The Veterinary Development Council Report

Transcription

1 The Veterinary Development Council Report May 2012

2 Contents Foreword 2 Executive Summary 3 1. Introduction Background Terms of reference Priority issues Ways of working 6 2. Report of the Veterinary-Led Team Working Group Introduction and terms of reference Views of farmers Views of the Animal Health and Veterinary Laboratory Agency Views of veterinary surgeons Views of technicians Conclusions Recommendations Report of the Business Models Working Group Introduction and terms of reference Classification of business models Survey of farm animal practices Discussion Recommendations Report of the Food Industry Engagement Working Group Introduction and terms of reference Main findings Recommendations The use of Pillar II funding to improve farm animal health and welfare 24 Annexes 5.1 Introduction Background View of the VDC Core Group Recommendation 25 Annex 1 Annex 2 Annex 3 Annex 4 Annex 5 Annex 6 Annex 7 Annex 8 ii vii x xvi xviii xx xxiii xxiv 1

3 Foreword The Veterinary Development Council (VDC) was the brainchild of Professor Philip Lowe in his Report Unlocking Potential produced for the Vets and Veterinary Services Steering group in His recommendation was taken up by the British Veterinary Association (BVA) with help with funding from the Department for Environment, Food and Rural Affairs (Defra). I was pleased to be asked by the BVA in 2010 to chair the VDC for an initial year (i.e. during 2011) and to undertake a programme of work during that time that is outlined in this Report together with the recommendations that stem from it. This Report marks the end of the initial period of work of the VDC. It is directed primarily towards the BVA and the veterinary profession but also towards other key food supply chain stakeholders most of whom are represented by the VDC s Core Group membership. Indeed, the work of the VDC and production of this Report could not have been undertaken and completed without the cooperation, support and hard work of the Core Group Members to whom I express my heartfelt thanks. Neither could it have been undertaken without the cooperation of the veterinary profession, especially members and officials of the BVA and its Divisions who have participated in surveys, responded to requests for information and shared their views. The veterinary profession has a key and changing role to play in the provision of high quality, safe, nutritious and affordable food for the population and in protecting the health and welfare of farm animals. There are many demands on the veterinarian from the food supply chain and an increasing challenge to adapt the provision of veterinary services to meet those demands as effectively and efficiently as possible. The aim of the VDC has been to identify practical ways in which this adaptation by the veterinary profession might be supported. We look forward to seeing how the BVA (and other stakeholders) respond to our recommendations and how consideration of the future development of the provision of veterinary services is taken forward. Richard Bennett Chair of the Veterinary Development Council 2

4 Executive Summary The Veterinary Development Council (VDC) was set up by the British Veterinary Association (BVA), in association with a number of key stakeholders, at the end of 2010, following the recommendation of the 2009 Lowe Report. The terms of reference of the VDC were to (i) assess the market for veterinary services in the food supply chain now and in the foreseeable future (ii) consider how this market might best be serviced and organised so as to maximise benefits to veterinarians, users of their services and society in general and (iii) make recommendations regarding actions that need to be taken to ensure a sustainable, effective and efficient market for veterinary services in the food supply chain over time. Priority issues for the VDC to consider were identified by stakeholders as: (i) the need for greater engagement of the veterinary profession with food industry, (ii) the need to consider different business models for the delivery of veterinary services, (iii) better engagement of the veterinary profession with the Animal Health and Veterinary Laboratories Agency (AHVLA), (iv) the role of para-professionals and technicians for the delivery of veterinary services, (v) specialisation (allocation of tasks to increase efficiency) in the delivery of veterinary services 1, (vi) the implications of the above for veterinary education and training and for policy and regulation (vii) the future role of the VDC beyond its first year of operation. In order to consider these issues a Core Group of VDC stakeholders was established together with three working groups (the Vet-Led Team, Business Models and Food Industry Engagement Working Groups). This Report contains a summary of their work, findings and recommendations. In addition, VDC Core Group Members gave some thought to the greater use of EU rural development (Pillar 2) funds to help to increase profitability and competitiveness in livestock production through improved animal health and welfare. In summary, the headline recommendations arising from the work of the VDC are that: (i) the BVA should undertake a consultation and opinion poll, which captures the views of the UK veterinary profession, to establish the appetite or otherwise with regard to allowing technicians to undertake specified veterinary service activities (such as blood sampling, disbudding and tuberculin testing) under veterinary direction; (ii) the BVA should ask the Royal College of Veterinary Surgeons (RCVS) to consider the best course of action to establish an acceptable process of training for, and regulation of, technicians who undertake activities under existing or new Exemption Orders; (iii) in the light of this, Government should consider the appropriate mechanisms that would allow suitably trained lay persons to carry out minor acts of veterinary surgery (such as disbudding) under the employment and direction or supervision of a veterinary surgeon; (iv) a structured programme of training, consultancy and mentoring should be introduced to encourage veterinary practices to think strategically about how their businesses operate, to 1 It was decided that specialisation of veterinary surgeons in relation to them having specialist status would not be considered as there was an RCVS working group specifically addressing this issue, although the VDC has been kept informed of its deliberations. 3

5 consider whether changing how they do business would be beneficial and to share good practice examples of successful innovations; (v) the BVA and its divisions should investigate and publish around five in-depth business case studies; (vi) business education should be included in the curriculum of every UK veterinary school; (vii) the BVA should facilitate better engagement of the veterinary profession with food industry and with the Governments veterinary delivery agents; (viii) veterinary schools should encourage early and continued recognition amongst veterinary students of the importance of the role of the vet in supplying high quality, safe and nutritious food; (ix) veterinarians should engage more with the business of farming for food, helping their farmer clients attain profitable outcomes from their livestock and meet the demands of the market for high quality, safe food and should provide a link on farm between animal health and welfare and food quality/safety; (x) the food and farming industries, the veterinary profession and veterinary education/training establishments should explore opportunities for a food supply chain career development path for veterinary graduates and how it might best be serviced in terms of appropriate training and experience; and (xi) working with industry, the Government should actively consider animal health and welfare when deciding detailed priorities for the future programme to be funded under the Rural Development Regulation. This initiative should include consideration of a Farm Animal (Health and) Welfare Stewardship Programme and involve appropriate bodies such as the Farm Animal Welfare Committee, the Animal Health and Welfare Board for England and bodies in the devolved administrations. 4

6 1. Introduction 1.1 Background The veterinary profession has a unique and highly trusted role in the food supply chain and most particularly up to the farm gate. Of all the advisors and technical practitioners the veterinarian is probably the most highly trained and respected. This gives the veterinarian, and veterinary practices, an enormous opportunity to provide a range of added value services to their farm and food industry clients which can help them achieve both commercial and broader societal objectives. In order to do this, the veterinary profession has had to develop how they deliver their services and adapt to a seemingly ever changing economic and policy environment affecting agriculture and food production. The challenge for the profession is to be able to continue to appropriately innovate and adapt to change to meet the future needs and expectations of its clients and of society more widely. The Veterinary Development Council (VDC) was set up by the British Veterinary Association (BVA), in association with a number of key stakeholders, at the end of This was in response to a recommendation made by Professor Philip Lowe in his 2009 report on veterinary expertise in food animal production for a Veterinary Development Council to be established charged with guiding the long-term development of veterinary services. The VDC had its first meeting in January attended by over 50 stakeholders from along the food supply chain (see Annex 1a for a list of attendees at VDC meetings). At this meeting the terms of reference for the VDC were agreed and these are outlined below. 1.2 Terms of reference The VDC s terms of reference are to: 1. Assess the market for veterinary services in the food supply chain now and in the foreseeable future, in particular, to determine the animal health, animal welfare and public health role of the veterinary profession in the food chain. 2. Consider how this market might best be serviced and organised so as to maximise benefits to veterinarians, users of their services and society in general. 3. Make recommendations regarding actions that need to be taken to ensure a sustainable, effective and efficient market for veterinary services in the food supply chain over time. The term market is used here to refer to both the supply of veterinary services (i.e. veterinarians and other animal health professionals, veterinary practices, organisations, skills and expertise etc - in terms of quantity, quality and costs ) and the demand for veterinary services in terms of the current and future needs of clients (in the private and public sector) and the expectations of stakeholders and wider society, together with the coming together of supply and demand under market conditions (which includes consideration of market prices, institutional/market arrangements, competition etc.). 2 The reader is referred to the VDC website ( for a full report of all the VDC s meetings. 5

7 1.3 Priority issues The first meeting of the VDC also helped to identify some of the priority issues that stakeholders felt the VDC should explore. These were: 1. The need for greater engagement of the veterinary profession with food industry. 2. The need to consider different business models for the delivery of veterinary services. 3. Better engagement of the veterinary profession with the Animal Health and Veterinary Laboratories Agency (AHVLA). 4. The role of para-professionals and technicians for the delivery of veterinary services. 5. Specialisation (allocation of tasks to increase efficiency) in the delivery of veterinary services The implications of the above for veterinary education and training and for policy and regulation. 7. The future role of the VDC beyond its first year of operation. 1.4 Ways of working The VDC s ways of working have been to consult, engage with and involve stakeholders in its work as widely as possible. To this end, a Core Group of key stakeholders (see Annex 1b) was formed at an early stage to help steer and undertake the work of the VDC. This Core Group comprised representatives from the four countries of the United Kingdom and included representatives from Government and its agencies (e.g. AHVLA and the Food Standards Agency(FSA)), the veterinary profession (including the Royal College of Veterinary Surgeons (RCVS), veterinary schools and private practice) and agricultural/livestock and food industry bodies. During 2011 three work streams and associated Working Groups were set up to begin to explore and address the priority issues identified above. The Working Groups were comprised of selected members of the Core Group together with a number of co-opted members chosen for their knowledge and expertise in particular areas (see Annex 1b). The main work of these groups has been to gather and assimilate information and help put forward recommendations for action, either for the VDC itself or directed towards stakeholders. The three Working Groups were set up to consider (i) the veterinary-led team and the role of technicians (ii) different business models for delivery of veterinary services and (iii) better engagement of the veterinary profession with food industry. The work and findings of these three Working Groups are reported in the following sections. 3 It was decided that specialisation of veterinary surgeons in relation to them having specialist status would not be considered as there was an RCVS working group specifically addressing this issue, although the VDC has been kept informed of its deliberations. 6

8 2. Report of the Veterinary-Led Team Working Group 2.1 Introduction and terms of reference The Veterinary-Led Team Working Group was drawn from the veterinary and farming community to give a spread of interests and experience. Membership of the Group can be found in Annex 1b. The terms of reference of the Group were: (i) To identify the range of services that could be supplied to the farming community by a veterinary-led team including: Those services that could be undertaken by non-veterinarians. Those specialist services that could be delivered by veterinary surgeons. Those services provided by others with which vets need to integrate/co-operate. Those typical Official Veterinarian services that might be delivered as part of a veterinary-led team. (ii) To identify how these services are currently delivered. (iii) To describe the benefits of bringing non-veterinary services into the team e.g. reduced costs, appropriate treatments. (iv) To assess the desire of vets and non-vets to work together to deliver the services. The Group confirmed that, irrespective of how services were delivered, it was essential to protect animal health and welfare. It was also recognised that the work of the Group could not be taken in isolation from the work of the other working groups of the VDC (for example, different business models would utilise the services of technicians in different ways). The priority was to identify the range of services that could be delivered through veterinary practices and there was considerable discussion on legal restrictions that prevented delivery of some services by non-veterinarians. Examples of services from veterinary practice where lay staff were employed were identified and, together with further examples from the farming community, formed the basis for a wide range of services that potentially could be delivered by a veterinary-led team. (see Annex 2). The Group identified the need to capture the views of all stakeholders, including the veterinary profession, on the range of services that are or could be delivered to the farming community and the way in which these could be delivered. The key stakeholders were identified as: Farmers AHVLA Veterinary Surgeons Technicians. 2.2 Views of farmers There is a clear indication from the farming industry for support for the use of technicians as part of a veterinary-led team. Input from the National Farmers Union (NFU) Commodity 7

9 Boards significantly contributed to the identification of potential services (Annex 2), but also asked the question of who should, does or could provide the service. Under the Veterinary Surgeons Act 1966 only veterinary surgeons can carry out acts of veterinary surgery. There are exemptions for farmers or their employees (e.g. disbudding) or where an Exemption Order is in place (see Annex 3 for a summary of restrictions on the practice of veterinary surgery). These exemptions are inconsistent. For example, a lay person can carry out tuberculin testing when employed by AHVLA but not when employed by a private veterinary practice. A farmer s employee can carry out disbudding but not a layperson employed by a veterinary practice, irrespective of the training or supervision. Most Exemption Orders do not require the layperson to be part of a veterinary-led team. Activities that are not acts of veterinary surgery (e.g. foot trimming) can be carried out by a layperson over whom there is no statutory control or regulation. Thus there are three groups of people who could provide services to a farming business: Veterinary surgeons (generalist/specialist) Technician under direction and supervision Technician Farmers require the most appropriate combination of these options to deliver effective and efficient services. 2.3 Views of the Animal Health and Veterinary Laboratories Agency An exchange of correspondence with AHVLA indicated support for the development of a veterinary team that included non-veterinarians who were appropriately trained. AHVLA identified the wider use of lay staff for tuberculin and blood testing to be of potential benefit for the control of notifiable diseases. While not possible under current legislation, AHVLA would support changes to legislation if there was support from the veterinary profession. Current EU legislation under review seeks to introduce non-veterinarians formally into the process of certification and health management in European aquaculture. 2.4 Views of veterinary surgeons Potential benefits of allowing suitably trained and supervised technicians to undertake such activities include: cost-savings for veterinarians and for food animal producers by utilising the most appropriate staff; potential new business opportunities/revenue streams for veterinary practices; improved resource management in terms of veterinary surgeons time, allowing veterinary surgeons to concentrate on higher level problem solving; timely and appropriate level response to clients needs. To help clarify the views of the veterinary profession a survey was undertaken using Survey Monkey. This was targeted at food animal, equine and mixed practice and was publicised through the BVA, the BVA website, the BVA s online member forum - the BVA Community Platform - and The Veterinary Record. The survey was open to BVA members and nonmembers. It was designed to obtain an indication of the current use of lay staff and of their 8

10 possible use in the future (see Annex 4). The results need to be treated with caution as it was not a statistically robust sample. However, it is a useful indicator of the current thinking of the veterinary profession. There were 269 respondents of which 74% did not employ technicians and more than 60% had never considered employing technicians (Annex 5). Of those that did employ technicians they used them for a wide range of work. The majority of respondents (75%) were aware that their clients used technicians not employed by the practice. Two thirds of respondents indicated that they would consider employing technicians in the future as part of a veterinaryled team. Almost 90% of respondents did not have any agreements with self-employed technicians. Discussion within the Working Group identified the potential difficulties of such arrangements, for example, in terms of legal liability. Overall there appears to be a willingness to develop a veterinary-led team that is likely to give greater control over training and supervision. However, despite the results of the survey it is not clear that the veterinary profession as a whole wants the changes in the legislation to allow the greater use of lay staff. 2.5 Views of technicians The Working Group wrote to a number of service providers to gather views on the concept of a veterinary-led team. Replies were only received from The Equine Podiatry Association and The National Association of Cattle Foot Trimmers. Both associations expressed the view that they wanted to work closely with the veterinary profession and ensure accredited standards of training and competency. However, neither saw the way forward as being direct employees of veterinary practice, rather they were in favour of developing a better working relationship with veterinarians and enhancing training and monitoring. 2.6 Conclusions There are clear potential benefits for veterinarians and their clients from the greater use of technicians as part of a veterinary-led team. There appears to be general support for the development of a closer working relationship between the veterinary profession and those providing technical services to the farming/equine community. There are two very different models that could deliver this but these could run simultaneously. The first would be the direct employment of laypersons by veterinary practices to deliver an extended range of services. This is, however, constrained by current legislation which restricts the activity of such laypersons. It is also dependent on how practice is organised to ensure sufficient work for laypersons to justify their employment. This could mean that it is restricted to larger practices or the sharing of laypersons between practices. One way to develop the role of the non-veterinarian would be to enhance the remit of the veterinary nurse in farm animal practice (e.g. as farm animal para-veterinarians 4 ) along the lines of the changes that have taken place within companion animal practice. This would address the issues of dealing with minor acts of veterinary surgery but perhaps not the range 4 A working group of the World Organisation for Animal Health (OIE) has defined a veterinary para-professional as a person who is authorised to carry out certain veterinary tasks with authorisation from a Veterinary Statutory Body, under the responsibility and direction of a registered or licensed veterinarian ( 9

11 of potential new services. It would clearly address issues of training and regulation but the costs might be a deterrent. The second model is the development of a closer relationship between existing service providers, for example foot trimmers, and veterinary practices. This may be the most likely option for these services and would require greater confidence by the veterinary profession in the training, regulation and accreditation of such providers. To allow either option to be taken forward there needs to be further action to overcome some of the obstacles. We have made three initial recommendations but recognise that these are only the first steps in developing the concept of a veterinary-led team. 2.7 Recommendations 1. The BVA should undertake a consultation and opinion poll, which captures the views of the UK veterinary profession, to establish the appetite or otherwise with regard to allowing technicians to undertake specified veterinary service activities (such as blood sampling, disbudding and tuberculin testing) under veterinary direction. 2. The BVA should ask the RCVS to consider the best course of action to establish an acceptable process of training for, and regulation of, technicians who undertake activities under existing or new Exemption Orders. This should include a clear differentiation between veterinary direction and supervision. In addition the assurance of competency and appropriate approved training, accreditation and registration must be clearly identified. 3. In the light of the conclusions resulting from the recommendations above, Government should consider the appropriate mechanisms that would allow suitably trained lay persons to carry out minor acts of veterinary surgery (such as disbudding) under the employment and direction or supervision of a veterinary surgeon. 10

12 3. Report of the Business Models Working Group 3.1 Introduction and terms of reference Food animal veterinarians have a critical role in promoting animal health and welfare and protecting public health from food borne diseases. Recent disease outbreaks, including foot and mouth disease, BSE, E. coli and avian influenza, have illustrated the importance of the profession and the need to ensure continuing veterinary care for food animals. The decreasing numbers of veterinarians working with production animals has led to concerns that this area may be neglected in the future (Lowe 2009, p. 21). In 2009, a report by Philip Lowe on veterinary expertise in food animal production analysed the current farm animal veterinary sector and key challenges faced by farm animal veterinarians in the UK (Lowe, 2009). This report highlighted the need to classify types of veterinary business models and how they were changing (Lowe 2009, p. 51). The Business Models Working Group (see Annex 1b for a list of members) conducted a preliminary survey to: - Identify and classify different business models of food animal veterinary practices; - Consider the merits and limitations of these models; and - Provide case examples of successful models. 3.2 Classification of business models A business model is quite a broad term that describes the various ways in which a particular business operates. In its simplest form, a business model can be defined as consisting of two key elements: what the business actually does, and how the business makes money doing it (Weill et al., 2005). Analysing an organisation's business model in practice is about much more than simply categorising it in terms of its business type, legal structure, size or market focus. Rather, analysing the business model requires one to gather information on: the business' value proposition, target customers/market, sales/distribution channels, core capabilities, management systems, cost structures and the strategy employed to generate revenues. The list is not necessarily exhaustive and it must be recognised that sometimes it is not easy to identify and categorise the business models that exist in particular sectors. It may be that new typologies need to be constructed or revised that are relevant to the sector under investigation. This is particularly the case in the veterinary sector, where the term business model does appear to be strongly associated with operating structure, i.e. whether the practice is independent, affiliated to a larger group or part of a large corporate. The latter category, in particular, may be somewhat confusing, as affiliated group practices, joint venture partnerships and wholly owned branded practices often tend to be 'banded together' into a single 'corporate' grouping. Due to the complexity of defining business models, this report has sought to classify the types of veterinary practice businesses according to size, legal status and business focus. Businesses were classified as independent if they were independent sole traders, independent partnerships or independent but part of a larger group. Practices were excluded if they did not provide sufficient information. Several key business types were identified and the characteristics and challenges were identified for each type. The business types identified included those shown in Figure 1 and Table 1. 11

13 Figure 1: Classification of food animal veterinary practices Table 1: Characteristics of food animal veterinary practices Corporate practice - Corporate status - Limited liability - Primarily large animal practice, some mixed practices - All corporate practices surveyed had over 5 veterinarians (FTE 5 ) Farm animal practice - Independent - Farm animal practice only - 1 or more veterinarians (FTE) Mixed practice, 5 or fewer FTE vets Mixed practice, over 5 FTE vets Specialist consultancy practice Small animal or equine practice - Independent - Large and small animal practice - 5 or fewer veterinarians (FTE) - Independent - Large and small animal practice - More than 5 veterinarians (FTE) - Independent - Specialist practice veterinarians (FTE) - Independent - No farm animal work - Not included in analysis 5 FTE: Full time equivalent, calculated as part time = 50% FTE 12

14 3.3 Survey of farm animal practices A survey (see Annex 6) was developed to identify the business models of veterinary practices and their strengths and weaknesses. Questions included: - Numbers and type of staff employed - Type of practice and legal status - Location - Management practices - Income sources (such as private and government services, veterinary medicine sales) - Methods of advertising and marketing - Key challenges and ways of dealing with them. The survey was published online and advertised through the BVA, its divisions and the veterinary press. The types of veterinary practices of survey respondents were compared with the national RCVS database of all veterinary practices in the United Kingdom. Additionally, challenges and business practices were analysed for each business type. Case examples of successful practices were identified based on their business strategies and ability to meet challenges. A total of 127 veterinary practices responded to the survey, of which 16 were excluded for providing inadequate information or not treating food animals. Of the practices treating food animals, 77% (86/111) were mixed practices (Figure 2). In comparison, 92% (1324/1444) of all RCVS registered UK practices treating food animals reported being mixed practices (Figure 3). It was not possible to classify practices into business models based on the information in the RCVS database. A minority of practices (2/111) reported being specialist consultancies, with one practice consulting on aquaculture and another solely performing tuberculosis testing. Figure 2: Practice types of survey respondents 13

15 Figure 3: Veterinary practice types in the UK (RCVS, 2011) Veterinary practice locations were classified according to the country and regional development area. Locations were provided by 104 veterinary practices. Figure 4: Regions of the UK and Ireland The highest numbers of practices were reported from the South East and South West of England. There was no association between the practice type and location. Table 2: Locations of practices surveyed England East Midlands 1.9% (2/104) East of England 3.8% (4/104) London 0% (0/104) North East 0% (0/104) North West 6.7% (7/104) South East 12.5% (13/104) South West 25% (26/104) West Midlands 14.4% (15/104) Yorkshire 12.5% (13/104) Northern Ireland 5.8% (6/104) Scotland 12.5% (13/104) Wales 4.8% (5/104) Source: CILIP, 2009 All corporate practices had a dedicated practice manager or practice team. In other types of practices, a minority of practices had dedicated management (Annex 7). Practices had different liability statuses, with a majority of corporate and farm animal practices being limited liability companies while most mixed practices had no legal liability status (Table 3). 14

16 Table 3: Limited liability statuses Practice type Limited liability company (Ltd) Limited liability partnership (LLP) Other status None Not answered Corporate 100% (7/7) 0% (0/7) 0% (0/7) 0% (0/7) 0% (0/7) Farm animal 56% (9/16) 13% (2/16) 0% (0/16) 31% (5/16) 0% (0/16) Mixed ( 5 vets) 23% (8/35) 6% (2/35) 6% (2/35) 63% (22/35) 3% (1/35) Mixed (>5 vets) 26% (13/51) 4% (2/51) 4% (2/51) 67% (34/51) 0% (0/51) Specialist 50% (1/2) 0% (0/2) 0% (0/2) 50% (1/2) 0% (0/2) Practices used a range of marketing strategies to advertise their businesses (Table 4). Table 4: Advertising strategies Website 36% (27/74) Word of mouth 31% (23/74) Regular newsletter 30% (22/74) Local advertising 24% (18/74) Meetings, open days/ evenings 23% (17/74) Local shows/ exhibitions 12% (9/74) Yellow pages 11% (8/74) Facebook 7% (5/74) ** Practices listed multiple strategies, percentages will not total to 100% Veterinary services were identified as the most profitable for the majority of all types of practices. Fewer practices listed government services, veterinary medicines and other activities such as specialty pathology services as the most profitable (Figure 5). Although half of the farm animal only practices reported veterinary services as their most profitable activity, these practices reported the lowest percentage of income from veterinary services and the highest percentage from veterinary medicines (Table 5). Figure 5: Most profitable activity 15

17 Table 5: Percentage of income reported from different activities Average % (minimum, maximum) Type Veterinary services Veterinary medicines Government services Training Corporate 40% (25, 59) 40% (30, 55) 11% (1, 20) 3% (0, 10) Farm animal only 24% (20, 35) 55% (43, 61) 10% (2, 18) 4% (0, 11) Mixed ( 5 vets) 46% (20, 80) 43% (20, 68) 10% (0, 40) 0% (0, 2) Mixed (> 5 vets) 49% (30, 71) 40% (25, 65) 7% (1, 25) 2% (0,15) ** Insufficient data was available on specialist practices Veterinary practices identified a number of challenges common to many small businesses, including: - Maintaining profits and turn over - Recruiting, managing and keeping staff - Maintaining facilities - Maintaining customer satisfaction - Effectively marketing businesses - Getting paid - Providing out of hours cover. A higher proportion of farm animal practices reported difficulties recruiting and keeping staff. Additionally some mixed practices reported difficulties recruiting staff for farm animal practice. Several practices had problems with younger vets being uninterested in farm animal practice or being unwilling to do out of hours work. Veterinary practices used different strategies to meet challenges, including marketing approaches and joining veterinary groups such as XL Vets. Practices deal with these challenges in a number of ways: Recruitment challenges are dealt with by waiting for the right people to come along, or arranging internship with the local vet school. Marketing challenges are addressed by the introduction of new/specialist services, raising the practice s profile or developing a new website or newsletter. Financial challenges are dealt with by: raising fees, reducing overheads, strategically managing cash flow by setting internal targets, strict management of the debtors list, offering discounts for early payment (for farmers) and encouraging the use of card payments where possible. Significantly, a number of practices (11/111) reported either working harder or longer hours as a solution to business problems. Succession planning was seen as an issue by many practices. Strategies for succession planning included: Introduction of shares to younger vets; Recruiting new and/or younger partners to take over; 16

18 Forming limited company or LLP 6 ; Working to improve image and profitability of practice to make it more attractive to buyer; and Allowing working beyond 65 years. Veterinary practices were asked to provide brief examples of the use of beneficial innovative strategies and ways of working. A few case study examples supplied by practices can be found in Annex 8. Innovative ways of working included: Strengthening communication: Within the practice: regular meetings, mobile phone networks, provision of laptops for staff, electronic scheduling systems; To clients and the community: newsletters, websites, community meetings, open days and other outreach activities; Diversifying services: Offering specialised services, such as alternative medicine; Conducting training activities such as the Farm Training scheme; and Offering health plans; Making use of different sources of information, including through continuing professional development (CPD); Investing in infrastructure and equipment; Increasing activities with other veterinary practices through: Membership in groups such as XL Vets; and Membership in groups for joint medicine purchases; Increased coordination with neighbouring veterinary practices; Increasing use of non-veterinary staff, including: Non-veterinary practice managers or management team; Accountants; and Veterinary nurses. 3.4 Discussion The majority of food animal veterinary practices were mixed practices, both amongst survey respondents and in the UK. Business models of all UK veterinary practices could not be classified due to a lack of information about legal status, employee numbers and business types (i.e. consultancies). The RCVS database could be further expanded to include this information. The veterinary practices surveyed faced a range of challenges common to small businesses. There is a need for business training to effectively employ marketing or other business approaches as solutions to business problems. A number of practices reported difficulties with succession planning or recruiting recently graduated veterinarians for farm animal work. Further details about the profitability of practices and the turnover of veterinarians could be useful to examine the challenges faced by clinics. Additionally, questions could be included about consultancy services provided by veterinary practices. 6 This is an important structural business strategy decision for veterinary practice and not just of relevance in the context of succession. 17

19 3.5 Recommendations 1. A structured programme of training, consultancy and mentoring should be introduced to encourage veterinary practices to think strategically about how their businesses operate, to consider whether changing how they do business would be beneficial and to share good practice examples of successful innovations. This could be implemented as follows: a) Business leaders from the non-veterinary sector should be invited to speak at the BVA Congress and the congresses of its specialist (including species) divisions. This could inspire practice owners to review how they are running their own businesses. It is important that, as a general rule, these speakers are not placed in a separate business type seminar, rather, they need to be integrated into the main programme, as clearly it is important that all delegates are exposed to these presentations. b) Business Development Groups should be developed where a number of veterinary practices, and possibly other businesses, come together with a facilitator to discuss how their businesses could be run most effectively and to share good practice. Facilitators should generally, but not exclusively, be non-veterinary. To be successful, these groups will need to be sufficiently motivated to attend and be basically selffinancing. The BVA should be responsible for encouraging the initial set up of these groups and, indeed, providing pump-priming finance for a period of say 6 months, after which the groups should become self-financing. It would be quite acceptable to get commercial sponsorship so long as the role of the sponsoring organisation was clearly defined. The BVA has been successful in setting up Recent Graduate Support Schemes in a variety of locations around the UK using its territorial divisions, and this could be a model for setting up Business Development Groups. Such groups could also be established by species divisions of the BVA with BVA support. Species divisions have the advantage that members are likely to come from a wider geographical area, and practices may be more comfortable discussing their businesses with practices which are not local to them. The role of the BVA overall would be to communicate with its divisions to encourage the establishment of these groups, to set out a likely working method to get them started and to provide a list of suitable facilitators and possible speakers for initial meetings and to pay for these with on-going funding for around 6 months from set up. c) CPD Courses. The Working Group have not attempted to review the provision of CPD courses currently available; this was beyond the scope of its remit. The Society of Practising Veterinary Surgeons (SPVS) and Veterinary Practice Management Association (VPMA) are amongst the main providers of CPD in the area of business management for veterinary practices. Their web site indicates that 11 CPD courses are being jointly organised by them in We are very supportive of this. To ensure that this type of training is accessed by as many people as possible we would encourage other organisations to try and incorporate similar types of sessions into their congresses and meetings. A good example of this is where an internet marketing session was included in the BCVA Congress of

20 The results of our survey have highlighted that business-related training specifically in the following areas would be most appropriate: Staff Recruitment, Retention and Succession Planning Financial Management Marketing. d) The BVA should make full use of its journal In Practice to ensure that the issues highlighted in our Report are fully covered. In Practice currently has an excellent and comprehensive Practice Management section, and is thus already making a very significant contribution in this area. A series of articles directly themed to the issues highlighted by the VDC should be commissioned. This would raise awareness and provide an invaluable resource to members. 2. The BVA and its divisions should further investigate and publish around five indepth business case studies. As a follow up to our survey we have included four short case examples where respondents have described particular ways of working that they have adapted and believe to be beneficial to their businesses. We believe the BVA should further investigate and publish around five in-depth case studies, which could be made available to the wider community of interest. These would allow us to gain further valuable insights into the actual ways of working (i.e. specific business models) currently being adopted by veterinary practices, and gather data typically not accessible by survey alone. This would involve site visits and in-depth interviews with key practice personnel and would require resourcing. By way of example, a considered in-depth case study might require two or three site visits and several days of time to prepare. We would suggest that each of the appropriate BVA species divisions is invited to nominate and possibly fund one such case study. 3. Business education should be included in the curriculum of every UK veterinary school. It is essential that future veterinary surgeons are aware of, and start to think about, the business aspects of their practices right from the start of their undergraduate education. In this regard, we would recommend that some type of business programme should be included in the curriculum of every UK veterinary school. Again, we are aware that in many cases this is already beginning to happen. Indeed, there are many examples of successful veterinary business education initiatives amongst UK veterinary schools as shown by a recent review (HEA, 2011). We recommend that the Heads of Veterinary Schools Group and the RCVS consider whether current undergraduate and postgraduate business education provision is adequate. 19

21 4. Report of the Food Industry Engagement Working Group 4.1 Introduction and terms of reference Most farm animals are kept for food, with a small number kept as breeding animals. Given the expected human population increase both in this country (from 60 million to 70 million by 2030) and in the world (from 5 billion to 9 billion by 2050), the role of farmers as food producers is at the forefront of the challenge to feed this growing population with safe, nutritious and affordable food. The veterinary surgeon has an important role to help ensure that (i) the health and welfare of farm animals is protected (ii) the quality and safety of the food produced from these animals are high and (iii) the farm producer uses his resources as effectively and efficiently as possible and markets his outputs to achieve a satisfactory financial return. All stakeholders along the food supply chain have some shared interest in each of these goals, of better health and welfare, greater efficiency and lower emissions and carbon footprint. The aims of this Working Group (see Annex 1b for membership) were to: define what food industry stakeholders want, or need, in terms of veterinary services; consider the implications for the veterinary profession in meeting these wants;and determine how effective engagement between the veterinary profession and food industry can best be facilitated. Our way of working has been to gather information from various sources including from face to face meetings and telephone interviews with five of the major food retailers, a representative of the British Meat Processors Association (BMPA), representatives from the levy bodies for the pig, red meat and dairy sectors, a number of private veterinary surgeons, a number of veterinary undergraduates and interns, representatives from the FSA and from the Institute for Grocery Distribution (IGD). 4.2 Main findings The main findings to emerge from the information gathering are: There was frustration expressed by food industry at the apparent lack of engagement in food chain activities by the veterinary profession. It was reported that veterinary students were not inclined to support or attend lectures on food chain activities and visits to abattoirs and primary processing plants where either viewed as slightly staged, or not detailed enough. Issues around trust and visitor security to abattoirs had made such visits difficult or costly to organise on anything but an infrequent basis. Retailers saw the value of vets as advisers for very specific issues around animal welfare but were reporting inconsistencies in knowledge and ability to truly help farmers to add value to their businesses through improving the health and welfare of their animals. Some food industry stakeholders reported that vets should view animal care as an input to safe products going into the food chain, rather than just making the animals feel better. 20

22 There were many comments on the potential benefits that integrated farm health planning involving the vet, the farmer, food chain information, the processor and the retailer could bring to the production of safe, high quality food produced profitably. Most of the comments, however, reflected a negative perception where either farm health planning was being done to inconsistent standards, or it failed to address the issues which were important to the food chain (for example, fluke incidence was mentioned several times). Food retailers expressed frustration at an apparent lack of engagement demonstrated by some of the veterinary education establishments. They have great success and demand for retailer work placements offered to agriculture students but similar offers to veterinary schools appeared to generate little, if any, interest. The balance of priorities between animal welfare and food safety was questioned in terms of consumer wants and needs. There are regulatory commitments in the food chain that vets will always need to meet, especially in terms of EU Regulations, but there are issues which need to be resolved around outdated or inflexible risk assessments along the food chain. 4.3 Recommendations Following these various conversations and fact finding exercises, we make the following recommendations in light of discussions with partners in the food supply chain. 1. The BVA should facilitate better engagement of the veterinary profession with food industry and with the governments veterinary delivery agents (AHVLA, FSA). There would appear to be a distinct divide between the work of farm animal vets and those serving the needs of abattoirs, food processors and food retailers, whether they are employed by individual companies or by government agencies. This is unfortunate given that the constant through these stages in the food chain is the farm produce. A greater understanding of regulatory pressures across the food chain, risk-based meat inspection, European legislative developments and general market pressures is needed by the veterinary profession to highlight and identify opportunities for greater engagement and cooperation. The BVA should (i) meet with key players in the food industry to discuss how the veterinary profession might best service their needs (ii) meet regularly with the governments delivery agents and (iii) host an online food industry forum linked to the BVA online Community Platform with food industry veterinarians and food industry representatives invited to participate in the forum. 2. Veterinary schools should encourage early and continued recognition amongst veterinary students of the importance of the role of the vet in supplying high quality, safe and nutritious food. Whilst it is recognised that the veterinary undergraduate curriculum in the UK is intensive, there is a need for veterinary schools to review their teaching to encourage more recognition amongst students of the importance and nature of their role as custodians of food safety rather than purely animal clinicians. 21

23 Individual veterinary schools need to change attitudes amongst their students and create an enthusiasm for the wider purpose of farming, animal care and food production. 3. Veterinarians should engage more with the business of farming for food, helping their farmer clients attain profitable outcomes from their livestock and meet the demands of the market for high quality, safe food and should provide a link on farm between animal health and welfare and food quality/safety. There is considerable disparity amongst practising vets in the level of involvement and added value that they give to their farmer clients. Vets must be encouraged to be conversant with farm business structures, practices and the pressures (both financial and regulatory) facing their farmer clients. Vets should strive to be providers of business solutions, working with farmers to help them achieve the highest market value and specification for the animals on the farm, and being fully engaged with the farm to plate market place. This may mean vets becoming involved in, and integrating services on, areas outside their natural competence but which are nevertheless of utmost importance to their farmer clients in terms of productivity and performance, for example genetics, feed and nutrient management and marketing. In certain cases this may mean additional training for the vet or integration of these other services within a vet-led team. There is a considerable business opportunity for vets to help deliver improved productivity and performance for their clients. There is a range of ways in which this engagement can be achieved; post graduate CPD, engagement of non-veterinary guest speakers at veterinary conferences, professional membership deals with industry and food chain organisations, etc. The BVA should make full use of its external contacts to explore beneficial relationships and networks available to its membership in order to grow their knowledge and confidence of the wider business environments. The proof of opportunity lies in the feedback from farmers claiming that private vets are not always sufficiently proficient in skills to aid in endemic condition or management issues such as lameness, fertility, nutrition, building design, etc. The growth of unqualified (and largely unregulated) consultants in these fields is not coincidental. The overriding delivery tool for delivering animal health and welfare benefits and improved food safety must be effective farm health planning based on the achievement of outputs. More use could be made of meat hygiene inspection reports, processor quality reports, etc. by private vets in order to maximise returns and commercial opportunities for their clients. The BVA could seek to facilitate formal arrangements with private abattoirs to send electronic data on animals to private practices to then highlight health issues on farm. 4. The food and farming industries, the veterinary profession and veterinary education/training establishments should explore the opportunities for a food supply chain career development path for veterinary graduates and how it might best be serviced in terms of appropriate training and experience. This would encourage the marriage of clinical knowledge with knowledge of the demands of the food supply chain, including food security and food safety. 22