Good afternoon, morning, evening, wherever you are and however you're listening to this pre-recorded webinar. Thank you very much for tuning into the webinar and thank you very much to the webinar vet for having me today. I'm recording this during the day, so if I say good afternoon at the end, that's entirely my fault, and I apologise for that.

So the fundamental principle that we're gonna be looking at today is professional discipline. Now this is a, Area of law, ultimately, and an area of regulation and an area of your practise, which doesn't necessarily get looked at until things go wrong. And I say that not only from experience of of having advised clients and nurses and vets in terms of Their struggles when they face this, but also as a researcher and as somebody that that lives their life researching this area of law and, and certainly dealing with it.

Now, a little bit about me, first of all, my name's Phillip Cowburn, I'm a barrister. I don't practise currently, in terms of, the higher courts, although I do consult for a number of solicitors firms and, and advocate in the lower courts, but I am a senior lecturer in law at Leicester de Montfort Law School, and my academic specialty is criminal law and professional regulation. So that's specifically in relation to professional discipline.

So that might be for you guys, the RCVS and, and the associated codes, guidance and case law related to it. But for other sectors, it might be, the general, Medical council or the Healthcare Professions council or, or, or elements like that. Now, of course, we can see that.

Not only sort of professionally, am I engaging with, with the law through my career and, and also through, members of associations in regulation and professional discipline. But ultimately as well, I engage with the profession. So I am an associate of the BVA and an associate of the BVNA and for what it's worth, my partner is a veterinary nurse.

So it's certainly something that, interests me both on a professional and personal level and hopefully, this webinar will help you guys think more about those fundamental elements of professional discipline that if we think about them early, can often prevent, practise issues, personal issues, HR issues, and certainly, discipline issues moving forward. It's that old adage, isn't it, that, that, Inadequate preparation makes for inadequate performance. So hopefully this will allow you to prepare not only in your practises, and by way of your practise policies, but also as, as an individual professional, as a registrant yourself.

And we'll talk a little bit more about that later on, as to how you can achieve gold standard, not only in your care of your patients, and certainly their, their parents or their client or your clients, but certainly. How you can achieve gold standard in terms of the professional ethical side of your practise and the regulations that accompany them. So what are the learning objectives today then?

Well, ultimately, we want to understand what context the discipline processes for surgeons and for nurses take. And I'm not going to take you through the individual elements of the discipline process. They're freely available on the RCVS website, but we are going to empower you to, to understand those.

And what we're also going to look at, and the bulk of the presentation, certainly in terms of the the me talking bit as opposed to the empowerment of learning that we're going to give you to, to go away and work further, is looking at the principles of practise. And we're going to look at those in context. We're not just going to sort of discuss the abstract as might have happened at that school or, or, or certainly during nursing diplomas or degrees.

But we're gonna look at the fundamental principles of practise in context. So we're gonna use some real life cases, as recent as a couple of months ago that the RCVS have dealt with, and we're gonna look at why those principles of practise are so important for you guys in terms of informing your practise, but also for your regulator, the RCVS, in relation to that. We're gonna look at a little case study as well, so that's going to be part of our empowered learning, activity towards the end of this seminar, this workshop webinar.

And what that's gonna do is present you with a scenario. I'm going to then ask you to pause the recording and consider on your own or in a team if you're watching this together, how you might approach that scenario as if you were the regulator. What principles of practise do you think come into play and what do you think's relevant, not relevant?

So on and so forth. And then I'll give you a worked example of that, case study afterwards so that when you press play on the recording once more, you can get the answer. It's not just an abstract thought for you, there is an answer to it.

And then what I'm gonna give you the opportunity to do is springboard from this session to further empowered learning around veterinary discipline, and to further broaden your knowledge and, and horizons in terms of those gold standard policies and, and practises. So hopefully those five learning objectives, will benefit you and by the end of the session, you should be able to, understand them fundamentally. I'm working on some assumed knowledge.

As registered professionals, you should all have a basic understanding of the charter of the RCVS and the relevant discipline rules that they have available to them. If you don't have that knowledge, what I'd suggest is fundamentally, you, you need to gain it. And the best way to do that in the immediate term is to have a copy of the rules available to you wh.

You watch this webinar. And of course, as a registrant, you should have that knowledge. And further, as a registrant, you should have, understanding of the various codes of professional conduct for veterinary surgeons and certainly for nurses, you know, if you're a nurse or you manage nurses, and again, the best way in the short term for the purposes of this webinar to get to know those codes is for you, principally to have a copy available to you or to go and have a look at a summary.

At this stage. So what I'd suggest is pause this recording at this juncture. If you don't have this knowledge, go and get the knowledge, or at least a price of it, and then play the recording once more.

And it's certainly on that basis that you'll be able to be empowered by the further learning that we're going to do now. So here's the opportunity to pause it. And we'll move on to the next slide.

So now you've got that assumed knowledge or you've had it and, and we're continuing with the recording, we're gonna look at two principal methods of learning today in terms of this section of, of, of, of the webinar, let's provision. Thought provocation. So I'm going to give you some ideas and and there that's going to prompt thoughts in your mind.

It may relate to your current practise or your current policies, and those thoughts are OK. Don't become paranoid or don't second guess yourself as a registrant, you should continually develop and those thoughts through this webinar are the, the, the, the, the jumpstart, they're the key to that further thought and development in your own standards and in your own practises. And then springboard empowerment as well, and this is a term I like to use in terms of.

What's it going to do? So this webinar is going to give you those thoughts, but also it's going to give you places to look and springboards to use in terms of not only your ability to revamp your practise policies, for example, or, or indeed recognise that there is less than gold standard practises occurring in your area. Of work, but also the springboard to empower you to fix those problems on a practical level.

So this isn't a theoretical seminar. It is very much a practical approach to to ethics and it's going to give you these thoughts on this, the springboards to, to apply that to your everyday practise. So, we start off by me taking a very quick sip of water.

I do apologise, but talking for an hour does make your throat go dry. So what is professional discipline? Well, the first thing is what it's not actually, and this is what a lot of practises see professional discipline as, first and foremost, a HR matter, a matter for HR.

Well, actually, it, it goes before that, just like doctors and lawyers are, are subject to professional standards, so are you, and you have duties to engage with your regulator in relation to that. So what I don't want any of certainly the delegates of this, this course to think is that professional discipline is solely a matter for HR. It isn't.

It's a matter for each registrar and, and certainly that's something I'm going to talk about in just a moment. That being said though, breaches or potential breaches of professional discipline of the RCVS codes will impact on employment discipline. It's certainly worth, in, in my view, incorporating a reference to.

The individual codes of practise in either employment contracts or codes of practise within, within a business. I know certainly some of the bigger chains in the industry do that. That being said, I'm also aware that some of the smaller chains or even bigger chains don't.

And it's an interesting point because you're employing professional registrants, you're employing people that are held to a higher standard than a typical employee. So employment discipline. Generally, won't reach.

The the standard required of a registrant. So by incorporating professional discipline codes into your practise handbooks or employment contracts or codes of conduct for for employee behaviour, you'll certainly be able to hold employees to a higher standard. Through employment discipline, but also it'll be clear and transparent that if you were to make a referral to their regulator, on what basis that they've done that, and certainly if they were to argue that, well, they weren't aware of it, it's another thing for the regulator to point out that actually, yes, you were, because it's in your employee handbook or it's in your employment contract.

And it's a safeguard as well for practise management. To hold somebody to a standard, they must be fairly warned of the standard. Now, as a registrant, they are all fairly warned.

It's, it's clear when you register that you're held to those codes, but further warning, certainly doesn't go amiss. So it is. Isn't a HR matter.

It impacts on HR and professional discipline can be useful when it comes to HR, but certainly it is a matter, in my view, superior to that of employment discipline. It is a voluntary assumption of regulatory regulation, essentially by regulation by a regulatory body. And certainly that voluntary assumption upon registration.

Is a matter, that we'll go on to discuss on the next 4 bullet points, but certainly it is an important one. Further, professional discipline is a matter of public safety and a matter of patient safety. So when you get Lassie the dog come to the practise, and their mum is particularly worried about them, the reason that they are going to you is because they are concerned about their patient's safety.

But also those veterinary surgeons with contracts with the RSPCA for example, or indeed those that act as expert witnesses for the courts on matters of dangerous dogs and and so on, you have a duty to the public safety. Certainly the Dangerous Dogs Act for all its flaws, and, and it is certainly flawed in my view. But for all its flaws, ultimately it is there to protect the public, and veterinary surgeons when consulting with the courts or indeed for the RSPCA or similar, on matters arising from the Dangerous Dogs Act, you are there as a public safeguard.

You are there to serve the public, so it's worth bearing in mind that professional discipline informs that duty. It informs a duty to not only develop your clinical knowledge and your clinical skills to, to benefit animal welfare, which is of course one of the, the principal responsibilities, but also, to develop your knowledge and your skills to the benefit of the public and to the betterment of the public. And on the same principle, when Lassie's mum and Lassie come into the practise, it's a matter of public trust.

They are coming to you because you're a vet or you are a veterinary nurse. The reason that they're coming to you is because you have that professional delegation, you have that, that professional designation, sorry, to consider. Their problem in a matter that's not only open and transparent, but also that's trustworthy.

And they rely on the fact that you are a member of a regulated profession, that you are subject to professional discipline, to increase that trust. So professional discipline needs to be effective because it is essentially what maintains the public trust. The moment that vets or vet nurses don't answer to a professional regulator or don't engage with professional disciplinary protocols and procedures and regulations is the moment that they lose trust in the that they lose the trust that the public has in them.

And that transcends again, and you'll see all of this is linked, that that matter transcends into public perception. The reason lawyers like me have such a bad name is because historically, we operated in a grey area. And it's only now with the, implementation of, of the Solicitors Regulation Authority and the Bar Standards Board and, and so on and so forth, that we are developing a reputation that, that isn't the traditional lawyer.

That, that, that the public didn't trust. The reason politicians are distrusted is because their regulation, they're self-regulated, just like you and I, but their regulation ultimately. Doesn't recognise wrongdoing.

You'll you'll note from, from matters of in, in the press as recently as this year that actually when a minister is accused of bullying, for example, or a, you know, very senior members of government breach regulations, the internal discipline there is essentially non-existent, and that's one of the reasons that the public's perception and the public's trust of politicians and governments is, For want of a better phrase, through the floor. So it's about maintaining that perception that you hold yourself to this higher standard and that that's overt, you know, it's OK to tell clients I am professionally obliged to do X, Y and Z or I am ethically obligated to do X, Y, and Z. It's OK to tell clients that and explain it to them, make them understand the background that you're not just a vet that doles out.

Antibiotics or doles out surgeries or or X, Y and Z, you are a professional agent, you are a registrant of a professional body, and it's OK for the public to understand that, and certainly that's something that should be overtly explained to, in my view, every client, they should be given an information leaflet or, or something of that view because the more they know about professional discipline, the more that your perception, your trust, and ultimately, public and patient safety is able to be prioritised. And the better you are at those, those three things, the less you're going to have to deal with HR and employment discipline, as well as the regulation, of, of your staff through their professional bodies through the RCVS. So the last bullet point on this slide is that each point, each rule, each regulation, each element of professional discipline is a matter that is personal to each registrant.

It's equally permissible for a day one qualified veterinary nurse to report a 50 year qualified veterinary surgeon to the RCVS as it is the other way round. Each registrant has a duty to abide by the code. And that's not something that you can discharge by saying, oh well HR will deal with it, which is a phrase often heard.

Oh, well, HR will deal with it, it's fine, I don't need to. Actually, you are under a duty to cooperate with your regulators and you are under a duty to prioritise public and patient safety, and if you see something, you need to say something. So certainly, incorporating transparent reporting procedures that are supported by management is certainly something that you can do on a practical level to enhance the abilities that you have to not only ensure that your, your clients, your patients trust you more, but.

Generate an environment that is conducive to open and transparent working, to critical friends, to feedback, to wellness, and by making sure that each registrant knows that they can report something in a way that is clear and transparent and managed, is going to put their mind at ease. Often. You'll see registrants say, well, I knew something was going wrong, but I didn't know whether it was my place to report it or it's not my place to call out a vet.

That, that's a lot of, a lot of the time nurses will say, well, it was the vet's call. Actually, the vet is just as much of a professional as you are as a veterinary nurse. So, It's a matter of professional discipline, for each registrar, each vet, each nurse to protect that perception, that trust, and ultimately the safety of their patients and their clients and at a larger scale, the public.

5 principles of practise. Now, these are taken directly from the codes. And they are common between surgeons and nurses.

There are simply 5 elements, 5 values to live by. Professional competence, honesty and integrity. Independence and impartiality, client confidentiality and trust, and professional accountability.

Now we're gonna look at these principles of practise in a little bit more detail over the next 5 slides. Obvious answer, isn't it? But over the next 5 slides, we're gonna have a look at these principles, but broadly speaking, what I want you to do now, and this is gonna be one of those springboards, is pause the recording.

And consider what each of these 5 elements mean to you. Just grab a piece of paper or in the notes section on your phone or even just in your head and think, what do these mean to you? Take 1 or 2 minutes just to pause the recording now and consider that point.

So now you've considered what each of these principles of practise mean to you, let's have a look what they mean to your regulator and see if the two match up. Now professional competence is one of those things that. Can we have a lot of meaning.

But let's see what it means to your regulator. And to do that, we're gonna look at the case of Re Seymour Hamilton's 10th application for restoration. Now this was an application for restoration to the veterinary surgeons register that happened in 2002.

Several decades ago, Mr. Seymour Hamilton was removed from the register following an inspection of his practise, where there were a considerable amount of issues identified that posed a risk to animal health and welfare. And in 2022, .

Mr. Seymour Hamilton put in his 10th application for restoration. Now What the panel went on to say was, and it's on the slide, but I'll, I'll read it to you, and I, I quote, If restored to the register, the applicant would then be free to undertake general practise in all its forms.

Of clear concern to the committee was his assertion that a lot of surgery, is just the same, unquote, even after 28 years out of practise, as well as the fact that he accepted that he had not undertaken any formal structured training. And had not seen any practise at all since 2021. End quote.

Now, broadly speaking, the position that Mr. Seymour Hamilton was in is that with this 28 years out of practise and with, The fact that he had not been to a practise since 2021, he would struggle to to satisfy the day one competencies of a veterinary surgeon, which is the threshold to practise, the threshold to qualify as a veterinary surgeon, and when your application to restore to the registered herd, that's essentially the position, excuse me. That's essentially the position.

That the RCVS considers, can you meet the day one criteria for a veterinary surgeon. Now in this intervening 28 years, Mr. Seymour Hamilton certainly had been active in a form of the industry, he'd.

Essentially been researching herbal remedies to. Particular issues in relation to the care of animals, and he said to the committee that Actually, I don't want to go back to practise in general practise in. You know, being a vet day to day, I want to go into research and, and being able to say that I'm a vet will aid my ability to persuade drug companies to accept my herbal remedies.

Now, what the RCVS's position was, was, and you'll see that in the first line of that quote that I've taken, it's paragraph 60 of the decision, in relation to his application, if you want to read it. But, if restored to the register, the applicant would then be free to undertake general practise in all its forms. So this informs that key competency, that principle of practise of professional competence.

Because you don't just have to be competent in the area that you're practising in, you have to be those day one competencies, and that's for a vet or a vet nurse. So what it's really important to see is that in your practises, you're not holding people to their competence in relation to a very, very, very specific point. You're actually saying, right, are you competent broadly?

Your CPD budget should be allowing for CPD that looks at broad competence. It may be that your nurse is a consult nurse. Your nurse might only do consults in a first opinion practise, which is a perfectly valid job to have.

Indeed, it was the job that my partner enjoyed the most. But the thing that you've got to really consider. Is whether or not that consult nurse is competent professionally to go and monitor an anaesthetic or to deal with matters in, in relation to Schedule 3, or to deal with, Client care during a.

Euthanasia procedure. Not only does that consult nurse need to be really, really good at consults, but they need to be professionally competent in all areas that they are licenced to practise in. So if it's a small animal vet nurse, for example, then all animals are small.

Animals, all all matters of small animals, should I say. So that's a really, really important point. Don't limit your CPD budgets just to the role that that nurse, for example, or that vet is, is, is, is under.

Make sure that you foster their professional competence across the board, because that ultimately is what stopped Mr. Hisimo Hamilton from being restored to the register. The committee said that their concern was that he was not professionally competent.

Take a consult nurse that had been consulting and registered for 28 years, and they go and monitor an anaesthetic and come out with the same thing. Well, it's just the same as 28 years ago. The fact of the matter is it's not.

And without ongoing development and without ongoing recognition that you need that professional competence. You're going to struggle. So make sure that on a practical level, your CPD budgets and your CPD policies are allowing your staff to maintain their professional competency across the board.

And that's certainly one thing you can do to massively help them in terms of their. Adherence to that principle of practise and make them prove it as well. CPD logs are a wonderful thing, because if stuff does hit the fan, then that CPD log is a great piece of evidence to protect you and your staff.

Let's have a look at honesty and integrity. And this is where we consider the case of Re Strangeway. Now, in Strangeway.

The respondent created what she knew to be a false record. And she said that she'd attended and conducted observations throughout an evening and, and a night, when she hadn't done. On 2 of the 5 occasions she also said that she'd administered medication when she hadn't done.

Now The bit that's really, really clear here, and that 7 is a paragraph marker, if you do read the case, it'll help you find it. Now what's really, really clear here is the committee said that the respondent must have known that when she was doing this, it was dishonest, she was lying. And indeed in the hearing that the respondent strange way admitted just the same thing.

The committee in their decision, said that they were satisfied that her conduct was dishonest, and they applied the criminal standards. So the criminal standard in relation to dishonesty er arises out of the case of Ivy and gentting casinos. And in, in that case, the defendant was counting cards that well that responded it was a civil claim, but in that case, the individual was, counting cards in the casino, and they considered whether or not that was dishonest.

And what the court said is where the ordinary and everyday person, the man on the lap and omnibus, for example, is, is the phrase that the law used, or the man on the North Circular, whoever it is, would say that that conduct was dishonest, then it will be dishonest. The case law in relation to dishonesty's evolved, but for your purposes, if the reasonable observer would say it's dishonest, then it's dishonest. And the committee said, and that last bullet point is a quote from them, that this is a case involving serious dishonesty.

Ultimately, it's dealing with observations which are massively important, and the administration of medication, which are, which is massively important. So not only is the dishonesty there, but it's in relation to serious issues, and it was sustained over a long period of time. And the conduct itself was detrimental to animal welfare and a willful disregard of professional regulations.

So those four points there serious dishonesty, sustained over a long period of time, detrimental to animal welfare, and a disregard of the regulations. And it's those points there that ultimately sum up honesty and integrity. Not only have you got to be.

Honest in relation to everything that you do and and transparent. But certainly in cases where The honesty is in relation to the care of an animal. That is a heightened requirement.

The honesty in in those cases is a heightened requirement because ultimately it links in to the principles that every vet and vet nurse is bound by. Now, the sustained over a period of time bit is important because it relates to integrity. Not only have you lied, but you've maintained the lie over a significant portion of time through not only the time you were actually lying, but also the time that you'd left those records complete in an.

Dishonest form. But also through an investigation internally if one arises and and so on and so forth. So that sustained period of time is if you realise you're wrong.

Admit it. Say, actually no, I didn't, I, I said I did but I didn't. That's integrity.

Honesty is not lying in the first place. Conduct potentially detrimental to animal welfare. Well, of course, the RCVS treat this as ultimately the most serious of aggravating factors, because that's what you're there to do.

You're there to prioritise animal welfare, unless the law says otherwise. A typical example is the Dangerous Dogs Act. You may be required to put a healthy animal to sleep.

But that being said, your purpose is to protect animal welfare. So certainly, integrity relates to what is in the best interests of the animal. And also here that There's a disregard of professional regulations.

Now integrity relates to your relationship with your clients, but it also relates to your relationship with other professionals and your regulator. So if you don't abide by the regulations, if you think, yeah, well, it, it's an insignificant one, it doesn't really matter if I bend the rules a bit, you're not acting with integrity. And it's certainly something that would be challenged were it to get to the RCVS.

Now, in this case, er, the committee decided that the respondent's misconduct was so serious that removal from the register, was the only means of protecting animals and the wider public interest. And ultimately, this was a few observation sheets in one night. Now in the context of a career, it's an extremely small snapshot.

But that small snapshot is so important. That the RCVS says the career is no longer, the career is no more, because that snapshot says you don't deserve it. So honesty and integrity is important because you need.

To embed it in your practise, you need to embed it not only as an individual practitioner, but also if you're a practise manager or a practise partner or so on, you need to embed that in your practise and having robust procedures to deal with honesty and integrity. I really, really important. What I would recommend is having a policy around, actually, if you make a mistake, this is how you admit to it, and ultimately so long as you cooperate and the mistake was honest, then there's not going to be any, any splashback, it's a lessons learned approach rather than a who to blame approach.

And that's something that healthcare and the veterinary industry often gets wrong. What's really important, and the NHS have taken this on board and it's about time the veterinary industry do too, that what's really, really important is actually not punishing somebody or finding someone to blame for an honest mistake, but it's having those lessons learned. And as part of honesty and integrity, and as part of you embedding that principle of practise into your practises, you can make that really, really easy.

So the takeaway from Strangeway is for practise managers, at least, at the, at the very least, have a lessons learned approach, not a who to blame approach when things go wrong. Let's look at independence and impartiality then. So here we, we, we leave the veterinary arena for just a moment, but I promise it's relevant.

And we look at Hilo and the Secretary of State for the Home Department. And another, and this appeared in the second volume of the appeal case reports for the year of 2002 at page 357. And this case was all about a Palestinian who challenged the involvement of a particular judge in their case.

That judge was Lady Cosgrove, and Lady Cosgrove is Jewish, and is connected to pro-Jewish lobbying organisations. So on the face of it. The app, the appellant in this case, Hilo said that because this judge is a because I'm a Palestinian and this judge is a Jew, there's an immediate sense of bias there and therefore she shouldn't be able to look at my case.

Now, let's have a look what. The House of Lords said in this case. Now, they said that the observer who is fair-minded, is the sort of person who reserves judgement on every point until she has seen and fully understood both sides of the argument.

She is not unduly sensitive or suspicious. She knows that fairness requires that a judge must be and must be seen to be unbiased. Now, what that means is that just because you hold a view, for example, that the Dangerous Dogs Act is a terrible piece of legislation and shouldn't be there.

Doesn't mean that you can't objectively, independently. Apply your skills to the furtherance of that act. And ultimately you should be asking yourselves, I'm dealing with this case.

Would somebody sat at the back of the consult room or somebody sat at the back of court if you're giving evidence as an expert, say that I am impartial? Would they say that I'm independent, or would it appear that there is some bias? Now, ultimately.

In Halo. The court concluded that although someone with Very, very clear views about a particular matter shouldn't be the presiding judge on a particular case. In the case of Lady Cosgrove, she didn't subscribe to the extreme views of some of the lobbying organisations that she was connected to.

She was more mindful. And it's because of that reason that they said ultimately in this case there was no evidence of bias. That being said though, you should consider in your practise whether you can justifiably be said to be independent in every case that you deal with.

And that relates to things like I've, you know, seen vets on regular occasions give treatment to their own animals. Now, arguably there's nothing unlawful about that. But actually, does it abide by this principle of practise?

Well, my suggestion, and certainly my advice to any vet who does that, or indeed nurse that that does that, is that, no, it doesn't, because you can't act impartially or independently, you're emotionally invested. And it's for those reasons that it shouldn't happen. Now The line to be drawn is where, for example, you treat a colleague's animal.

You need to be sure that you can be independent and impartial. So if you're best friends with the nurse that's brought her rabbit in, for example, should you be treating that rabbit? Are you emotionally invested?

Are you going to act in the animal's best interests or your friend's best interests? Can you draw that distinction and can you draw that line? And it's certainly a hard line to draw, but you should have policies in place that enable you to draw that line more accurately.

And certainly you should have, a, an environment that's conducive to reflection and that's conducive to a nurse or a vet saying, actually, I can't do this one because I'm not independent, I'm not impartial. I'm not in a position where that fair-minded observer stood at the back of the consult room or at the back of court would say that I am acting professionally because I have a conflict. And you should have policies in place to preserve that independence and that impartiality.

Let's have a look at trust and broadly, client confidentiality. The code, I think unhelpfully combines confidentiality and trust, but actually. It's something that you really need to treat separately.

Now, client confidentiality is, is quite clear, you'll have data protection policies. This generally is something that the veterinary industry are quite good at doing. The one thing I would say is, and I've, I've seen this from people I've represented from, from, from experiences dealing with the profession, is that when.

Staff share updates on an animal's progress, that is, be that in a picture or be that in a text message or a WhatsApp, that is client data. So bear that in mind, that, that, you know, you, you could be held to, the standards that you're communicating in those messages just as much as what you put on the client file. So bear that in mind.

And certainly it would be disclosable if you know, if it came to a court case or if it came to disciplinary proceedings, those issues would be disclosable. Now, in Henry, this vet composed a letter that stated a ewe died in transit to her practise. In actual fact, the ewe arrived alive, was subjected to a C-section procedure, and was then euthanized.

So we can see clearly that not only has this vet, Henry, produced this letter that's lied, so has already breached that honesty and integrity point. They've also undermined the trust that the public places in the profession. They've undermined the trust of their managers, their colleagues, and ultimately their clients.

Now, that's because they lied. Regulation, C 6.5, so the conduct regulation 6.5 says that veterinary surgeons must not engage in any activity or behaviour.

That would likely to, that would be likely to bring the profession into disrepute, or indeed undermine public confidence in the profession. So she's clearly done that in this case, and the committee agreed that, that, you know, they've they've clearly done this. The ewe arrived alive, was subjected to a procedure and then was euthanized.

But the letter that was submitted to the insurance company said that the ewe died in transit. So we had clearly there have trust issues arising. And guidance to the conduct rules at 21.40 states that misleading, incomplete or inaccurate or untrue certification reflects adversely on the veterinarian that signs the certification and calls his or her professional integrity into question.

This also impacts adversely on the general reputation of the profession. So it's clear that that this certification, which doesn't have to be a particular certificate, the letter would the letter in this case did comprise of a certification. Has to be Completely truthful and accurate and complete.

And in this case it was none of those things, it was misleading, incomplete, inaccurate, and in and untrue. So actually every one of those points in guidance, 21.40 states that what Henry did was wrong.

Now it's here where my two areas of specialism, criminal law and professional discipline, come into contact. Because actually, because this letter was submitted to an insurance company and ultimately the vet would have known that, there are criminal law implications here as well. Conspiracy to commit fraud, for example.

Come into the mind of of any barrister advising Henry in relation to this action, if the police get wind of it or the insurance company get wind of it, she's in a lot of trouble. Not just with the RCVS, but with ultimately the courts in terms of the criminal jurisdiction that they have. So bear in mind there that, you know, how maybe you might want to, if you're in a big practise or even a small practise, you might want to dual sign letters.

If you're gonna send a letter out, have it dual signed, have the file reviewed. That's a really easy policy to check and balance each other in terms of this trust. Yeah, so review the case file, check the letter, yeah, they match, dual signatures.

Not only is that going to increase your ability to understand that your trust, and, and certainly indeed, you know, the trust that you project to your clients is there, but it's gonna reassure your clients that actually this vet really care that I get an accurate update. So, you know, I've got a dual signed letter. Make sure notes on the file are dual signed.

You can just check and countersign drug dispenses, so why not letters? And that might be worth giving a thought to. So, let's talk a little bit about professional accountability.

And again, we move away from the veterinary profession for an example of this, but what we do use is a, is a piece of case law from healthcare. Now it's worth noting that the courts cross apply in professional discipline. So what's relevant to the General Dental Council will all be, also be relevant to the General Medical Council or to the Healthcare Professions Council, or indeed the RCVS and the Bar Standards Board, so on and so forth.

So we cross apply. And this is the council for the Regulation of Healthcare Professionals and the General Dental Council. Heard in 2006 in the High Court, in the, the administrative division of the High Court, and we look principally at this quote.

Quote, I therefore regard the failure to give reasons dealing with the issue set out as a serious procedural or other irregularity in proceedings before the conduct board. And a failure of process without knowing if the conditions were needed to ensure protection of the public were or can be satisfied, I'm unable to decide whether the decision as to penalty was appropriate or not in this case. I accordingly allow the appeal, quash the penalty imposed by the conduct board, and remit the case to it, unquote.

So what happened here is a dentist faced a conduct inquiry. After dealing with a significant number of issues, ranging from inappropriate treatment, to, you know, just not wearing gloves when treating a particular patient, not providing adequate treatment plans, failure to diagnose and treat something as simple as, as, as, as cars and, and so on and so forth. Now, what This decision tells us is that professional accountability goes both ways and in all directions.

Here, the High Court held the conduct board at fault. The dentist's fault is, is to be examined later, but they actually held the conduct board was in fault because they didn't give appropriate reasons. So Bear in mind that not only are you as professional registrants responsible for.

Your own professional accountability. But also as businesses, you're responsible as a collective to be professionally accountable as an industry, but also your regulators have to give reasons when they deal with their decisions and their professional accountability. Now, that's in certain circumstances and certainly in terms of professional discipline reasons are always given for verdicts, so the decision on, on actually the conduct and of course the decisions on sanction.

But also looking wider than this, and this is about as theoretical as it gets in this session, looking wider than this, you can read this piece of case law to say that actually where you're dealing with professional discipline, you have a duty to have a sound basis of logic. Now, what I would advise is that you consider that duty to apply to everything. It's not gonna hurt you to have a sound basis of logic that you can evidence.

So rather than just saying this is. You know, in a consult rather than just saying we need to give them some antibiotics, saying, why do you need to give them some antibiotics? So we need to do this because of X, Y, and Z reason.

Now good vets and good nurses will do that naturally. They'll explain everything to their clients. But actually, don't just assume that that basis of logic.

I Evident, because it might not be. That's what the PCC did in. You know, in, in this case, originally before it went to the High Court.

And they were told off for it. They assumed that, well, it's clearly obvious why we're saying this. Well, actually it's not.

So set the reasons out. It's not we're giving antibiotics, and it's not we're giving antibiotics because they've got an infection. It's we're giving antibiotics for X, Y, and Z reasons.

The alternatives to this are X, Y, and Zs. In my professional judgement, this is the best option because it's that extended. Discussion and that extended explanation to mum and dad of X, Y and Z animal.

Now Certainly, that's something that you should bear in mind, but it's also something that you can make really easy. You can have a form, an explanation form that the vet or the nurse fills in. Nice and easy, can be tick boxes, couple of lines of, of, of, qualitative text, commentary, on an A5 or an A4 form that says, and this explains all the reasons for our decision.

Now, as a bunny dad, formerly to 2, that would have been really nice if when I took peanut or stitch to the vets, I could say, well, actually, this is the reason why we're doing all of this. And that would have given me a little bit more peace of mind. So certainly, as a client, I can tell you it's a good idea.

As a lawyer, I can suggest it's a good idea, and obviously you guys will see whether it's professionally feasible, but certainly I think that's an option that you could quite easily put into practise, and would ultimately raise your client satisfaction rates. So let's have a look at this case study then. So Paul, a registered veterinary nurse, undertook the following acts in the course of his employment as an RVM.

The first thing he did was unlawfully administered and I can never say drug names, so I apologise. But an unlawfully administered brorphenol, I think, to a dog and failed to record the administration of this medicine in the dog's clinical records. The second thing he did was stole trazodone and methacam from the practise, for which he was working.

And the third thing that he did was falsely made entries into the clinical records of his own dog in the name of a veterinary surgeon colleague to the effect that that collie had examined the dog and that methacam had been prescribed for the dog. So, what I want you to do here, I'll leave this on the slide, take 2 or 3 minutes to pause the recording and given everything that we've discussed, consider. What you think Paul has done?

What principles of practise do you think Paul needs to be mindful of, in his upcoming RCVS investigation into all of these actions. So, what principles of practise are relevant to Paul? Pause the recording now, give yourself 5 or 6 minutes to have a think about that case study.

So, now that you've thought about that case study, and considered what Paul needs to think about, I can tell you that this was a real case. It was Paul Cheney in 2020. Now, what happened to Mr.

Cheney was that as a whole, they considered that his conduct had fallen far below, no surprise there, the expected standard. He had no doubt that fellow professionals would regard his conduct taken in terms of his actions in relation to treatment of, of this dog. His possession of prescription-only medications and stealing of medications, also the alteration of the record for his own dog, was separately or as a whole deplorable.

The committee found him guilty of disgraceful conduct in a professional respect, and they directed his, name be removed from the register. Now, what do we consider when we consider Cheney? Well, let's have a look at the professional.

Principles of practise. The first one that screams out at me certainly is honesty and integrity, as well as trust. Now I go back to that 0.3 the false records in the name of another surgeon, sorry, in the name of a surgeon colleague, he was a nurse, of course.

Those records scream back to the case we looked at earlier. They've been falsely made and they've been left there, so they've been falsely made and not rectified over a significant period of time. So that screams out.

Honesty and integrity, again, integrity he's stolen not only from his employer, but he's stolen prescription only medicines. So, again, we're, we're looking towards this honesty, integrity, trust here as well. And the unlawful administration of the medicine as well, without recording it in the clinical records.

Again, trust, confidence, honesty, integrity, and to a certain extent, professional competence because those records should have been updated. So we can see that the principles of practise not only exist in their vacuum of the code and the case law, but actually that vacuum is significantly broken because the principles of practise flow into every decision you should make as an RVN or a vet. And should inform not only the, the, the, your methods of working in a practise, but also the ability that you have to influence positive change in the veterinary industry, your practise, society, and ultimately the lives of your patients and their parents.

So. If you take nothing else from this, read those principles of practise and at the very least, put them on a big poster on the wall of PEP. Yeah.

And do that because ultimately it will help your practise grow and it will help instil. A good working environment, trust and confidence in the profession. So.

They're my contact details, of course, the webinar vet host, . This, this webinar and thank you again to them for making it available to you and I hope it's helped. And if you do have any questions, you can feel free to get in touch with me either at the university by post or indeed through the email address that's on screen.

I thank you for your time, and moreover, I thank you for the things that you do in practise. I see it firsthand as someone who, goes home every day to a nurse, . Thank you for everything that you do.

It's a hard job, and hopefully, these principles of practise and the little few tips that I've given you today will make the job not only a little bit easier, but also more enjoyable, more transparent, more honest, and a better service to the public. So thank you very much, and I will now end that presentation.