Emergency Care

The Vet Council has developed an Emergency Care Action Plan, following its recent review of emergency care, after hours. The plan will be activated from March 2025 and can be viewed here. 

The key actions in the plan include providing:

  • more guidance from the Vet Council on emergency care requirements,

  • greater support for the profession in the sustainable delivery of emergency care, after hours,

  • public awareness campaigns about veterinary emergency care, after hours,

  • education for veterinary students and new graduates about the value of doing emergency care work,

  • further emergency care training for experienced veterinarians,

  • a review of the current mentoring scheme,

  • more information to support veterinary businesses.

This work will be done in collaboration with the veterinary profession and partners such as the NZVA, the New Zealand Veterinary Nursing Association (NZVNA) and the Allied Veterinary Professional Regulatory Council of New Zealand (AVPRC).

The Council will also investigate establishing a national advice line for veterinarians doing after hours shifts.

A wide cross section of veterinarians engaged in the Emergency Care Review to ensure there was strong representation from different parts of the sector, including rural and urban veterinarians, and those from small and large practices. In mid-2024, a survey was sent to all veterinarians asking for feedback on the review’s findings, which received 239 responses.

Some of the main findings from the survey included:

  • 42% of respondents reported there was a major issue around vets sometimes feeling compelled to discount fees because of a client’s financial constraints, or concerns about patient suffering, or risk to their reputation.

  • 43% of respondents felt that unrealistic demands for emergency care, after-hours could increase veterinarian fatigue and wellbeing concerns.

  • 74% of respondents thought that mentoring less experienced vets was vital, and 69% reported that non-technical skills, not developed in vet training or mentoring, were often required when practising.

  • 82% noted the importance of veterinarians needing non-technical skills for managing client relations and financial matters.

The review and survey results both highlighted the complexity of emergency care, after-hours veterinary care, and the interconnectedness of issues such as client expectations, financial pressures, training needs, and professional wellbeing. A collaborative approach involving the Vet Council, the New Zealand Veterinary Association (NZVA), individual clinics, and educational institutions has been identified as critical to addressing these challenges.

Survey respondents emphasised the importance of education, fair compensation, and standardised policies to ensure sustainable and effective emergency care, after hours for veterinary professionals, clients and patients.

Of the 239 respondents, 55% covered their own after-hours work; 16% shared responsibilities with one or more other practices; 19% referred clients to dedicated after-hours centres; 5% used a hybrid model, managing some cases personally while referring others; and 2% relied entirely on another clinic for after-hours coverage.

A summary of the survey feedback can be viewed here.

What is the Emergency Care Review?

In 2023, the Veterinary Council of New Zealand decided that challenges for vets in providing emergency care, after hours deserved closer investigation – especially as they were being singled out as one of the biggest influences on veterinarians’ wellbeing and work satisfaction.

These issues became more noticeable after workforce shortages intensified during the COVID-19 pandemic.

Why are challenges in providing emergency care, after hours important to the Vet Council?

If veterinarians’ wellbeing and work satisfaction are significantly affected by any issue, this will naturally flow on to the standards of care and treatment they provide. This is of great importance to the Vet Council as the profession’s regulator. 

The Vet Council’s purpose is to lead veterinary excellence, ensure quality and advance trust.

At the same time, emergency care provision is a requirement set by the Council for all veterinarians in clinical practice to ensure that animal welfare is protected, public expectations are met, and the burden falls fairly on all those in clinical practice.

As a modern regulator, the Council has to ensure that the requirements it has set for emergency care, after hours are fit-for-purpose in today’s working environments and are reasonable for those who need to comply with them.

What has the review involved?

Before starting the review, we knew that current emergency care issues had evolved over a long period of time and many were interconnected. To truly understand these tensions and what was influencing the delivery of emergency care, we used a systems thinking approach to provide us with the most in-depth results.

Systems thinking uses graphics to help clarify how different parts of a system affect each other. It focuses on closed interdependencies, where one element influences another, which in turn affects other elements in the system. 

To put this methodology to work, we held three workshops involving people from across the veterinary sector. During these sessions, we explored the potential issues affecting the delivery of after hours emergency care and considered how they interconnected in both positive and negative ways. 

The issues were then sorted into themes and plotted on a causal diagram to give a comprehensive picture of the whole system. From here, there will be a wider conversation about what needs to be done to improve the system and who might be involved.

To find out how to interpret the Emergency Care Review Causal diagram, watch this short video below.

 

 

What are our findings so far?

The review has highlighted that there is no single solution to challenges in providing after hours emergency care but a range of actions that will be required across the short and long term. A broad level of ownership will be needed within the sector to achieve transformative change.

The tensions and insights discussed in the workshops have been captured under six interconnecting themes that are shown in the causal diagram and are described below. More detail can be found in the Emergency Care Review report. The video below summarises the key findings.

You can also view a recording of the webinar we held about the Review.

 

The Six Themes

 

Vet confidence, proficiency and willingness to do emergency care shifts:

Vet confidence, proficiency, and willingness to do emergency care shifts are all linked and involve not just technical clinical skills, but also the expertise to deal with clients and manage the non-technical aspects of emergency care, after hours. 

Willingness to do shifts also influences the number of vets available on each roster and the resulting roster frequency.

Client circumstances and expectations:

There are a range of circumstantial pressures on clients that vets cannot change, such as the number of animals they have; the value they see in their animals; and the extent they believe animals need high levels of care. Vets can, however, adjust the way they provide services to shift client experiences and expectations. 

Tensions often arise when there is a difference between what clients expect and what individual vets consider is appropriate for emergency care, after hours. This can increase pressure on vets and affect their wellbeing.

Discussions about pet insurance fit under this theme. As well as providing security to clients that their vet bills will be covered, it ensures that vets are properly remunerated for the work they do.

Financial considerations:

There are a range of external pressures on clients’ ability and willingness to pay for emergency care, after hours - not all of which vets can influence. There are also many  factors, which vets can influence, that determine whether vet fees are fully charged or discounted. Both sets of influences are linked to the financial viability of emergency care and clinics in general. They are also important when practices are considering partnering to provide emergency care, after hours.

Medical knowledge and training:

Clients and many vets expect that sophisticated medical care and technology will be available, even after hours. There is also a current expectation that people will see a vet rather than another member of the veterinary team, even outside normal business hours.  

The role that Massey University plays in veterinarian training and graduate preparedness is also critical under this theme and is an important area of influence. However, there are significant delays before new Massey graduates can complete their studies and have an impact in the industry.  

Veterinarian professional development in practices:

Professional development through on-the-job training and mentoring has a strong impact on the confidence and proficiency of vets. This relates to both the technical and non-technical skills required to deliver high quality veterinary services.

Time delays mean that recent changes to training and mentoring will take time to flow through to results.

Vet stimulation in work, wellbeing, and job satisfaction:

Influences on vet stimulation in work, wellbeing and job satisfaction include remuneration; anxiety relating to emergency services delivery; the level of challenge received from work; health and safety concerns; and general life pressures. Non-technical skills, such as dealing with people and money, also play a role and flow through to all parts of the emergency care system.

Concerns about liability are also linked to the likelihood a vet will accept non-emergency cases.

Feedback

The Vet Council asked for input on its Emergency Care Review through a survey that ran between 17 June and 30 September 2024. A brief summary of the survey responses can be downloaded below.

Survey results

We also held a series of regional meetings and an online webinar to discuss the review with the profession and to seek direct feedback.

An action plan, incorporating all of the feedback, is being prepared and will be shared in early 2025.