

Agreement to mediate Informed agreement by both parties to participate in mediation and confirming acceptance of the ethos of mediation, confidential and without prejudice nature of the process

Client did not pursue Where a complainant contacts the VCMS and their referral falls within the remit of the scheme, but they do not progress to mediation.

Complainant Veterinary client who has concerns regarding the veterinary care or service received from a veterinary practice

Complaint A referral to the VCMS which falls within the scheme rules, and is accepted by the VCMS for mediation.

Consent Agreement by the veterinary client to participate in mediation and for personal data and information to be disclosed by the practice to the VCMS and by the VCMS to relevant third parties where necessary

Direct access scheme An ADR scheme where either party may contact the ADR provider and request for their complaint to be mediated

Enquiry Contact by either a veterinary client or practice regarding a concern or dispute

First trial Trial ADR scheme operated by Ombudsman Services between November 2014 and December 2015

INTRODUCTION

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Local resolution Resolution of a veterinary clients complaint at practice level without direct involvement by the VCMS

Mediation The process of exploring the positions of both parties in a dispute to facilitate resolution or a conclusion to a dispute

Phase A Assessment phase to determine whether a referral falls within the VCMS scheme rules and importantly whether it involves any allegations of Serious Professional Misconduct to be referred to the RCVS under the safeguarding protocol.

Phase B Explaining mediation to the complainant and obtaining their informed agreement to participate in mediation, then securing engagement and participation by the practice

Phase C Mediation process conducted by the resolution manager

Practice declined to engage Where the referral falls within the remit of the scheme, the complainant consents to mediation but the practice decides not to proceed and the complaint cannot progress to mediation

Referral A complaint circumstance between a client and veterinary practice received by the VCMS from either the client or the practice

Referred to practice Where a complainant has not raised their concern with the practice or followed the complaint procedure of the practice to the conclusion

Resolution Concluding a complaint or dispute so the complainant no longer pursues the complaint

Resolution agreement Written summary of the agreed resolution to include clear description of steps to be taken by both parties, timescale and signed agreement by both parties

Resolution Manager A member of the VCMS team who is assigned to the Complaint to undertake the mediation

Senior Resolution Manager One of 2 senior members of the Nockolds ADR team with expertise in complaint resolution and regulatory compliance, who will review a Complaint which remains unresolved at the conclusion of mediation by the Resolution Manager. This review will consider whether the mediation has been conducted fairly and is exhausted or whether further mediation is appropriate. Senior Resolution Managers will also review any referral where a complainant or practice raises concerns regarding the VCMS.

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C1. Executive Summary

In reviewing the VCMS trial, it is necessary to critically assess the need, impact and cost of a mediation based ADR scheme by considering:

— The level of activity - as veterinary clients and practices were able to contact the service directly

— Whether mediation would provide greater complainant satisfaction

— The willingness of practices to engage in mediation

— The effectiveness of mediation in resolving veterinary complaints

— The level of mediation input required to achieve resolution.

C2. The Trial Experience

C2.1. Is there a need for a direct access ADR service?

Trial Experience

a. The VCMS has received 870 referrals since the launch on 3 October 2016

C. Executive Summary

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b. ‘Referrals’ are defined as a circumstance involving a veterinary client and a practice regarding the care of an animal. A referral is categorised as a ‘complaint’ once it is assessed as falling within the remit of the VCMS

c. Referral levels have increased from an average of 54 per month in the first three months to 114.7 in the months June – August, which is a 209% increase.

The Future VCMS Based on the trend seen during the trial, if referral levels remain at 114 per month, the VCMS would be handling 1,368 referrals per annum.

Experience from other ADR schemes indicates that complaints volumes are continuing to rise through raised awareness and attitudinal changes in society. Over a three year period, the Optical Consumer Complaint Service (OCCS) saw an average annual increase of 49.5%.

Based on current activity levels during the final three months of the trial, it is forecast that referral rates of 111 per month, would equate to 1,300 referrals per annum.

As the VCMS is a new service awareness is likely to continue to grow, and if engagement rates are maintained, referral rates by November 2017 could be as high as 134 per month, equating to 1,612 per annum.

C2.2. Have complainants and practices contacted the VCMS with relevant complaints?

Trial Experience

a. 91% of the referrals fell within the remit of the service, namely they did not involve concerns relating to professional misconduct and fell within the defined scheme remit. Only 9% of referrals fell outside the remit

b. 1.7% of all referrals were referred to the RCVS under the safeguarding protocol as the VCMS considered them to involve issues of professional misconduct. These accounted for 24% of all referrals declined by RCVS. The RCVS audit of all directly received referrals has confirmed appropriate assessments and referrals to RCVS have been made by the RCVS

c. Following Council’s decision on 2 June 2016, the VCMS remit was extended beyond the initial Nockolds’ proposal to include complaints involving allegations of negligence. Nockolds has breadth of experience and expertise in professional negligence litigation and civil county court proceedings and this extension was easily accommodated by the VCMS Team. With almost 60% of the referrals involving allegations of negligence this expertise has been essential.

d. In addition to the understanding of the requirements of a negligence claim, the Nockolds Team:

— Has supported the VCMS with a full a clear and working knowledge of:

» Alternative Dispute Resolution methodology and implementation, and

» Operating within a regulatory framework

— Is subject to the highly regulated standards of practice of a firm of solicitors regulated by the Solicitors Regulation Authority and as required by Professional Indemnity Insurers.

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— Enabled the VCMS to draw down opinion from senior lawyers and advisers:

» To deliver a safeguarding protocol and team understanding that is sufficiently robust to ensure concerns involving Serious Professional Misconduct (SPM) are identified and referred to the RCVS, and to test and review this process regularly

» To train Resolution Managers to ensure they have a full understanding of the legal tests in negligence, causation and quantum in order to progress mediations sensibly and with credibility

» To undertake reviews of the data protection obligations and their impact on the without prejudice status of the mediation process, the mediators and the practice in terms of disclosure and inadvertent waiver of privilege

e. This list is not exhaustive but gives an overview of the added value within the contract for the delivery of the ADR scheme. The ability to deal with issues such as these has reassured stakeholders and this confidence in turn, facilitates engagement and participation in mediation.

The Future VCMS The RCVS audit established that the remit assessment was competently undertaken by the VCMS Team. Strengthening the relationship with the professional conduct team at the RCVS will enable the VCMS Team to evolve their understanding of the RCVS approach.

The scheme rules will require review, but at this early stage Nockolds would recommend removing the species exclusion and offering mediation for all species.

C2.3. Has the VCMS resolved complaints effectively during the trial?

Trial Experience

a. The VCMS has accepted 794 complaints into the VCMS process

b. 694 complaints were concluded as at 31 August 2017, and achieved the following outcomes:

The Future VCMS The mediation approach has been successful in resolving veterinary complaints which are not resolved within an internal practice procedure.

While the process may be adapted to improve efficiencies and in light of familiarisation, the overarching mediation approach would be utilised and rolled out in a permanent service.

C2.4. Does the VCMS discourage complainants and practices from resolving complaints at a local level? Resolving complaints effectively at an early stage

Trial Experience

a. All complaints are reviewed to establish whether the client has raised the concern and given the practice the

EXECUTIVE SUMMARY

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opportunity to resolve the complaint. Where the practice’s own complaint procedure has not been followed to the final stage, the complainants are referred back to the practice for local resolution. This represents ‘Phase A’ of the VCMS dispute resolution process. During this initial discussion, the veterinary client has the opportunity to discuss their complaint with a VCMS resolution manager and:

— Vocalise and clarify their core concerns

— Justify and explore the reasonableness of their desired outcome

— Discuss their complaint with an independent third party trained in dispute resolution which can begin to diffuse the high levels of emotion felt by some complainants

— Help focus and summarise the complaint and desired outcome in a constructive manner

— Explore the reasonableness of their desired outcome.

b. Complaints received by the VCMS at an early stage are referred back to the practice with guidance on constructive complaint presentation or handling. This has a direct and positive impact on the likelihood for local resolution by the practice at that early stage and also gathers useful insight on complaints which may not collated by other organisations.

c. Dealing with referrals within Phase A is estimated to account for approximately 25% of the VCMS activity.

d. 43% of referrals received were handled within Phase A.

e. As at 26 August 2017, only 7% of those referred back to the practice subsequently returned to the VCMS for mediation suggesting a positive impact in assisting local resolution at that early stage.

The Future VCMS The VCMS would be promoted as supporting local resolution, and while a practice can refer to the VCMS within in their complaint process, the service provides an escalation route if the practice is unable to resolve the complaint and is not a stage within the local process.

Information about the service will be continually reviewed to ensure that it is clear that the VCMS will not mediate a complaint until the practice has had an opportunity to resolve the complaint.

Insight sharing regarding this preliminary phase will be focused on understanding why situations escalate and how these can be managed and avoided.

C2.5. Is mediation an appropriate means of ADR for veterinary clients and their complaints?

Trial Experience

a. If the complaint remains unresolved following the practice’s complaint procedure, the VCMS will accept the referral and offer mediation. The referral then passes to ‘Phase B’. It is important to evaluate levels of participation and engagement for both clients and practices.

b. Within Phase B, the VCMS Team explains what mediation entails, the focus on resolution over adjudication and seeks a commitment from both parties to participate in the mediation process. At this stage, referrals are categorised as ‘complaints’.

c. In 11% of referrals, the veterinary client did not pursue the matter further. These will include:

— Those whose feelings of frustration or dissatisfaction are diffused and appeased during discussions with a VCMS Resolution Manager

— Those not proceeding for personal or unrelated reasons

— Those complainants seeking an adjudication or finding of negligence, and who decide they do not wish to mediate. These rates are low at approximately five complainants. On information currently available, it appears these clients have not pursued their complaint via litigation or other forums so were drawn to a conclusion

— This figure does also include those who withdraw from the process during the mediation.

EXECUTIVE SUMMARY

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The Future VCMS Ongoing feedback and analysis of why referrals do not progress through to full mediation (Phase C) will be undertaken to ensure all parties who wish to participate are supported to do so.

Data collection can be evolved and widened if appropriate to ensure the service captures relevant information. It will be important to capture why complainants do not proceed with the mediation to monitor the efficacy of the service and whether mediation remains an appropriate method of ADR for this type of complaint.

C2.6. Are practice’s engaging and participating in mediation?

Trial Experience

a. During the course of the trial, only 8% of practices declined to engage in the VCMS process. The VCMS has approached any practice who declined to engage to understand the basis for their decision. The following reasons were given:

— The circumstances of the complaint had previously been investigated by the RCVS

— The complaint had been ongoing for considerable time and although fell within the remit of the VCMS, the practice felt all discussions had been exhausted

— The practice had already commenced debt recovery proceedings and felt mediation should be conducted within those civil proceedings

— They were unwilling to participate in a trial scheme

— The client had been abusive or threatening

— The practice did not, as a matter of principle, wish to participate in mediation.

b. The level of engagement by individual practices has been excellent given this is a new service, and the VCMS would hope engagement rates would increase further over time. There will always be certain complaints referred in a direct access scheme where there are justifiable reasons for a practice to feel the circumstances are not suitable for telephone mediation.

c. The Veterinary Defence Service has been willing to engage and respond to consultation during the initial implementation phase, and then throughout the course of the trial. A detailed summary of the interaction between the VCMS and VDS is at section XX. Over the course of regular meetings during the trial and effective communication within individual complaint assessments and mediations, a constructive working relationship between the two organisations has been achieved. There are strong foundations to develop this relationship over the long-term. Nockolds acknowledges the support given by the VDS in engaging in these consultations, informing their members and encouraging participation in mediation in appropriate complaints and would look forward to working with the VDS.

The Future VCMS Practice participation is encouraging and with a permanent service, is likely to increase further.

As familiarisation with the service increases, there may be less mediation explanation to practices at this Phase B.

C2.7. Has mediation by the VCMS been effective in resolving complaints?

Trial Experience

a. Almost 85% of the complaints referred to the VCMS have been concluded following interaction with the VCMS, with the VCMS having a positive impact on 499 veterinary relationships during the trial

b. 165 referrals progressed through the full mediation process, known as ‘Phase C’, with 78% of those being successfully resolved

c. 4% of referrals conclude the VCMS without resolution or conclusion. When considered with the referrals where the practice declines to engage, this means only 12% of referrals are not concluded by VCMS. It is worth noting that anecdotal evidence suggests these clients have not pursued

EXECUTIVE SUMMARY

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their complaint via litigation or other forums so these complaints have been concluded

d. Veterinary Advisers have been consulted in 233 complaints. The role of the Veterinary Advisers has been two-fold:

— Provide veterinary and clinical input on potential enquiries which may involve allegations of Serious Professional Misconduct

— Inform the resolution managers within the mediation discussions, allowing sensible and productive conversations with practices, and on occasion clients.

e. The number of referrals is as anticipated as the reason for escalation is often based on communication and the breakdown in trust and confidence between the client and practice, rather than clinical dispute. As a mediation service, the VCMS does not make judgements or findings. Veterinary input is therefore informative and needed to support credible mediation, rather than provide an expert opinion. Nockolds is grateful to the panel of Veterinary Advisers who have provided helpful guidance and contributions throughout the trial

f. It has been necessary to involve more senior Resolution Manager input. In optics, less than 1% of complaints have been referred to the senior review phase. During the trial, over 21 have required input from a Senior Resolution Manager for senior review input during the course of the initial phase, such as protracted mediations where the complainant was initially seeking a punishment and was unable to accept the RCVS was not progressing the matter as a Serious Professional Misconduct.

The Future VCMS The approach is proving effective, and would continue to be evaluated.

Veterinary Advisor Panel is required with the potential to introduce direct contact between the veterinary advisors and the parties in appropriate complaint circumstances.

Senior Resolution Manager reviews will continue, along with ongoing ad hoc support for resolution managers.

C2.8. Has the VCMS mediation process resolved complaints swiftly?

Trial Experience

a. The VCMS target for resolution is 45 days from the date of the signed consent returned by the veterinary client. The industry standard is 90 days from receipt of a complete bundle of relevant documents from both parties but given the emotive nature of veterinary complaints and at the launch of a new mediation service, it was felt appropriate to keep the target timescale as short as possible

b. During the trial, resolution has on average taken 63.34 days, 18 days longer than the 45 day initial target

c. The Resolution Managers summarise the following reasons for more protracted mediations:

— The time spent in explaining mediation as a form of ADR to veterinary clients, the complainants

— The time spent discussing the benefits of mediation as a form of ADR to veterinary practices to secure engagement

— The nature of allegations of negligence and matters relating to clinical standards require more detailed review and intensive mediation

— As highlighted by Council and stakeholders, the nature of veterinary complaints is highly emotive, and therefore mediation often has to proceed at a measured pace.

d. In light of the average resolution time scale exceeding the 45 day target, in March 2017 a mediation process review was performed following which VCMS introduced some further explanation of mediation as a concept in the initial literature and use of the Agreement to Mediate process at the outset.

The Future VCMS A target of 60 day resolution period is proposed. This is well within the 90 day industry standard but allows adequate time for practices to consider the request to engage and participate.

EXECUTIVE SUMMARY

3 Due to the numbers involved, the exact figure, rather than percentage is given.

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The VCMS Team has been given additional administrative and senior Resolution Manager resources during the course of the trial. It is proposed that this needs to be increased to ensure the number of referrals and mediations can be progressed efficiently and within the required target timeframe.

C2.9. Public / Client Satisfaction

Trial Experience

a. All parties contacting and interacting with the VCMS are asked to provide feedback. The request for feedback mirrors the survey used in the initial trial, where the questions are relevant. As can be seen in more detail at section 6, feedback is consistent between veterinary clients and practices.

b. Response rates are good in comparison to similar surveys, particularly where no incentive is offered, at 29% for veterinary clients and 19% for practices.

c. Veterinary client satisfaction is high, with responses giving:

— Understanding your concerns – average score of 8.3/10

— Rating of overall experience – average score of 8.7/10

— Satisfaction with the outcome – average score of 5.4/10 – this is consistent with most forms of ADR and resolution services. It is important that outcomes be achieved, however the critical aspect is whether the process is seen to be fair, independent and productive. Indication of outcome ratings in comparable services is provided within the review.

— 94% of responders considered the VCMS to be independent

— 82% of responders considered the VCMS to be fair

— Around ¾ of responders considered the VCMS to be helpful and efficient

d. Levels of satisfaction vary depending on the stage at which a complaint progressed through the VCMS process. Those who referred their complaint to the VCMS at an early stage and were referred back to the practice with constructive complaint management guidance result were more satisfied (6.67 / 10) with the outcome of their complaint, which highlights the benefit for veterinary clients in terms of advice and early dispute resolution expertise. Satisfaction with outcome amongst those whose complaints were fully mediated was comparably high at 6.4. Understandably, those whose complaints did not progress to mediation because either the client did not proceed or the practice declined to engage, were less satisfied with the outcome of their complaint (1.6). In these circumstances either the client wished to mediate but the practice declined or the client was seeking an adjudication and did not want to proceed when they understood the approach of mediation. This is however based on a small sample of responses (9 / 159- 5.6% response rate).

C2.10. Is the VCMS seen as independent and fair ADR service?

Trial Experience

a. Independence is critical to engagement and effectiveness of a complaint resolution system based on mediation. Mediators must be seen as independent in order to gain the trust of the parties and allow them to explore the positions taken by each party in the dispute. In feedback provided by Veterinary clients and practices:

— Over 90% considered the VCMS to have acted independently

— 82% considered the process to be fair.

b. As the service is delivered by a separate organisation, Nockolds, the VCMS can be seen as independent of the veterinary professions and the RCVS.

The Future VCMS The feedback requests will be evaluated to ensure relevant and critical aspects are included and to monitor key performance measures.

EXECUTIVE SUMMARY

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C2.11. Are practices satisfied with the VCMS service?

Trial Experience

a. Veterinary practices provide direct feedback in addition to central feedback obtained from the Veterinary Defence Service and corporate practices. Practitioner satisfaction is also high, with responses showing:

— Understanding your concerns – average score of 8.11/10

— Rating of overall experience – average score of 8.1/10

— Satisfaction with the outcome average score of 7.9/10

— 96% of responders considered the VCMS to be independent

— 93% of responders considered the VCMS to be fair

— Over 80% of responders considered the VCMS to be helpful, productive and efficient


Feedback from individual practices, major employers and corporate practices and stakeholders will be a priority in a permanent service as engagement and positive participation is key. Positive working relationships will also allow the VCMS to share the insight gained across the sector.

C2.12. What is the overall view of those using the VCMS?

Trial Experience

a. The responses of clients and practices are consistent and show high levels of satisfaction in most areas

b. Parties are asked whether they would recommend the service, and for both clients and practices, 80-85% would recommend the VCMS and would use the service again. 80% overall and for complainants whose complaint progressed to Phase C, 86% would recommend and 81% would use the VCMS again

c. 80% of veterinary clients and 78% of practices considered mediation to be a positive addition to the sector

d. Constructive feedback from parties has been reviewed and incorporated into continual evaluations during the course of the trial, with appropriate adaptations or changes implemented to evolve the service

e. As a voluntary mediation service, feedback and satisfaction with the process is critical as parties must have the confidence in the service to engage and to continue to participate in the mediation process.


Feedback from the trial will also be shared with the sector to reassure the sector and to encourage participation.

C4. Conclusion

During the 11 months of the trial, the VCMS has assisted 499 veterinary clients and practices to resolve client complaints ranging from those at an early stage through to protracted complaints which had been ongoing for months and have involved RCVS case examiner review or referral to Preliminary Investigation Committee.

The VCMS provides the veterinary sector with a proportionate and cost-effective means for complaint resolution, which:

— Focuses on a practical resolution rather than blame and liability

— Seeks to bring the complaint to a point of closure exemplified by the high resolution and conclusion rates

EXECUTIVE SUMMARY

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— Addresses the heightened emotional concerns of animal owners illustrated by the levels of complainant satisfaction

— Seeks to support practices to find a way to conclude ongoing complaints where the complainant is motivated to pursue matters further which is demonstrated by the practice feedback received during the trial.

The provision of this ADR scheme is one element of RCVS’ ambition to provide a regulatory framework and concerns handling approach which maintains and improves standards of client care alongside first rate clinical care. This supports the sector to enhance animal health and welfare while protecting owner and veterinary professional wellbeing. In time, the VCMS would be able to reinvest the insight gained in complaint resolution process to contribute in the understanding of client concerns and addressing these challenges through communication, education and profile raising.

This review seeks to provide the RCVS Council with a thorough review of the VCMS trial to enable an informed decision as to the future need for an ADR service and the provision of that service by a professional, credible and committed ADR expert.

Should members of Council have any questions arising from this review, Jennie Jones is happy to discuss any query with members of Council in advance of the meeting.

4 Full review paper and fee assessment report provided to RCVS Council in September/November of Year 3 to determine the fee for Year 4 and 5.

EXECUTIVE SUMMARY

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VCMS Proposal

Section 1Review of VCMS Trial


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1.1. Enquiries

As the VCMS trial established a new direct access service for veterinary clients and practices, forecasting activity levels was difficult. Over the 11 month main trial period, the VCMS saw a steady increase in the ‘referrals’ received.

‘Referral’ is defined as a complaint circumstance referred to the complaints mediation service (i.e. a consumer relating to a practice concerning one set of facts). As veterinary clients contacted the service directly, initial contacts are categorised as ‘enquiries’ until the remit assessment is completed.

The VCMS received 870 enquiries between 3 October 2016 and 26 August 2017, with monthly enquiries increasing from an average of 54 in the first three months to 114 in the final three months of the trial.

While direct comparison with the first trial is not like for like, 117 complaints were referred to Ombudsman Services over the trial period (November 2014 – December 2015).

1.2. Remit of VCMS – Outside Remit

The VCMS Resolution Managers reviewed the circumstances of the complaint and considered whether the complaint

VCMS Activity

VCMS ACTIVITY

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fell within the remit of the service.

Of those referrals received, 91% (794) fell within the remit of the service and only 9% were declined on the basis they involved circumstances outside the remit of the trial scheme.

1.3. Professional Misconduct – Referral to RCVS

All referrals were initially reviewed to assess whether the circumstances included allegations of Serious Professional Misconduct. If so, the complaint is referred to the RCVS in accordance with the safeguarding protocol in place.

As part of Nockolds, the VCMS has a comprehensive understanding of:

— Professional conduct/regulatory concerns

— Consumer statutory rights

— Professional negligence actions

24% of referrals falling outside the remit of the VCMS involved allegations that could amount to Serious Professional Misconduct and necessitated a referral to the RCVS for disciplinary consideration or investigation.

All referrals received directly (i.e. without referral from RCVS) have been audited by the RCVS project team to ensure that the correct assessment of any potential allegation of Serious Professional Misconduct has been made by the VCMS Team. These audits were undertaken at the VCMS office in Bishop’s Stortford, which had the additional benefit of developing the working relationship and communication between key members of the RCVS Professional Conduct and the VCMS Teams.

1.4. Scheme Remit

Having assessed referrals for any professional misconduct element, the circumstances of the complaint are reviewed to ensure they fall within the defined scheme rules. Of the 99% referrals assessed as outside remit5:

— 38% where the circumstances of the complaint occurred over 12 months ago

— 11% were not accepted as the complainant presenting to the VCMS was not the owner of the animal / client of the practice

— 11% involved excluded species

— 14% involved other circumstances, such as insurance dispute which would rest with Financial Ombudsman, a full and final settlement had already been accepted, complaint already in litigation and duplicate enquiries – e.g. husband and wife contact by telephone and online form

VCMS ACTIVITY

5 One referral related to a practice outside the UK

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— The remainder were received by prior to 31/03/17 and were considered by the VCMS to be outside remit due to the value of the treatment involved. This was reviewed with the ADR Advisory Panel in April 2017 and it was concluded this would no longer be a defined reason to exclude a referral from the VCMS process, but it would be for the parties to consider whether mediation by the VCMS was appropriate given the issues in dispute.

1.5. Remit of VCMS - Within Remit

Of the 91% falling within the remit of the VCMS, a further initial preliminary review was undertaken to ensure the veterinary client had exhausted the complaint procedure of the veterinary practice. This is ‘Phase A’ of the VCMS process to ensure local resolution has been fully explored.

34% of the referrals received were referred back the practice for the complaint procedure to be completed (43% of the complaints i.e. enquiries assessed as falling within remit).

A further 8% were closed at a preliminary stage as the client had contacted the VCMS for more information about the service or for advice on how to raise their concern with the practice.

Where enquiries are referred back to the practice for local resolution, the veterinary client has the opportunity to discuss their complaint with a VCMS Resolution Manager and are helped to clarify their core concerns and vocalise and justify their desired resolution. This provides the client with the chance to discuss their complaint with an independent third party trained in dispute resolution. This interaction can assist in beginning to diffuse the high levels of emotion felt by some complainants, and seeking to help the client summarise their complaint and desired outcome in a constructive manner. This discussion does also explore with the veterinary client, the reasonableness of their desired outcome.

The VCMS monitored those returning to the service who had followed the complaint process but remained dissatisfied. As at 26 August 2017, only 7% of those preliminary complaints returned to the VCMS for mediation. Although based on preliminary findings, this suggests a positive impact and that these discussion are beneficial and appear to assist local resolution at that early stage.

Dealing with those preliminary enquiries is estimated to account for approximately 25% of the VCMS activity.

1.6. Evaluation

The scope of complaints mediated by the VCMS is appropriate. The nature of veterinary complaint means allegations regarding the standard of clinical care are frequently combined with customer service and communication issues.

The VCMS would propose removing the species exclusions and using the status of the animal owner as the defining criteria. The VCMS will review the need for a wider veterinary advisor panel.

VCMS ACTIVITY

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2.1. Mediated Complaints

Where the complaint falls within remit and has passed through the practice’s complaint process without resolution, the VCMS invite both parties to participate in the mediation process (‘Phase B’). At this stage the VCMS Resolution Managers explain what mediation entails and importantly, the approach.

2.2. Participation by Veterinary Clients

Over 99% of the enquiries were received from veterinary clients. They are motivated to contact the service as they are dissatisfied and seeking an outcome. In any complaint resolution service, some complainants do not proceed to the conclusion of the process. During the trial 11% of veterinary clients contacting the service did not progress through the mediation process for the following reasons:

— They were seeking an adjudication or finding of fault and did not consider mediation appropriate. In these circumstances, the VCMS discuss the veterinary client’s desired outcome and explains the benefits of mediation to encourage them to consider an alternative dispute resolution pathway

— They were seeking a disciplinary resolution which is not available via mediation. As with those seeking a finding of fault, the VCMS explain in broad terms the Serious Professional Misconduct (SPM) threshold and the potential outcomes from a SPM investigation to ensure the veterinary client understands the prospects of achieving their desired outcome and to explore their motivation as this is often fuelled by emotion which can be addressed during mediation

— Changes in personal circumstances meant they were taking no further action e.g ill health or death of a relative

— The expected fall off rate where the complainant does not complete or return the necessary signed authorities nor responds to further contact.

When the veterinary client confirms they wish to proceed with mediation, they are asked to provide written authority to allow the practice to discuss the complaint with the VCMS and also allow the VCMS to disclose information to the RCVS, the practice and the VDS where necessary. This signed authority was then passed to the practice with a written request to engage in mediation.

Mediated Complaints

MEDIATED COMPLAINTS

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2.3. Evaluation

The number of complaints not proceeding is comparable with other services. As a permanent service becomes more established, the VCMS will collate data as to why a client does not proceed to ensure:

— Client engagement is maintained

— Any trend or reason for non participation is identified early

— Service performance is monitored

— Any beneficial changes to the process can be considered.

MEDIATED COMPLAINTS

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3.1. Engagement by Practices

As a direct access scheme utilising a mediated approach to resolution, the parties to the complaint need to voluntarily engage in the process. The response from practices has been overwhelmingly positive and levels of engagement have been excellent. Only 89% of practices have declined to engage with the VCMS process.

At the outset of the trial, scheme rules were established following consultation with the ADR Advisory Panel. The scheme rules confirmed the process would be without prejudice and confidential. This was necessary to secure engagement of the parties and to encourage full and frank discussions during the mediation.

Where possible, the VCMS contacted any practice who declined to engage to understand the basis for their decision. The following reasons were given:

— The circumstances of the complaint had previously been investigated by the RCVS

— The complaint had been ongoing for considerable time and although fell within the remit of the VCMS, the practice felt all discussions had been exhausted

— The practice had already commenced debt recovery proceedings and felt mediation should be conducted within those civil proceedings

— They were unwilling to participate in a trial scheme.

Practices are encouraged to fully understand what mediation entails and importantly to appreciate that complaint mediation is not focused on blame, and does focus on learning, resolution and bringing an end to the distress felt by the members of the practice team and the veterinary client. This will be the key message when reaching out to practices and veterinary professionals to raise awareness if the VCMS continues as a long-term service.

Engagement by Practices

ENGAGEMENT BY PRACTICES

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4.1. Mediation Process

Once both parties have agreed to participate in mediation and all relevant documents have been provided, the assigned Resolution Manager reviewed the complaint and began mediation discussions with each party.

The VCMS process allows flexibility for the practice to communicate and participate in the mediation in the most appropriate way for them. In the main, the VCMS resolution managers have liaised with practice managers and senior vets within the practice. While the complaint may concern an individual in the practice, a mediation approach focuses on the practice and allows the practice to decide who will participate in the mediation (providing the representative of the practice has the authority to decide and agree a resolution). Complaints concerning junior veterinary surgeons, veterinary nurses or those who may be unable to respond and handle the complaint can be mediated via the nominated representative(s).

The mediation approach of the VCMS initially establishes the agreed and accepted facts, and then goes on to explore areas of agreement and disagreement. At the outset, the practice is asked to provide copy records and copies of any responses or complaint investigation documents they are willing to disclose. The mediation activity then begins.

4.2. Evaluation

— Given the nature of the complaints, it is appropriate to mediate them with the practice rather than with individual professionals.

— The flexible communication has facilitated engagement and constructive participation by practices.

— The initial content of the correspondence sent to the practice was redrafted to further explain the mediation process, invite the practice to participate and explain why the provision of records and documents was beneficial;

— From May 2017 onwards, the form of authority was replaced with a Mediation Agreement in which the veterinary client gives the necessary authorities, but both parties agree to participate in spirit of mediation and noting this is a without prejudice and confidential process focused on resolution. Both parties are invited to

MEDIATION PROCESS

Mediation Process

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sign this meaning both understand the basis of mediation and the process followed.


The VCMS trial had access to the veterinary advice of the same veterinary adviser panel as the OS trial, comprising of three companion care veterinary surgeons and one equine specialist.

Input from the veterinary advisers has been obtained in 236 cases. As mediation does not involve an adjudication, the veterinary input has two uses:

— A clinical input on any assessment by the VCMS Team as to whether a referral should be referred to the RCVS under the safeguarding protocol

— Informing the Resolution Manager to ensure mediation conversations with either party, but particularly the practice are informed, targeted and maintain credibility with the professionals involved.

4.4. Evaluation

— The requests for input have been appropriate. The panel are not asked to give a judgement or determination on the standard of care provided

— Direct input from the adviser to either one or both parties will remain a potential development of the mediation process, but only in cases where this will be beneficial and effective.

6 Data given as a figure rather than percentage as this is more meaningful.

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5.1. Outcomes and Resolutions

Resolutions can be agreed at any stage, and during the course of the trial the VCMS has secured agreement and resolutions from parties as early as at the initial conversation stage and at various stages through to a full and extensive telephone mediation exchange.

Resolutions at Phase A and B are largely achieved where the complainant has the opportunity to discuss their concerns with a Resolution Manager, and either communicate them constructively to the practice OR to allay their concerns or accept the circumstances. Once the referral moves to ‘Phase C’, the mediation, resolutions and outcomes are achieved through conversations and the sharing of information.

Over 78% of Complaints mediated have reached an agreed resolution via the VCMS mediation process. The resolution is documented in a written agreement summary.

Practical resolutions have included:

— Further explanation or detailed response provided by the practice

Outcomes and Resolutions

OUTCOMES & RESOLUTIONS

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— Input from veterinary advisor has reassured / satisfied the veterinary client

— Removal negative social media postings

— Veterinary client accepted demands were unreasonable/awareness

— Practice agreed to review process/training

— Apology

— Agreement to reduce fees

— Charity donation

— Payment plan for outstanding fees agreed

— Agreement by the veterinary client that the matter is now closed.

Of the 22% of mediated Complaints concluding without an agreed resolution, we are not aware of further action being taken by the veterinary client. While we must note that given the limitation period during which legal action can be taken this cannot be stated with certainty, it suggests even this 4% of all referrals could be considered to have been ‘concluded’.

The VCMS reviews these complaints for learning and development purposes. Most of these complaints have involved protracted complaints where the parties have become entrenched over many months, the owners are unable to accept the outcome of treatment or the complaint came to the VCMS at the conclusion of an RCVS process which commenced prior to the trial launch.

5.1.1. Evaluation

When the outcomes of complaints are considered as a whole, over 89% of the enquiries received by the VCMS are concluded. This means the VCMS had a positive impact in almost 500 client/practice relationships over the 11 month trial.

— The resolution agreement is now signed by both parties. Written confirmation of the resolution has always been provided, however it was felt a formal summary signed by both parties was effective in reiterating the agreement and ensuring this was actioned by both parties.

At this stage and given the sample numbers, Nockolds would not advocate providing the mediation service with fall back adjudication powers. This may deter practitioners from engaging where they feel a resolution will be imposed upon them.

5.2. Timescales

The VCMS trial model set a resolution target of 45 days. The ADR Directive and complaint resolution best practice states the timescale for resolution should be 90 days.

As at 20 June 2017, the average resolution time frame for all concluded enquiries was 22.3 days, and 67.7 days for all mediated complaints. By 26 August 2017, this had improved slightly to 63.34 days in all. The VCMS measures the timescale from receipt of the agreement to mediate from the consumer until the conclusion of the mediation. The ADR standard of 90 days is based on a measure from the point at which the ADR provider receives a complete bundle of documents from both parties (i.e. information and documents from the practice), which is at least seven days from the receipt of the agreement to mediate from the consumer.

Based on the current staffing resource and the level of activity, the VCMS has also seen a 30% increase in complaints requiring more than 45 days to reach a resolution.


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5.2.1. Evaluation:

Having evaluated the process, the VCMS has determined that the following factors have influenced timescales:

— As anticipated, the volume of information provided by both parties is often considerable. The VCMS is focused on providing proportionate and effective mediation which requires the Resolution Manager to appreciate the facts of the complaint and the position of both parties. The information must therefore be collated and then considered. Additional administrative assistance has been in place since March which has contributed to shorten resolution timescales

— Again, as anticipated, the nature of the allegations mean the complaints are often multifaceted and cover standards of care and client care elements

— Highly emotive state of the client

— Response of the practice to the complaint which can heighten tension between the parties

— The VCMS is currently a new trial and service – explanation of the trial, mediation and securing engagement of practice lengthens the mediation process

— Appropriate and necessary interaction with VDS, which in effect introduces a third party in some of the complaint mediations

— The cost of resourcing the VCMS team to enable a 45 day target to be achieved can be provided but may not be proportionate.

5.3. Proposal

The RCVS will need to consider whether the cost of resourcing a service which can meet a resolution timescale target of 45 days against a revised 60 day resolution timescale target is justified allocation of resources. It is important to note that swift resolution is important to veterinary clients and practices alike. Options would be:

— Maintain 45 day target with greater resource

— Extend target in all complaints to 60 days

— Implement a policy whereby the 45 day target can be extended to 60 days in certain circumstances.

Nockolds would propose a 60 day target.


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6.1. Feedback from Service Users

All parties interacting with the VCMS are asked to provide feedback. The feedback survey mirrors that used in the initial trial (Appendix A for details of the survey).

Feedback is key to evaluating the impact of the service and also refining the approach and process used in delivering complaint mediation in the veterinary sector.

Client satisfaction is paramount as the objective of the VCMS is to resolve client complaints proportionately, efficiently and effectively. In order to do so, clients must have confidence in the independence of the service, and feel the interaction was a positive experience.

Practitioner satisfaction is also key to the success of the service, as the VCMS requires voluntary engagement and in all forms of mediation, both parties must be willing to try and resolve the dispute.

6.1.1. Responses

VCMS(Average score out of 10)

Client Feedback Practice Feedback

62 28

How well did we understand your concerns? 83%

8.3 / 10

84%

8.4 / 10

How satisfied were you with the outcome? 54%

5.4 / 10

79%

7.9. / 10

How would you rate your overall experience? 7.7 / 10 8.1 / 10

Feedback from Service Users

FEEDBACK

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The response rates are consistent with those expected for services of this nature. In general, a response rate of 10% where no incentive is offered is common.

To allow for comparison, the following schemes publish feedback on the outcome and experience of the respective services:

SPSO

(2015 - 2016)

Legal Ombudsman

(2013 - 2014)

OCCS

(2016 - 2017)

How well did we understand your concerns?

73%

7.3 / 10

56%

5.6. / 10

82%

8.2 / 10

How satisfied were you with the outcome?

47%

4.7 / 10

32%

3.2 / 10

72%

7.2 / 10

How would you rate your overall experience?

70 %

7 / 10

52%

5.2 / 10

80%

8 / 10

An effective and successful ADR scheme using a mediation approach must be, and be seen to be:

— Helpful

— Productive

— Efficient

— Independent

— Fair

These five components encourage participation, engagement and allow mediation the best opportunity for success, and should be seen as important performance measures.

All parties contacting the VCMS are asked to confirm whether they considered the service to have these qualities:

FEEDBACK

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When considering the satisfaction of clients and practices in the context of the stage of the VCMS process the Referral was concluded, the following can be seen:

6.1.2. Phase A

Feedback from complainants who referred their complaint to the VCMS at an early stage and were referred back to the practice with constructive complaint management guidance result was good:

— Understanding your concerns 9.4 / 10 (higher than overall)

— Rating of overall experience 9.3 / 10 (higher than overall and those concluded at Phase B and C)

— Satisfaction with the outcome 6.67 / 10 – which is higher than overall response which indicates the input at this stage is beneficial for clients

— 100% considered the VCMS to be independent

— 89% considered the VCMS to be fair and productive.

6.1.3. Phase B

Where mediation did not progress, either due to the client taking on further action or the practice declining to engage, the feedback was slightly lower as expected:

— Understanding your concerns 8.4 / 10 (consistent with overall)

— Rating of overall experience 7.1 / 10 (lower than overall)

— Satisfaction with the outcome 1.6 / 10 – this is understandable as the majority of the responders wished to progress mediation but the practice declined to engage


— Around 85% considered the VCMS to be fair and productive.

6.1.4. Phase C

Feedback from those veterinary clients whose complaints were fully mediated by the VCMS is critical. During the course of the trial, this indicated:

— Understanding your concerns 8.6 / 10 (highest average rating)

— Rating of overall experience 8 / 10

FEEDBACK

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— Satisfaction with the outcome 6.4 / 10 – complainants are therefore more satisfied with the outcome of their complaint when they progress through the full mediation process


— Around 85% considered the VCMS to be fair and productive.

These statistics do not include responses where the outcome was not identified by the responder.

Gathering and analysing feedback is a key tool in developing the skill set within the service, the remit of the service and the in depth mediation required.

6.2. Lessons Learned

During the course of the trial, the VCMS has collated all feedback and comments received. Any constructive feedback has been logged and evaluated. This has been limited (9) in the context of the 870 referrals received and handled. In each circumstance, the referral has been reviewed by a Senior Resolution Manager or the Head of VCMS to reflect on the feedback and any improvements required. This has proved to be insightful and a useful exercise.

These can be categorised into two areas:

6.2.1. Communication

Feedback Detail Lesson and Action Taken

Response times telephone messages and emails

Call response targets are in place, and the VCMS aim to action any callback within 24 hours. Due to activity levels, there was some delay in returning any call back messages. The VCMS is not set up on a call centre basis as parties receive personal interaction with an assigned member of the team, and if that team member is not available, this can result in a delay.

Emails – the VCMS team aim to respond to emails within three working days. Due to activity levels and volume of communication, there have been occasions where the team have been unable to meet this target.

Additional administrative resource was provided to assist the team to ensure reasonable response times can be achieved in light of the increase in enquiries.

New team members were recruited in April 2017. Their induction and an introductory phase had an impact on response times.

Email acknowledgements confirming intended response times are now used to manage expectations.

Delay As a consequence of the activity levels and referral volumes, the Resolution Manager team were unable to provide responses or progress mediations in line with our response time targets or mediation timescales.

Additional administrative resource was provided to assist the team.

Response time indications were given to those contacting the service

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6.2.2. Remit Assessments

Feedback Detail Lesson and Action Taken

Client frustration if complaint falls outside remit

Two complaints were reviewed by the VCMS Team and considered to fall outside remit after the initial phase of the mediation process had commenced.

Refresher of remit assessment with the team to ensure any outside remit assessment is identified as early as possible

Clarification discussion with RCVS and Advisory Panel on scheme rules.

Client frustration if practice declines to engage

Reviews by the VCMS Team to reflect on how best to manage this situation – whether this be via further discussions with practices or communication with the client

6.3. Feedback on the future of VCMS

Clients and practices have also been asked to comment on future use of the VCMS:

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Since July 2017, complainants have been asked to indicate what action they would have taken if the VCMS had not been available. Responses are limited at this stage but examples of those provided are:

— “I would have had to contact the vet again myself as there is no other option. I am dismayed that there is no way of ever making a complaint about a vet that would mean they are investigated for their ability to perform their job. Unless the vet has carried out a criminal act they are free to continue working essentially unsupervised. Without this logging of complaints, how are vets ever held accountable for their actions? It should not require a criminal act to be proved for a vet to be reviewed. How does continued professional development work - the vet attends an annual workshop, but who is reviewing their standard of practice, the number of complaints they receive? If a vet is receiving above average complaint this is flagged and a review can be made to see if additional training is required etc. …. This should not go un-noted!”

— “With payment in the hands of a debt collection agency, I would have gone to court”

A summary of narrative feedback comments from veterinary clients and practices is at Appendix XX.

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7.1. Operational Review

Nockolds launched the VCMS on 3 October 2016, 14 weeks following the RCVS council decision of 2 June 2016.

During this implementation period:

— A clear and transparent name was selected – Veterinary Client Mediation Service (VCMS)

— Branding and logo design agreed and launched

— Communication programme agreed and implemented to raise awareness with practitioners and stakeholders:

» The existence of the service

» The remit of the service

» How to access the service

» The aims and objectives of the service

— Launch of bespoke Veterinary Complaints Mediation Service website – www.vetmediation.co.uk — Lo-call rate telephone line set up

— Initiating and developing constructive relationships with Veterinary Defence Organisation

— Initiating introductory relationships with professional bodies such as BVA, BSAVA, BEVA and BVNA

— Establishing and implementing a protocol with Veterinary Advisors

— Publication of VCMS guides setting out what the service does and how it does this, which can be downloaded from the website or sent out to practitioners and other interested parties

— Additional correspondence issued by VDU to all their members to inform members of the service

— Gentle introductory PR activity with professional bodies including articles and news items in journals and the veterinary press

— Attendance at Major Employer Group and further individual consultation meetings with a number of large employer businesses to explain the mediation approach and agree protocols for efficiencies.

Launch of Trial Service

LAUNCH OF TRIAL SERVICE

- 38 -- 38 -

VCMS Proposal

Section 2Review of the Input of Nockolds


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8.1. Expertise and Experience

In addition to the ADR expertise provided by Nockolds under the VCMS name, the experience and wide skill set of the firm has supported the service both strategically and operationally, examples include:

— The availability of concise and succinct opinion on:

» Likely prospects of success of any action in the civil courts (professional negligence, debt recovery, defamation and slander, enforcement) which informs the resolution managers in the mediation

» County Court processes (pre-action protocols) and cost implications (including ‘without prejudice’) » Negligence and breach of contract disputes that are more complex than consumer statutory rights

scenarios, which was key as the service was extended to include these disputes.

— Professional conduct and regulatory obligations which enable the VCMS Team to quickly identify the status and nature of the allegations, and are well placed to identify the correct forum for the issues raised by a complainant. The consumer can then be directed accordingly if the issue sits outside the remit, or considered and mediated if within. This also means the Team are mindful of these issues within the course of the mediation should further information come to light or issues arise

— Determining the impact of classifying the mediation (process and content) as ‘without prejudice’ to any civil legal action

— Data protection duties, obligations and best practice

— Training, implementation and ongoing review of the safeguarding protocol, and full understanding of the impact of operating within a regulatory framework, led by Jennie Jones and Jayne Kendrick-Jones;

— Review of the VCMS process against mediation good practice guidance and adaptations to the approach and communication e.g. introduction of Agreement to Mediate. Initial and ongoing training provided by Zen Thompson, an experienced mediator whose biography is at Appendix XX. Zen is an experienced mediator with a focus on emotive disputes such as family breakdown and neighbour conflict. As a member of the Civil Mediation Council and engaged to provide training on mediation to the judiciary, Zen is well placed to review the process and approach. This review led to revisions to the process such as the explanation of mediation as a concept in the initial literature and introduction of the Agreement to Mediate process at the outset.

Expertise and Experience

EXPERTISE & EXPERIENCE

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This expertise is provided by an organisation entirely independent of the veterinary sector. Consumers will therefore be reassured that their complaints will be considered independently against the expectations of the reasonable man, balanced against any duties and responsibilities placed on the practitioners by their regulation and ethical responsibilities.

Practices and their representatives / defence bodies are also reassured as the VCMS fully appreciates the applicable legal tests, and at a strategic level has been able to raise and address issues which overlap with a direct access ADR scheme and actions pursued in other forums.

8.2. Regulated Status

As a firm of solicitors, Nockolds is regulated by the Solicitors Regulation Authority, is Lexcel5 accredited and bound by the Code of Conduct. The standard of care and the approach to the delivery of the VCMS is therefore highly professional, giving the VCMS credibility with veterinary clients, practices, defence bodies and stakeholders.

8.3. Approved Status

Nockolds has submitted the application to the CTSI ADR Competent Authority. The OCCS falls outside the remit of the ADR directive given the ‘healthcare’ exclusion6 and therefore the application is based on the data and insight collated during the VCMS trial. Nockolds is confident the model meets the requirements of an ‘approved ADR body’.

EXPERTISE & EXPERIENCE

5 The Lexcel Practice Management Standard is the Law Society’s quality mark

6 2013| E11| EU Article 2(h)

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9.1. Stakeholders

During the trial, the Advisory Panel has provided an effective means for the VCMS to update key stakeholders and in particular to develop a positive relationship with the Veterinary Defence Service (VDS). As a mutual society providing indemnity cover for 90-95% of veterinary practices, surgeons and nurses, the involvement of VDS has been crucial.

— Veterinary Defence Society

» Introductory meetings

» Consultation meetings to obtain input on the process and content of communications to the launch the trial

» Review meetings to reflect on the mediation process and interaction/working relationship between VCMS resolution managers and VDS claims managers

» Regular communication on individual complaint mediations

» Inter team meetings to establish an effective working relationship

» Latterly, consultation on the potential long term strategy should the RCVS decide to proceed with the VCMS on a long-term basis

The VCMS is grateful to the VDS for its willingness to explore the potential gains of mediation in veterinary complaints and to engage with the VCMS at a strategic and individual complaint mediation level.

In addition, the following introductory activity has be undertaken:

— British Veterinary Association

» Advisory panel meetings

» Sharing communication and updates

» Attendance at London Vet Show – seminar presentation and stand

— Major Employers Group

Engagement

ENGAGEMENT

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— British Small Animal Veterinary Association


» Attendance at BSAVA congress – stand attendance

— British Equine Veterinary Association


— Society for Practicing Veterinary Surgeons


» Attendance at SPVS Congress - networking

9.2. Impact of VCMS Trial on the Parties and Stakeholders

It is useful to reflect on the impact of the scheme on all parties:

9.2.1. Veterinary Client / ‘the Complainant’

— Feedback demonstrates complainants contacting the VCMS feel their concerns have been acknowledged and understood. This is an important objective of the VCMS as addressing and understanding client complaints is a key reason for the service existing. Feedback showing 94% of client responses and 96% of practitioner responses considered the VCMS to be independent - this highlights the fair and unbiased approach adopted by the VCMS Resolution Managers. Importantly, the service has to be seen to be independent

— A practical resolution or redress is achieved in a short time frame

— High satisfaction ratings from consumers - regarding the VCMS process and experience overall, with strong positive responses in terms of recommending to others and willingness to use the service again. It has clearly been seen by the majority of veterinary clients as a positive experience

— Over the long term, VCMS insight can inform and help the sector and individual practitioners to further understand the client perspective, and learn from complaints to improve practice.

9.2.2. Practitioners

— The focus on practical resolution helps to move complaints away from the ‘blame game’

— The mediation process has allowed practices to demonstrate insight i.e. changes to practices and further training, which highlights a positive response to complaints

— Positive feedback from practices confirms they felt the VCMS understood their concerns (84%), and the average rating of their overall experience was 8.1 / 10, which illustrates the impact of a fair and independent mediation service particularly in diffusing anger and frustration and facilitating effective communication

— Some practices have utilised the service for guidance on complaints handling to enhance their own in-house procedures for the benefit of themselves and consumers

— Constructive interaction with the VCMS can minimise the detrimental impact of complaints on practitioners’ mental health and wellbeing. The process is less stressful and focused on drawing matters to a conclusion

— Feedback to practices on complaint handling and client care is given in a supportive and constructive way assists professional development

— VCMS satisfies the requirement to offer ADR for all consumer disputes7 via a service that is bespoke and understands the interaction between consumer statutory rights, civil liability and a regulatory framework

— Rising public expectations are a factor in veterinary complaints. Veterinary Clients and practices have different views and expectations regarding what a veterinary practice and profession can and should provide.

ENGAGEMENT

7 EU Directive

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This variance triggers complaints and the parties’ positions become emotionally charged and entrenched. Practitioners can respond defensively where they feel they have provided appropriate clinical care, and the client’s expectation is unreasonable. This can lead to concerns escalating as veterinary clients feel dismissed or ignored. Mediation is an effective method of dispute resolution in these scenarios;

— In the longer term, Nockolds can clearly envisage VCMS insight informing and complimenting collaborative communication with the RCVS and the other professional bodies or defence organisations helping the sector and individual practitioners to learn from complaints and improve practice. Mediation of complaints and sharing the insight gained assists the sector in a shift to a learning culture. The focus is on practical resolution and understanding why concerns escalate to become complaints or disputes.

9.2.3. RCVS

— The elements of a complaint not involving professional misconduct have a forum which enhances the public’s perception of the RCVS as first rate regulator

— Proportionate and cost-effective means of addressing those concerns which fall outside the RCVS remit allowing RCVS resources to be targeted to core function

— Mediation of complaints and sharing the insight gained assists the sector in a shift to a learning culture. The focus is on practical resolution and understanding why concerns escalate to become complaints or disputes

— VCMS satisfies the requirement to offer ADR for all consumer disputes8 via a service that is bespoke and understands the interaction between consumer statutory rights, civil liability and a regulatory framework, which therefore supports the profession

— VCMS insight can inform and compliment collaborative communication with the RCVS and the other professional bodies or defence organisations helping the sector and individual practitioners to learn from complaints and improve practice

— Mediation as an approach to complaint resolution helps to address the distressing impact of complaints on both veterinary clients and veterinary professionals, consistent with the RCVS strategy on commitment to the Mind Matters initiative.

9.2.4. Defence and Representative Organisations

— Disputes can be resolved via mediation without recourse to costly litigation or disciplinary proceedings

— VCMS satisfies the requirement to offer ADR for all consumer disputes9 via a service that is bespoke and understands the interaction between consumer statutory rights, civil liability and a regulatory framework, which therefore supports the profession

— Insight gained is informative and collaborative communication can assist in improving standards and reducing risk.

ENGAGEMENT

8 EU Directive

9 EU Directive

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10.1. Nature of Complaints Received by VCMS

Each referral received is categorised by nature of complaint, and then wherever possible, a more detailed assessment and sub-categorisation is recorded.

This analysis enables the VCMS to reinvest the overall insight gained during the delivery of complaint mediation. While a reasonable sample size is required before meaningful analysis can be undertaken, it is already clear that the VCMS will be able to feed into or facilitate strategic focus on issues and aspects of the client & veterinary professional/practice interaction which may lead to escalated complaints or would benefit from further consideration in terms of best practice.

Almost 60% of the enquiries received by the VCMS concern allegations relating to the standard of clinical care received. This may be one aspect of an overall complaint, and it is likely that there are other factors which have exacerbated the client’s feelings of dissatisfaction.

Complaints Insight

COMPLAINTS & SAFEGUARDING

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By their nature, these complaints require more detailed review and can potential involve input from the veterinary advisor. They also represent an extension of the remit of the service as set out in the trial proposal presented by Nockolds in June 2016.

10.2. Species

10.3. Evaluation

Should the trial be rolled out to a permanent service, the categories will be consistent with those used by the RCVS and the VDS to allow collaborative analysis of all types of complaints across the sector.

The VCMS would recommend lifting the species exclusion.

10.5. Direct Access and Forecasting the Activity Levels

Prior to the trial it was difficult to forecast activity levels for a direct access scheme. Enquiries in October were immediate, and the increase has continued from an average of 54 in Q1 to 92 in Q3. In this final quarter, the monthly average is 114.

When considering the level of activity it is important to examine how complainants become aware of the VCMS.

10.5.1. Referrals Generated via RCVS

Approximately 48% of the referrals received by the VCMS came via the RCVS. 36% of complainants had been in touch


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with the RCVS Team and were directed to the VCMS. A further 12% contacted the VCMS having viewed the information about the service on the RCVS website.

10.5.2. Referrals Received Directly

Encouragingly, over the VCMS trial period, over 50% of enquiries were received by the VCMS directly from the public. This is higher than anticipated. With more promotional and profile raising activity, this percentage is likely to increase. The objective would be to increase these direct contacts as this means clients are contacting the most appropriate forum for their complaint from the outset and reduces enquiries to RCVS. The safeguarding process and assessment at the outset of the referral ensure that Serious Professional Misconduct allegations are directed to the RCVS. From the audit conducted by the RCVS Team, Council can be reassured that this process is effective and there is a solid foundation of appropriate complaint assessments on which to base a long term direct access service.

The VCMS website – www.vetmediation.co.uk provides a source of information and a signpost via search engines. The site has over 400 visits per month.

The VCMS online presence has provided a significant information source and a means of referring complaints to the service. Almost a third of enquiries have quoted the website as their source. The VCMS is also engaging with the public and the professions via social media.

10.6. Forecast

Month March April May June July August

Activity 74 79 73 123 106 115

Average 75 114

Average Monthly Referral Rate

October - December 16 54.7

January - March 17 70 +28% increase on Q1

January - June 17 80.83

April - June 17 91.7 +31% increase on Q2

April - August 17 97 +16% increase on previous 6 months

June - August 17 114 +21% increase on Q3

October 16 - August 17 80

The activity forecast is extrapolated from the average monthly referral trend. Given the increasing number of referrals per month, an increase of 20% during year 1 is reasonable.


@vetmediation

/VeterinaryClientMediation

/company/veterinary-client-mediation

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In Nockolds’ experience of complaint resolution services, should the service continue, an increase in referrals is likely as:

— The VCMS would be a permanent service encouraging further engagement

— Awareness will increase over time

— High satisfaction ratings result in recommendations and increased reference to the VCMS by practices

— VCMS increasingly referred to literature and practices’ complaint procedures

— Potential impact on any subsequent adjustment to RCVS triage process

— Other regulators and complaint ADR services are reporting an increase in complaint referrals. This is partly due to attitudinal changes in society with increased willingness to complain and also increased awareness of ADR as an alternative to litigation. As a comparison, the Optical Consumer Complaint Service saw a 44% increase in referrals between 2014-15 and 2015-16, and a further 55% increase between 2015-16 and 2016-17.

If an increase is not realised, it is highly likely the volume of referrals would continue at the average monthly of 114 per month, which was seen during the last three months (June, July and August).

Monthly Referrals Would Equate to an Annual Total Of

95 1,140

100 1,200

125 1,500

150 1,800

Based on the increase in referrals over the course of the 11 month trial, it is forecast that:

Year 1 (2017 - 18) 1,300 referrals Based on average of 110 per month. If the % increase over the trial is extrapolated across year 1, referrals could increase to 125 per month (1,500 per annum).

Year 2 (2018 - 19) 1,600 referrals Based on a 30% increase on year 1, and 134 referrals per month.

Year 3 (2019 - 20) 2,000 referrals Based on a 30% increase on year 2, and 167 referrals per month.

Given that ‘costs per Referral’ are lower for VCMS than RCVS, this is likely to be a more cost proportionate means of handling the ongoing increase in complaints experienced across all sectors by all regulators. The safeguarding policy ensures that referrals received by the VCMS that necessitate professional conduct investigation are referred to the RCVS either directly in serious cases or signposted.


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SAFEGUARDING

11.4. Safeguarding

As set out in section 2.b.1, the VCMS Team has demonstrated an ability to identify circumstances that necessitate a referral to the RCVS for disciplinary consideration or investigation, with 15 Enquiries referred to the RCVS for review.

All enquiries received directly (i.e. without referral from RCVS) have been audited by the RCVS Project Team to ensure that the correct assessment of any potential allegation of Serious Professional Misconduct has been made by the VCMS Team. These audits were undertaken at the VCMS office in Bishop’s Stortford which had the additional benefit of developing the working relationship and communication between key members of the RCVS Professional Conduct and the VCMS Teams.

This safeguards animal welfare and maintains practice standards by establishing a clear pathway for the referral of professional misconduct allegations that come to the attention of ADR service. The service has demonstrated it can deliver effective support to the RCVS’ role as the regulator in terms of resolving those complaints that fall outside the regulatory framework, while ensuring fitness to practice allegations are identified and investigated by the RCVS.

Under the scheme rules, and at this early stage, any complaint circumstance involving any misconduct allegations has not proceeded through the mediation process allowing the practice to focus on the regulatory investigation process.

Clear and effective communication between the Professional Conduct Team at the RCVS and the VCMS Team allows any referral where either team has concerns that a complaint circumstance may fall within the statutory remit of the RCVS to be discussed and a strategy agreed.

11.4.1. Evaluation:

A sample auditing process would be appropriate as referral levels and complaint mediation volumes increase.

In the event of a permanent service, further development work would be undertaken to ensure the two teams have greater understanding of their respective roles and processes. Where complaint circumstances are referred to the RCVS Professional Conduct Team do not amount to Serious Professional Misconduct, the RCVS Team can consider whether mediation may benefit the parties and provide appropriate contact details to the veterinary client.

Safeguarding

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VCMS Proposal

Section 3Future Delivery of the VCMS


- 50 -

12.1. Complaint Mediation

In the above review, details of any changes or developments to the process have been set out. Aside from these the process will be delivered on the basis of the model used during the trial.

12.2. Remit of the Scheme

12.2.1. Nature of Complaint

The ADR directive requires an ADR scheme to be available for consumer disputes. The RCVS did extend the scheme to negligence allegation and any claims or complaints of a non-professional conduct nature. While the clinical issues may not in themselves be complex, the nature of the treatment or risks involved can be. The complaints will, in reality, be multifaceted combining client care and standards of care allegations. While this requires more time-consuming mediation, the VCMS as delivered by Nockolds has demonstrated the expertise and knowledge to successfully resolve those wider complaints.

12.2.2. Species Exclusions

The VCMS would propose allowing mediation of complaints relating to the care provided to all species, and the criteria applied be the status of the owner, i.e. a consumer.

12.2.3. Individuals and Business Clients

Consumer is defined by the directive as an individual. Veterinary professionals provide services to commercial clients. It is proposed any final scheme will only be available to individual consumers.

12.2.4. Practitioner Not Regulated by RCVS

These will continue to fall outside the VCMS remit.

Future Delivery

FUTURE DELIVERY

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12.2.5. Professional Conduct Complaints

These will be referred to the RCVS as set out in the protocol.

12.2.6. ‘Unfair’ Complaints - Repeat Complainants, Vexatious Complainants and Those Unwilling to Accept Outcome

While veterinary clients contacting the VCMS have often been distressed, the number of repeat or vexatious complainants has been low. The proposed policy of confirming that their enquiry will not be actioned and nor mediated as a complaint remains effective. The use of ‘Agreement to Mediate’ clearly explains the scope of mediation and minimise the risk of parties being frustrated during the process.

12.3. Engagement

Engagement levels during the trial have been excellent. Some practitioners have expressed a reluctance to participate in a trial. If the decision is made to offer a long-term service then this reluctance may diminish. Further communication to explain the outcome of the trial will also serve to reassure practitioners.

Once the service is established and there is industry confidence, consideration can be given to requiring practitioners, under the Code of Conduct, to provide the details of the service within their complaints policy or at an appropriate stage of their complaints process. This is not currently proposed but could be kept under review based on engagement and impact.

12.4. Promotional Activity

Promotional activity with practitioners and stakeholders has been vital in the early stages of the trial and will need to be extended if a full service is to be provided. This activity intends to secure the confidence of practitioners in the value, impartiality and effectiveness of the service. Where such activity can be undertaken collaboratively with the RCVS and VDS practitioner confidence will continue to grow.

A promotional activity and insight sharing plan is set out in Appendix XX

This is based on a programme of consultation with stakeholder organisations and practitioners to build professional working relationships to engage them in the strategic development of the service and specific complaint resolution. Nockolds’ experience during the trial and in the optical sector, has found this to be effective and a useful means of widening engagement at a grass roots level.

Direct practitioner activity will work on building trust with individual practitioners using the service.

Consumer promotional activity would be targeted to ensure that interested consumers were aware and had access to the service.

12.5. Staffing and Training

— In addition to the envisaged staffing, additional Resolution Manager and administration support is required to progress mediations efficiently, given the referral volumes and the inclusion of negligence and non-consumer complaints/claims within the remit of the service. Following the trial, it is also necessary to resource the VCMS Team with greater input by the Senior Resolution Managers.

— Training will continue to be provided by Nockolds’ Client Care Team and Mediation division led by Zen Thompson to equip the team with complaints handling, managing emotional and dissatisfied people and RCVS safeguarding requirements. This training was delivered and has been refreshed and repeated in months 5 - 8. Further training and

FUTURE DELIVERY

- 52 -

development is scheduled throughout the contract.

— Training has also been provided by RCVS Team and this is sufficient for the ongoing delivery of the VCMS. Further interactive lunch and learn sessions may benefit both teams to deepen understanding and encourage closer working enabling VCMS to support the Professional Conduct Team.

— A mid trial process and communication was conducted by Zen Thompson, who will also continue to provide training and best practice guidance to the Resolution Managers.

12.6. Efficient Use of Online and In-House Resources and Processes

The scheme proposes to continue to offer / use:

— Online complaints referral process

— Online equality and diversity information capturing

— Online feedback

— Secure document exchange between the service, practitioners and relevant representatives

— Online secure reporting process to allow provision of information to RCVS. Nockolds has been able to deliver online data sharing which has enabled the RCVS to access data as required and ensuring that current information is available on demand. This enables ease of access in a secure form, which is vital to ensure compliance with data protection requirements and regulations.

12.7. Performance Measures and Targets

Nockolds proposes the VCMS be monitored and evaluated on the basis the following performance measures:

— Timescales – subject to a target of60 day resolution period.

— Outcomes achieved

— Satisfaction rating (as a percentage) in terms of the process and efficiency of the service.

12.8. Complaints Relating to the Service Provided by Complaint Service

The service intends to process and resolve all complaints to the satisfaction of the parties, however we are aware that complainants will come to the service feeling aggrieved and this can be transposed to the complaints handler particularly if their complaint is not upheld or the solution desired is not available to them.

A complaints policy will be followed where a service user is dissatisfied and in the first instance they will be asked to raise concerns with the VCMS.

The VCMS will log all complaints received and provide details to the RCVS. The VCMS must be seen as an independent service with appropriate oversight and governance by the RCVS as the contracting party.

FUTURE DELIVERY

- 53 -

13.1. Interim Reports - Monthly and Quarterly

Nockolds has provided monthly reports, data and analysis via a secure online portal.

Analysis of data will be conducted on a monthly basis so any key trends can be readily and quickly identified and raised. This monthly report can be provided to the RCVS. It is intended that any practitioners who are the subject of complaints on a regular basis will be highlighted to the regulator and monitored.

The service has reported full data analysis on a quarterly basis at ADR Advisory Panel meetings and an example of the report and data supplied is exhibited at Appendix XX . It is proposed quarterly updates be convened with the VCMS and RCVS.

13.2. Annual Reporting

The annual report will be provided to the RCVS and published within eight weeks of the anniversary of the contractual commencement date. This will consider:

— Complaint numbers

— Nature of complaints

— Key trends

— Resolution

— Source of complaints

— Public and registrant awareness

On an annual basis, the complaints service would then present the annual report with analysis to the RCVS council before this is shared with stakeholders, practitioners and the public.

Reporting

REPORTING

- 54 -

13.3. Relationship Manager

It is proposed that Jennie Jones will continue to be key RCVS Partner. At the outset of the full service, Nockolds would liaise with the RCVS Team to establish to beneficial level of reporting to allow information to be shared on activity and any immediate trends identified. Quarterly meetings will then be offered to share analysis and update the RCVS on engagement and promotional activity as well as consider any strategic issues.

13.4. Content of Reports

As can be seen, the reports can include:

— Number of complaints

— Type of complaint

— Number of new complaints since last report and this 12 month period

— Number of new complaints since start of contract

— Number of complaints:

» Resolved in the time frame

» Not resolved within time frame (with explanation)

» Still under investigation

» Closed

— Number of consumer complaints who were satisfied at the conclusion of the investigation

— Demographic details of the complainants

— Business type (independent, franchise, in-house or multiple)

Nockolds will discuss with RCVS Executive Team and stakeholders any further or alternative data that may provide useful insight.

REPORTING

- 55 -

14.1. Interim Period

In Spring 2017, it was agreed the VCMS would continue to accept complaint referrals beyond 30 June 2017, and the service would continue until November 2017 to allow for the decision of RCVS Council in September 2017 to be implemented. Following the decision, either:

— The full service plan would be implemented with immediate effect from 1 November 2017, or

— Should the decision be taken not to proceed, a run off procedure will be activated.

Interim Period

INTERIM PERIOD

- 56 -

D1. Conclusion

Nockolds has successfully launched and delivered the VCMS trial. The VCMS has offered the veterinary sector a comprehensive and effective approach to dispute resolution, and in particular complaints resolution.

The mediation model has been and will continue to be, tailored and a bespoke resolution service established to provide the RCVS, practitioners and consumers with:

— A means of resolving concerns and complaints falling outside the professional misconduct remit of the RCVS as the regulator

— An independent mediation based approach that identifies the circumstances of and root cause of the complaint at an early stage to improve the likelihood of a resolution

— A focus on resolution not confrontation or blame

— A commitment of fairness to both parties. This is key to gaining trust and engagement, and is only achieved when independence is valued and seen.

Feedback from veterinary clients and practices is overwhelmingly positive with over 80% recommending the service and seeing it as a positive addition.

Resolution rates show the VCMS has been effective. The VCMS is confident that the rate of successful mediations will continue to pick up pace as awareness and confidence in the service grows. To achieve a resolution rate of 85% of enquiries within 11 months is a testament to the commitment shown by the VCMS and also the RCVS Team, stakeholders and practices who have interacted with the service since 3 October 2016.

If Council are minded to proceed with the long-term provision of the service, the evaluations and revisions to the process will continue to hone an effective and efficient service. This will assist in releasing capacity within the VCMS Team to assist in mediating more complainants and practices.

Safeguarding has been protected via a clear communication and referral policy between VCMS and RCVS, with the security of auditing by RCVS during the course of the trial.

Conclusion

CONCLUSION

- 57 -

Complaints not relating to professional misconduct have an early pathway to resolution. Consumers satisfaction is often linked to swift and fair resolution. Further work can be undertaken to explore how the benefits of a cost efficient and proportionate ADR can be maximised in supporting the Professional Conduct Team to manage the increase in complaints and concerns seen across all sectors. The focus on resolution rather than blame is also key to obtaining participation by practices, and having a positive impact on the emotional and psychological wellbeing of the individuals involved in the circumstances of the complaint.

In the longer term, the insight gained and analysis given will be available to inform the understanding of the RCVS and stakeholders on trends and practice activity. Using this to illustrate best practice or support guidance and explain strategic developments and aims for the RCVS can only assist the regulator and those regulated.

The overall aim of the service is to resolve complaints and use that insight to help practitioners improve standards of client service and relationships, which ultimately benefits consumers and improves the welfare of their animals. The objectives set for the trial have been achieved, and Nockolds is passionate in its mission to ensure that by working together with the RCVS, a complaints resolution service meets that objective and importantly, can be a long-term positive addition to all those involved in the sector.

CONCLUSION

Council Sept 17 AI 05b

Council Sept 17 AI 05b – Disc LRO Unclassified Page 1 / 4

Meeting Council


Title Terms of Reference for Review of Legislative Reform Order 2013


Summary This paper sets out the proposed approach / terms of reference for the Review of the Legislative Reform Order 2013 for consideration by the Committee.

Decisions required None. The views of Council are sought regarding the approach taken and the terms of reference for the LRO review.

Attachments Annex A: Copy of Legislative Reform (Constitution of Veterinary Surgeons Preliminary Investigation and Disciplinary Committees) Order 2013 (“LRO”)

Authors Eleanor Ferguson Solicitor Registrar / Director of Legal Services 020 7202 0718 [email protected]




Background 1. The Legislative Reform (Constitution of Veterinary Surgeons Preliminary Investigation and

Disciplinary Committees) Order (LRO) came into effect in 2013. A copy of the LRO is attached at Annex A.

2. The objectives of the LRO were (in broad terms):

a. To maintain public confidence in the RCVS by making the disciplinary process independent from the setting of standards, and, therefore, human rights compliant under Article 6 of the Human Rights Act 1998;

b. To make the disciplinary process more sustainable by facilitating increasing membership of

committees to allow cases to progress more quickly (as previously all DC members came from a narrow Council ‘pool’ and it had meant that the same (few) people were called upon to consider cases and struggled to do so);

c. To avoid any perceived veterinary bias by:

i. enshrining in statute the involvement of lay people; and ii. instigating an independent recruitment process for members.

3. The principle changes introduced to bring this about were:

a. Members of PIC / DC no longer drawn from RCVS Council;

b. Introduction of a selection process independent of the RCVS;

c. Lay members stipulated (and stated “in statute”) as full members of the committees (not as previously, in the case of DC, by convention and internal policies; and, in the case of PIC, Lay “Observers” rather than full committee members), with a requirement for 1/3rd of members to be lay. Quorums were introduced: PIC – 3 members (of whom, one must be a lay person and one must be a registered person), and DC – 5 members (of whom, two must be lay persons and two must be registered persons);

d. The size of both committees was reformed to remove obstacles to efficiency arising with

‘future proofing’ built in; re: DC the number increasing from 12 to 20 (now stipulated as the minimum) but allowing up to a maximum of 40; re: PIC the number increasing from 6 to 9 (now stipulated as the minimum) allowing up to a maximum of 15.

e. The term of office for individual members was limited to 2 terms of 4 years – to allow for on-

going ‘refreshing’ of the committees. Extent of review required 4. In terms of the LRO, the Secretary of State must carry out a review of the amendments made

under the LRO and the impact on carrying out their functions, by the committees, at the end of every 5 year period; i.e. by 1 July 2018, and every successive period of 5 years thereafter.



5. Paragraph 3 (2) of the LRO states:

‘The Report must in particular:

a. Set out the objectives intended to be achieved by Part 1 of Schedule 2 to the Veterinary Surgeons Act (VSA) 1966 (Constitution of Committees) as amended by Article 2 of (the Order);

b. Assess the extent to which these objectives are achieved; and

c. Assess whether those objectives remain appropriate.’

6. The changes made are (in legislative terms) small and are focussed on the particular areas

specified; it is not a generalised review of the concerns process or a ‘wish list’ of other reforms or changes that might be considered desirable.

7. Current formal written guidance regarding the scope and expectations of any review are pretty

much non-existent. Some information had been available through the ‘Better Regulation Framework’ manual, issued for the benefit of government officials. This stated (in various extracts):

“During an evaluation the following questions should be considered:

• To what extent has the policy achieved its objectives? • To what extent have the success criteria been met? • To what extent have there been unintended consequences? • What are the costs and benefits, in hindsight and in going forward? • Is government intervention still required)?”

It also stresses proportionality, with reviews envisaged along a wide spectrum from “full PIRs, for high impact measures, to desktop reviews”.

Further that:

“Light touch reviews should be quick and efficient ...at a minimum you should establish whether the policy has achieved its objectives, to what extent it has met success criteria and whether there have been unintended consequences. Information collected during monitoring should be collated and stakeholder views sought.”

8. This manual, however, was withdrawn in 2015, at which time it was stated that “...reference

should be made to the departmental Better Regulation Unit for guidance”. However, where such a unit sits within Defra is something of a mystery. We are, however, actively seeking a meeting with members of Defra’s policy team to try to clarify the position and with whom the RCVS needs to liaise; with a view to and obtaining from Defra’s Better Regulation Unit confirmation / approval of the approach proposed and also, crucially, a time frame, given that Defra is required to publish



the Report (having taken any preliminary steps it requires via its internal committees) by 1 July 2018.

9. Given the lack of formal guidelines, clarification was sought from Bircham, Dyson, Bell, Solicitors

re: their experience of such processes and what might be expected. Discussions with them have confirmed the lack of formal guidance, and a lack of clarity within government departments on the process required following the change to a departmental approach. They agreed that the expectation would be that the RCVS would undertake the review for submission to Defra; they concurred that as the changes were limited, a proportionate approach was entirely reasonable and that a desk based approach taking into account the factors indentified above (at paragraph 7) were reasonable; they also agreed with the view of the RCVS, that confirmation should be sought from Defra in advance on what was being proposed and timings, to avoid any disputes / last minute discrepancies or issues arising.

10. It is proposed, therefore, that the approach and terms of reference will (subject to any clarification

from Defra) extend as set out in paragraph 7 above. 11. Council’s views are sought regarding this proposal.

Council Sept 17 AI 05d

Council Sept 17 AI 05d – Codes/Policies Unclassified Page 1 / 4

Meeting Council


Title Code of Conduct for Council (and committee) members / Policy for Managing Potential Conflicts of Interest / Policy for dealing with Complaints about Council (and committee) members / Policy for handling concerns about Members of the Preliminary Investigation and Disciplinary Committee(s)


Summary This paper sets out the proposed terms for: 1. An amended Code of Conduct for Council (and committee)

members; 2. An amended Policy for managing potential conflicts of interest; 3. Policy for dealing with complaints about Council (and committee)

members; and 4. Policy for dealing with concerns about members of Preliminary

Investigation Committee (PIC) / Registered Veterinary Nurse Preliminary Investigation Committee (RVN PIC) / Disciplinary Committee (DC) / Registered Veterinary Nurse Disciplinary Committee (RVN DC)

Decisions required To approve the terms of :

1. (Amended) Code of Conduct for Council (and committee) members; 2. (Amended) Policy for managing potential conflicts of interest; 3. Policy for dealing with complaints about Council (and committee)

members; and 4. Policy for dealing with concerns about members of (PIC) / (RVN

PIC) / (DC) / (RVN DC)

Attachments Annex A: Current Code of Conduct for Council Members (June 2012) and Code of Conduct for Managing Conflicts of Interest (April 2017); Annex B: PIC / DC Protocol (2014); Annex C: [New] Code of Conduct for Council (and committee) members; Annex D: [New] Policy for managing potential conflicts of interest for Council (and committee) members; Annex E: Policy for dealing with complaints about Council (and committee) members; Annex F: Policy for handling concerns about members of PIC / RVN PIC / DC / RVN DC

Author Eleanor Ferguson Registrar / Director of Legal Services 020 7202 0718 [email protected]




Background 1. The Veterinary Surgeons Act (VSA) 1966 currently contains no provisions to allow Council

members to be suspended or removed from office for matters of conduct. There are therefore very limited / provisions sanctions / enforcement provisions contained in the current Code of Conduct for Council and Committee Members (Code of Conduct) and Code of Conduct for Managing Conflicts of Interest (Conflicts document) (both documents are set out for reference at Annex A).

2. The entire complaints / enforcement process is set out in two sections:

Complaints are dealt with under paragraph 15 of the (current/old) Code of Conduct which states:

‘Complaints that an RCVS Council or Committee Member has breached the Code of Conduct for Council and Committee Members should be made at the earliest opportunity to the RCVS President and Chief Executive, who together, subject to the rules of natural justice, have discretion to deal with the complaint informally, for example, by conciliation or advice from the President, or formally, by establishing a group of three-persons, who may be Council Members, to hear the complaint and make recommendations to Council, including suspension from committee membership. In the event that the complaint is dealt with informally and concerns remain, complainants may report the matter to the Chair of the Audit and Risk Committee, who will report to the Audit and Risk Committee, and the Committee may refer the matter to the Council.’

The Conflicts document – with reference to failure to keep declarations up to date – states in the final two paragraphs:

‘Enforcement

The system should be self monitoring, relying on peer pressure and the fact that declarations will be published – but Council Members will not be required to ‘blow the whistle’ on each other as this would be contrary to the Collegiate ethos of the RCVS.

In the absence of a power to suspend Council Members for a deficiency in a Council Members declarations of interests, and a continued refusal to address it, the President is entitled to ‘name and shame ‘ such a member and this will be recorded in the Minutes’

3. The Legislative Reform Order (LRO) (currently with Defra) relating to governance changes,

contains the following provision:

Amendments to Schedule 1 to the Act

(4) After paragraph 3 insert— “3A.—(1) A member of the Council may be removed from office if the member fails to satisfy

any conditions about fitness to be a member that are determined by the Council. (2) The procedure for removal of a member from office is to be determined by the Council”.



4. This introduces the concept of removal from office effective once the LRO is granted. In light of this it is necessary to have in place policies and procedures so that it is clear that suspension and removal may occur and that state how this should be actioned, along with a more general policy relating to complaints about Council members, and how these should be handled.

5. The current provisions would not ‘fit the bill‘; the ‘naming and shaming’ provision catalogued in the

Conflicts document would seem unusual, and out of line with current expectations. Likewise, with the complaints process there are some obvious drawbacks including placing a high degree of responsibility on the President, somewhat lacking in detail / transparency and independence, and limited in scope to suspension (though even here it is not clear the source of the authority for such action).

PIC / DC 6. Conditions relating to fitness to be a member of the statutory PIC / DC are covered by the

Preliminary Investigation Committee and Disciplinary Committee Protocol 2014 (see Annex B), which states (in paragraphs 10 and 11):

The Council may remove from office any member of a statutory committee if satisfied that they do not comply with one or more of the conditions mentioned above, or that their membership of the committee would for any other reason be liable to undermine public confidence in the regulation of the veterinary profession.

Before removing from office a member of a statutory committee, the Council will set up a panel to advise it on the matter and will have regard to the advice of that panel. The panel will not include members of the Council.

7. This envisages the possibility of removal from office, and sets conditions and standards to be met.

It is somewhat ‘sketchy’ as regards the process by which this would occur, though an outline structure is in place.

Proposals 8. It is proposed that the Code of Conduct for Council Members should be amended slightly (see

Annex C) – to include (not just by reference) the Nolan Principles, with minor changes also introduced in Conflicts document – now named the Policy for Managing Potential Conflicts of Interest (see Annex D).

9. It is further proposed that a new Policy for dealing with complaints about Council (and committee)

members is introduced (see Annex E); also to be given to a Policy of handling concerns about members of PIC / RVN PIC / DC / RVN DC (see Annex F).

Policy for dealing with complaints about Council (and committee) members 10. As can be seen, the process proposed allows for the possibility, in appropriate situations, for

issues to be dealt with by way of mediation by agreement of both parties, but for more serious issues to be investigated, with Council making decisions regarding the outcome based on recommendations from a Panel of three constituted to investigate under the guidance of a Legal Assessor. It should be noted that it is proposed that the same processes should be applied to



complaints about committee members (who are not otherwise members of Council). While it is anticipated that such use would be rare (in particular where it is envisaged that ad hoc committee members would be appointed on a year-to-year basis) it has been provided as a ‘backstop’.

Policy for handling concerns about members of the Preliminary Investigation and Disciplinary Committees 11. The Policy follows the terms of the Protocol. To an extent it may be argued that it gives only

limited additional information regarding the process for handling concerns / removal of PIC / DC members. It does, however, include by reference the members of RVN PIC and RVN DC on which all other provisions are currently silent, and adds the requirement for legal guidance.

Decisions required 12. Council is asked to approve the terms of the:

• Code of conduct for Council (and committee) members; • Policy for managing potential conflicts of interest; • Policy for dealing with complaints about Council members; and • Policy for handing concerns about members of the PIC and DC committees.

Council Sept 17 AI 05d An A

CODE OF CONDUCT FOR COUNCIL AND COMMITTEE MEMBERS

Role of the RCVS

1. The Royal College of Veterinary Surgeons has statutory and Charter functions, and through the RCVS Trust, charitable functions. These are set out more fully in the Handbook for Council and Committee Members, the Guide to the Constitution and in the Charter, Veterinary Surgeons Act 1966 and the Trust’s Memorandum and Articles of Association.

Purpose of this Code

2. ‘The Council is the guardian of the good standing of the profession and, in order to maintain this position and the powers of self-regulation, it is important that the College, Council and all Council and committee members behave in a way that commands the respect and trust of the public. This must involve high standards of integrity, fairness, impartiality, openness and accountability, to both the public and the profession.’

3. The purpose of this Code is to help ensure that high standards are met and that those who act in the name of the RCVS are beyond reproach in the way that they conduct themselves and the business of the College.

Scope of this Code

4. This Code of Conduct applies specifically to Council Members, although its principles should apply generally to those who sit on Committees, sub-committees, etc.

General Guidelines

Council and Committee members are expected:

a) to act in good faith b) to treat others equally, fairly and with respect c) to behave in a business and professional manner d) to work collaboratively with colleagues (including staff) e) to act in accordance with the 7 principles of public life, as set out by the Committee

on Standards in Public Life [recited in the Code of Conduct for Managing Conflicts of Interest and at www.public-standards.gov.uk ]

http://www.public-standards.gov.uk/


Specific Guidelines

Understanding of the Role

5. Council Members are responsible for ensuring that they have a clear understanding of their role and the role of the RCVS, as set out in the Veterinary Surgeons Act 1966 and the Royal Charter. Having been elected or appointed they are expected to make themselves available for meetings and other commitments in so far as personal and professional obligations allow and be diligent in reading papers, researching and thinking about issues to ensure that they are making decisions on a fully informed basis.

Legal Liability

6. Acting collectively Council Members may have their decisions challenged in the courts and the Code of Conduct for Managing Conflicts of Interest sets out a number of examples of decisions which could be subject to Judicial Review. Council members also have a collective and individual responsibility for the College’s finance and governance arrangements and may also be personally liable in certain circumstances.

Confidentiality

7. Council Members must not disclose information which has been shared with them but designated by the College as private or confidential, within the terms of the Freedom of Information Act and its Publications Scheme; nor should they use information obtained in their role as Council or Committee Member for personal gain. Subject to these constraints Council Members should be open and transparent about what they do and about what the College does.

Conflicts of Interest

8. Under the Code of Conduct for Managing Conflicts of Interest all Council and Committee members are required to file a Declaration of Interest, to keep it up to date and to declare additional interests as necessary at each meeting.

Communications

9. Council Members have a role in communicating with the public and profession about what the College does but should take care to ensure that what they say is accurate and consistent with established policies and procedures. If in doubt they should consult with the Communications Department. In any event any communication with the media should be discussed in advance, wherever possible in the interests of achieving coordinated and consistent messages. Council Members should be particularly wary of expressing a view on a matter which may end up being referred to Preliminary Investigation or Disciplinary Committees.


10. Communications between Council Members on the internet should be conducted with the same courtesy as a face to face meeting and with an awareness of who else might be copied into the messages and the fact that such communications could be subject to disclosure under the Freedom of Information Act or in court proceedings.

Conduct /Personal Behaviour

11. All College Members and Fellows make a declaration on being admitted to the College:

" I PROMISE AND SOLEMNLY DECLARE that I will pursue the work of my profession with integrity and accept my responsibilities to the public, my clients, the profession and the Royal College of Veterinary Surgeons, and that, ABOVE ALL, my constant endeavour will be to ensure the health and welfare of animals committed to my care."

12. Council Members, whether veterinary surgeons or not, have a responsibility for upholding the College’s reputation and integrity and should try and avoid acting in a way that could bring the College into disrepute. In short their behaviour should conform to the standards expected of holders of public office: see the reference to the principles of public life above. Council Members are encouraged to discuss with the President or Chief Executive any incident in their personal or professional life that might impact on their role with the College.

13. Council Members are expected to contribute freely to discussion and debate to enable a robust and informed decision to be made. It is accepted that there will sometimes be dissenting views but once a final decision has been made all members are expected to respect that collective decision. Any public dissent should be measured and due consideration given to the impact this might have on the College, its staff, Council and other Council Members.

Feedback / Appraisal

14. Council Members can seek feedback from the President or their Chairman at any time. In any event they will have an annual opportunity to feedback experiences as a Council or Committee member to the President [on the reverse of the Committee Preferences Form].

Enforcement

15. Complaints that an RCVS Council or Committee Member has breached the Code of Conduct for Council and Committee Members should be made at the earliest opportunity to the RCVS President and Chief Executive, who together, subject to the rules of natural justice, have discretion to deal with the complaint informally, for example, by conciliation or advice from the President, or formally, by establishing a group of three-persons, who may be Council Members, to hear the complaint and make recommendations to Council,


including suspension from committee membership. In the event that the complaint is dealt with informally and concerns remain, complainants may report the matter to the Chair of the Audit and Risk Committee, who will report to the Audit and Risk Committee, and the Committee may refer the matter to the Council.

17 February 2012 revised June 2012

A Code of Conduct for Managing Potential Conflicts of Interest Role of the RCVS The Royal College of Veterinary Surgeons has statutory and Charter functions, and through RCVS Knowledge, charitable functions. These are set out more fully in the Handbook for Council and Committee Members, the Guide to the Constitution and in the Charter, Veterinary Surgeons Act 1966 and the Trust’s Memorandum and Articles of Association. RCVS Knowledge is a separate legal entity and the responsibilities of its Trustees are set out elsewhere. This document relates only to the principles of corporate governance adopted by the College. Although these principles apply equally to the statutory and Charter functions it should be noted that in relation to the discharge of its statutory functions the College has the status of a public body, which makes it imperative to follow the principles of good governance. Why do conflicts of interest need to be managed? The College is the guardian of the good standing of the profession and, in order to maintain this position and the powers of self-regulation, it is important that everybody elected or appointed to undertake activities on behalf of the College must behave in a way that commands the respect and trust of the public and the profession. This must involve high standards. The First Report of the Committee on Standards in Public Life (1995), known as the Nolan Committee after its then Chairman, set out clear expectations of those serving the public in whatever capacity: Selflessness o holders of public office should take decisions solely in terms of the public interest. They should

not do so in order to gain financial or other material benefits for themselves, their family, or their friends;

Integrity o holders of public office should not place themselves under any financial or other obligation to

outside individuals or organisations that might influence them in the performance of their official duties;

Objectivity o holders of public office should be objective in carrying out public business, including making

public appointments, awarding contracts, or recommending individuals for reward and benefits;


Accountability o holders of public office are accountable for their decisions and actions to the public and must

submit themselves to whatever scrutiny is appropriate to their office; Openness o holders of public office should be as open as possible about all the decisions and actions that

they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands;

Honesty o holders of public office have a duty to declare any private interests relating to their public duties

and to take steps to resolve any conflicts arising in a way that protects the public interest; and Leadership o holders of public office should promote and support these principles by leadership and example. There is both a legal and public relations imperative to look after the reputation of the profession and College by ensuring that business is conducted in accordance with proper procedures. The RCVS is subject to the Freedom of Information Act and is obliged to make information about its activities available to the public. It should be borne in mind that perception may damage the reputation of an individual or an organisation irrespective of the truth of the situation. Avoiding situations that might be construed adversely is therefore advisable. Judicial Review The legal imperative to adhere to principles of good governance arises from the fact that a number of the College’s statutory and public functions can be challenged in the courts, for example, by means of judicial review. The decisions that are potentially vulnerable to challenge are those relating to registration, recognition of registerable qualifications, certificates, diplomas, Fellowships and other examinations, along with decisions of the Preliminary Investigation and Disciplinary Committees. The grounds for such a challenge might be based on alleged illegality, irrationality, failure to give reasons or some procedural impropriety such as bias or abuse of process. One of the common grounds for seeking judicial review is that a decision is unfair or unreasonable because one or more of those making the decision were less than objective or prejudiced in some way. The various individuals involved in the decision making of any organisation will always have their own personal and professional interests which may or may not be relevant to the subject matter of the decisions. To minimise the risk of College decisions being challenged, or even viewed with concern, it is important for due process to be followed. All those involved in the decision making process must understand their responsibilities and declare publicly - so far as that is possible - full details of all their external interests. The purpose is to ensure widespread knowledge and understanding of the back-ground of those making the relevant decision on any particular issue under consideration by the Council. Following such declarations it is far easier


to defend the validity and fairness of the decision making process carried out by the Council, its committees and its individual members. Bias may arise in a number of forms; it may be the result of an involvement with a particular organisation or activity; it may be by virtue of knowing a particular individual or it may be because of certain views or beliefs which have been publically expressed. If a decision is challenged on the basis of such bias or the clear presence of a prejudicial interest it is likely that any legal proceedings would be brought against the College rather than any individual. Individuals can, however be personably liable in certain circumstances, such as defamation, but the College does carry insurance to cover such possibilities. The veterinary profession In a small profession the potential for conflicts of interest is exacerbated. In order to utilise relevant knowledge and experience in decision making it is often necessary to involve those who have personal or professional interests. In making decisions about particular individuals it may be the case that those involved in the decisions know the individuals involved, directly or indirectly. In order to discharge its responsibilities the College must take a pragmatic approach and take particular care in assessing the risks involved and in mitigating them, where ever possible. This Code is intended to assist in this by ensuring that all concerned are fully aware of any conflicts of interest and that those interests are managed appropriately and proportionately. This Code relates to the conduct of Members of Council and Council Committees in the way that the Code of Professional Conduct relates to the conduct of veterinary surgeons and veterinary nurses. Since 1999 Council Members have been invited to submit a Declaration of Interests form and to update this on an annual basis. The requirements for declarations of interest were reviewed in detail by independent Corporate Governance Group in 2008. Who is the Code for? The Code of Conduct should be made available to all those standing for election to Council or offered an appointment to sit on Council, its committees or to undertake any of the activities for which Council has decided that declarations of interest are required and the responsibilities set out in the Code should be accepted by all concerned. Who needs to submit a declaration of interest? Council Members and those non-Council members who serve on Council Committees [Audit & Risk; Education; Standards; PIC & DC Liaison; and Veterinary Nurses Council] must submit a Biographies and Declaration of Interest form (attached). Members of the two statutory Committees, Preliminary Investigation and Disciplinary, are covered in the practices and procedures for those committees. Given the nature of the work of these committees it is necessary for interests to be declared on a case by case basis, in addition to completing the form. Other activities undertaken on behalf of the College in relation to which declarations of interest need to be made only on a case by case basis, rather than on a general form:

i. Lay Observers on Preliminary Investigation Committee


ii. Members of the Examination and Registration Appeals Committees – on a case by case basis

iii. All members of Council Committee sub committees and working parties and Boards (with the exception of liaison groups)

iv. University visitors v. Practice Standards and Preliminary Investigation Inspectors – on a visit by visit basis vi. Examiners – in response to an advance list of candidates vii. Post Graduate Deans viii. External Verifiers – on a visit by visit basis ix. The Registrar

When should declarations be made? The form attached at Annex A should be completed on election or appointment to Council or any Council Committee. Where ever possible the form should be submitted electronically, on the RCVS intranet or by e-mail to the Executive Office. Interests not recorded on the form, such as personal relationships or any change of circumstance, should be raised at any meeting or on-line discussion at which they may be relevant. Members of sub-committees or working parties do not need to complete a formal declaration but should mention at any meeting or on-line discussion interests which relate to matters on the agenda. For visitors, inspectors, external verifiers, Board Members and examiners the relevant time to record any declarations of interest is when the list of visits or candidates is circulated in advance. What interests need to be declared? Any professional, business or personal interests which may impinge on the activities of the College. If in doubt, disclose - or at least ask the President, Chairman or Registrar. NB Conflicts of interest are not just things which you think may be a bar to objectivity, but should also include things which others, such as outsiders, may think give rise to bias. The ultimate test of when an interest needs to be declared is if it might be seen by an objective observer as something that might have influenced the decision arising from any discussion you participated in. The list may include current or previous employment or practice (covering at least the last 7 years); professional qualifications; memberships, fellowships and offices held in professional bodies; links with local, national and community organisations; consultancies and directorships; shareholdings, membership of the freemasons or a political party; directorships; appointments, e.g. as advisors to pet insurers; gifts and hospitality (which exceed the value of £150 in any year from a single source); published views and personal relationships (including employees) and other interests. In appropriate cases it may be necessary to disclose religious beliefs or vegetarian preferences in so far as they may have a bearing on a particular discussion. Relevant interests relating to immediate family or people with whom you have a close association should be disclosed, in so far as they are known to you.


Personal relationships would usually only be relevant in the context of a specific discussion and for that reason are not included in the attached form. Personal or sensitive information, e.g. relating to connections with animal research institutions, need not be disclosed on the published form but should be made known internally, in writing, at least to the President or Registrar. What action to take when a conflict of interest arises Where a conflict of interest has been identified it should be for the Chairman and /or the President to decide the extent to which the individual may participate in the meeting. Decisions will be informed by the circumstances of each case and the extent to which the decision renders the College vulnerable to legal challenge or adverse PR. The range of options include the following:

i. standing down from the committee, sub-committee, etc ii. not attending a particular meeting iii. leaving the room for the duration of a particular item iv. staying in the meeting for the discussion but leaving the room when the decision is

made or a vote taken v. staying in the meeting throughout to provide information and advice only vi. staying in the meeting throughout and participating fully

It is already established practice that University appointees to Council do not participate in any decision or vote on motions relating to the recognition or continued recognition of the veterinary degree awarded by that university, whether at Council or in Committee. They are usually invited to remain for the initial part of the discussion so that they can provide information. It is also written into the procedure for electing the (Junior) Vice President that candidates for election may be asked to leave the room to enable Council to have a confidential discussion before the secret ballot takes place. The same principle would apply in relation to any other nomination or appointment of someone present in the meeting and in the absence of a secret ballot the individual would not return to the meeting until the decision had been made. Where something other than a meeting, such as a visit or an examination is involved, similar principles will be applied to determine the extent to which the individual may participate. “Err on the side of caution” is good advice in the absence of any other!

Who to consult in the event of uncertainty? The relevant chairman, the President or Registrar. Storage and Publication of declarations The Declaration of Interest forms are stored electronically. Declarations of interest for Council Members are published on the RCVS website, along with profiles and photographs, on the basis that all Council and committee papers are potentially disclosable under


the Freedom of Information Act and those reading them should be aware of the interests of those involved in the discussion. The Declarations of interest for Council and non-Council members will be stored on the RCVS intranet. Keeping declarations up to date Declarations of interest should be continuously kept up to date by reporting any changes when they arise [within 28 days of any change in circumstances]. NB It will not be the responsibility of RCVS staff to send reminders. Declarations of interest will be the first substantive agenda item at relevant meetings. This should be taken as an opportunity to bring declarations generally up to date, not just in relation to interests which may be relevant to the discussion. These changes must be recorded in the minutes of the meeting and it would be helpful if the relevant Council or Committee Member could provide the Minute taker with a note of the declaration to ensure that it is accurately transcribed. Council and Committee members must take immediate steps to update the Declaration forms they have previously submitted. The electronic form, stored on the intranet, will dateline any changes to the document. It will therefore be possible to see when declarations have been added or deleted. Enforcement The system should be self monitoring, relying on peer pressure and the fact that declarations will be published – but Council Members will not be required to ‘blow the whistle’ on each other as this would be contrary to the Collegiate ethos of the RCVS. In the absence of a power to suspend Council Members for a deficiency in a Council Member’s declaration of interests, and a continued refusal to address it, the President is entitled to “ name and shame” such a member and this will be recorded in the Minutes.


RCVS Council Member Biography and Declaration of Interests 1

RCVS Council Member Biography and Declaration of Interests

Please note: this information may be placed on the RCVS website www.rcvs.org.uk and as such would be publicly available.

Title Prof Dr Mr Miss Mrs

Ms Mrs Other

Forename(s)

Surname

Select as appropriate

MRCVS FRCVS RVN N/A

Veterinary qualifications

Register no.

Short biography

Please see examples of biographies of other Council members online at: http://www.rcvs.org.uk/about-us/rcvs-council/council-members/ for guidance – up to 300 words

Current RCVS committee / sub-committee / board membership (if applicable)

Please indicate if Chair

http://www.rcvs.org.uk/

http://www.rcvs.org.uk/about-us/rcvs-council/council-members/



Directorships

Company/organisation Role

Shareholdings (of relevance, eg in pharmaceutical companies, farming, food, etc)


Consultancies


Appointment to other bodies




Membership of other veterinary or allied organisations


Employment (practice, industry, university, etc; past and present)

Qualifications (other than veterinary qualifications listed in the Register)



Interests relating to immediate family or close friends

Other relevant information (includes links with local or national bodies, political organisations, gifts and hospitality [exceeding £150 in any year from a single source] or other interests: anything which may be perceived to constitute a conflict of interest and which, if not disclosed but subsequently identified, could cause embarrassment for the individual and the College)

Photographs Please also submit a recent photograph, preferably a large digital image at as high a resolution as possible (ideally 300 dpi at full size). A good quality print would also be acceptable. Please either email this to [email protected] or post to the College address for the attention of Mrs Peris Dean. If you do not have a suitable photograph, we can organise for one to be taken next time you are in College – please let Ian Holloway know on [email protected] or 020 7202 0727. Authorisation By returning this information electronically to [email protected] or by post to the College address for the attention of Mrs Peris Dean, I agree that the above information can be held on file at the RCVS, published on the website and used in response to specific and relevant requests for information. I hereby declare that in signing and returning this form I accept and will abide by the RCVS Code of Conduct for Managing Potential Conflicts of Interest.

SIGNATURE: ................................................................. DATE: .................................................




Council Sept 17 AI 05d An B

Preliminary Investigation Committee and Disciplinary Committee protocol Made by the Council of the Royal College of Veterinary Surgeons on 6 November 2014, to come into force on the date when the Supplemental Royal Charter of 2014 comes into operation Citation 1. This protocol may be cited as the Royal College of Veterinary Surgeons Preliminary Investigation

Committee and Disciplinary Committee Protocol 2014. Interpretation 2. In this protocol, "the committees" or "the statutory committees" means the Preliminary

Investigation Committee and the Disciplinary Committee. 3. References to the appointment of members of the committees are to the appointment by the

Council of persons other than its own members under paragraph 1 of Schedule 2 to the Veterinary Surgeons Act 1966.

Appointment of committee members 4. The Council will set up a committee (here referred to as "the selection committee") to advise it on

the appointment of members of the statutory committees. Before appointing members of the committees Council will have regard to the advice of the selection committee.

5. The selection committee will not include members of the Council. 6. A person who has served as a member of the Preliminary Investigation Committee will not be

appointed to the Disciplinary Committee unless three years have elapsed since the person concerned ceased to be a member of the Preliminary Investigation Committee.

Term of office 7. Appointed members of the committees will hold office for four years or such shorter term as the

Council may determine in a particular case. 8. Members of the Council elected to serve as members of the committees during the transitional

period specified in paragraph 3A of Schedule 2 to the Act will hold office for one year or such shorter term as the Council may determine in a particular case.


Conditions about fitness to be a member of a statutory committee 9. Members of the committees will hold office subject to satisfying the following conditions:-

(a) they must at no time have been convicted of an offence involving dishonesty or deception in the United Kingdom, or in relation to the welfare of animals, or where the final outcome of the proceedings was a sentence of imprisonment or detention, the conviction not being a spent conviction; (b) they must at no time have been removed from the office of charity trustee or trustee for a charity by reason of any misconduct or mismanagement in the administration of the charity for which the person was responsible or to which the person was privy, or which the person contributed to or facilitated by their conduct; (c) they must at no time have been removed from office as the chair, member, convenor or director of any public body on the grounds that it was not in the interests of, or conducive to the good management of, that body that the person should continue to hold that office; (d) they must at no time have been adjudged bankrupt or had sequestration of their estate awarded, the person not having been discharged; (e) they must not be the subject of a bankruptcy restrictions order or an interim bankruptcy restrictions order; (f) they must at no time have made a composition or arrangement with, or granted a trust deed for, their creditors, not having been discharged in respect of it; (g) they must not be disqualified from being a company director; (h) they must not be included in a barred list under statutory provisions for the safeguarding of vulnerable groups; (i) they must at no time have been subject to any investigation or proceedings concerning fitness to practise by any licensing body, if the final outcome of the investigation or proceedings was suspension from a register held by the licensing body (that suspension not having been terminated), or erasure from such a register, or a decision that had the effect of preventing practice of the profession licensed or regulated by the licensing body, or only allowing practice subject to conditions which were not lifted; (j) they must at no time have had their name removed from the register of veterinary surgeons under section 16 of the Veterinary Surgeons Act 1966; (k) they must not have been the subject of a direction under section 16 of the Veterinary Surgeons Act 1966 for their registration to be suspended, if that suspension remains in operation;


(l) they must not be, or have been, subject to any investigation or proceedings concerning fitness to practise by any licensing body or by the Council, or at any time convicted of an offence elsewhere than in the United Kingdom, if the Council is satisfied that their membership of the committee would in view of that investigation or those proceedings or that conviction be liable to undermine public confidence in the regulation of the veterinary profession; (m) their attendance at meetings of the committee must not have fallen below a minimum level of attendance acceptable to the Council; (n) they must undertake any education or training required by the Council and comply with any arrangements as to appraisal of their performance as committee members which the Council may require; (o) they must not be unable to perform their duties as committee members because of adverse physical or mental health.

10. The Council may remove from office any member of a statutory committee if satisfied that they do

not comply with one or more of the conditions mentioned above, or that their membership of the committee would for any other reason be liable to undermine public confidence in the regulation of the veterinary profession.

11. Before removing from office a member of a statutory committee, the Council will set up a panel to

advise it on the matter and will have regard to the advice of that panel. The panel will not include members of the Council.

Vice-chairmen 12. The Council may from time to time designate one or more members of a statutory committee to be

vice-chairmen, and may at any time remove such a designation. Chairing of meetings of the Preliminary Investigation Committee 13. The chairman or a vice-chairman of the Preliminary Investigation Committee shall preside at its

meetings. If, during the course of a meeting of the committee, the person presiding ceases to be able to do so by reason of indisposition, conflict of interest or some other cause, the chairman or a vice-chairman or such other member of the committee as the members of the committee present may choose shall preside for the rest of the meeting.

Clerk to Preliminary Investigation Committee 14. The registrar shall appoint a clerk to the committee, who may be an employee of the College but

not a member of the Council.


Convening of meetings of Preliminary Investigation Committee 15. The clerk shall convene meetings of the committee, having consulted the chairman or, in the

absence or incapacity of the chairman, the vice-chairman or vice-chairmen. At least ten days' notice shall be given of every meeting, unless the chairman or vice-chairman who is to preside at the meeting directs that a shorter period is permissible.

16. The agenda for a meeting of the committee shall state clearly the business to be transacted. Meetings of the committees 17. The committees may meet and conduct inquiries with less than the full membership of the

committee being present. 18. Any decision made by one of the committees at such a meeting or inquiry shall be a decision of

the committee, provided that the quorum for meetings of the committee, as specified in paragraph 3 of Schedule 2 to the Act, is observed.

Reporting to the Council 19. The committees shall report to the Council from time to time on the discharge of their functions.

Council Sept 17 AI 05d An C

Council Sept 17 AI 05d An C – Ccl Code of Conduct Unclassified Page 1 / 3

Code of conduct for Council (and committee) members Role of the Royal College of Veterinary Surgeons (RCVS) 1. The RCVS has statutory and Royal Charter functions; and, through the RCVS Trust (also known

as RCVS Knowledge), charitable functions. These are set out more fully in the Charter; the Veterinary Surgeons Act (VSA) 1966; and the Trust’s Memorandum and Articles of Association. See: http://www.rcvs.org.uk/about-us/royal-charter-and-legislation

Purpose of this Code 2. In order for the RCVS to command the confidence of all interested parties, it is necessary for the

Council members to observe appropriate standards of conduct. The purpose of this Code is to help to ensure that high standards are met and that those who act in the name of the RCVS are beyond reproach in the way they conduct themselves and the business of the RCVS. The required standards are set out in this Code that applies to all members of Council upon appointment. Its provisions apply generally to those who sit on committees; sub-committees; working parties, etc.

Principles 3. In performing their duties, Council members should observe the seven principles of public life

(‘The Nolan Principles’); namely:

Selflessness: holders of public office should take decisions solely in terms of the public interest. They should not do so in order to gain financial or other material benefits for themselves, their family, or their friends;

Integrity: holders of public office should avoid placing themselves under any obligation to people or organisations that might try inappropriately to influence them in their work. They should not act or take decisions in order to gain financial or other material benefit for themselves, their family or their friends. They must declare and resolve any interests and relationships;

Objectivity: holders of public office must act and take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias;

Accountability: holders of public office are accountable for their decisions and actions to the public and must submit themselves to whatever scrutiny is appropriate to their office;

Openness: holders of public office should be as open and transparent as possible about all the decisions and actions that they take. They should give reasons for their decisions and restrict information only when the wider public interest clearly demands;

Honesty: holders of public office should be truthful;

http://www.rcvs.org.uk/about-us/royal-charter-and-legislation



Leadership: holders of public office should exhibit these principles in their own behaviour. They should actively promote and robustly support the principles and be willing to challenge poor behaviour wherever it occurs.

General guidelines 4. Council members are expected:

a. To act in good faith; b. To treat others fairly, equally and with respect; c. To behave in a business-like and professional manner; d. To work collaboratively with colleagues/staff; e. To listen to and value the views of others.

5. Members should also lead by example and demonstrate the values that underpin the culture of

the RCVS:

- Fairness; - Openness; - Understanding; - Forward thinking; - Accountability; - Consistency.

Specific guidelines 6. Council members are responsible for ensuring that they have a clear understanding of their role

and the role of the RCVS as set out in the VSA 1966, and the Royal Charters. Having been elected or appointed, they have a responsibility to make themselves available for meetings of the Council and any committees, sub-committees, working parties, etc., to which they have been appointed (unless they are unable, with good reason, to do so); and to be diligent in reading papers and giving appropriate consideration to issues to ensure that they are making decisions on a fully informed basis.

7. Council members should follow the principles of mutual respect in all their activities and be

prepared to accept that others may have equally strong views in good faith that differ from their own. Council members must uphold high standards of courtesy and respect in all Council debates and meetings. Council members should treat colleagues with respect and not engage in any behaviour towards any colleague or member of staff that might reasonably be interpreted as discriminatory, bullying or harassment.

Collective responsibility 8. Council members are collectively responsible for the decisions, even if they have voted against,

abstained from voting or were absent when the decision was made, and are expected to respect the collective decision.



Confidentiality 9. Council members must not disclose information that has been shared with them but designated

by the RCVS as private or confidential. Conflicts of interest 10. The policy for managing conflicts of interest requires all Council members to file a Declaration of

Interest; to keep it up to date; and to declare any additional interests as necessary at each meeting and generally to comply with the requirements of the policy (see Annex D).

Communication 11. Council members have a role in communicating with the public and the profession about what the

RCVS does but should take care to ensure that what they say is accurate and consistent with established policies and procedures – if in doubt, they should consult the Communications Department. Any communication with the media on behalf of the RCVS must be discussed with the Communications Department in advance.

12. Council members have a responsibility to distinguish clearly when speaking or writing in any

public forum, between the views of the RCVS and their personal views, or of any other organisation they may be affiliated with.

Enforcement 13. Complaints that an RCVS Council member has breached this Code of Conduct should be made

at the earliest opportunity to the RCVS President /Registrar, in accordance with the Policy for Dealing with Complaints about Council Members (see Annex E).

Council Sept 17 AI 05d An D

Council Sept 17 AI 05d An D – Policy for conflicts Unclassified Page 1 / 9

Policy for Managing Potential Conflicts of Interest Role of the RCVS 1. The Royal College of Veterinary Surgeons has statutory and Charter functions, and through

RCVS Knowledge, charitable functions. These are set out more fully in the Charter, Veterinary Surgeons Act 1966 and the Trust’s Memorandum and Articles of Association.

2. RCVS Knowledge is a separate legal entity and the responsibilities of its Trustees are set out

elsewhere. This document relates only to the principles of corporate governance adopted by the RCVS. Although these principles apply to all functions it should be noted that in relation to the discharge of its statutory functions the College has the status of a public body, which makes it imperative to follow the principles of good governance.

Why do conflicts of interest need to be managed? 3. The RCVS is the guardian of the good standing of the profession and, in order to maintain this

position and the powers of self-regulation, it is important that everybody elected or appointed to undertake activities on behalf of the RCVS must behave in a way that commands the respect and trust of the public and the profession. This must involve high standards and adherence to the Seven Principles of Public Life (‘The Nolan Principles’) as recited in the Code of Conduct for Council Members.

4. There is both a legal and public relations imperative to look after the reputation of the profession

and College by ensuring that business is conducted in accordance with proper procedures. The RCVS is subject to the Freedom of Information Act and is obliged to make information about its activities available to the public.

5. It should be borne in mind that perception may damage the reputation of an individual or an

organisation irrespective of the truth of the situation. Avoiding situations that might be construed adversely is therefore advisable.

Judicial Review 6. The legal imperative to adhere to principles of good governance arises from the fact that a

number of the College’s statutory and public functions can be challenged in the courts, for example, by means of judicial review. The decisions that are potentially vulnerable to challenge are those relating to registration, recognition of registerable qualifications, certificates, diplomas, Fellowships and other examinations, along with decisions of the Preliminary Investigation and Disciplinary Committees.

7. The grounds for such a challenge might be based on alleged illegality, irrationality, failure to give

reasons or some procedural impropriety such as bias or abuse of process. One of the common grounds for seeking judicial review is that a decision is unfair or unreasonable because one or more of those making the decision were less than objective or prejudiced in some way.



8. The various individuals involved in the decision making of any organisation will always have their own personal and professional interests which may or may not be relevant to the subject matter of the decisions. To minimise the risk of College decisions being challenged, or even viewed with concern, it is important for due process to be followed.

9. All those involved in the decision making process must understand their responsibilities and

declare publicly – so far as that is possible – full details of all their external interests. The purpose is to ensure widespread knowledge and understanding of the background of those making the relevant decision on any particular issue under consideration by the Council. Following such declarations it is far easier to defend the validity and fairness of the decision making process carried out by the Council, its committees and its individual members.

10. Bias (or the appearance of bias) may arise in a number of forms; it may be the result of an

involvement with a particular organisation or activity; it may be by virtue of knowing a particular individual or it may be because of certain views or beliefs, which have been publically expressed. If a decision is challenged on the basis of such bias or the clear presence of a prejudicial interest it is likely that any legal proceedings would be brought against the College rather than any individual. Individuals can, however, be personably liable in certain circumstances, such as defamation, but the College does carry insurance to cover such possibilities.

The veterinary profession 11. In a small profession the potential for conflicts of interest is exacerbated. In order to utilise

relevant knowledge and experience in decision making it is often necessary to involve those who have personal or professional interests. In making decisions about particular individuals, it may be the case that those involved in the decisions know the individuals involved, directly or indirectly. In order to discharge its responsibilities the College must take a pragmatic approach and take particular care in assessing the risks involved and in mitigating them, wherever possible. This Code is intended to assist in this by ensuring that all concerned are fully aware of any conflicts of interest and that those interests are managed appropriately and proportionately.

Who is the Code for? 12. The Code of Conduct should be made available to all those standing for election to Council or

offered an appointment to sit on Council, its committees or to undertake any of the activities for which Council has decided that declarations of interest are required and the responsibilities set out in the Code should be accepted by all concerned.

Who needs to submit a declaration of interest? 13. Council Members and those non-Council members who serve on Council Committees [Audit &

Risk; Education; Standards; PIC & DC Liaison; and Veterinary Nurses Council] must submit a Biographies and Declaration of Interest form (attached).

14. Members of the statutory Committees: Veterinary Preliminary Investigation and Disciplinary

Committees; and Registered Veterinary Nurse Preliminary Investigation and Disciplinary Committees, are covered in the practices and procedures for those committees. Given the nature of the work of these committees it is necessary for interests to be declared on a case by case basis, in addition to completing the form.



15. Other activities undertaken on behalf of the RCVS in relation to which declarations of interest need to be made only on a case by case basis, rather than on a general form, include, but are not limited to:

i. Members of the Examination and Registration Appeals Committees – on a case by case

basis; ii. All members of Council Committee sub committees and working parties and Boards; iii. University visitors; iv. Practice Standards Assessors and Preliminary Investigation Committee Investigators – on a

visit by visit basis; v. Examiners – in response to an advance list of candidates; vi. Post Graduate Deans.

When should declarations be made? 16. The form attached should be completed on election or appointment to Council or any Council

Committee. Wherever possible the form should be submitted electronically, on the RCVS intranet or by e-mail to the Executive Office. Interests not recorded on the form, such as personal relationships or any change of circumstance, should be raised at any meeting or on-line discussion at which they may be relevant.

17. Members of sub-committees or working parties do not need to complete a formal declaration but

should mention at any meeting or on-line discussion interests which relate to matters on the agenda.

18. For visitors, inspectors, Board Members and examiners the relevant time to record any

declarations of interest is when the list of visits or candidates is circulated in advance. What interests need to be declared? 19. Any professional, business or personal interests which may impinge on the activities of the

College. If in doubt, disclose – or at least ask the President, relevant Committee Chair or Registrar.

20. NB Conflicts of interest are not just things which you think may be a bar to objectivity, but

should also include things which others, such as outsiders, may think give rise to bias. The ultimate test of when an interest needs to be declared is if it might be seen by an objective observer as something that might have influenced the decision arising from any discussion you participated in.

21. The list may include current or previous employment or practice (covering at least the last [7]

years); professional qualifications; memberships, fellowships and offices held in professional bodies; links with local, national and community organisations; consultancies and directorships; shareholdings, membership of the freemasons or a political party; appointments, e.g. as advisors to pet insurers; gifts and hospitality (which exceed the value of [£150] in any year from a single source); published views and personal relationships (including employees) and other interests. In appropriate cases it may be necessary to disclose religious beliefs or vegetarian preferences in so far as they may have a bearing on a particular discussion.



22. Relevant interests relating to immediate family or people with whom you have a close association should be disclosed, insofar as they are known to you.

23. Personal relationships would usually only be relevant in the context of a specific discussion and

for that reason are not included in the attached form. 24. Personal or sensitive information, e.g. relating to connections with animal research institutions,

need not be disclosed on the published form but should be made known internally, in writing, at least to the President or Registrar.

What action to take when a conflict of interest arises 25. Where a conflict of interest has been identified it should be for the relevant Committee Chair and /

or the President to decide the extent to which the individual may participate in the meeting. Decisions will be informed by the circumstances of each case. The range of options include the following:

i. Standing down from the committee, sub-committee, etc; ii. Not attending a particular meeting; iii. Leaving the room for the duration of a particular item; iv. Staying in the meeting for the discussion but leaving the room when the decision is made or a

vote taken; v. Staying in the meeting throughout to provide information and advice only; vi. Staying in the meeting throughout and participating fully.

26. It is already established practice that University appointees to Council do not participate in any

decision or vote on motions relating to the recognition or continued recognition of the veterinary degree awarded by that university, whether at Council or in Committee. They are usually invited to remain for the initial part of the discussion so that they can provide information.

27. It is also written into the procedure for electing the Vice President (Junior) that candidates for

election may be asked to leave the room to enable Council to have a confidential discussion before the secret ballot takes place. The same principle would apply in relation to any other nomination or appointment of someone present in the meeting and in the absence of a secret ballot the individual would not return to the meeting until the decision had been made.

28. Where something other than a meeting, such as a visit or an examination is involved, similar

principles will be applied to determine the extent to which the individual may participate. 29. “Err on the side of caution” is good advice in the absence of any other! Who to consult in the event of uncertainty? 30. The relevant Committee Chair, the President or the Registrar. Storage and Publication of declarations 31. The Declaration of Interest forms are stored electronically [on the RCVS intranet].



32. Declarations of interest for Council Members are published on the RCVS website, along with profiles and photographs.

Keeping declarations up to date 33. Declarations of interest should be continuously kept up to date by reporting any changes when

they arise, or at least no later than 28 days of any change in circumstances. 34. NB It will not be the responsibility of RCVS staff to send reminders. 35. Declarations of interest will be the first substantive agenda item at relevant meetings. This should

be taken as an opportunity to bring declarations generally up to date, not just in relation to interests which may be relevant to the discussion. These changes must be recorded in the minutes of the meeting and it would be helpful if the relevant Council or Committee Member could provide the Minute taker with a note of the declaration to ensure that it is accurately transcribed. Council and Committee members must take immediate steps to update the Declaration forms they have previously submitted.

36. The electronic form, stored on the intranet, will dateline any changes to the document. It will

therefore be possible to see when declarations have been added or deleted.



RCVS Council Member Biography and Declaration of Interests

Please note: this information may be placed on the RCVS website www.rcvs.org.uk and as such would be publicly available.

Title Prof Dr Mr Miss Mrs

Ms Mrs Other

Forename(s)

Surname

Select as appropriate

MRCVS FRCVS RVN N/A

Veterinary qualifications

Register no.

Short biography

Please see examples of biographies of other Council members online at: http://www.rcvs.org.uk/about-us/rcvs-council/council-members/ for guidance – up to 300 words

Current RCVS committee / sub-committee / board membership (if applicable)

Please indicate if Chair

http://www.rcvs.org.uk/

http://www.rcvs.org.uk/about-us/rcvs-council/council-members/



Directorships


Shareholdings (of relevance, eg in pharmaceutical companies, farming, food, etc)


Consultancies


Appointment to other bodies




Membership of other veterinary or allied organisations


Employment (practice, industry, university, etc; past and present)

Qualifications (other than veterinary qualifications listed in the Register)



Interests relating to immediate family or close friends

Other relevant information (includes links with local or national bodies, political organisations, gifts and hospitality [exceeding £150 in any year from a single source] or other interests: anything which may be perceived to constitute a conflict of interest and which, if not disclosed but subsequently identified, could cause embarrassment for the individual and the College)

Photographs Please also submit a recent photograph, preferably a large digital image at as high a resolution as possible (ideally 300 dpi at full size). A good quality print would also be acceptable. Please either email this to [email protected] or post to the College address for the attention of Mrs Peris Dean. If you do not have a suitable photograph, we can organise for one to be taken next time you are in College – please let Ian Holloway know on [email protected] or 020 7202 0727. Authorisation By returning this information electronically to [email protected] or by post to the College address for the attention of Mrs Peris Dean, I agree that the above information can be held on file at the RCVS, published on the website and used in response to specific and relevant requests for information. I hereby declare that in signing and returning this form I accept and will abide by the Policy for Managing Potential Conflicts of Interest.

SIGNATURE: ................................................................. DATE: .................................................




Council Sept 17 AI 05d An E

Council Sept 17 AI 05d An E – Ccl complaints Unclassified Page 1 / 2

Policy for dealing with complaints about Council (and committee) members Purpose 1. This Policy sets out the procedures to be followed in dealing with a complaint about a Council

member, where it is alleged or appears that the conduct of the Council member has fallen below the standards expected.

Scope 2. The standards expected of Council members are as set out in the Code of Conduct for Council

Members. Any alleged breach of the Code or other conduct unbefitting of a Council Member should be considered in accordance with this Policy.

3. Poor performance on the part of a Council member would normally fall outwith the scope of this

policy and be dealt with by means of advice issued to the Council member by the President / Registrar. However, consistent poor performance that goes unremedied, or exceptionally poor performance, may be matters when a Council member could be declared unfit to be a member of Council and, therefore, becomes an appropriate matter to be dealt with under this policy.

4. Complaints about a Council Member should be raised in writing with the President and Registrar.

In the event that the complaint relates to the President then it should be raised with the Vice President (Senior) and the Registrar.

5. In the event that the complaint relates to actions of Council as a whole, these should be raised

with the Privy Council: https://privycouncil.independent.gov.uk/work-of-the-privy-council-office/complaints

Who can bring a complaint? 6. Complaints may be brought by anyone including Council members, MRCVS’, RVNs and

employees of the RCVS and should be raised as soon as practicable, and in any event no later than [6] calendar months after the date of the alleged misconduct (or the date on which the complainant became aware of it). The President (or as the case may be Vice President (Senior)) may dispense with the time limit, if he / she considers that there were exceptional circumstances and that it is reasonable to do so.

Procedure re: Complaint 7. Upon receipt of a complaint the President / Registrar (or as the case may be Vice President

(Senior)) may:

a. Conclude that the complaint does not fall within the scope of this policy, and will notify both the Complainant and Council member accordingly; or

b. Direct that the matter should be investigated and notify both parties accordingly; or

https://privycouncil.independent.gov.uk/work-of-the-privy-council-office/complaints

https://privycouncil.independent.gov.uk/work-of-the-privy-council-office/complaints

Council Sept 17 AI 05d An E

Council Sept 17 AI 05d An E – Ccl complaints Unclassified Page 2 / 2

c. Conclude that the matter is one where informal resolution should be explored. Informal

resolution can only be pursued if agreed upon by both the Complainant and the Council member and could include resolution via mediation. In the event that either or both parties do not agree to informal resolution then the matter must go forward for investigation;

d. An investigation should be directed, if it is considered that, if established, the complaint is

such that it could lead to the suspension or removal of the Council member. 8. Where an investigation is directed, the President / Registrar will direct this to be carried out by

one of the Legal Assessors appointed to the RCVS under paragraph 6 of Schedule 2 to the Veterinary Surgeons Act (VSA) 1966, who shall according to the nature and extent of the complaint decide the appropriate procedures to be followed to determine the complaint; to include, for example, written submissions / formal hearings. The procedures to be followed shall be at the discretion of the Legal Assessor but would ordinarily include the establishment of a Panel of three persons (the Conduct Committee), to include: the Chair of the Audit and Risk Committee, a lay person, and a veterinary surgeon; to consider the complaint (the lay person and veterinary surgeon may, or may not, be members of Council). The Legal Assessor may also delegate responsibility for contacting participants and other administrative functions to an appropriate member of RCVS staff.

9. Upon conclusion of the investigation the Legal Assessor will submit a written report and

recommendations to the President / Registrar to include one of the following:

a. To dismiss the complaint; b. To uphold the complaint, but with no further action; c. That the Council member should be issued with a written warning; d. That the Council member should be suspended for a period of up to 12 months, or removed

from Council. 10. The President / Registrar will arrange for the Report and recommendation of the Legal Assessor /

Conduct Committee to be considered by RCVS Council, which will decide on the appropriate action to be taken.

11. This policy may be implemented, if considered appropriate to do so by the President / Registrar,

in relation to a complaint against a member of one of the College’s Committees (other than Preliminary Investigation Committee (PIC), Disciplinary Committee (DC), Registered Veterinary Nurse Preliminary Investigation Committee (RVN PIC), or Registered Veterinary Nurse Disciplinary Committee (RVN DC)) who is not also a Council Member.

Council Sept 17 AI 05d An F

Council Sept 17 AI 05d An F – Concerns re Stat cttes Unclassified Page 1 / 2

Policy for handling concerns about members of the Preliminary Investigation and Disciplinary Committees Purpose 1. This policy sets out the procedures to be followed in dealing with a concern about a member of

the Preliminary Investigation Committee (PIC) or Disciplinary Committee (DC). Scope 2. The conditions and standards to which members of PIC and DC are expected to adhere are set

out in the Preliminary Investigation Committee and Disciplinary Committee Protocol (2014) (the Protocol).

Procedure 3. Concerns should be raised in writing and submitted to the President / Registrar, who may:

a. Conclude that the concern does not fall within the scope of the Protocol, and notify the complainant and committee member accordingly; or

b. Direct that the matter should be investigated.

4. Any investigation will be carried out by a Panel of three persons to be appointed by RCVS Council

(The Conduct Panel). The Panel will not include any member of RCVS Council. The Panel shall determine the appropriate procedures to be followed to investigate any concern, and must appoint a Legal Advisor to assist, who shall be a qualified Barrister or Solicitor of at least 10 years standing. The Legal Advisor may delegate responsibility for administrative functions.

5. Upon conclusion of the investigation, the Panel will submit a written report and recommendations

to the President / Registrar. 6. The President / Registrar will arrange for the report and recommendations to be considered by

RCVS Council, which will decide on the appropriate action to be taken; to include one of the following:

a. To dismiss the concern;

b. To uphold the concern, but with no further action;

c. That the committee member should be issued with a written warning; or

d. That the committee member should be suspended for a period of up to 12 months, or

removed from the committee.

Council Sept 17 AI 05d An F

Council Sept 17 AI 05d An F – Concerns re Stat cttes Unclassified Page 2 / 2

7. The provisions in this Policy shall also apply to members of the Registered Veterinary Nurse Preliminary Investigation Committee (RVN PIC) and Registered Veterinary Nurse Disciplinary Committee (RVN DC), who are also bound by the terms of the Protocol (notwithstanding that they are not a committee constituted under the Veterinary Surgeons Act (VSA) 1966).

Council Sep 17 AI 05e

Council Sep 17 AI 05e – Election procedure Unclassified Page 1 / 3

Meeting Council


Title Election procedure for RCVS Treasurer


Summary Process to be put into place following the RCVS Supplemental Charter, and subsequent Bye-Laws, that were granted on 17 February 2015.

Decisions required • To agree the proposed process for election of Treasurer; • To agree whether there should be a convention or rule that

limits the number of years that the position is held per person.

Attachments Annex A: Draft process for election of Treasurer

Author Dawn Wiggins PA/Secretary to Registrar/Director of Legal Services 020 7202 0737 [email protected] Eleanor Ferguson Solicitor Registrar/ Director of Legal Services 020 7202 0718 [email protected]





Election procedure for Treasurer Background 1. The Treasurer position was traditionally included on the Committee Preference Forms that were

sent to Council annually in March to complete and return for Nominations Committee (thereafter Operational Board following changes to committee structures in 2014) to consider the role along with committee membership, and make recommendations to Council at the June meeting for agreement for the following College year.

2. The latest RCVS Supplemental Charter was granted on 17 February 2015, and, with it, new Bye-

Laws came into force on the same date the Charter came into effect. At paragraph 18 of the Bye-Laws it states:

Treasurer

A Treasurer shall be elected from amongst the members of the Council by the Council in each year at the first meeting of the Council held after the Annual General Meeting. The Treasurer may at any time resign by submitting a written notice of resignation addressed to the Registrar, and a successor shall be elected by the Council at its next meeting after the resignation shall have been received. The Treasurer shall remain in office until the meeting of the Council at which a successor is elected notwithstanding that the Treasurer may at the Annual General Meeting held immediately prior to the meeting of the Council at which a successor is elected have ceased to be a member of the Council.

Proposed election process 3. It is proposed to run the election for Treasurer along the same lines as the Election of Vice

President (Junior) (VP(J)) and Election of Committee Chairs:

• The notice of election to be sent out to Council not less than 60 days prior to the February/March Council meeting at which the election is to take place;

• Nominations to be received by 30 days prior to the meeting;

• Candidate details and any accompanying documentation to be circulated to Council at least

15 days prior to the meeting;

• Election held at the February/March Council meeting (annually). Voting 4. General Administration Bye-Laws (2013) (Schedule 2, paragraph 6) stated that in the event of

only one candidate, the motion will be put to the meeting that the candidate be elected, but if there was dissent, or more than one candidate, there would be a secret ballot. Those Bye-Laws were repealed when the Supplemental Charter was granted in 2015 and replaced by the Meeting Procedure Rules in which it states: ‘…the person chairing a meeting…shall have discretion to modify the rules in their application to that meeting…’. Also, that ‘…voting shall be by show of hands, except that the Council may direct that a secret ballot shall be held for elections to the



offices of President or Vice-President…’. This option has been exercised for recent elections of VP(J) and committee Chairs, and can be extended to include the election of Treasurer.

Decisions required 5. Council is asked to consider and approve the draft procedure for election of Treasurer attached at

Annex A. 6. A further decision is required on whether standing for the position of Treasurer be limited to a

maximum amount of years (convention for Committee Chairs is to hold the role for 3 years, but this does not stop the Chair standing for re-election for further years as it is only convention). Since 2000, the following Treasurers held the office for:

Dr C P Sturgess (July) 2017 – current (c. 3 months) Ms A K Boag 2014 – 2017 (3 years) Dr B P Viner 2010 – 2014 (4 years) Dr J V Davies 2006 – 2010 (4 years) Dr R P Moore 2003 – 2006 (3 years) Professor R E W Halliwell 2001 – 2002 (1 year) Mr J Parker 2000 – 2001, 2002 – 2003 (2 years)

Council Sep 17 AI 05e An A

Council Sep 17 AI 05e An A Unclassified Page 1 / 3

Election procedure for Chairs of Education and Standards Committees Treasurer

These procedures were first put in place in 1994 for the election of President and Vice President following a review conducted by Sir Colin Shepherd MP. Minor modifications were made in intervening years and more substantive changes were agreed by Finance and General Purposes Committee in June 2005. The procedures set out below represent a consolidation of all the amendments and they were further adopted for the Election for Chairmen of Education and Standards Committees at the Council meeting held in November 2013 and for the Election of Treasurer in 2017. Nomination 1. A notice of election for Chairs of Education and Standards Committee Treasurer will be circulated

to all Council Members not less than 60 days before the February/March Council meeting at which the election is to take place.

2. The notice will be accompanied by a nomination form for each Committee and these notes. 3. Any candidate seeking election should complete, sign and return the relevant form to the

Registrar. 4. Each nomination must be supported by four Members of Council. No Council Member may

support more than one candidate per Committee. Supporting forms can be submitted separately. It is the responsibility of the candidate to ensure that his/her nomination has the necessary number of supporters. [NB. Office staff will not get involved in chasing the necessary paperwork].

5. All forms must reach the Registrar on the date given, which will be 30 days before the Council

meeting. Fax or e-mail copies will be allowed provided the original arrives in the post within 48 hours.

6. Each candidate may circulate one letter to Council, limited to 250 words, indicating why s/he is

standing for election. This should be submitted to the Registrar, where possible with the nomination form, but in any event by the date given.

7. The candidate details and any accompanying letters will be circulated to all Council Members at

least 15 days before the Council meeting. Voting 8. The election will be an agenda item held in public. After the Chairman’s introduction, the Registrar

will read out all the nominations, in alphabetical order, with the names of the supporters.



9. There will be no opportunity for the candidates or supporters to address Council but Council will be given the opportunity to have a confidential discussion, in which case the candidate or candidates and the public will be asked to leave at this stage. Candidates will be invited back to vote and others to hear the results.

10. In the event that there is only one candidate, the motion will be put to the meeting that the

candidate be elected. In the event that there is dissent there will be a secret ballot (in accordance with The General Administration Bye-Laws 2013, Schedule 2, paragraph 6 the Meeting Procedure Rules (paragraphs 2 and 6)). In order to succeed a single nomination must receive more than 50% of the vote. If the nomination captures less than 50% the election will be postponed until the next meeting of Council, during which time additional nominations will be sought.

11. In the event that there is more than one candidate a secret ballot will take place at the Council

meeting (in accordance with The General Administration Bye-Laws 2013, Schedule 2, paragraph 6 the Meeting Procedure Rules (paragraphs 2 and 6)).

12. A ballot box will be located at the front of the Council chamber. All voting papers will be numbered

to secure the principles of anonymity and ‘one member; one vote’. 13. Council Members not able to be present may ask for a postal vote which will be opened at the

meeting by the Chairman. 14. Ballot papers will be issued to all members present and collected in the ballot box, along with any

postal votes, by the Registrar. 15. Ballot papers will be counted by the Registrar in private with the Head of Finance or another

member of the internal management team acting as scrutineer. The winner must receive more than 50% of the votes. Where this does not happen the position will be reported; the last placed candidate eliminated and a further ballot carried out until an outright winner is identified. In the event of a tie the procedure outlined below will apply.

16. The Registrar will report the result of the ballot to Council, with the voting figures for each

candidate together with any abstentions. 17. A tie. In the event of a tie there will be an immediate re-run of the ballot between the two tying

candidates:

a. where the tie is between the only two candidates then there will be a short adjournment after which another vote will be called. In the event of yet another tie the candidate who is an elected Member will be preferred. If both be elected Members then the winner will be the one with the greatest number of votes on the most recent election to Council. If both are nominated/appointed members then the winner will be the one with the greatest seniority on the Council. If all these consideration fail then lots shall be drawn.

b. where the tie occurs in the last round of a ballot in which there were more than two candidates initially then the winner shall be the one with the greatest number of votes in the first round.



c. where the tie is amongst two, one of whom is to be eliminated from the next stage the

considerations in a) shall apply.

ECF/dw 28/9/17

council meeting - to be held in committee · pdf filethe president further informed council...

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