Preparation for the relaxation of lockdown 

Dear all, 

As you are aware, the release of guidelines by the RCVS takes effect in England and Northern Ireland as of the 12th April, This enables practitioners across these counties to join our colleages in Wales and Scotland in returning to full clinical practice rather than essential/urgent services. 

RCVS will remove the flow charts previously used to support decision making and practitioners are asked to provide services in accordance with their professional judgment whilst remembering to continue undertaking the ongoing required biosecurity and social distancing measures as well as additional relevant government guidelines and restrictions. 

This has been a long road, and whilst we are not fully out of the end yet, many of our animal patients need MSK attention. RAMP holds animal welfare as a priority and while we have previously advocated treatment for urgent cases only inline with government and RCVS guidlines, we are aware that many regular patients are deteriorating without on-going treatment. We welcome the ability for our practitioners to offer care as appropriate to the wider animal population once again. However, the threat of Covid remains and social distancing is still in place which provides us with our biggest logistical challenge therefore we highlight that the professional judgement of the practitioner should always lead the decision as to whether it is safe to attend and treat an animal and remain conscious not only of their own safety but that of their owners and animals. 

Beyond the change in scope of practice, many of the previous guidelines remain regarding biosecurity, social distancing and safety measures. 

To remind you, here are some points that should be taken into account: 

  1. Animals with demonstrable pain and welfare issues should be seen, these may include all pathologies. 

  1. A pre-visit risk assessment and telephone call is essential. Gain as much information prior to the visit as possible to minimise contact time. If appropriate, would the use of an oral sedative, supplied by the clients’ vet to the client, mitigate risk? Do you have access to a responsible ‘safe’ handler that can attend with you? 

  1. No appointments should be made with anyone who has Covid symptoms or who is in close contact with anyone with Covid symptoms. There must be a 10-day quarantine period for them, prior to seeing them. Consider the suitability of wearing a mask to reduce the risk of the practitioner spreading Covid between yards/clients. Consider asking owners/handlers to wear masks to reduce the risk of transmission to the practitioner. 

  1. If you have symptoms do not treat, get tested, and await a clear result, prior to seeing any clients. 

  1. Animals with owners in the vulnerable categories should not be treated in the normal way. Try to see if any other approach other than face to face can be used or if there are mediated ways of treating the animal in person. 

  1. Small animals should be seen in a clinic setting, (physio or vet) rather than home visits if possible, as cleanliness, disinfection and biosecurity are easier to control. If home visits are necessary, ensure that no other pets/family etc are present. In a clinic setting explore the possibility of treatment without owner present. Risk assess home visits very carefully. 

  1. Yard visits- Risk assess individual setups. As a professional you will be aware of the situations, and risks, at each of your regular yards. Some may be relatively ‘safe’, others less so. The decision to attend a client should be dictated by the risk assessment. 

  1. Home/yard visits, ask for gates to be opened and closed for you to minimise touching surfaces. No loose dogs/cats around that could transmit virus via petting, ensure animal is ready and waiting for you (ie no putting on headcollars, leads etc and unnecessary handling of owners equipment), carry your own soap and towels to wash between visits and ask for a fresh bucket of warm water or easy access to sink to wash. Accept no refreshments. 

  1. Other considerations, can the animal be left tied up with the owner at an appropriate distance? If not, are there any other strategies to improve safety and appropriately handle and restrain the animal. Is this a safe approach for you, the client and the animal? 

  1. Is this animal safe to treat with these restrictions in place? 

  1. All visits should be risk assessed and the results documented. Including those where treatment is refused and the reasons why, with documented details of the explanation to the client. 

  1. Payment- attempt to remove the need to handle payments. Request payment by BACS/credit card/paypal. 

  1. This is not a return to normal, please follow all PPE, and government guidelines and advice.. 

This is not an exhaustive list of all the possible considerations and scenarios but some guidance. Your professional judgement and expert opinion should be used at all stages to ensure yours and the client’s safety while also minimising the risks of spreading Covid 19. 

The professional judgement of the practitioner, based on a thorough risk assessment, should always lead the decision as to whether it is safe to attend and treat an animal. 

Your professional Associations will offer instruction of their plans for relaxation of lockdown restrictions, please pay heed to their guidance. 

The RAMP team

Help Someone Today

Reaching out in COVID when things get tough

Written by Dustie Houchin
frustrated black woman touching lips and sitting on bed

I was talking to a colleague the other day. She’s a really tough lady and usually quite upbeat, but today was different. She sounded low, a bit down. So, I asked what was wrong. She said, “I love my family, but trying to find new ways to help my patients and diversify the practice enough to make a living, is really hard when you also have to be on tap 24/7 as a mother and wife.” She went onto say that she was spending a great deal of time feeling guilty, because whilst she didn’t want to appear grumpy or short fused, she really needed her own space to work through her own career issues and emotional struggles. She has been a very Independent lady for many years, running a highly successful small animal and human practice. She enjoyed the interactions, camaraderie and the day today challenges. Yet, here she is, trying to juggle home-schooling with a husband who sits in his new office (the lounge), constantly talking to colleagues in various remote locations. “There is never a quiet moment. ” she lamented, with a sad tone. 

“My husband is a gem” she said….”but sometimes I just want some peace and quiet to switch off from the world. It’s been really tough trying to help patients virtually and much more demanding, so sometimes I just need the space to breathe, get some silence and unwind.”

R’s practice had been located inside another business, which sadly hasn’t survived COVID. As a result, she lost her clinic rooms. This isn’t an unusual story. Sensibly, R made the decision to wait until the pandemic was over before trying to find new premises, but it has left her trying to juggle home visits, with remote consultations, which (if you’ve tried it) is not easy. And all this, whilst dealing with bad-tempered teenagers and a husband who’d rather be in the office, talking shop with the lads.  

I realised then, how often I’ve heard variations of that story since COVID began. 

Many practitioners are struggling. Not just financially, but also emotionally. Most of us have been forced into unnatural settings, trying to modify the way we work in order to accommodate regulatory demands. But, it’s not easy. Our homes don’t feel like “home” anymore. Most are modified offices, classrooms and customer call centres. Places where we’re stuck with people we love, but would like to see a little less of…  That lovely feeling we used to get when putting our feet up at the end of a day, has gone. Instead, we can’t wait for the day that we can “get out”, move and go somewhere other than around the block. 

These aren’t easy times and stories vary dramatically. Some people are happy doing emergency home-visits and are incredibly busy, whilst others are scared of the risks and so struggling to make ends meet. The result is, that depending on your personal circumstances and how you feel about mixing with others, your life may vary dramatically from the practitioner next door. What I’ve observed as a result of all this, is a shutting down of open communication. Those who are doing just fine, feel guilty flaunting the fact and those who are falling apart inside, don’t like to admit it. It’s a tragic dilemma and one we need to try to overcome as a profession. 

Never has there been a time, when we need our colleagues more, so please, if you think someone is struggling, do reach out. Maybe offer some gentle suggestions as to how they could diversify without putting themselves at risk or, if it feels more appropriate, just have a virtual cup of tea and a chat. You could even discuss some cases and put it down as CPD! I frequently find, that just seeing someone I recognise on the Skype screen, smiling back, makes me feel better. Even if it seemed like an effort beforehand to glam up a bit for the event! So, if someone suggests a face to face call, try not to fight it. It  will be worth the effort and it will give you a chance to see a fresh face and hear a different perspective. Not to mention the fact that dressing up a bit and wearing a spot of make-up, will make you feel better 🙂 And that’s a researched fact LOL!

As practitioners, we are used to being around people all day long. We laugh and cry with our clients and patients and if you’re like me, some of your old-timers feel more like family, so it’s been hard not to see them. But, these are the times we are in and this is what we have to deal with. So, let’s reach out to one person a day (or one a week if you can’t find the time) and make someone smile. And if you think that someone might be having a hard time (especially if they are on their own), don’t ignore it. We know mental health issues are at a record high, so please reach out and offer a helping hand. Whether that be to talk to them yourself or to guide them towards a professional, it doesn’t matter, but we are supposed to be a community and communities support each other. 

AAO is always here to help and guide practitioners where we can and below are some links for groups and associations who might also be able to help.

Please support each other, because someday, it might be you.

Links to Associations and Resources

If you are feeling low or frightened and need to talk to someone, please reach out. If you don’t feel you want to do that with a friend or colleague, here are some professional organisations that you can reach out to for help and support. We’ve also included some organisations for young people, in case it’s a family member for whom you seek support. Many of these organisations have pages within them, that share information about other associations that might be able to help with specific concerns.

If you would just like to talk to someone at AAO, send an email to animalosteopaths@gmail.com and we will do our best to help or direct you. All communications will be treated as strictly private and AAO will not disclose your details or concerns to anyone. Please note, that whilst we maybe able to offer business suggestions to help you, we are not trained counsellors or mental health specialists. As such, if your issues are more clinical in nature, we would recommend that you reach out and speak to a specialist therapist or find a  local group via one of the links above. 

Guidance for Animal Practitioners

With COVID on the rise again, please use common sense and follow RAMP and RVCS guidelines. We all know to ask pertinent COVID pre-screening questions in advance of a visit and to touch gates, head collars etc. as little as possible. PPE wearing should be relevant to each case, based on your ability to keep a 2m distance from any person on the yard on in a garden – during the entire session. Where possible, treat outside. If you are inside treating an animal, you must be sure to follow PPE and hygiene guidelines to the dot.

Take your own cleaning and sanitising products to your visits. Make sure your owners know that you have clean sanitized hands and arms before touching their animal (after you get out of the car). Don’t shake hands, as before. Take your own food and drink with you. And where possible, ensure that you have a change of clothes between visits, if you are not wearing protective disposable items that can be disposed of, in between patients. This is because COVID can last on material for up to 3 hours.

More recently it has been announced that professionals in close proximity to people outside their household must wear both mask and visor – even if teaching (as opposed to treating). So, if you cannot keep a 2 meter distance from your owners, you need to keep this in mind.