Emergency Care Review
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 causal explainer document. The full review report will be added to this page soon. The video below summarises the key findings.
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.
How can I give my feedback?
The Vet Council is seeking input on its Emergency Care Review between 9am, 17 June and 5pm, 31 July 2024.
Complete the survey
Results from the survey will be collated and used by the Vet Council to help inform its final emergency care report and the actions that will come from it.
Personal information will remain confidential and your feedback will only be used in an aggregated form. All questions are optional.
