OK, thanks so much for joining us, everyone, and welcome to the Links Group webinar, the second one in a series we're running as part of our 20th year celebrations and obviously in the midst of the COVID COVID-19 pandemic, lots of considerations to, to, for, for veterinary teams around how to deal with certain cases that might involve non accidental injury, links to Abuse of other vulnerable family members and we're here to really help the veterinary team recognise, understand and, and take action when they've got that gut feeling around some of those considerations and, and concerns. So thank you very much for joining us. We'll just make sure everyone's with us, that's.
Fantastic. Great, great numbers today. So thank you for joining us.
I'm Vicky Betton. I work for PDSA as their veterinary policy and campaigns manager, and I'd like to take this opportunity to introduce the rest of my lovely panel. Hopefully you can all see, today.
We'll just start with Paula, please. Thanks, Vicky. My name's Paula Boyden.
I'm a veterinary director at Dogs Trust, and I'm also current chair of the Links Group. I'm Wendy? Hi, Wendy Sneddon, a registered veterinary nurse, and I am the honorary secretary of the Lins Group.
Caroline. Hi, I'm Caroline Allen and I'm the chief of the RSPCA and I'm also on our CVS. Feel like I'm taking a very illustrious register here.
Mike. Hello, I'm Mike Flynn. I'm the Chief Superintendent in the Scottish SPCA and I've been involved in this kind of work since 1998.
Dave Oh, you're just on mute, Dave. That's 1 pound in the swear jar. Sorry, I'm, I'm clinical director in Shropshire and I'm part of the IPC Evidencia non-acidental injury project team.
Fantastic, thank you very much. So we, the, the plan today is that we're gonna look at a few scenarios that might help you recognise some, some cases, and give us an opportunity to chat through some of our frameworks and, and, and, methods that we've got in place to, to help clinical teams recognise and act on non accidental injury and other, other suspicions and concerns. We've got, a number of questions that we've had, pre-submitted, and also we've got the fantastic, Q and A, functionality on here and the chat functionality.
So obviously we've got a few in the chat already, which is great, hello to everyone who's saying hi. Norway and Portugal, that's absolutely fantastic. Obviously we will be focusing on UK legislation and guidance today, with that's the, the, the remit, but there are, lots of, international similar links initiatives that we have great contacts with.
So please do get in touch through the website if you want any contacts in your sort of localities or any support in that way. We'll do our best to help, as I say, advice today focused on, on the linked group area in the UK. So if you've got any questions, if you put them in a Q&A box at the bottom, and then keep chat to the chat, and we'll, we'll do our best to answer your questions live as we go through, which would be fantastic.
We're going to start off with a couple of polls. We've got 3 polls for you to help us understand. Obviously we're, we're sat here and we're all in this strange Zoom world.
It'd be really great to get to know you a little bit and your experiences so that we can tailor our answers to that. So, Dawn, could I have the first poll, please? So have you ever been concerned that a case you've seen has been a non accidental injury?
So if you can, we've got about 20 seconds and we can just click whether you have or haven't seen a case that you think is an NAI. And we'll close that and share the answers. Fantastic.
So good split there so we've got about 65% saying yes they have seen that. So 2nd pole please. I'm just seeing the first question again, Dawn.
I don't know if there's. Perfect. So of those 65%, did you feel confident about how to report that case, how to report your concerns?
Again, just leave it open for a few seconds so we just think about that and click yes or no. Right, so 76% not confident about how to report the case. Good, good, because if 100% of you did, we could, we could all log off.
And the, the, the third one, please. Mhm Did you in fact end up reporting the case to the relevant authorities? Yes or no on that one.
We'll just give that out. About 1010 more seconds. Thank you.
She's got the answers going up there. So 64%. Saying no, 36% saying yes.
OK, thank you ever so much. Dawn, would you be able to copy those answers into the chat just so that we can reflect back on them if, if needed? That would be really useful, thank you.
And we can just bear that in mind. That's quite a, I don't know if anyone on the panel's got any thoughts about reflections on those ones. Reflections on those findings.
Before we start, Always helpful to get a bit of a starter for 10 on those, but would they be around what you'd expect? They'd probably be roughly what I would be expecting. I would be hoping that we could have, we could have at least given people, people would know how to report even if they, they chose that they weren't going to report for whatever reasons, but yes, they, they're not dissimilar to what I was expecting.
Yeah, yeah. It's fabulous. So in the, in the chat we've just got, it's, it's difficult to report compared to humans.
Hello, Joe, lovely to see you on the call. And Joe saying pretty much what I would expect, yeah, and I'd, I, it would be great to almost have an impact measurement of going back 20 years before. The linked group started to see what, you know, where, where the recognition was, was any different.
I think it was pretty much unheard of to, to sort of have any kind of recognition of the link or or understanding of some of the complexities of, of abuse back before the, the work started with the linked group. So, . Andrew's just saying, amazed so many haven't seen suspected cases, so potentially that's a piece around recognising that.
So hopefully we can, we can pick up on some of that today. So if we start with one of our scenarios and covering that suspicion of, of non accidental injury, so the scenario is I've just had a really difficult consult. The kitten had a broken leg and the history was that she fell off the sofa, but that doesn't sound plausible to me.
What would I do next? So a very common case I think with this, the, the puppy or the kitten fell, and then just people not knowing what to do and obviously treating what's in front of you and taking people at face value. So Paula.
Yeah, thanks Vicky and, and I do apologise, I'm having a few IT issues this end, but we'll, we'll crack on. I, I think the important thing to start with is just to take a step back from this case, and, and look at some of those indicators for non-acidal injury. So that the the key ones are where the history is inconsistent with the injury.
In those situations, generally, the injury is more severe than the history that's been given. A discrepant history. Now, that could be the same person giving different stories to different members of the team.
And the one One thing I would say at that point is it's just so important that we do speak to other members of the team if you do have suspicions about NAI and in particular, our, our veterinary nursing colleagues, because they, you know, they may be seeing a different vet at the consult level, but you're quite often the VMs of the constant if a patient needs to be admitted. And also repetitive histories as well. But if, if we go back to the, the, the case that you've mentioned, Vicky, you know, we've got a kitten that, that, fell off the sofa and broke its leg.
Now, if you think of, a couple of things about kittens. One is, obviously, if it's, if it's a young, a young animal, you know, it's bones are still gonna be quite cartilaginous. They're not gonna be brittle like an adult animal.
So would you expect to break falling from a relatively low height? And even if a kitten had fallen from a greater height, We all have what we call, development milestones, so humans have them, animals have them, which means that by certain points in our lives, we should be able to achieve certain things. And kittens have what we call an air right reaction, which basically means that by the time a kitten is 6 weeks of age, if it does fall from a height, it's going to right itself in midair and land on all 4 ft.
So we've, we've definitely got a history inconsistent with the injury, With this. I think that in, in terms of what do you do next, particularly if you're not, you, you're, you're, you're uncomfortable about the history, and it, it, it doesn't feel right. The first thing I would do is, is certainly, if possible, and I appreciate we're, we're in the midst of, of COVID restrictions here, is, is probably admit the kitten.
And, and, and the reason I say that is, that it then buys you time to, to really consider the case. Have a chat to your colleagues about it. But also, and, and the other thing I, I, I would say, and I'm, I'm sure Mike will probably have something to say as well, is, you know, please, wherever you are in the country, please get to know your local SPCA inspector, you know, because then you, if you get to know them, you've automatically got an informal resource of information where you can chat these cases through, to help you decide on what you're going to do, what is your plan of action.
So, so they're the things that I would certainly do in the first instance. Admit, admit the patient. You, you, you're not breaking any rules by admitting a patient for, observation.
Buy you time to buy you time to have a think about it. Do you really think you, is this a case of NAI? Do you have concerns?
Do you have sufficient concerns to, to consider reporting the case on? Thanks, Paula. Does anyone have anything to add to that one?
Probably just to say, I think it's a really good point about that vet inspectorate relationship and we recently had a restructure and have some new groups with new names, which I think is hopefully going to make it much more give clarity to vets about who their local chiefs are. So we will be communicating out around that, so aiming to make that easier. And I think, you know.
To make the point that our officers are, you know, really trained to investigate. We're not expecting that the vet has done any kind of investigation. You know, it's enough to have those suspicions and feel that you, you know, you can then reach out to the appropriate people to do the investigation.
And yeah, the, the college, you know, guidelines absolutely allow you to do that. The RSPCA SSPCA are recognised as appropriate authorities. I was interested in the, in the comment in the chat that said there was, it was difficult compared to, to humans, .
And I wonder if, if I, I believe it was James added that if he wanted to perhaps ask a more sort of specific question around that and maybe we can do a bit of myth busting around that reporting process a little bit later on in in the session, because I, I've certainly found from personal safeguarding experience reporting, child abuse was, was incredibly difficult, in, in a, in a sort of, in terms of a sort of flow chart way, and lots of people who Suggesting doing different things and in the end, the NSPCC was, was actually the, the, the most appropriate place for, for our concerns to be raised, and they were really helpful, but trying to go to children's services was, was incredibly difficult, and there was quite sort of confused about what should happen with many years ago now, but it would be really interesting if that's from personal experience or, or whether there was something they wanted clarified about the process and perhaps with having both the SSPCA and RSPCA on the call, we could, clarify some of that. Paula, we've got you twice now. Hiya.
And Vicky, Vicky, we've got a question. What would happen if you wrongly accused abuse of an animal? Somebody like to tell us what?
Yeah, go for it, Caroline. I think clarifying we're not accusing and in these cases. So Caroline, did you want to pick that one up?
I think it sort of speaks to the point I just made is, is that you're not asking, you know, you're not being asked to be a judge or jury in any way, shape, or form, you know, there is a process and you're just, you know, taking your professional expertise and saying something here isn't right. And just, that is, that is enough, you know, giving it careful consideration, but just thinking something isn't right here, and then is the role of the RSPCASSPCA to investigate. And, you know, it does happen that we do the investigation and it turns out that, you know, either there isn't enough evidence or there's not the public interest, or, you know, All sorts of other reasons that it's, it's not gonna move forward, but you know, it is down to the vet to, you know, just flag that concern, and you're absolutely not accusing anyone.
Yeah, I would totally agree with that. Just the information in the first place, there have been cases where it's possibly not been the most blatant no accidental injury, but when the inspector has attended. A bigger story comes out, and that's one way that we have found on a couple of occasions, it's actually been the child within the household that's done it.
But in a very short consultation, you're not going to get into that kind of depth with it. But Caroline's totally right, just by reporting it, it doesn't mean you're making any accusation that's happened, it just allows things to be checked. We did, in, in a previous webinar, we had a, a, a lot of questions around, children and whether children were sometimes the perpetrators, children could also be victims.
I noticed we've got a, a comment saying as an ex-nursery manager, you can always contact the on on duty local. Social worker, yes, that's an absolute route, but I don't know, I know, both SSPCA and RSPCA have programmes that work with children. I don't know if you want to take this opportunity just to flag those to attendees on the call, on the webinar and we can pick up from there.
I mean, in terms of the RSPCA we do obviously work very closely with local social services, with the NSPCC. We have sort of, you know, obviously a whole structure around safeguarding, because, because there is this link. In terms of education programmes, we're in, in the process of reviewing and developing those at the moment, but I know, you know, Mike and the SSPCA, you've, you've got a brilliant programme in Scotland.
Yeah, I mean, we've got a, an overall massive education programme, but specifically a very small part of that's what we call animal guardians, which is a service that's 1 to 1, it's totally anonymous. No turns up in a van or a uniform or anything. And I think we've now had about 170 referrals from that.
Most of them are coming we get them from social. Parents, foster parents, head teachers, all that kind of stuff. And it's just to join, join the pieces up and it's to try and break the cycle.
And it's not we visit, we then feed back anything that we found to the, the headteacher of the social worker. It becomes part of the kind of group casework, and it's been very successful in, some instances. And that, that, so people would refer directly to your organisation, Mike, for that, the SSPCC.
Yes, that's correct. Fantastic. So if we move on to another scenario, and please do as I say, keep typing the questions into the, into the Q&A box so we can, we can cover further areas.
This is always a hot topic that of our CVS reporting and GDPR and, and, and really. Concerns around what you can and can't say. So it would be good to get into that.
So, an old dog has come in that appears to have been badly neglected, and the owner won't put to sleep, but I think the dog is suffering. Should I report this? How will it be handled?
The owner appears to really love the dog despite his condition. Yep, so happy to, to have a go at that one and certainly having spent, you know, 20 years in private practise myself before joining the RSPCA, this is a all too familiar scenario, and I know one that can really cause a lot of, you know, anxiety and, and distress actually on both sides. But I think it's One of those situations where understanding the law and the role of the vet in the law is actually really empowering and means that, you know, I think in the vast majority of circumstances, you know, you shouldn't even need to involve the RSPCA or SSPCA but you may need to.
And I think it is, you know, the key thing for me is, is to remember that, you know, causing unnecessary suffering to an animal is, is an offence. You know, the law is being broken if that happens. And as I said, you don't necessarily want to be, you know, going to your client, you're breaking the law, this is outrageous.
But having that conversation with them with, when there is an animal that's suffering, they don't want to put to sleep. That really explaining your role as the vet is to put that animal first, and that, you know, you really cannot let that animal go, to carry on suffering because you were then kind of vetting a crime almost. And I think that through those conversations, through them understanding the role of the vet, that the animal is suffering.
And just having that, the law having your back, you can, I think, in most situations, you know, get the owner to come around to do the right thing for that animal. Now, you know, I've probably, I've only had to do this once, but there can be those scenarios where you've really got an animal that's suffering very badly, and the owner's just not coming with you. And that is where the law can come in.
You can do it then and there in your surgery, you may want to, but you can, which is to involve the police and the RSPCA. It's a little different in Scotland, and I'll leave Mike to, to cover that because they have inspectorate powers, which we don't in England. We do rely on the police alongside us, but With the police and, and the support of the RSPCA, there's part of the Animal Welfare Act allows this signing of something called a Section 183.
Don't worry too much about the terminology, but it does allow you as the vet to say, I'm gonna put this animal to to sleep in its best interests, and I'm, I'm sorry if you don't agree, but the law does allow me to do this. So that's one way. The other is obviously to let, to, to let the animal go home and then to report to the RSPCA.
And, or SSPCA. And I know, you know, we get contacted quite a lot. Oh, GDPR doesn't allow me to report, client confidentiality doesn't allow me to report, and, you know, that is, is just wrong.
It, it is wrong. I think, you know, look at the, look at the RCVS code, you know, it's a pretty good searchable document. If you just put in reporting.
Up it pops, and it's section 14.6 for those of you who like these things. And it really says, you know, animal welfare is compromised.
You, you can report to the appropriate authorities. Think it through carefully, yes, of course. Document your findings carefully, of course, but it is allowed and And I know that there's been a bit of growth in sort of people getting disclaimers side, while we're letting you take this animal, we don't really agree with it.
I, I really don't like that, you know, I, I think we do have, you know, we, we have that responsibility for animal welfare above all else. And, and for me, this is the process. It, yes, it can be a bit clunky, but it, but it is the process that enables you to put the animal 1st, 1st and foremost, then you absolutely can report.
I think there's a, there's a couple of follow-on questions from this. Do I need to make an owner aware that I'm breaching confidentiality? Can we just go back one stage, just a, a third option for this, this neglected, pet and the owner doesn't want PTS.
Sometimes there is an alternative way of dealing with these, and I've done this sometimes in practise where we've spoken to the owner and it's clear that there is a disagreement as to whether this animal should be PTS between what I think and what they think. Sometimes you can convince an owner that they should, if they go for a second opinion. With another practise, but you make the arrangements for that appointment, and speak to that other, other practise and make them very clear what you're doing, and also make it very clear to that owner that if they don't go to this appointment that you will be reporting them to the RSPCA.
That often, is sufficient to either get them to give in and put the animal down at this stage or to. To that second opinion and hear it from somebody else completely different, and at that point then give in and not have to go down this line of reporting. And I tend to find that's quite effective, but I would always, always make sure the owner is aware that this is not an opportunity for them to disappear into the, into the distance, that if they don't go to this appointment that you've you've created for them, that you will be reporting the matter.
Yeah, and we just basically we do have to keep reminding ourselves that this is within the framework of the pandemic and, and the vet practises are working under such incredible strain in such difficult circumstances, and these can be really difficult conversations to have in, in the car park in the rain with an elderly animal. I think there's all that context sort of. Running alongside this at the moment, isn't there?
So, we can, we can make our, our recommendations and give that advice, but we, we are very, very mindful of that frontline situation. But I think, Vicky, the other thing that comes up with this, in this sort of scenario, particularly the, the, the, the, scenario you've put here where the owner appears to really love the dog. You know, the other element that we do sometimes come across is where, you know, an animal has been presented for euthanasia, but actually, that animal has been neglected.
It's been left for far too long. Now, one approach is to say, well, you know, the animal is now, has been euthanized, it's now dead, it's no longer suffering. But again, I think we have to think really quite hard about reporting those.
You know, it's it's not, it's not our job to be judge and jury. Our job is to report our our concerns on. It's up to the RSPCA SSPCA inspectors to to make that call, whether an offence has been committed.
But the one thing I would say is, you know, in that in that sort of situation, you don't know if that that owner. Then going to go out the next day and get a puppy. And if we do nothing about it, if we say nothing about it, where you're potentially reinforcing their behaviours that it's absolutely OK to leave an animal for as long as possible in the hope that it will, you know, pass away by itself rather than us intervening.
And I know that these are incredibly difficult situations to to deal with. But as Caroline's quite rightly pointed out, You know, first and foremost, our, our responsibility is to the welfare of the animal in front of us. And that the code of professional conduct is absolutely clear, that the phrase in there is, if animal welfare or the public interest are compromised, you can breach client confidentiality.
And that was actually further enhanced, just a couple of years ago and actually gives a list of scenarios where you may consider that that is the case, and that includes abuse or neglect of an animal. I think it's important to remember way back to the beginning of data protection, there has always been an exemption for the detection or prevention of a crime. Animal suffering is an offence, whether it's intentional or not.
The point that you raised here about a person who's informed by a vet should be put to sleep. That's one of the ones that we get quite a lot of reports about, and that's where it's important, back to Caroline's earlier point, if you've got a Good relationship with your local inspector, you can speak to them about it because there's a big difference between somebody who genuinely loves that animal and just doesn't want to part with it, and someone that just doesn't care about it that just isn't gonna listen to a vet. Now, in the case where it's a loving, owner, you've already planted the seed in their mind that that the best thing is for humane destruction, and most times when it's that kind of call, we go around reiterate it, and the owner will comply.
There's a lot of guilt things involved in that as well. And all the advice there is, is totally sound. Dave's bit about offering to arrange a second opinion.
Which some don't want, some will do it, off their own back to try and prove that the first rate was wrong. But again, that is where discussion between vets could be very, very useful. Absolutely.
There's there's just a number of different threads coming from this one which I want to try and pick up on. So we've just got, 11 in the chat rather than the Q&A just saying, I've always taken the view that we're just reporting suspicion and there may be a problem. I think we'd probably want to counter that one, Paula.
Any thoughts on that one? I think it's, you know, if, if, if we, if we have sufficient concerns, then we should be reporting, and this is where, you know, going back to previous comments, you know, actually getting to know your local SPCA inspector, as Mike's just commented again, it means you can pick the phone up and have that conversation. So if you are in any doubt about reporting at all, you could have those informal chats and then obviously act upon it based.
On that conversation. But if you're in any doubt, then you, it, it, it is a case of, of, of making that call. It, it's, like I say, it's not our job to be judge and jury.
If you have sufficient concerns, then, then, you know, it is important to report them on. And it doesn't, and, and just to sort of counter that, it doesn't mean that every time that you report something that action is going to be taken, that somebody is going to be prosecuted. But you're basically saying, I have concerns about this.
And that's where you then get that objective view. You know, I'm obviously no longer in practise. You know, two of Caroline's colleagues, some of the prosecution's case managers, they're my informal resource.
I don't speak to them every week or even every month, but I know that if I have a situation I'm concerned about, I can pick the phone up and get some great objective advice. And I can't tell you how valuable that is. I, I would agree with what Joe's saying there.
You are reporting that a suspicion, you do not have to be certain before you report this. Report report to the level when you, when this is starting to cause you concerns and your suspicions are there, but don't hang on till you're absolutely red nailed on certain. There's an important point to make here, which I think has, has come up through a couple of points here that, you know, the RSPCA and SSPCA is not all about prosecution.
You know, it is actually a tiny percentage of cases that come our way where we do prosecute. There are some bad people doing bad things, breaking the law who do need to be prosecuted, but, you know, in a, in a vast majority of cases, it's all about. Advice and support, you know, explaining, supporting.
So, you know, the, the scenario that we started with, you know, the elderly person who doesn't want to, to euthanize, you know, we're not gonna be taking those people to, to court, but we can support. But actually, as Paula said, if you get that one animal that's really neglected, OK, you might put it to sleep, job done. But what's going on at home?
You know, you go in and you might find a whole lot of animals in a very bad situation. So I know that, you know, there are very old stories about the RSPCCA that do like to do the rounds on media, you know. The the media, certain elements of the media like to come back with some of these, but, you know, we do have, you know, I'm very confident in our process by which we decide to prosecute, you know, it's the same as the CPS.
There has to be that real sort of public interest, evidential tests. So, you know, I think that you, you know, I hope that, you know, can give you some confidence that we, we consider very carefully when prosecution's going to be in, in the public interest. And yeah, we give support where we can as well.
I mean, Caroline's made a very good point there. The Scottish SPC is the same, something like 0.01 of the investigations we do end up being reported for criminal prosecution, and it's very strict and tight guidelines.
But it's to prevent an animal suffering. So please always report that. I saw something coming up on one of the chat lines.
Just because you're in a veinary surgery, you can still report it anonymously. Now if we get an anonymous complaint and we go to the address, we would never disclose who it came from. And if they've come to your, that animal has left the house, there's every chance a neighbour or somebody else has it.
So if the information you give us is correct and we get there, then we can proceed even without a named complainer. That's really, from our perspective, anonymous complaints are a little bit more problematic because we, we do get a lot of . What's the word?
We, we get a lot of non-genuine complaints coming in that way, so we do probably have a higher threshold before we would look into those. So I'm not saying don't do it at all if you're worried, and I think there's been some comments here about being scared of client reactions, . Yeah, I, I do understand that, you know, it's something that comes up a lot.
People are, are scared of what the clients, what the client is going to do. You know, I think if you have got that suspicion of a, of a crime of, you know, for animal welfare, then that is their, that professional responsibility, . That that comes along with that.
And again, you know, we can, we can give support. And I know people are also worried about, you know, what's going to potentially happen on social media, you know, they're going to go after me. I think that that's probably not quite such a concern as people think, because people don't want to go on social media kind of saying they've been accused of, of animal abuse.
There there may be the odd case, but I think that in, in the majority of cases, the way that it's dealt with, I think that's not such a big problem. I mean, Dave, you may have. A bit more insight on that than I would.
And I think talking to clients and, and, and dealing with clients and being concerned about client reaction is always a natural, a natural fear and a natural understanding, I think. There are two ways of dealing with it. Where these complaints are made without you telling the client you're going to make the complaint, although we are always sure that the client is going to work out who's made the complaint, more often than not, they don't.
They don't think it's the vets that reported them, they assume it's the neighbour, they assume it's somebody else who's got more knowledge about what's going on in the house than than we, we do, so they don't actually suss out, it's us, . If you're going to do it, having told the clients you're going to do it, then you need to have those conversations very carefully and be careful and considerate as to whether this is a subject you should be raising with them or not. But it may be that you can suggest that, you know, you're concerned that the animal may be sustaining injuries outside the house that we're worried that there may be somebody else who's inflicting these injuries on the animal, even if you're pretty sure it's not that it's the owner, and that therefore it would be a.
Appropriate and reasonable to report this because you're concerned about not only this person's animal, but all the other people's animals in the neighbourhood. And certainly, we've done reports in that fashion. I had a case a while ago, of a, a puppy that was very obviously a non- accidental injury where the owner was trying to claim it was a vaccine reaction, and we were able to explain to them that we should get a postmortem conducted on this puppy.
. Because if this was a vaccine reaction, then we needed to protect all the other puppies who had a dose of this puppy vaccine, batch of puppy vaccination vaccine before we had a big outbreak of dying puppies and obviously they then were in a position where they effectively had to concede, particularly as one of the two people who attended genuinely thought it was a vaccine reaction, whereas the other one knew that he'd battered the puppy. That meant that the postmortem got conducted. So it, it, there's a natural fear, and yes, clients can get pretty nasty at times, but I think it's very, very uncommon for that to happen in the case of an NII.
Very uncommon. And most of these people are, who are doing this are bullies anyway, and they tend not to tackle people who they don't know and who they don't foresee as being weak. So they're unlikely to confront a practise.
I just want to bring Wendy in here because we're having a few, a few threads on the chat which are really interesting just about that veterinary nurse point of view. Obviously, VMs have incredible contact with the clients, they'll have a lot of those great relationships. They will have some, some insight into this, perhaps, that, that works alongside the diagnostic view of that of the vet.
So Wendy, your, your thoughts on these discussions? Yeah, absolutely. I think the important thing is to have those discussions with your colleagues and just see if, if anyone else shares a similar opinion.
And then hopefully that there's a consensus and, and you can go ahead and report. If, however, your colleagues don't feel the same way, or there's a reluctance to report, then you're perfectly within your rights to go ahead and, and make that report to yourself. And again, you can do that anonymously, or if you've got a good rapport with your local SPCA inspectors, then get in touch with them and have that conversation about how you could approach it.
When do we also have the relationship with Crime Stoppers? Yeah, so, Crime Stoppers will also take calls, so again, that report can be done anonymously and they will investigate and they will connect with, with the SPCAs as well. So there, there are ways of getting your, opinions out there.
I think if you suspect something, you've got to do something about it. If I could just add to that, Vicky and Wendy, we've mentioned the RCVS Code of Professional conduct and the, the, supporting guidance for veterinary nurses is exactly the same for vets, in terms of being able to report, if, animal welfare or the public interest are compromised. So, so, you know, that facility is there for veterinary nurses as well as vets.
Absolutely. We did a specific session with the BVNA at their online congress, and had some incredible interaction with, with veterinary nurses really keen to be able to understand the complexities here, what they were able to do and how they could have these conversations with colleagues. Wendy, I think it, it, there's a bit around having a practise protocol in these areas.
Did you want to pull anything out on that one? Yeah, so in the, in the ideal world, as a team, you would agree what the practise is going to do should a case of non accidental injury arise. And, so someone is aware and familiar of who to contact and how to go about it.
And we've got some resources available on, on our website to do that. But have a team meeting, you know, discuss what we've talked about today, download the resources we've got on our website and have a discussion as a team, as to who, who you're going to report to and and how you're going to go about it. And, you know, get the contact details of your local SPCA, Perhaps even domestic violence officers, social workers, make contact with all those kind of local connections.
And that's what we do at our links training group. We tend to invite these people along to our sessions in, in the areas where we hold the meetings so you can start to, to meet people and make those connections. But yeah, absolutely have that practise protocol in place.
Start talking about it now before the, the, the, the accidental injuries occur. And, so you know what you're all doing. Yeah.
Just make a point about reporting to the RSPCA and I think the point about building relationships with your local SPCA is really important, but it is also important that the reporting itself goes through our central red line, and because that is the way that it gets onto our tasking. And, you know, becomes, becomes captured. So the support is there for local SPCA, but reporting does have to go through that line.
And I think that number's on the slide that we're going to share at the end. Is that right? And that's the number that isn't to be given out to to the general public, otherwise you will never be able to get through.
Yeah, I mean, then feel free to pop it into the chat as well, Caroline, if you, if you have it to hand just so people can note that down, as I said, that's a specific line for veterinary professionals to contact you guys, isn't it? So, and yeah, great to have Joe Hind as past president of the BVNA saying absolutely a practise protocol is vital to have in place before any any eyes occur, and it can have all of that information on it so that you're not, you know, when one of these. Cases comes in, it's never at a convenient time.
I think Dave would attest to that. It's it's always when there's something else happening, when everybody's busy, and they can be, they can be time consuming, but it's, it's for us to have, you know, give as much guidance as we can around what to do in these cases so that everyone feels confident, because as we saw from the polls at the beginning, confidence around reporting isn't as high as we would like it to be, and that there are those concerns. So we do have as many publish as many resources on our way.
We can to help with that. There have been a couple of questions just to flag and we do sometimes are on to sort of pet centric areas. So actually looking at small, smaller pets at, farm animals and equines.
I don't know if anyone wanted to make any comment about how important this reporting might be with any of the areas that we've covered so far in that those sort of larger animal spheres. I've, I've put a comment on as an a written answer in. The comment about the equines.
This does happen in equine and farm animals. It is harder to diagnose and to be to establish your suspicions in equines and farm animals, in part because often multiple people have access to the animal, whereas if the animal lives in a house and only one or two people have access to it, then it's a lot easier to be considering that who might be involved in this. But yes, they do happen, and certainly I've been involved.
A number of serious cases, both involving farm and equines. The cases that I tend to see tend to be more extreme in equine and farm animal, and that's probably because we're not good at picking up the lower level type cases. And often they are cases that are reported or discussed with the vets by other people on the farm or on the yard, who raised serious, serious concerns about the way.
Animals are being cared for or looked after. So yes, it does occur. And as I've said in that in the chatbox, I did a meet interesting meeting presentation to a group of senior equine vets within the profession not that long ago, and virtually all of them recognised that NAI existed within the equine population.
One of them turned around, had turned around at the beginning and said, Well, this doesn't isn't an issue that affects us, and before I had chance to respond, he'd been lynched by most of the, most of the other panellists who said, yes, it is. Which was quite, quite amusing. So yeah, it is, it is a situation that is recognised, it's perhaps least recognised in farm animals.
On the farm animal, I think someone in the chat raised, the role of APHA. And just to say that we do work very closely with them, you know, the, the farm animal investigations, you, you can phone them into APHA or you can phone them into us. You know, we would do, initial sort of looking into that, but then bringing APHA as a statutory body.
So, you know, we are working very closely together and I'm saying. Fantastic. We've just had a question coming from Alexandra.
What advice would you give to a vet or vet nurse who suspects an owner is in an abusive relationship and an animal is at risk, but the partner is present, for example, in a consult? Should you just go straight to the police once they've left the practise? Who'd like to pick up on that one first.
OK, so if you, yeah, thank you. I think if you, if you've got . An adult victim of domestic abuse, I think the important thing is to try and have have a level of communication with the the person that you suspect is a victim, and that's obviously quite difficult if they're, they're both in the consulting room in front of you.
But, you know, whether it's a case of trying to get the, the, the, the suspected victim, perhaps in another room, perhaps you get them to do a nurse consult or something, so you can just start to, to have those conversations. Is everything OK? I, I say that with a caveat that if you think that somebody is in immediate danger, then clearly that, that, changes the whole scenario, and it really ought to be calling the police straight away.
But whenever, you know, whenever we're dealing with, adult, human adult victims of domestic abuse, we have to have those conversations with them, because, I'm, I'm sure you're very aware that you're one of the most dangerous times for a victim fleeing a domestic abuse situation is the point when they're leaving. And therefore, they have to be in the right place to be able to leave. And this is why, as the links group, we've, we've developed various resources for victims.
One is a little credit card sized piece of sort of business card with key telephone numbers on it, but we absolutely recognise that, if you are a victim of domestic Abuse and your perpetrator is such that every time you go out, when you come home, they search your bag, they search your wallet, then it's not safe to carry something like that. So the other thing that we have developed is, it's just a, a, a little voucher for money off pet food. But the key thing with that is the barcode is actually a free phone number, so that that victim can seek help at the right time.
So I, I think, you know, that we do just have to be mindful of the, you know, the, the risk around the time that that a human victim flees a domestic abuse situation. But similarly, if, if you have immediate concerns about the, the, the patients. The animal, then obviously the the the the previous comments that have been made about you know, reporting to the appropriate SPCA would still come into to standing, and it may well be that as part of those investigations that obviously the domestic abuse comes to light as well.
Thanks Paula. Anyone else? Yeah, sorry, I, I was, was busy typing and answering to a Q&A and didn't respond sooner.
Yeah, what I'm sorry I'm male, I can't multitask. What what I was gonna just say was at the moment we've got the perfect opportunity because of COVID, we can, we can utilise the restrictions on how many people we can allow in a building or into a consult room, so we can. Separate an abuser from, from their victims, so to be able to speak quietly with, with the victim, without being overheard.
And, and even, you know, after COVID or before COVID, you can use some ingenuity to manage to, separate, a, a, a, a victim and their abuser for a moment or two. You know, ask, ask one of them would like to take the animal back to the car while you, while you just get. The medicine's ready and speak to the other person, etc.
You can usually find a way of, of, of separating them, but you, you do have to be creative, and you also need to make sure that the rest of the team are ready to jump on the person who's who, who you want to speak to quietly, and will occupy the other person so that you don't get seen doing it. So it does need to be done carefully, but it is, it is perfectly feasible, and actually it's one of the things that COVID makes easier. There's not very many of them.
I was gonna say that's. OK, there's a, a little bit more, Dave, you've, you've marked you might want to answer this one live, so could the panel give us an idea on how common NAIs are, please? And I guess that's how common they are and how commonly they're recognised is is quite that's, that's two very different comments, but one thing I can say is that within my corporate group, now we've been running this NAI.
Project for 3 or 4 months, I am seeing reports from practises 2 to 3 times a week. So they are out there and they are recurring, and that's probably, that's the only the ones where the practises are starting to recognise them and starting to have concerns. There will obviously be a huge number that we just don't pick up at all, and I know that.
Mary Wakem, who's on, on as one of the attendees, is, is doing a PhD into this, this whole area and it really fascinating to see how many of the people she's spoken to have taken animals into practises. Those animals have been examined with NAI, and it's not been picked up by those practises and to look and see why it wasn't picked up by those practises, or is there lessons for us to learn the things that perhaps extra alarm bells that could, we could be ringing that we don't know about at the moment? Yeah.
I, if I might just add to that, I think, as a profession, we probably do just see the tip of the iceberg. And I say that for two reasons. One is, a few years ago, the Lins Group did some work with a team called Medics Against Violence, who are, maxillofacial surgeons who are putting people back together after they've been victims of domestic abuse.
But one of the police officers involved in that group was a lady called DI Linda Borland, and she He spent an afternoon, this is when Scotland was made up of a number of police forces, ringing colleagues in the other forces, just to ask them, you know, when they went out to domestic abuse cases, was there ever any animal involvement? And she very quickly came up with a very long list, which I unashamedly plagiarise when we do the undergraduate training. But if you look at that list, we're not going to see those as veterinary professionals because most of those animals were already dead.
So I think that is part of it, that for some cases we're never going to see them because they have already died. The other challenge that we face, and it, you know, it, it is improving with time, is that in terms of, for example, undergraduate training, we've now been delivering that for around about 15 years, but there's still a lot of members of our profession, and I include myself within that, who have never had any awareness raising in this topic as well. So there are, I think, as, as Dave's mentioned, a number of cases that do go undiagnosed.
We know, for example, that with the, the work that Helen Monroe did did over 20 years ago. That you and this was sort of surveying bets about their experience of non accidental injury. The feeling from the the the respondents was that NAI is more prevalent in areas of poverty and social deprivation, but the other take home message with that is that more educated people can be much more plausible.
How could you possibly think I would do something like that? And I think as a, as a profession, it, it is getting your head around that oxymoron that some people would deliberately hurt animals and bring them to us to get them fixed. We don't expect our clients to lie to us, especially if you're in private practise, they're paying for our services.
So that there's there's quite a big sort of hump to to get over with with some of these cases to actually come to a die. No s is so, you know, it, it's great and the work that that Dave's been doing within his group of practises in raising awareness and that he's now coming across, you know, 2 or 3 cases a week. You know, whilst that is devastating in one respect, it's also very encouraging in another that that the NAI is being more and more recognised within the profession.
It's a very good point that Paula raises because it's something we've seen in a couple of domestic violence, situations where the, the abusive partner deliberately harms the animal, goes to a vet, and that further proves to the partner they can do what they like and get away with it because they've sought very new treatment. It's not been picked up as non accidental. The partner's not said anything at the time.
So again, it's another coercive party of behaviour on the part of an abuser, so it, it can all play part of a picture and Please report anything that you think is suspicious because it's not just we going bang on the door and something will happen, but we do speak to other professionals, and it's sometimes that one report that adds the last bit of the jigsaw that can help another agency like the domestic violence unit or anything, right, that's all we need now, we've got enough enough evidence, so it might. Appear trivial to yourself, but please report it. And that's where it's more important that you've got contact with your local inspector, and that way it can be in total confidence and trust.
Thanks Mike. I think that just linking on from that, there was a question came with our email. If there's a case I feel in retrospect was most likely an NAI is it appropriate to report this even a year on?
It would always be good to know, because again, it it paints part of a picture, and that tends to be, there's, there's times just like Dave speaking to vets, no, no, we've never had a problem like that. And then the real of two or three cases that are just absolutely ideal in what we're talking about. But if we get information, look, that's the 6th rabbit.
I've had the 6th kitten that they've had. And then we got another report, because you still get some people that vet short practise. They they go from one vet to another, so they don't think anything will get, caught up because it's not like health service records.
So even if it's nothing that we can work on, it does add to the intelligence, so it would be helpful. Yeah. Yeah, please do.
Yeah. I, I agree. I think it is often a jigsaw puzzle, and it is important, you know, if you get requests for histories from the RSPCA, there is a, a, a process to follow and, you know, because people get very concerned about GDPR there as well.
And we are actually working with the Royal College to put together some FAQs, which hopefully will be helpful on this. . But yeah, it, it is a jigsaw puzzle.
And I would say, from my experience of having spent time out with the RSPCA inspectors, you'd be amazed at some of the situations that, you know, our inspectors end up going into. And you actually think, my goodness, it was the animals that people chose to report about here. And you're going into situations and you think, goodness, why is the RSPCA the first person here?
Where are the social workers and not their fault, you know, they have so much on their plate, and it's not been reported to them. But You know, sometimes people are more concerned about the animals and, and we're that first in to situations which, you know, can be quite, quite horrific. So I think reporting is important and I noted earlier up in the chat, something that we've become a little bit more aware of is, is, is bosses, being a barrier to reporting.
And I think, you know, I appreciate that can be very difficult. I think the work that Dave's doing with IVC is, you know, hopefully something that we can see, encouraging others that this is something that they should do. And again, we're working with the Royal College to put together some FAQs.
Because, you know, this is something that is that professional responsibility, and it's really concerning if bosses are trying to block that. And perhaps you can encourage them to engage with the, with the links group, and really understand where we're coming from because, as we've already mentioned, it, it just doesn't really lead to those, it's very, very rare for them to lead to those kind of problems that I think bosses are worried about. And the reporting is just so important.
Yeah, absolutely, thank you. It's just a, a couple more threads in the last sort of 10 minutes of, of the time we've got today. There's, there's a couple of comments, people asking, about concrete situations or examples where NAI was suspected and confirmed.
How it was picked up, any sort of, you know, how they tried to explain how, how clients might have tried to explain away non accidental injuries. Does anyone have an example they could talk us through briefly just to perhaps lay out how a case unfolded? Perhaps Dave?
Sorry, sorry to put you on the spot there. Do you, can you think of an example that you might be able to talk people through? I think it normally starts with, an animal that is presented that causes, with a history that just causes a, a concern and an itch at the back of the the vet's brain.
For instance, a referral that I've received recently, it was, was a cat that had sustained quite significant head injuries, and the history that came with it was that the cat had fallen off a windowsill. And then it was suggested later on that perhaps the cat had knocked a pot off the window sill, and somehow as they both fell off the windows. The pot ended up on top of the cat's head, and then it was suggested that maybe the other cat had knocked this cat off the window sill.
And it just started to cause the practise a few questions and concerns. And then when they further examined the cat, initially the cat was pretty seems pretty OK, was sent home, discharged that day, came back a couple of days later, and they found really extensive bruising to the, to the face, to the mouth, to. Neck and this really started to cause some concerns, and then they went back to the history.
This was a relatively new client and they looked in the history and they looked and saw that another animal in that practise had from the family had died. And this started to cause some concerns, and so they then got to the stage where they reported it. And we now know that these people who've moved around the country with their work quite a little, quite a bit, appear to have left a trail of vet notes with animal.
That have died in suspicious circumstances around the country over the last few years. But because they don't tend to stop anywhere long enough, no one's really managed to previously join the dots together. Now, I can't give you an outcome on that case because it's still, still, you know, only just being, being started to be investigated.
But that's the normal way in which these cases start to occur. Something just causes someone to have an itch at the back of their brain and they start asking questions, and the more questions they ask, the stranger the answers get. Absolutely.
So, and, and that reflects a point made in, in the chat actually. Sha saying history taking and ensuring history from other practises is so important and can highlight problems. I know we often talk, Paula, in the training about vet shopping.
People will have different animals registered different practises, and they'll move addresses, they'll be quite transient in a similar way to we see with with child abuse when, when children fall through the cracks, it can be the case with animals as well. Yes, absolutely. And do bear in mind that, you know, we, we speak about vet shopping in terms of clients going to different practises, but if you're in a large practise, your clients could potentially vet shop within the same practise.
You know, if you've got some multi vet practise, they'll just choose a different vet to see. And with the best will in the world at 6 o'clock on a Friday night, and you've still got 5 clients in the waiting room, we don't always have the luxury of scrolling back through an animal's clinical history, or indeed for other animals belonging to that family. And, and, you know, I go back to my earlier comment.
This is why it's so, so important and and how critical, the veterinary nursing professionals to these cases, because particularly if a patient is, is hospitalised, they may well be the constant, or well, didn't we see Mr. Jones with, with this particular, you know, this cat or wasn't his other, you know, his, his dog in a few weeks ago. So, you know, really important that intra practise communication, as Wendy said, not only a protocol, but make sure that you're actually having practise discussions about these cases if you're concerned about them as well.
It's important to remember that where somebody has intentionally done it, quite often the person or the people have got their story prepared when they go to the vet to try and make it sound plausible. We have had, I had personally cases in the past where they've said this is a no accidental injury and actually accused a neighbour, and it's when we go around and start to kind of speak to them in door to door inquiries. That's when the real truth comes out.
And it's amazing. There's been a couple of occasions in the past, you're in a household, the child will tell you who's done it. They weren't, there at the vet's surgery, but they'll just quite happily go, it's the boyfriend that's done it, or whatever.
So, again, if we didn't get the information in the first place, so if somebody does say, yeah, my, my kitten's got a broken leg, it was that bugger next door that did it, get them, and some people have reported falsely to us. We've investigated and it's been them that's done it themselves. Absolutely.
There is a question from Alistair, I don't know, Dave, if you could er to highlight this one. So Mike has just outlined that, sorry, someone's just clicked that it was answered but it wasn't quite, just said about can the evidence of children stand up in a prosecution. So yes, they, they absolutely can feed in, but would that, how would that work?
I was literally just answering that in, in, in the typing and answer. Ask me. Yes, yes, they, yes they can.
Children could obviously give evidence in court, depends on the age of the child as to how feasible or practical that's going to be, and it depends on also as to whether the child is, is the child of the perpetrator or is the child, if the child next door, then that's obviously a lot easier than if, if they're accusing dad, and more chance of getting child to court and being able to give that evidence. The one thing I. I always say to, to, as a vet or in practise, is if a child makes a disclosure like that, record it as absolutely word for word in your clinical notes, record who said it, record what time they said it, because that is going to be absolutely vital, and, and it's going to be able to support that child, that that's what that child said at that time, and the court will, will give weight to that.
And something we always flag, isn't it? And it's important in your contemporaneous notes to have exactly what was said written, rather than the vet version of what was said written. It's fine to have the vet stuff in there as well, or or the the end stuff obviously, but for for it to actually record, this is what the client said in this way.
One thing you can also do on some sort Some practise management systems rather than recording suspicions only in the histories for that animal, there is an area on the some of them on the client screen where you can make notes direct to that client, and there are some suggestions that some parts of that screen do not have to be disclosed if the clients ask for their records, for their animals' records. And they can highlight up when so if, if, if vet two sees animal, a different animal, it will highlight up that there is something within the client screen, even if they, without them going into each animal individually and finding the finding the comments from previously, and I've certainly seen that being used in practises. Probably one to pick up with the in the development of the practise protocol, what's what's applicable to your client management system, what's, you know, have an agreed team's discussion around that process, yeah, really useful.
So we've literally got 22 minutes left of of the webinar. Did anyone have any closing thoughts they wanted just to flag? One thing quickly on the sort of the, the step by step approach is it's, it's not down to the vet in practise who, who has the suspicion to do, you know, all of the investigation and decide if this is a non- accidental injury.
If it is a tricky case, one CRSP, CRSSP who involved, you know, We'll do an investigation. We can bring in vets like Dave or, or other sort of forensic vets to then, you know, they, they will be the ones looking more deeply into this, using all the research that is increasingly out there. So, yeah, you know, the history, the, you know, good quality diagnostic images, etc.
Were really important. But, you know, you will get that support there. You know, if you're not sure.
That support is available from, you know, people who have, you know, a lot more experience and expertise in this area. Yeah I think I, I would just say if I may, if you have a dead animal in front of you and you, you feel that it is a case of non accidental injury, and I know we're an inquisitive profession, but please, please, please resist the temptation to undertake, an in practise postmortem. It's, so there there's a couple of things there.
One is, if you have suspicions, report it on, because then the SPCA will become your client and, and help you, you know, help in terms of getting that animal off for the postmortem, they will fund the postmortem. But also the sorts of postmortems that we do in practise are, are not sufficient for these cases. You need a forensic veterinary pathologist to undertake these postmortems.
And, and part of that is, you know, if you were to undertake a postmortem, if a case then went to court, the first thing the defence barrister is going to be saying to you is, well, what, what, what are your qualifications in forensic veterinary pathology? Because part of their role is, is ultimate. Need to try and discredit you as a professional.
So, you know, it's no discredit to to you as a professional in terms of being a veterinary professional, but, you know, please, please, please resist that temptation, and, and, and, you know, contact the SPCA as soon as possible. Absolutely. Well, thank you so much.
Thank you to everyone for joining us and to my the the fantastic panel and to the webinar vet for hosting us again, and, and just a little plug for our our next session. Which is actually part of the webinar vet congress stream, on Saturday, the 27th of February, where we'll be reconvening a similar, round table but hopefully a little bit wider with some colleagues from, domestic violence charities and the police and others, and then have a stream throughout the afternoon looking at a number of these issues in in a lot more detail, so please do join us if you can on that Saturday. Thank you very much, everyone.
