Practice Standards Scheme Manual

CONTENTS

1 Staff ................................................................................................................................... 7

2 Clinical Governance and Communication ................................................................................ 15

3 Out-of-Hours Patient Care ..................................................................................................... 18

4 Premises and Out-patient Facilities ........................................................................................ 20

5 In-patient Facilities .............................................................................................................. 29

6 Diagnostic Equipment and Facilities ...................................................................................... 44

7 Laboratory and Post-Mortem Facilities .................................................................................... 53

8 Medicinal Products .............................................................................................................. 56

9 Safety Procedures ................................................................................................................ 67

10 Small Animal Emergency Service Clinics (ESC) ....................................................................... 79

Appendix 1 – Veterinary Nursing Training Practice – Additional Resources

RCVS Practice Standards Scheme

The Practice Standards have been developed by the Practice Standards Group which included representatives

from the British Veterinary Association (BVA); the British Small Animal Veterinary Association (BSAVA); the British

Veterinary Hospitals Association (BVHA); the British Equine Veterinary Association (BEVA); British Cattle Veterinary

Association (BCVA); RCVS Council; the Society of Practising Veterinary Surgeons (SPVS); the Veterinary Practice

Management Association (VPMA); the British Association of Veterinary Emergency Clinics (BAVEC); Veterinary Nurses

Council and the British Veterinary Nurses Association (BVNA) and were approved in principle by RCVS Council on

5 November 2009.

CORE STANDARDS - These standards are relevant to all veterinary practices and reflect mainly legal

requirements which must be met in running a veterinary practice.

GENERAL PRACTICE – The following categories are recognised:-

Small Animal, Equine, Farm Animal and Small Animal Emergency Service Clinic

For Small Animal and Equine practices the standards reflect the requirements of a primary care practice which

aims to facilitate the achievement of high standards of clinical care, and encompass many of the facilities

required for veterinary nurse training (TP) standards.

Appendix 1 gives guidance on additional resources to be provided by a General Practice wishing to apply for

accreditation as a Veterinary Nursing Training Practice. Please note that inspection of these resources and

assessment of the training capabilities of the practice will be carried out by a Veterinary Nursing Approved

Centre (VNAC).

For Farm Animal practices, the standards reflect both the requirements of a primary care practice which

promotes the achievement of high standards of clinical care, and also a proactive approach to management,

through the use of health planning, client training and communication.

For Small Animal Emergency Service Clinics, the standards reflect the requirements of a designated out-of-

hours provider. A Small Animal Emergency Service Clinic must fulfil the requirements for a Small Animal

General Practice and the additional requirements set out in section 10.

A General Practice must meet all Core Standards as well as General Practice standards.

VETERINARY HOSPITAL - the following categories are recognised:-

Small Animal and Equine

For Small Animal and Equine Veterinary Hospitals, the standards reflect the requirements of a General Practice

(above) allied with additional facilities and protocols for the investigation and treatment of more complex cases.

A Veterinary Hospital must meet all Core Standards and General Practice Standards, as well as specific Hospital

Standards.

KEY TO ABBREVIATIONS

C = Core Standards

GP = General Practice

VH = Veterinary Hospital

SA = Small Animal

FA = Farm Animal

EQ = Equine

ESC = Emergency Service Clinic

L = Legislative Requirement

++(FA) = Where this symbol appears the Standard is to be met by GP/FA, if applicable

Production of documentary evidence is required

Guidance notes are highlighted in yellow text

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

1 STAFF

1.1 All the veterinary surgeons and veterinary nurses working for the

practice must be registered with the RCVS and covered by Professional

Indemnity Insurance. Suitably Qualified Persons (SQPs) must provide

evidence of registration with the Animal Medicines Training Regulatory

Authority (AMTRA) appropriate for the product range supplied

(L)

The practice must provide the RCVS registration numbers of all veterinary surgeons

and veterinary nurses working for the practice in any capacity, as well as a copy of

current Professional Indemnity Insurance (covering all vets and veterinary nurses,

including locums and veterinary surgeons from overseas).

1.2 The practice must provide a written statement of the main terms of

employment for all employees (L)

C / ALL

RCVS registration numbers are listed in The

RCVS Directory of Veterinary Practices or can

be obtained direct from the Royal College of

Veterinary Surgeons, Belgravia House,

62-64 Horseferry Road, London SW1P 2AF

T 020 7222 2001 or E [email protected]

and at www.rcvs.org.uk/checkregister.

Registration numbers for RVNs/LVNs can be

found at www.rcvs.org.uk/vnlist.

A “Veterinary Nurse” means a person whose

name is entered in the List of Veterinary Nurses

(which incorporates the Register of Veterinary

Nurses) maintained by the RCVS. Types of SQP

and colour-coding for current IDs can be found on

the AMTRA website www.amtra.org.uk/SQP_types.

html.

All employers are legally obliged to give their

employees a written statement relating to the

terms and conditions of their employment

within two months of starting work. This may be

provided in the form of a letter of engagement

and/or written contract.

The law allows the employer to issue the

written statement in instalments but certain

key information should be included in a single

principal document. These are:

• Names of employer and employee;

• Date when employment began;

• Scale or rate of pay;

Continued on following page...

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

1.2 The practice must provide a written statement of the main terms of

employment for all employees (L)

C / ALL

Continued...

• Pay intervals;

• Hours of work – taking into account the

Working Time Regulations;

• Holiday entitlement, including Public

Holidays;

• Job title;

• Job location.

Instalments added to the principal statement

should include:

• Sickness and injury rules;

• Details of pension arrangements. There

must be provision for a Stakeholder Pension

scheme where there are more than five

employees;

• Length of notice on both sides;

• Disciplinary rules;

• Grievance procedure.

The inspector will ask to see written statements/

contracts for veterinary surgeons, veterinary

nurses and all categories of support staff, but will

respect their confidentiality.

(Please note that the inspector will not be able

to comment on the legal correctness of the

contracts/written statements.)

The BVA provides sample contracts for its

members only. They are freely available to

download in PDF format from their website:

www.bva.co.uk, or contact the Technical

Development Officer at BVA: 7 Mansfield Street,

London W1G 9NQ T 020 7636 6541

F 020 7637 0053.

Continued on following page...

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

1.2 The practice must provide a written statement of the main terms of

employment for all employees (L)

1.3 The practice must provide written job descriptions for all veterinary

surgeons, veterinary nursing and other support staff (L)

C / ALL

Continued...

SPVS has a manual of forms available, including

contracts and terms and conditions.

A Self Help Guide to Producing a Written

Statement is available from ACAS – the Advisory,

Conciliation & Arbitration Service – by contacting

the National Helpline 0845 7474747 or via

www.acas.org.uk or via Head Office - address:

ACAS, Brandon House, 180 Borough High Street,

London SE1 1LW.

An Advisory Booklet Written statement of

employment particulars (PL 700) is available

from most offices of the Employment Service and

Job Centres.

Additional assistance is available from the

Department for Business, Enterprise and

Regulatory Reform T 020 7215 5000;

E enquiries@berr.gsi.gov.uk.

Please note: as requirements may change,

practices should check with individual

organisations that forms/samples supplied are up

to date.

C / ALL

The inspector will ask to see examples of each

type of job description within the practice and

that they are reviewed annually. A job description

exists to define the role of the employee within

the practice, their areas of responsibility and a

clear understanding of their day-to-day duties.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

1.4 The practice must have an equal opportunities policy that is known to

all staff (L)

1.5 The practice must have a non-discrimination policy that is known to

all staff (L)

1.6 The practice must have written requirements for a professional

standard of behaviour, personal hygiene and appearance to be

maintained by all members of the practice at all times. A biosecurity

policy must also be available

C / ALL

A written policy is required which may be part of

the Terms and Conditions of Employment.

C / ALL

A written policy is required.

C / ALL

The inspector will ask to see the written policy

relating to veterinary surgeons, veterinary nurses

and all categories of support staff. This may be

part of Terms and Conditions of employment,

job contracts or a separate Standard Operating

Procedure (SOP). This policy is to help portray a

professional image and comply with Health and

Safety advice.

The practice biosecurity policy should include

disinfection of personal protective equipment and

clothing and cleanliness of vehicles.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

1.7 The practice must have protocols, known to all relevant staff, for

dealing with members of the public

Written protocols required.

The hospital must employ at least one Registered/Listed veterinary nurse, with respon-

GP / ALL

The inspector will ask to see written protocols for

staff dealing with members of the public.

The inspector will ask to see guidelines where

appropriate for such things as:

• Staff induction procedure;

• Client confidentiality;

• Answering the telephone/greeting clients;

• Appointment procedures and recognition of

emergencies;

• Practice policy for home, farm, stable, and

yard visits;

• Complaints procedure;

• Practice arrangements for out-of-hours cover,

referrals and second opinions;

• Practice arrangements for acceptance of

incoming referrals;

• Vaccination, parasite control and neutering

policies (where applicable);

• Prescribing – dispensing policy;

• Systems/training for those assisting a

veterinary surgeon;

• PETS passports, TB testing, exports and other

OV activities.

Where veterinary nurses are carrying out work

under Schedule 3 of the Veterinary Surgeons

Act 1966, the inspector will require evidence

of suitable training. Where suppport staff are

required to assist with clinical activities, the

inspector will ask to see evidence of suitable

training. Evidence may be provided verbally, with

the inspector speaking to a cross-section of staff.

The aim for the future is that the requirement

for employment of Registered/Listed VNs will be

extended to GPs. Also, that SA/EQ Hospitals will

be required to increase the number of Registered

/Listed VNs employed by them.

VH / SA

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

sibilty for nursing in the hospital.

The hospital must employ at least one Registered/Listed equine veterinary nurse.

1.8 Veterinary surgeons and veterinary nurses must undertake Continuing

Professional Development (CPD)

CPD records must be provided for all veterinary surgeons and veterinary nurses in the

practice team to satisfy the RCVS requirements as a minimum.

A written policy encouraging CPD for all veterinary surgeons, veterinary nurses and

VH / EQ

The inspector will ask to see the CPD records of

all the veterinary surgeons and veterinary nurses

showing the details of CPD undertaken. This

must provide evidence that at least the minimum

CPD recommended by the RCVS is being

undertaken. (It is required that Listed Veterinary

Nurses will undertake the same requirements as

Registered Veterinary Nurses.)

For veterinary surgeons, the minimum

requirement is 105 hours over three years (an

average of 35 hours per year). For Registered

veterinary nurses the requirement is 45 hours

over three years. The practice team includes full-

time and part-time employees, as well as locums

and others supplying veterinary services on a

regular or ‘ad hoc’ basis.

C / ALL

GP / ALL

The inspector will ask to see a written policy

encouraging CPD for all veterinary surgeons,

veterinary nurses and clinical support staff.

Up-to-date reference material may be provided

from a range of sources (eg books / e-library)

provided that they are demonstrable to the

Inspector.

While there are no restrictions on the areas of

CPD undertaken by individuals it is expected that

a significant proportion of CPD will be relevant to

the overall types of work undertaken by the both

the individual and the practice as a whole.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

clinical support staff is required, as well as CPD records for all qualified staff.

Suitable up-to-date reference material must be freely available and accessible to all

staff.

The hospital must have at least two certificate holders (one with a component covering

equine surgery) on the veterinary team. Other certificates may be in any discipline

that has an equine component.

A one-year CPD plan must be provided for the hospital team.

It is recognised that where a certificate holder

leaves a practice, some time may be required

for obtaining a replacement. Evidence should

however be provided of the steps taken to ensure

continuity in compliance with this standard.

The aim for the future (2015) is that VH/EQs

will have one Diplomate in Equine surgery to

replace the current Certificate holder; and that

VH/SAs will have at least one Certificate holder

in a discipline appropriate for the workload of the

practice.

VH / EQ

VH / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

1.9 The practice must have in place an annual performance review system

for all clinical staff to monitor and plan development

C / ALL

This would include:

• PDP for newly-graduated veterinary surgeons;

• Developing Schedule 3 skills for veterinary

nurses (if appropriate);

• Developing skills for current and new

equipment and technology.

It is expected that this would inform training

needs and direct future CPD both for individuals

and to meet the overall needs of the practice.

It is expected that members of staff will explain

to the inspector how developmental needs have

been discussed and any issues addressed.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

2 CLINICAL GOVERNANCE & COMMUNICATION

2.1 The practice must have a system in place for monitoring and

discussing the clinical outcome of cases and for acting on the results

The inspector will ask to see some system for monitoring and discussing the clinical

outcome of some common procedures. This may vary from clinical audit reports to

notes of clinical discussion meetings but inevitably starts with some form of record

keeping.

Regular Morbidity and Mortality meetings should be held to discuss the outcome

of clinical cases. Hospitals must be able to produce records of such meetings and

demonstrate any changes in procedures as a consequence of any resultant action list.

Continued monitoring to assess the effectiveness of any changes must be undertaken.

GP / ALL

For all practices:- this is a developing area and

practices should avail themselves of the skills

and information available through individual

organisations such as the BCVA, BVHA, BSAVA,

BEVA, SPVS, VPMA, BVA.

A recommended starting point would be rates of

post-surgical infection and actions taken/ discus-

sion of significant events and resultant action.

Significant events could, for example, include

unexpected reactions/critical incidents/peri-

anaesthetic deaths, but could equally include

positive outcomes.

For FA practices, a starting point might be a

record of outcomes of operations, unexpected

deaths and actions taken.

Auditing of the standard of hospital procedures

is encouraged and may become mandatory in the

future (VHs).

VH / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

2.2 The practice must access and use animal health data from the farms

under their care

Evidence must be available of pro-active farm health management. The inspector will

expect to see the use of farm data.

2.3 The practice must have an effective means of communication with its

clients

The practice will need to demonstrate how it communicates with all, or the majority,

of its clients.

The practice must provide evidence of pro-active communication with clients

• Client training or general meetings to be held at least twice a year;

• Newsletters to clients at least quarterly.

The practice must ensure that the public are aware of the identity of the individuals

involved in the care of their animals.

GP / FA

This may take the form of access to Herd

Companion, Interherd, CIS (Cattle Information

Service) records as well as ready access to farm

records, farm-specific advisory notes for some or

all of the practice clients.

C / ALL

This could be by means of waiting room notices,

newsletters/brochures, invoice messaging, general

mailings, emails, websites or client meetings

and will include at least opening hours/services

provided/contact numbers.

GP / FA

It is acceptable for client training/general

meetings to be held jointly with another

practice(s). The inspector will expect to see

evidence of the meetings/training, for example,

the contents of meetings, issues focused upon,

as well as a record of the key points discussed.

GP / ALL

It would be acceptable for clients to be made

aware of the identity of individuals by such

means as badges/picture boards/websites/

newsletters. The inspector will check that only

Registered and Listed veterinary nurses are

identified as ‘veterinary nurses’.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

2.4 The practice must have a means of monitoring client perceptions and

feedback

The practice must have a means of recording and considering client complaints.

The practice must have a written complaints policy and must keep a record of

complaints received and the responses made.

The practice must have a means of encouraging feedback from clients and acting

upon the results of feedback.

C / ALL

GP / ALL

VH / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

3 OUT-OF-HOURS PATIENT CARE

3.1 The practice must take steps to provide 24-hour emergency cover for

the care of animals of those species treated by the practice during

normal working hours

A veterinary surgeon must, if in practice, take steps to provide 24-hour emergency

cover for those species treated by the practice during normal working hours, including

attending away from the practice premises on the rare occasions when in the

veterinary surgeon’s professional judgement it is deemed necessary.

The inspector will ask to see the written duty rota or formal written arrangement with

an alternative veterinary surgeon/practice and by what means the practice informs

clients of the out-of-hours arrangements. It is acceptable for clients’ initial contact to

be with an automated or remote device such as an answering machine used to give a

duty telephone number.

24-hour emergency cover must be provided by a veterinary surgeon suitably trained in

farm animal practice. A protocol must be available to ensure that back-up is available

if required.

The inspector will ask to see what arrangements are made for surgical emergencies

to ascertain that a suitably trained person would be available to assist in the

administration of a general anaesthetic. (It is recognised that this may not be relevant

for FA practices where the use of general anaesthesia would not be commonplace.)

Initial direct contact with a mobile telephone is not acceptable, unless a back-up

C / ALL

Please refer to the Code of Professional Conduct

and Guidance note 3. While no acceptable

time or distance is specified, as each will be

influenced by local conditions, when making

arrangements for the provision of 24-hour

emergency cover, practices should give

consideration to these factors. Practices should

check carefully that their written contract/

agreement with another practice or Accredited

Emergency Service Centre (ESC) establishes

clearly who is responsible for out-of-hours home

visits, on the rare occasions that such visits may

be necessary.

GP / FA

Back-up may be by telephone/by personal

attendance, as appropriate.

Reliance by a practice on individuals

predominantly working in other disciplines would

not be considered as meeting the requirement

without evidence of ongoing training/levels of

training attained.

GP / ALL

VH / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

landline is used as well. This would mean that incoming calls to the mobile telephone

must be diverted to a landline if the mobile telephone is not answered.

Out-patients

The hospital must make arrangements for the provision of 24-hour emergency cover

either:

By making a veterinary surgeon available 24 hours a day to attend animals on site;

In the case of a SA Hospital, by outsourcing the provision of 24-hour emergency cover

to another SA Hospital or to a designated Small Animal Emergency Service Clinic.

(ESC) (See Section 10).

The inspector will require to see the formal written arrangement entered into between

the SA Hospital and the SA Hospital/ESC.

4 PREMISES AND OUT-PATIENT FACILITIES

VH / ALL

For a practice to provide out-of-hours emergency

cover to a Small Animal Hospital, it must either

be another SA Hospital or an accredited ESC

under the Practice Standards Scheme (ie it must

fulfill all of the GP requirements as well as the

additional requirements set out in Section 10 of

the Manual). All Hospitals must continue to care

for their own in-patients. Accredited ESC status

requires at least one on-duty veterinary surgeon

to “be on the clinic’s premises at all times during

all of the hours of operation of the clinic.” This

does not preclude a veterinary surgeon attending

off-site in the rare circumstances that this may

be necessary. Practices should therefore check

carefully that their contract with an ESC estab-

lishes clearly who is responsible for out-of-hours

home visits, on the rare occasions that such visits

may be necessary on clinical or welfare grounds.

VH / SA

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

4.1 The practice premises must be accessible, well maintained and kept

clean (L/BP)

The premises must be in good decorative order, clean and well maintained so as to

create an atmosphere of clinical cleanliness and efficiency. The premises must be free

of offensive odours, and be kept in an orderly condition. Cleaning Schedules must be

produced on a regular basis and be routinely audited. All parts of the premises must

be adequately lit and ventilated. Adequate storage facilities must be provided. The

area immediately surrounding the premises must be maintained in a clean and tidy

state.

The buildings must be constructed of brick, stonework, or other substantive materials.

The internal walls and floors of in-patient areas must be impervious so as to permit

thorough cleansing and disinfection. The join between the floor and the wall must

have a curved finish to aid cleaning, with the coving being carried at least 75mm up

the wall. All joints in the flooring material or coving must be impervious and finished

flush with the surface. Stick-on coving is not acceptable.

Emergency lighting must be provided to allow the hospital to continue to function in

NOTE: GP requirements set out in sections 4.1/4.2/4.4/4.5/4.7 MARKED ++ (FA)

WILL ALSO APPLY TO GP/FA where practice premises (other than administrative

offices or drugs and other equipment storage facilities) are provided.

C / ALL

The premises must be suitable and adequate for

its intended purpose. Buildings must be heated

to fulfill minimum legal requirements (ordinarily

16ºC), as appropriate.

In the event that this Standard is not met, it is

recommended that a list of decorative shortcom-

ings be written down at the time of inspection.

GP / SA &

.EQ ++ (FA)

The Standards currently only require coving in

“in-patient areas” so that coving in waiting areas,

and consulting rooms is not to be insisted on.

VH / ALL

Both emergency background lighting to

enable safe evacuation of the premises and

an uninterruptable source of light/power for

completing surgery, in the event of a power

failure, are required.

If powered lifts are used in equine practices it is

essential that emergency power or an alternative

mechanical means of lifting is available to

ensure the ability to lift/move the patient upon

completion of all procedures.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

the event of a power cut or electrical failure. Additional emergency power/lighting, to

permit the completion of essential tasks such as operative surgery, must be provided

by a back-up generator, portable rechargeable lighting units, uninterruptable power

supplies or similar devices. Simple torches are not sufficient as emergency back-up in

operating areas.

Adequate temperature regulation must be available for efficient functioning of the

hospital staff and equipment.

Heating may be required so that the ambient temperature can be maintained above

18 degrees Celsius in the working area of the building. In addition, cooling may be

required to avoid working temperatures exceeding 26 degrees Celsius. Maximum/

minimum thermometers must be provided and records kept.

There should be adequate back-up power supply to enable intraoperative radiography

to be performed.

4.2 The practice must provide a waiting room or reception area of

adequate size, with sufficient seating, for the normal caseload of the

practice. Staff must have access to appropriate staff amenities (L/BP)

Office and reception facilities must be provided which are easily accessible to clients

VH / EQ

C / ALL

The inspector may ask to see the appointment

diary or enquire about the busiest times to assess

if the waiting room or reception area is adequate.

Appropriate staff amenities should include toilets

and handwashing facilities.

Staff refreshments must not be prepared in

clinical areas.

GP / SA &

.EQ ++ (FA)

It is acceptable for these to be available “on

request” on an ad hoc basis. No general signpost-

ing is required.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

and staff as appropriate. Sufficient telephone capacity and reception staff must be

provided to meet the workload of the practice.

Toilet and washroom facilities must be available to staff and clients and maintained in

a clean and orderly manner. These do not need to be separate facilities.

The inspector will require to be satisfied that arrangements are in place suitable for

the workload of the practice for clients to contact the practice, book appointments

and arrange visits.

The waiting area must be designed to encourage reasonable separation of dogs, cats

and other predator/prey species, and nervous animals.

4.3 Any other commercial businesses run from the practice must be of an

acceptable professional nature

The display of commercially retailed merchandise within the veterinary premises shall

be permissible, provided the display is of an acceptably professional nature and of

relevant goods. Medicines must not be available for self-service except those with a

category AVM-GSL.

There must be separate accommodation for hospital patients and animals being

groomed. Any boarding or grooming business must be separate from hospital facilities.

Public areas (waiting room, reception, public toilets) and staff facilities (rest-room,

toilets, offices) may be shared.

4.4 Where consultations are carried out at the premises, the practice must

have one or more consulting areas, which provide a clean, hygienic

environment for consultations in private

The consulting area may be used for other purposes, provided that hygiene is not

compromised.

A stretcher or trolley must be provided for the safe transportation of heavy animals.

GP / FA

VH / SA

Where absolute separation cannot be achieved,

a protocol for achieving separation as necessary

should be available.

C / ALL

VH / SA

C / ALL

C / SA

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

There must be an adequate number of examination rooms. The size and number of

examination rooms must be sufficient for the normal workload of the practice. There

must be sufficient space for the veterinary surgeon, nurse, patients and client(s).

Privacy must be ensured by adequate soundproofing, and must allow complete closure

from the public (ie doors and windows that close, windows with blinds).

The area used for unloading, loading and examination of large animal patients must

be able to be secured to prevent escape of the patient.

There must be appropriately designed facilities in which detailed examinations of

horses, as well as diagnostic procedures such as diagnostic analgesia, radiography,

ultrasonography and endoscopy can be performed. An area suitable for trotting and

lunging horses must also be available.

An appropriate area out of sight of the general public must be available for the safe

euthanasia of horses.

A facility for the unloading of emergency cases close to the examination/induction

area is essential. A loading ramp must be available in a quiet secure area for non-

emergency cases.

A covered area suitable for farriery must be available at the practice.

A trot up area, which must be dedicated, level, firm and 25 metres long, and a firm

area for lunging horses, must be available on site. An all-weather exercise area must

also be available on site.

4.5 The floor area and table in the consulting area must be made of

GP / SA ++

.(FA)

“Consultation Area” for Farm Animal Practices

could, in certain circumstances be the “back of a

truck”. However, if animals are being off-loaded

(and not examined on-trailer) - the area must be

secure. It would be acceptable to tailgate into a

building so long as the vehicle was driven right

up to the building. If unloading takes place into

an open car park, there must be a gate to close

off the car park.

GP / EQ ++

(FA)

GP / EQ

Please note: for GP/EQs the area for trotting and

lunging need not be on the pratice premises so

long as it is available.

VH / EQ

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

materials suitable for thorough cleaning and there must be adequate

washing and disinfection facilities

The floor finish must be such as to reduce the risk of the patient slipping and/or

falling. Every examination area must have a hand basin available for use by staff and

clients either within or immediately adjacent to the consulting area. Procedures must

be in place to minimise cross-infection in clinical areas. Particular attention should

be paid to high contact areas such as phones/door-handles/keyboards and clinical

equipment used. Each room must have facilities for safe disposal or sharps, hazardous

and non-hazardous waste.

There must be a hand basin within each consulting area available for use by staff and

clients.

4.6 Basic diagnostic and surgical equipment, appropriate to the practice,

must be readily available in the consulting area(s) (BP)

A minimum of a stethoscope, thermometer, ophthalmoscope and auroscope must be

available in the practice, which may be shared between consulting areas.

At least the following must:

a. be present in each vehicle: stethoscope, thermometer, foot-trimming equipment,

basic obstetric equipment, flutter valve and basic surgical equipment, waterproof

boots and outer clothing and a means of disinfection after each visit.

b. be otherwise available: sterile operating kits appropriate for the species and

procedures generally encountered and in date equipment for the collection and

storage of laboratory specimens.

Stomach tubes and shoe removing/hoof kit must be available, as well as sterile

operating kits for procedures generally encountered and in-date equipment for the

collection and storage of laboratory specimans.

Minor surgical instruments such as scissors and forceps must also be available. An

X-ray viewer must be easily available within the out-patient area.

Equipment for the measurement of systolic blood pressure must also be available.

This may be measured by oscillometric or Doppler methods.

GP / SA &

.EQ ++

VH / SA

C / ALL

C / FA

It is accepted that equipment in each vehicle

may vary depending on the species treatment, so

that, for example, the needs of a poultry practice

will differ from a cattle practice. Equipment must

be appropriate for the range of species treated by

the practice.

GP / EQ

GP / SA ++

(FA)

VH / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Equipment for the measurement of intraocular pressure must be available. This may

be measured by Schiotz tonometer or by electronic methods.

Suitably constructed stocks for the restraint of patients are required.

4.7 There must be adequate ventilation and lighting in the consulting

area, as appropriate to the work undertaken

At least one examination area must be able to be darkened.

4.8 The practice must have a means of estimating the weight of species

routinely treated

Charts must be available.

Weigh tapes/bands or scales must be provided.

Scales must be provided to allow accurate weighing of the full range of species

routinely treated. The weight of all patients to be anaesthetised must be routinely

recorded.

4.9 Likely charges must be discussed with clients and updated as

necessary

Discussion should take place with the client covering a range of treatment options and

prognoses, and the likely charges (including ancillary or associated charges and likely

post-operative care) so as to ensure that the client is in a position to give informed

consent. The practice must be able to provide written estimates on request.

4.10 Itemised invoices must be available at the request of the client

VH / SA

VH / EQ

C / ALL

GP / SA &

.EQ ++

C / ALL

For example, standard weight tables.

GP / EQ

VH / EQ

GP / SA &

C / ALL

The inspector will ask to see how fee estimates

are generated and what procedures are in place

to update and inform clients of ongoing costs.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Itemised invoices may be produced by computer or manually and must include a

breakdown of services, drugs and consumables, VAT and any surcharges.

4.11 The practice must maintain an efficient system of documenting and

filing clinical records and comply with the Data Protection Act

(L)

Where appropriate, records must be maintained for each animal or herd. There must

be adequate back-up for computerised records.

An efficient system of recording, filing, and locating records must be in operation.

C / ALL

The Data Protection Act 1998 (as amended) sets

out eight enforceable principles of good practice

with which all organisations processing personal

data, even if exempt from notification, must

comply. These require data to be:

• fairly and lawfully processed;

• processed for limited purposes;

• adequate, relevant and not excessive;

• accurate;

• not kept longer than necessary;

• processed in accordance with individual’s

rights;

• kept secure;

• not transferred to other countries without

adequate protection.

Practices may be exempt from notification if

they are processing data only for the following

purposes of their own business:

• accounts and records;

• staff administration;

• contacting own clients.

Evidence of registration under the provisions of

the Data Protection Act (if appropriate) should be

provided.

C / ALL

Different organisations (eg Veterinary Defence

Society/Veterinary Medicines Directorate/

HM Revenue and Customs) will have different

requirements for the length of time records

should be kept. Practices should check

directly with these organisations for up-to-date

information.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Records must be maintained so that any veterinary surgeon coming into the practice

may, by reading the records, be able to proceed with the continuity of care of the

patient.

Complete records must contain the following information, where applicable:

• Owner identification - name, address, contact telephone numbers;

• Patient identification - name, species, breed, colour, age, sex, radio frequency

identification device or tattoo number and weight (re FA – individual animal

identification may be useful and held by the practice but is not compulsory);

• Dates - of all examinations, investigations, and treatments;

• Clinical information – history and details of clinical examination, investigations,

provisional diagnosis and treatments;

• Vaccinations - batch numbers and dates (re FA – All treatments – batch numbers

and dates)

• Special considerations – abnormal drug reactions by patient or client, concurrent

clinical conditions;

• Repeat prescriptions – authorisation and review date;

• External communications – referrals, lab reports;

• Consent forms and estimates.

There must be facility for easy referral of patients from a branch surgery to the full

facilities available at a hospital. The clinical records system must be capable of

passing patient records between branches and the hospital.

Records must also include therapeutic and nursing plans.

4.12 Vehicles routinely used for practice must be clean and well maintained

GP / ALL

VH / ALL

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

and equipped sufficiently to enable basic procedures to be performed

at the client’s premises

The contents must be organised in such a way to give the appearance of

professionalism and enable the medicines carried to be stored according to the

manufacturers’ recommendations.

There must be clear segregation of clean and contaminated items and protective

clothing and safe storage and transport of waste materials, including sharps.

The inspector will view as many vehicles as practicable to be reasonably sure that this

Standard is met.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

5 IN-PATIENT FACILITIES

5.1 When animals are admitted for any diagnostic or surgical procedures,

informed consent must be sought

The inspector will require to see evidence that informed consent is sought for all

procedures.

Signed consent forms are required for all procedures when a patient is admitted to

the care of a veterinary surgeon. This will include: diagnostics, medical treatments,

surgery and euthanasia.

5.2 In-patient facilities must be secure, in good condition and sufficient

for the workload of the practice

Any in-patient facilities must be of a suitable size, securable, sturdy, escape-proof,

without potentially injurious faults and easily cleanable. A range of bedding, feed

stuffs and clean fresh water must be available.

Washing and disinfectant facilities must be provided for staff in the kennels annd

cattery.

Dirt trays, absorbent litter and adequate cage space are required for feline in-patients.

Sanitary facilities for ambulatory canine in-patients must be provided. These may be

outside and precautions must be taken to prevent the escape of animals.

Feeding equipment must be disposable or regularly disinfected.

NOTE: ALL GP requirements set out in sections 5.1/5.2/5.3/5.7/5.8 and marked

++(FA) WILL ALSO APPLY TO GP / FA PRACTICES if inpatient facilities are provided).

C / ALL

For further information, see Code of Professional

Conduct and Guidance note 11 and the

Veterinary Defence Society website:

www.veterinarydefencesociety.co.uk

GP / SA &

.EQ ++ (FA)

“Admitted” means where an animal is in the

care of the veterinary surgeon and is outwith the

presence of the owner.

C / ALL

C / SA

The expectation is that each ward area will have

its own sink located in the ward. Where this is

impossible, and the nearest sink is located in

an adjacent room, then consideration must be

given as to whether the room in which the sink

is located is in a ‘clean’ or a ‘dirty’ environment.

As ‘dirty’ procedures are done in the ward area,

it would generally be unsuitable for the sink

or access to it to be via a clean environment.

Additionally, consideration must be given to the

touching of the door handles; it would not be

acceptable for staff to use their hands to open a

door to access a sink in the adjacent room.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

There must be the ability for hospitalisation of the full range of species routinely

admitted.

There must be a range of accommodation of a suitable size for the number and

species routinely treated. There must be adequate heating, lighting and ventilation of

this area. A suitable range of bedding materials, feeding utensils and sanitary facilities

must be provided. There must be suitable provision for the storage and preparation of

food. A range of diets must be available to meet the needs of in-patients and stored

appropriately.

The inspector will ask to see the daily surgery log and appointment list to correlate

with in-patient facilities available.

Washing, disinfection and food storage facilities that are separate from those in the

clinical areas, must be provided for staff.

Equipment that will be in contact with the patients must be chosen to minimise the

risk of cross-contamination or exacerbation of any clinical condition.

There must be a positive means of identifying the patient while on the premises. This

may involve tagging the patient and/or well-identified accommodation.

Facilities to maintain body temperature (eg heat pads) must be available.

Facilities to provide supplementary oxygen must be available.

Re: GP/SA - Suitable cages must be available for

day hospitalisation. It is acceptable for patients

requiring overnight hospitalisation to be trans-

ferred elsewhere, where it is in the interests of

the patient.

Re: GP/EQ – At least one stable suitable for

accommodating horses overnight must be

available.

GP / SA &

.EQ ++ (FA)

GP / SA &

.EQ ++ (FA)

GP / SA ++

(FA)

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

There must be a minimum of six kennels or cages for the hospitalisation of patients.

Towels, blankets, or acrylic bedding materials must be provided. The kennels or cages,

and their fittings, must be made of non-permeable materials so as to be easily cleaned

and disinfected. Where dogs are treated there must be at least one large kennel

suitable for a giant breed of dog together with a good range of smaller kennels and

cages. At least one cage must be of the walk-in type. There must be no overcrowding.

Newspaper alone is not considered a suitable bedding material for overnight stay

patients.

There must be the ability to cater for the full range of species treated and species

segregation where appropriate. In particular, consideration must be given to separation

of prey and predator species.

Facilities must be provided for the bathing, grooming, and drying of in-patients.

Heat pads must be available for in-patients. Sanitary facilities for ambulatory canine

patients must be provided indoors, under cover or outside within the site boundary.

Suitable facilities for neonatal care must be provided.

There must be provision for the cooking of fresh food for in-patients. Refrigeration is

necessary for storage of fresh foods.

There must be a minimum of six stables. Stables must be made of non-permeable,

durable material to allow easy cleaning. There must be a stable of suitable size to

accommodate a mare and foal.

There must be facilities for adequate, hygienic, safe storage and disposal of bedding.

Ready access to an exercise yard or paddock of suitable size must be provided with

safe and well-maintained fencing.

Facilities must be provided for the routine washing, grooming and handling of

patients.

VH / SA

VH / EQ

See section 4.4 GP / EQ – the lunging area

referred to may double as the exercise paddock.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

5.3 The practice must provide facilities and adequate nursing staff for the

care of any in-patients

The practice must have a written policy for the overnight care of in-patients detailing

who is responsible, frequency of checks etc. The owners must be informed of the level

of overnight supervision during an overnight stay.

All hospitalised animals (other than short/routine surgical procedures admitted as day

cases) must have in-patient sheets recording basic husbandry parameters, with timed

and initialled entries:

• Temperature;

• Pulse;

• Respiration;

• Treatments;

• Food and water intake;

• Urine and faeces output;

• Clinical signs;

C / ALL

The inspector will ask to see what arrangements

are made for the care of in-patients (if

applicable) including information given to

clients regarding the level of care given. This

may include a written duty rota for a nurse or

veterinary surgeon on call to regularly attend the

practice or for the transfer of in-patients to a

more appropriate practice.

Practices are encouraged to use Registered/Listed

VNs to provide the nursing care of in-patients

whenever possible.

The inspector will wish to be satisfied that all

post-op cases are being monitored until dis-

charged from the premises.

GP / SA &

.EQ ++ (FA)

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

A person directly responsible for the nursing care of in-patients must be within the

curtilage of the site at all times. There must be a minimum of daily examination of all

in-patients by a veterinary surgeon, which should be recorded on the hospital records.

There must be residential accommodation or other arrangements so that a veterinary

surgeon, veterinary nurse or an adequately trained member of lay staff is present on

the premises 24 hours a day, every day of the year. There must be reasonable and

secure night-time access from the residential accommodation to the hospital facilities

(it is not acceptable for staff members to have to step on to a public highway); 24-

hour continual nursing attention must be available, if needed, for in-patients, and a

veterinary surgeon must be available 24 hours a day to attend in-patients.

5.4 The practice must provide separate accommodation for the isolation of

infectious and zoonotic cases or have a written policy for dealing with

such cases that is known to all members of staff

The inspector will expect to see a Standard Operating Procedure (SOP), which details

the procedure for isolation and care of infectious cases. Either separate isolation

facilities must be provided along with the SOP, or, if such facilities are not available,

there must be a detailed SOP for isolation of infectious cases, including barrier-

nursing requirements.

Staff must be trained to implement the SOP, which must include:

• Details of waste disposal;

• Protective clothing to be worn;

• Disinfection of all utensils/equipment and accommodation;

• Designated persons to be responsible;

• Reference to COSHH and Health and Safety information pertaining to the risks of

dangerous pathogens and zoonoses;

• Clear information regarding the demarkation of the isolation area.

Evidence of the monitoring and up-to-date

hospital records will be looked at.

For hospitals, a veterinary surgeon or other

responsible person (not necessarily, but prefer-

ably a Listed/Registered VN or enrolled student

VN) should be on the premises 24/7 in order to

meet public expectations for a hospital. It is not

acceptable only to have a presence on the

occasions when there are in-patients already in

the building.

VH / ALL

C / ALL

Where truly separate and self-contained isolation

facilities are not available, there must be a

detailed SOP setting out how infectious cases are

to be dealt with or referred elsewhere. Sending

patients home is insufficient.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

A hospital must have the ability to isolate an infectious animal from all other patients.

Isolation facilities must have:

• Hand-washing facilities;

• Separate air space;

• Ventilation that produces a negative air pressure in the facility to reduce the risk of

cross-infection;

• Separate drains to avoid cross-infection.

Isolation facilities can mean either a special area to which access is limited or a

separate ward. It is recommended that there is a written policy, which details the

procedure for isolation and care of cases including barrier-nursing requirements. The

written policy must be available to relevant staff who must be fully conversant with its

contents.

Isolation facilities must be provided.

5.5 The practice must provide a range of intravenous fluids, suitable

administration sets and catheters for those species routinely treated

Intravenous fluids must include blood volume expanders and crystalloids. There must

be the ability to deliver controlled small qualities of intravenous fluids (eg Burettes).

There must be the ability to provide close control of fluid replacement by an infusion

pump or syringe driver suitable for infusion of high volumes rapidly or low volumes

slowly. Facilities for blood transfusion must be available.

Provision must be made for continuous administration of intravenous fluids at an

appropriate rate.

VH / SA

In ward areas, ventilation could be arranged for

air to be drawn from cleaner areas to isolation or

contaminated areas and thence extracted from

the building. The underlying principle is that the

risk of any cross-infection should be minimised,

therefore airflow should be from “clean” to

“dirty” areas, rather than “dirty” to “clean”.

VH / EQ

The isolation box should be separate from the

general-use boxes, and must not be a stable

within an American barn set up where the air

space is shared. It could possibly be on the

end of a row of externally-opening stables but

it should open in the opposite direction to the

others. It must not share air space with the other

boxes (ie walls must extend to the ceiling all

round), must not drain into a common area and

must be accessible for all purposes (treatment,

feeding, mucking out etc) without crossing the

general stable or treatment area. There should be

separate PPE, tack and mucking-out equipment

and access to the box must be restricted to

limited personnel who must wear protective

clothing. There should ideally be separate

handwashing facilities.

GP / SA

VH / SA

VH / EQ

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

5.6 Area used for the conduct of surgical procedures

This area must have easily cleanable surfaces and a good source of illumination.

The operating theatre must be available for the conduct of sterile surgery at all times

– it must not double up as a consulting room. It must only contain equipment for use

in surgical procedures and X-ray equipment. There must be a written procedure for

the maintenance of a surgically clean environment. A separate preparation area for the

clipping of patients must be provided. There must be an adjustable-height operating

table. Scrub facilities must be separate from ward washing facilities. Lighting

suitable for the accurate illumination of surgical sites on the patient must be provided

in the theatre.

A means for displaying radiographs must be available in the theatre.

The induction of, and recovery from, general anaesthesia are high risk for both

patient and handler. If undertaken, there must be an area that is appropriate for

the procedures to be undertaken, bearing in mind patient and handler safety. The

induction area can also be the operating area providing surgical cleanliness/sterility is

not compromised and is appropriate for the procedure undertaken.

A suitable and safe system of transporting horses between the operating area and the

induction/recovery area (if different) must be available.

C / ALL

A separate area for clipping does not mean that

a practice has to have a separate room used

exclusively for preparation purposes. The clipping

area may be situated in a room that has another

function; it cannot, however, be in the operating

theatre.

An autoclave can be placed in an operating

theatre, provided that there is a suitable SOP for

maintaining asepsis.

Endotracheal tubes should not be stored on the

wall of the operating theatre. Anaesthetic circuits

are permissible.

GP / SA

A laptop or mobile X-ray viewer or digital display

screen would be acceptable.

GP / SA ++

.(FA)

GP / SA ++

.(FA)

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

A preparation room must be provided, separate from the operating theatre, for the pre-

operative preparation of surgical patients. Scrubbing-up facilities must be provided,

with suitable elbow, foot, or electric-eye operated taps. The scrubbing-up facilities

must be separate from those provided for cleansing and disinfection and adequately

screened from the operating table(s).

At least one operating theatre of adequate size must be provided and used only for

the conduct of surgical operations. Such operating theatres shall not be used for the

pre-operative preparation of patients, or for any purpose which could compromise their

use for aseptic surgery.

The operating theatre must be a closed room with no through traffic. There must

be no clear view of the interior of the theatre by the general public from outside the

premises. Doorways must be sufficiently wide for access into the theatre by trolleys.

Where possible, all fittings in the theatre must be flush with the walls and ceilings.

Orthopaedic operations must be performed as the only procedure in the theatre (at any

one time).

Electrosurgery and suction must be available for surgical use. There must be a high

standard of surgical asepsis (eg surgical gloves must be worn during all aseptic

procedures). All personnel must wear scrub suits and hats in the theatre and no

outdoor shoes or clothing are allowed. Consideration must be given to the order in

which procedures are undertaken, with those most likely to introduce contamination

being done last.

A clock with a sweep second hand must be visible from within the operating theatre.

Lighting suitable for the accurate illumination of surgical sites on the patient must be

provided in the theatre. This lighting must continue to function in the event of loss of

power. An operating lamp must be supplied by an uninterruptable power supply or a

generator sufficient to complete a surgical procedure.

There must be a provision for performing aseptic intra-operative radiography.

VH / ALL

The inspector may want to observe a surgical

procedure.

A written protocol for maintenance of asepsis

should be produced.

VH / EQ

Continuous lighting which is suitable to complete

operative surgery must illuminate automatically

in the event of power failure.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

An operating table of adjustable height, and capable of holding the patient in a tilted

position, must be provided in the operating theatre.

Provision must be made to remove a horse from the operating table in case of winch

failure.

5.7 The practice must have equipment for the administration of oxygen

and the safe maintenance of anaesthesia

Equipment for the administration of oxygen and the safe maintenance of anaesthesia

and resuscitation must be appropriate for the species treated.

There must be adequate facilities for the induction and maintenance of general

anaesthesia in the full range of species routinely treated. Equipment must be

available for the maintenance of body temperature during anaesthesia and recovery.

A range of endotracheal tubes must be available. Anaesthetic circuits suitable for

the range of patients routinely treated must be provided. Circuits must include a

circuit suitable for small patients such as a T-piece, a circuit suitable for medium-

sized patients, such as a Lack or a Bain, and a circuit suitable for a giant breed of

dog such as a circle unit, or a high flow rate mechanism for a non-rebreathing unit.

There must be a source of oxygen and emergency oxygen flush with reducing valve,

rotameter and vaporiser. Temperature-compensated vaporisers must be used. The use

of uncompensated vaporisers is not permitted except when used in-circuit such as in

the Stephen’s machine.

There must be suitable means of resuscitation. A resuscitation pack must always

be maintained and be readily available for instant use, and checked to ensure the

contents are in date.

VH / SA

A tilting table is advised but not compulsory at

this stage, as long as other means of tilting are

available.

VH / EQ

C / ALL

GP / SA &

.EQ ++ (FA)

GP / SA ++

(FA)

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

A range of induction and maintenance agents must be stocked to permit anaesthesia

of all patients treated including the high risk patient. There must be adequate primary

and reserve supplies of oxygen.

There must be adequate means of supportive therapy under anaesthesia. Facilities for

lengthy intermittent positive pressure ventilation must be provided.

5.8 The practice must provide suitable monitoring for anaesthetised

patients

A veterinary surgeon should administer general anaesthesia if the induction dose is

either incremental or to effect.

A member of staff adequately trained in monitoring patients under general anaesthetic

must be present throughout the procedure.

A trained member of staff, other than the surgeon, must be present to monitor

the patient throughout the general anaesthetic. Evidence of suitable training must

be provided if the member of staff is not a Listed/Registered veterinary nurse.

Anaesthetic charts must be filled in for each patient (except in emergency or for very

short procedures (eg cat castrate).These charts must form part of the clinical records.

Also:

• at least one other monitoring device must be available eg oesophageal

stethoscope, pulse oximeter, capnograph, ECG.

• The charts must include:

* Date;

* Personnel involved;

* Induction agent;

* Maintenance agent;

* Duration of anaesthetic;

* Surgical procedure;

* Any anaesthetic complications;

* Vital signs.

Mechanical ventilation is required for EQ

Hospitals. It is not, however, a requirement for

SA Hospitals. These must be able to provide IPPV

for as long as is necessary and must be able to

demonstrate to inspectors how this is undertaken

safely, whether mechanically or manually.

VH / ALL

C / ALL

GP / SA

In-house training is acceptable, but must be

evidenced to the inspector. The inspector will

wish to speak to those put forward as having

competency in anaesthestic monitoring.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

All general anaesthesia must be induced and maintained by an MRCVS. Anaesthetics

lasting more than an hour must be adequately monitored by a veterinary surgeon and

must include monitoring by direct arterial blood pressure measurement and ECG.

Monitoring must be available including pulse oximetry and capnography, blood

pressure measurement facility, and oesophageal stethoscope. Records of vital signs

and agents employed must be retained. Evidence of staff training in the use of

monitoring facilities must be provided.

There must be adequate post-anaesthetic monitoring. An anaesthetic monitoring

room or area must be available and records must be maintained until the animal

has recovered. Proper ventilation must be provided to limit staff exposure to exhaled

gases.

5.9 There must be a programme of regular care and maintenance of

anaesthetic equipment (L/BP)

Anaesthetic equipment must be subject to professional maintenance according to the

manufacturers’ recommendations. Regular service records must be produced for all

anaesthetic equipment.

5.10 The practice must provide facilities for the scavenging of anaesthetic

gases (L)

Scavenging must comply with current health and safety laws.

Facilities for scavenging include any device or ducting system for the removal of waste

gases from the operating area:

• Passive scavenging – by duct to the open air;

• Charcoal absorbers – eg Aldosorb;

• Active scavenging – via a pump and air break device.

GP / EQ

VH / SA

The criteria should not be interpreted to imply

that every piece of monitoring equipment is

required for every operation. What is required

should be based on a risk assessment and will

depend on the number and nature of operations

performed – practices should ensure that

equipment provided is adequate for the work

actually undertaken.

VH / ALL

C / ALL

The inspector will ask staff how equipment is

checked before use on a daily basis.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

5.11 The practice must carry out monitoring of anaesthetic pollutants in

operating areas and maintain written records of this (L)

Written evidence of measurement of personal exposure to anaesthetic monitoring is

required. Monitoring must be carried out on an annual basis, or if the nature of the

anaesthetic equipment and circuitry is changed.

Inspectors will check that the readings recorded fall within the current Workplace

Exposure Limits for the agent(s) used. These are currently:

10ppm Halothane

50ppm Isoflurane

60ppm Sevoflurane

100ppm Nitrous oxide

All these values are subject to review and are calculated on an eight-hour Time

Weighted Average (TWA) basis.

If a sophisticated active scavenging system is in operation, it must be serviced

annually. An inspection certificate must be available and is an acceptable alternative

to personal dosimetry.

5.12 The practice must have disinfection and/or sterilisation facilities

suitable for the work undertaken

There must be adequate facilities for sterilisation, and a recognised method of

sterilisation must be employed.

The practice must provide an autoclave, vacuum or non-vacuum or other recognised

sterilisation systems, for the effective sterilisation of instruments and equipment.

Sterile gloves and gowns must be available and used where appropriate.

Appropriate external and internal sterility indicators for the system employed must be

used to monitor the efficiency of the technique.

C / ALL

External sterility indicators should be employed

in all instances; internal and external indicators

are necessary in wrapped/bulky packs. (Internal

indicators are not required for single instruments/

non-bulky packs).

GP / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Sterile packs must be provided in sufficient quantity to meet the workload of the

practice.

Sterile packs must have the sterilisation date marked on them, and there must be a

written practice policy on when re-sterilisation will be required.

Vacuum autoclaves are compulsory.

Vacuum autoclaves are compulsory for wrapped packs/drapes.

5.13 The practice must provide a range of suitable surgical instruments and

suture materials for the work undertaken

Sterile packs for emergency surgery must be available at all times.

Surgical instruments must be provided for the following types of procedures:

• General;

• Dental;

• Ophthalmic.

Orthopaedic surgery, including facilities for the repair of fractures.

Orthopaedic instrumentation must include arthroscopic and internal fixation

equipment.

5.14 There must be a Written Scheme of Examination for all autoclaves

within the practice, as required under Pressure Systems Safety

Regulations (2000). A current certificate of inspection must also be

available (L)

For autoclaves and dental compressors greater than 250 bar litres, a separate Written

Scheme of Examination and Certificate of Inspection are required.

GP / ALL

VH / EQ

VH / SA

C / ALL

GP / ALL

VH / ALL

VH / SA

VH / EQ

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

A Written Scheme of Examination must be titled as such, and must specify how and

when the autoclave(s) must be inspected. Practices must also have a Certificate of

Inspection under the regulations. It will be titled Certificate of Inspection under the

Pressure Systems Safety Regulations (2000).

5.15 Provision of dental equipment

If the dental machine has a compressor greater than 250 bar litres it requires a

written Scheme of Examination.

A selection of hand scalers, curettes, periodontal probes, elevators and/or luxators

must be available suitable for the range of species to be treated.

The instruments must be sharp and evidence of training of staff in the proper use,

sharpening and instrument care must be available. Personal protective equipment

should include aprons, face masks, goggles and disposable gloves.

A range of angled and straight hand held rasps and a gag must be available.

Facilities must be available to mechanically scale and polish teeth.

Facilities must be available to mechanically section teeth and perform surgical

extractions. Suitable cooling water must be available at the operative site. High speed

air driven dental hand pieces are recommended. Electrically driven hand pieces may

be used.

Suitable facilities for performing rabbit dentistry should be available (Including

suitable gags, anaesthesia, rasps). Rabbit incisor teeth should be mechanically

trimmed. Clipping the teeth would not be considered acceptable.

Only pressure vessels over 250 bar litres

are covered by the Pressure Systems Safety

Regulations (2000). All autoclaves would come

into this category and each would require both a

written Scheme of Examination and Certificate of

Inspection. Dental machines are unlikely to work

at such high pressure and so are usually exempt

from the provisions.

NB - A service is not necessarily an inspection

under the regulations, and a note of the last

service is not a written Scheme of Examination.

A Written Scheme may be obtainable from the

manufacturers.

C / ALL

C / EQ

GP / SA

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Proper dental records and treatment charts must be maintained. Suitable summaries

must be made on the patient main record.

Measures must be employed to reduce aerosol contamination of other areas, especially

the sterile operating theatre.

Dentistry must never be performed in surgical theatres. Suitably-powered air extractors

in the dental area will be of assistance.

The use of sterilised dental packs for each procedure is expected.

Suitable facilities to obtain dental radiographs must be available. This will require the

use of intra-oral and non-screen films or digital facilities.

Motorised dental equipment and evidence of training in their use must be available.

GP / SA

Specific measures to prevent contamination

beyond the immediate dental area must be taken.

These might include use of suction tips close to

the operating head of scalers and dental hand

pieces, an extraction fan close to the operating

site or ideally a dedicated dental procedure room

with negative pressure ventilation.

VH / SA

VH / EQ

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

6 DIAGNOSTIC EQUIPMENT AND FACILITIES

6.1 The practice must:

Provide ultrasonographic equipment capable of acquiring good quality images of the

flexor tendons of the distal limbs, superficial structures and per rectum images of the

ovaries and uterus.

Provide (or demonstrate an ability to access where necessary) ultrasonic equipment for

the full range of species treated.

Provide an ultrasound system capable of providing diagnostic quality images of the

full range of species treated.

Provide electrocardiography equipment producing a recordable trace suitable for

taking measurements.

Electrocardiography Recordings (ECG) must be suitably filed and stored. Use of a

remote diagnostic facility is acceptable.

Facilities must be available for bone marrow aspiration.

Endoscopes must be provided to allow diagnostic investigation of the upper and lower

digestive tract and upper airway/trachea of appropriate species.

A pair of biopsy forceps must be available.

GP / EQ

Evidence must be provided of training or CPD for

staff in use of the equipment. Reference material

must be available.

GP / SA

VH / SA

VH / ALL

Evidence must be provided of training or CPD for

staff. Reference material must be available.

It is recognised that there are few courses for

endoscopy. “In-house” training could be provided

by one individual in a practice to another. In

this case the approach accepted would be that

competency should not be purely taken on trust

and that more will be expected in the inspection

process. The inspector will wish to speak to those

put forward as having competency in endoscope

use, and depending upon the responses given, for

the inspector to decide upon what (if any) further

issues might be raised (eg look at what reference

material is available, look at evidence of use by

reference to clinical cases).

VH / SA

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Diagnostic ultrasound will require sector and linear transducers with a frequency range

of 2.5 to 7.5 MHz. A recording system for images must be available.

Endoscope(s) of an appropriate quality suitable for the workload of the hospital must

be provided. A pair of biopsy forceps must be available.

6.2 X-ray facilities

Evidence must be provided of diagnostic quality radiographs of all parts of the range

of species treated. There must be sufficient provision for the non-human physical

restraint of SA patients during radiography and regular inspection of safety equipment

must be recorded. Sufficient means of mechanical restraint must be provided for the

range of species treated. Core SA/EQ practices must be able to demonstrate what

system/procedure/protocol is in place if a patient requires an X-ray and this facility is

not available within the practice.

There must be X-ray facilities suitable for the range of species routinely treated.

Equine practices must have equipment to X-ray distal limbs.

Radiographic facilities must be suitable and adequate for the needs of the hospital

and be readily available at all times.

It must be possible to obtain diagnostic radiographs in adult horses of the head, the

cervical and thoracic spine, the chest, the fore and hind limbs including shoulder,

pelvis and stifle.

VH / EQ

C / SA / EQ

For an individual premises (branch or main

practice) to be accredited as a GP there must be

X-ray facilities actually available on site in those

premises.

GP / SA

The equipment and a competent radiographer

must be readily available at the practice at

all times; it cannot be available intermittently

through, for example, an external provider.

GP / EQ

VH / ALL

VH / EQ

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

6.3 A suitable and sufficient assessment of the risks of ionising radiation

must be made for the purpose of identifying the measures to restrict

exposures to employees and other persons (L)

The risk assessment must be sufficient to demonstrate that:

• All hazards with a potential to cause a radiation accident have been identified;

• The nature and magnitude of the risks have been evaluated.

Where the risk assessment shows the existence of a risk of a reasonably foreseeable

radiation accident, the radiation employer shall take all reasonable steps to:

• Prevent any such accident;

• Limit the consequences of any such accident;

• Provide employees with such instruction and training as is necessary to restrict

their exposure.

6.4 The practice must appoint a radiation protection adviser (RPA) who

possesses appropriate knowledge and experience relevant to veterinary

practice (L)

The inspector will ask to see an agreement with an RPA, including the scope of the

activities upon which advice is required. RPAs previously appointed under IRR85

must be reappointed in writing. The inspector will ask to see a copy of the last RPA

report, together with evidence that any recommendations have been complied with.

C / ALL

The precise frequency of visits by an RPA will be

discussed and agreed between the RPA and the

practice. Material changes in eg equipment or

workload must be notified to the RPA, who will

decide if a visit is required.

Practices should note that a Certificate of

Competency issued to an RPA does not

automatically denote experience of veterinary

practice and suitable enquiries should be made.

A list of the RPA 2000 Certificate holders is

available from

http://www.rpa2000.org.uk/lists-of-certificate-

holders-and-available-consultants

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

6.5 The practice must appoint a Radiation Protection Supervisor (RPS) in

writing (L)

The RPS must command sufficient authority to supervise the work so that it is

performed in accordance with the local rules and have an adequate understanding

of the requirement of the Ionising Radiation Regulations. They must also know what

to do in an emergency. The inspector will ask to see a written appointment of one or

more suitable RPSs.

6.6 The practice must notify the Health and Safety Executive (HSE) of

their use of ionising radiations (L)

Veterinary use of ionising radiations requires prior notification to the HSE at least 28

days before commencing such work for the first time. Where any subsequent changes

are made to the work with ionising radiations, which would affect the particulars given

in the notification, the changes must be notified to the HSE immediately.

C / ALL

In the absence of a copy of the letter sent by the

practice to HSE (and for practices in business

for a number of years and without any formal

documents) the practice should send a fax or

email ([email protected].uk) to the HSE and retain

a copy of the notification for their records.

There is no specific form for notifying HSE but

notification must be in writing to the local HSE

office and the inspector will require to see a copy.

Notification should include:

• Name and address of Radiation Employer;

• Address of premises where the work is carried

out;

• Nature of the business of the employer;

• Category of the source of the ionising

radiations;

• Whether or not any source is to be used at

premises other than the address of the work

premises;

• Dates of notification and commencement of

the work activity.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

6.7 A copy of Guidance Notes for the Safe Use of Ionising Radiations in

Veterinary Practice (IRR 1999) must be available to all members of

the practice

These guidance notes do not seek to give detailed and comprehensive advice on all

aspects of the use of ionising radiations in the veterinary profession and the practice

must have consulted a RPA.

6.8 There must be a system of personal dose monitoring for all persons

entering the controlled area as agreed with the appointed RPA.

Records must be maintained of the doses received for at least two

years (L)

The arrangements for personal dose monitoring must be made in consultation with the

RPA.

6.9 Written local rules must be approved by the RPA and clearly displayed

to all staff (L)

Local rules must be displayed in the X-ray room and MUST contain:

• Name of RPS;

• Controlled area – when and where it exists;

• Dose investigation level;

• Contingency plan;

• Written arrangements;

• Name, address and telephone number of RPA;

• Duties of RPS;

• How entry to controlled area is restricted;

• Arrangements for maintenance of equipment

• Dosimetry arrangements;

• Use, storage and inspection of Personal Protective Equipment (PPE).

C / ALL

Copies are available from the BVA.

C / ALL

Any personal dose meters should normally be

worn on the trunk. They must not be left inside

a controlled area when not being worn and

must be stored away from sources of ionising

radiationsand extremes of temperature. They

must only be worn by the person to whom they

are issued.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Clinical staff involved with radiography must sign to indicate that they have read

and understood the local rules. Separate local rules must be agreed with the RPA in

respect of any separate dental X-ray equipment.

6.10 A controlled area must be designated in accordance with advice from

the RPA. It must also be adequately described in the local rules,

physically demarcated where practical and provided with suitable and

sufficient signs and warnings, all in accordance with the RPA’s advice

(L)

A specified room must be provided for radiography. It is desirable but not essential

that the room is used solely for radiography. The controlled area should be designated

according to the RPA’s advice and usually requires a red warning light at each

entrance to the X-ray room, which should be wired so as to illuminate automatically

while the X-ray machine is in use.

6.11 The X-ray machine must be serviced annually and there must be

written evidence of a satisfactory report (L)

6.12 The X-ray machine must have a functional light beam diaphragm

The X-ray beam must be collimated so as to leave a margin of unexposed film on all

edges of the radiograph.

C / ALL

The inspector will ask to see the X-ray machine’s

service records.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

6.13 Sufficient personal protective equipment must be provided and

examined at regular intervals (L)

When necessary, the practice must provide at least one protective apron with a lead

equivalence throughout of not less than 0.25mm, and, if animals are ever held,

must provide hand and forearm protectors with a lead equivalence of not less than

0.5mm, sufficient for all personnel involved. When not in use, aprons should be hung

over large diameter bars to avoid damage. All protective clothing must be thoroughly

examined on an annual basis.

6.14 Suitable cassettes and positioning aids must be provided (L/BP)

A range of foot blocks and cassette-holding devices must be available and be used so

as to ensure that no part of any person is exposed to the primary beam.

No animal should be held unless there are clinical reasons why they cannot be

restrained by other means. Suitable drugs and equipment for anaesthesia or sedation

must be available. Positioning aids such as sand bags, cradles, wedges and ties must

be suitable for the range of species routinely treated.

A good quality grid must be available. A suitable range of cassettes, screens or digital

alternatives must be available.

Screen film combinations or digital systems to minimise exposure while providing

the necessary level of detail must be used. Screens must be kept clean. Measuring

callipers, or other suitable devices, must be available to determine accurately the

depth of the part being radiographed.

The hospital must be able to perform a range of contrast examinations and a suitable

range of contrast material must be available.

Personal protective equipment may not be

required where a practice confirms that:

• Animals are never held; and

• There are no circumstances where staff enter

the controlled area when the x-ray machine is

switched on; and

• The isolation switch for the machine is

located out with the controlled area; and

• The practice provides written confirmation

from their RPA that the situation is

acceptable.

C / ALL

C / EQ

C / SA

GP / SA

A range of grids suitable for species routinely

treated should be available. This should include

a grid and cassette of at least 30cm x 40cm. The

underlying principle is that x-rays of a large dog’s

chest may be taken in one picture to avoid errors

in two frames.

VH / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

6.15 A chart of commonly used exposures must be available

6.16 A record of all X-ray exposures, which contains a chronological record

of the patient details, date, region radiographed, exposure factors and

personnel involved must be available/easily retrievable (L/BP)

This must provide a permanent record of all X-ray exposures and records and identify

the persons involved. Suitable back-up must be provided for the electronic files

produced by digital radiography.

The detailed record of X-ray exposures must contain:

• Patient identification;

• Breed;

• Area exposed/view;

• Exposure factors;

• Type of film/grid/screen;

• Date;

• Quality of the resultant radiograph;

• Names of any personnel present.

Original x-ray plates should be retained or scanned and kept in computerised form.

The sole use of self-adhesive labels for the identification of radiographs is not

acceptable. Radiographs should be identified at the time of the exposure.

6.17 There must be suitable film processing facilities (used and maintained

in accordance with the manufacturer’s instructions to avoid wasted

exposures). The film processing area must be ventilated (L/BP)

Good film processing techniques are essential to avoid unnecessary exposures.

In particular, the development time, temperature and replenishment must be in

accordance with the manufacturers instructions.

A chart of commonly used exposures is more

accessible than an X-ray logbook and helps to

reduce the number of incorrect exposures.

C / ALL

GP / ALL

VH / ALL

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Unless digital radiography is in use, automatic processors with automatic

replenishment must be employed to develop radiographs instead of manual methods.

6.18 All X-ray chemicals must be stored safely and disposed of in an

appropriate manner (L)

Advice of relevant local water authorities must be obtained and recorded unless all

material is disposed of by a registered contractor.

VH / ALL

C / ALL

Silver traps may be used in accordance with

guidance/approval from the relevant local water

authority.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

7 LABORATORY AND POST-MORTEM FACILITIES

7.1 Provision of laboratory facilities and/or referral of samples to an

external organisation (L/BP)

Where pathological samples are sent to external organisations, a suitable range of

containers, envelopes and forms must be available. There must be an SOP for the

post and packaging of pathological samples which complies with current packaging

regulations.

There must be a clinical microscope, and facilities to assess packed cell volume,

prepare blood smears, and to measure blood glucose, blood urea concentrations and

urine specific gravity.

There must be a clinical microscope and facilities to assess packed cell volume and

total protein.

Laboratory facilities for routine diagnostic tests must be available at all times. Where

laboratory facilities are not provided on site, suitable arrangements must be made to

enable laboratory investigations on emergency cases.

Suitable arrangements must be made for the following detailed investigations:

• Biochemistry;

• Haematology;

• Parasitology;

• Bacteriology.

The following equipment must be provided on the premises:

• Binocular microscope with mechanical stage, electric light source and oil

immersion facility;

• Centrifuge suitable for PCV, blood separation and urine sedimentation;

• Urinary refractometer;

• Biochemistry analyser to include Creatinine, Urea, Glucose, Total Protein and

Calcium;

• Electrolyte analyser.

Laboratory facilities for biochemistry, haematology, parasitology, and bacteriology must

be available on the premises at all times.

C / ALL

GP / SA

It is acceptable for BUN testing to be done

off site. In that situation we would expect the

inspector to be provided with details of the

arrangements in place for obtaining results within

a reasonable time (reasonable to be considered in

light of the clinical necessities of the individual

practice under consideration).

GP / EQ

The reason for requesting these facilities is to

ensure that the practice is able to perform basic

diagnostic procedures at all times.

VH / SA

There must be the ability to look at smears on

site. Evidence must be provided of training or

CPD for staff in use of all equipment and in the

interpretation of results. Reference materials

must be provided.

VH / EQ

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

7.2 The laboratory procedures must be performed in a clean and tidy

designated area used specifically for that purpose

The laboratory bench shall be made of impervious materials to permit proper cleaning.

There must be adequate facilities for washing of hands. There must be adequate

facilities for storage of specimens and reagents, including refrigeration, and disposal

of waste materials.

7.3 All laboratory procedures must be undertaken by designated persons

who are suitably trained in the tasks performed by them

A list of persons trained in handling laboratory specimens and in the risks of

laboratory work must be kept.

If bacteriology is undertaken on site, adequately qualified staff must be available. The

accurate interpretation of bacteriology plates requires staff qualified to HNC in

Applied Biology or equivalent standard.

If bacteriology is undertaken on site, adequately qualified staff must be available.

The accurate interpretation of bacteriology plates requires staff qualified to HNC in

Applied Biology or equivalent standard. There must be a nominated person in overall

charge of the laboratory facilities.

7.4 The results of all laboratory tests must be stored so as to permit easy

retrieval

Data must be stored safely in an easily retrievable form.

A complete recording system must be maintained of all tests undertaken in the

practice or by any outside laboratory. A system must be in place to track samples

referred to an outside laboratory to ensure results are obtained and communicated

promptly to the client.

The designated area does not have to be a

separate room and may, for example, be part of

the dispensary or the preparation area. However,

the designated area/bench must be clearly used

only for laboratory purposes.

C / ALL

GP / EQ

VH / ALL

The inspector will expect to see evidence of

storage of results.

C / ALL

GP / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

7.5 There must be suitable arrangements for quality control (QC) and

assurance of automated practice laboratory tests

In addition to internal QC procedures, quality assurance by reference of internal

samples to external laboratories or internal analysis of external samples must be

routinely undertaken and results documented.

7.6 Adequate post-mortem facilities must be available or other

arrangements made

Post-mortem examinations on site must be performed in an area not concurrently

used for clinical work. This may be achieved by performing the examination after

clinical work has ceased or an external laboratory may provide facilities, in which

case, adequate licensed arrangements must be in place for the transport of carcases

for diagnostic quality examination to be performed. Adequate Health and Safety

procedures must be in place if post-mortem examinations are conducted on site.

When conducting post-mortem examinations full consideration must be given to the

health and safety issues associated with primates, birds and reptiles. Adequate risk

assessment and protocols need to be undertaken and consideration must be given

to the use of active filtered air extraction and the provision of suitable additional

adequate protective clothing, and the use of glove boxes or similar, to guard against

zoonoses.

GP / ALL

The inspector will expect to see results of the

external qualilty assurance.

The frequency of external quality assurance

testing should be related to the number of tests

undertaken. It is expected that this will be at

least quarterly.

When making arrangements for a post-mortem

examination the practice must ensure that clients

are made aware of the level of procedure being

undertaken, ie whether or not it will involve a full

pathological examination, as well as the costs

involved.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

8 MEDICINAL PRODUCTS

8.1 All medicinal products must be stored in a clean and tidy location in

accordance with manufacturers’ recommendations and appropriate

records kept (L)

A record of premises and other places where medicines are stored or kept must be

available.

All medicines should be stored in accordance with manufacturers’ recommendations

whether in the practice or in a vehicle. If it is stipulated that a medicine be used

within a specific time period, it must be labelled with the opening date, once

broached.

Accurate records of POM-V and POM-VPS medicines received and supplied must be

kept.

Records of medicines administered to food-producing animals must include batch

numbers; in the case of a product for a non-food-producing animal, this need only be

recorded either on the date of receipt of the batch or the date a veterinary medicinal

product from the batch is first supplied.

Under the Veterinary Medicines Regulations

(VMRs), it is necessary for a record to be kept at

a practice’s main premises of all premises and

other places where medicines are stored. This

could, for example, be homes where medicines

are kept for on-call purposes and practice cars.

The Record may be in any form, provided that it

is accessible to the inspector.

C / ALL

Premises should have Veterinary Medicinal

Product (VMP) storage areas clearly separated

from food / drink for human consumption and

toilet and washing areas

VMPs should be stored in areas that are not

accessible to the public. Medication should

be placed out of sight in closed cupboards

(not glass-fronted) or drawers but there is no

requirement for cupboards to be locked. It is

acceptable for small quantities of drugs to be

in consulting rooms for use during consultation.

These should be kept to a minimum and should

be in drawers/cupboards.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

There should be additional records of medicines administered to food producing

animals under the Cascade as detailed in Part 3 of the VMRs.

The pharmacy must be operated in accordance with the rules laid out in the

current BVA Code of Practice or alternative appropriate publication. Monitoring of

temperatures wherever medicines are stored must be undertaken (including consulting

rooms and prep rooms).There must be proper monitoring and recording of maximum

and minimum temperatures in the refrigerator and pharmacy, and where temperatures

have been recorded outwith the appropriate ranges, there must be evidence of

an action plan to remedy such deviations, and to deal with affected medicines.

Consideration should be given to the use of alarms to indicate when temperatures

stray out of set parameters. An adequate supply of medicines and materials used in

the treatment of patients must be readily available.

At least one member of staff must have completed an appropriate pharmacy course,

(for example, BSAVA Dispensing Course or Glasgow University dispensing course)

within the last five years.

8.2 There must be an efficient stock control and stock rotation system in

operation. Out-of-date medicines must be disposed of according to

current legislation (L)

There must be an efficient stock control system to ensure a continuous supply of

all medicines and removal of out-of-date medicines. At least once a year a detailed

audit should be carried out and incoming and outgoing medicines reconciled with

medicines held in stock and any discrepancies recorded.

A practice must be able to demonstrate to the inspector the ability to carry out a

detailed audit as clarified by the VMD; in addition, the inspector will ask to see a full

audit and reconciliation of all Schedule 2 controlled drugs (ie the Register - see 8.3

below – and the balance of drugs in stock).

Medicines should be disposed of in accordance with the relevant regulations.

If maximum and minimum temperature

recordings are being taken wherever medicines

are stored it is not necessary to take additional

recordings of ambient temperatures.

Data loggers and maximum/minimum

thermometers will provide constant monitoring.

However, for those without an alarm to warn

of temperature deviations, and for maximum/

minimum thermometers, checks are required to

be made daily and the inspector will ask to see

written records, produced on a weekly basis,

showing the results for the week.

VH / ALL

See VMD’s clarification note on record keeping

www.vmd.gov.uk/General/VMR/VMG07notes.htm.

This indicates that a system linking incoming

and outgoing transactions with stock held, for

example, may provide an ongoing running total

which, with the addition of a periodic physical

stock count to verify the stock held, may meet

the audit requirement.

Where an annual or more frequent stock take,

which includes the main features set out above,

is carried out for any reason such as, for example,

tax purposes, the VMD would consider that the

“detailed audit” requirement is being met.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

8.3 If Controlled Drugs are kept, these must be stored and recorded

according to current legislation (L)

Schedule 2 Controlled Drugs must be kept in a secure, lockable and immovable

receptacle that can only be opened by a veterinary surgeon or a person authorised

by him or her. A register of such drugs obtained, supplied and used must be kept in

accordance with the Misuse of Drugs Act 1971 (and the Misuse of Drugs Regulations

2001, as amended).

Controlled drugs are regulated by the Misuse of Drugs Act 1971 and the Misuse of

Drugs Regulations 2001 as amended. These regulations classify such drugs into 5

schedules, numbered in decreasing order of severity of control.

C / ALL

For information on the requirements on a CD

Medicines/The BSAVA Guide to Medicines.

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Schedule 1: Includes LSD, cannabis, and other hallucinogenic drugs, which are not

used medicinally. Possession and supply are prohibited except in accordance with

Home Office Authority.

Schedule 2: Includes etorphine, fentanyl, morphine, papaveretum, pethidine,

diamorphine (heroin), cocaine and amphetamine. Record all purchases and each

individual supply (within 24 hours). Registers must be kept for two calendar years

after the last entry. Drugs must be kept under safe custody (locked secure cabinet),

except quinalbarbitone. Drugs may not be destroyed except in the presence of a

person authorised by the Secretary of State. Failure to comply with this Act can lead

to prosecution.

Schedule 3: Includes butorphanol, buprenorphine, pentazocine, the barbiturates (eg

pentobaritone and phenobarbitone but not quinalbarbitone - now Schedule 2) and

others. Subject to certain exemptions, Schedule 3 drugs must be kept under safe

custody (locked secured cabinet), buprenorphine, diethylpropion and temazepam must

be kept under safe custody (locked secure cabinet); it is advisable that all Schedule 3

drugs are locked away. Retention of invoices for five years is necessary.

Schedule 4: Includes most of the benzodiazepines (temazepam is now in Schedule 3)

and androgenic and anabolic steroids (eg clenbuterol).

Schedule 5: Includes preparations (such as several codeine products) which, because

of their strength, are exempt from virtually all Controlled Drug requirements other than

the retention of invoices for five years.

Ketamine may be the subject of misuse and, therefore, must be stored in the

controlled drugs cabinet and its use recorded in an informal register.

The inspector will ask to see the Controlled

Drugs cabinet and registers (a register should be

kept for each controlled drug) and prescriptions

against which supplies of Controlled Drugs of

Schedule 2 and 3 have been made, to confirm in

particular that:

• Appropriate records are kept;

• That any out-of-date Controlled Drugs have

been destroyed by an authorised person;

• For supplies of Controlled Drugs of Schedules

2 and 3, against other veterinary surgeon’s

prescriptions;

* The prescriptions have been retained at

least two years;

* The date on which the supply was made is

marked on the retained prescriptions;

* The supply of Controlled Drugs was made

within 28 days of the appropriate date

on the prescription (also for supplies of

Controlled Drugs of Schedule 4);

* The name of the person who collected

the controlled drugs is recorded in the

Controlled Drugs Register (for Controlled

drugs of Schedule 2 only).

C / ALL

The requirements for entries for the informal

ketamine register are the same as for the Register

(though the entries need not be signed). It is

expected that running totals will be kept and

checks against stock carried out at least weekly.

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

8.4 Medicines must be prescribed and supplied according to current

guidelines (L)

POM-V and POM-VPS medicines may be prescribed and supplied by a veterinary

surgeon. Alternatively, medicines may be prescribed and a prescription written

by a veterinary surgeon and the supply made by another veterinary surgeon (or a

pharmacist) on the authority of that prescription.

PRESCRIBING GENERALLY

• A veterinary surgeon who prescribes a POM-V medicine must first carry out a

clinical assessment of the animal and the animal must be under his or her care

(See Code of Professional Conduct and Guidance note 4).

• A veterinary surgeon who prescribes a POM-V or POM-VPS medicine must be

satisfied that the person who will use the product will do so safely, and intends to

use it for the purpose for which it is authorised.

PRESCRIBING WITHOUT SUPPLYING

If a veterinary surgeon prescribes by written prescription (for supply by another

veterinary surgeon or a pharmacist), in addition to the requirements for prescribing

generally, he, or she must:

• Each time he or she prescribes the medicine advise on its safe administration and

as necessary on any warnings or contra-indications on the label or package leaflet;

• Not prescribe more than the minimum amount required for the treatment

(see exemptions in Schedule 3 paragraph 7 of the VMRs).

PRESCRIBING WITH SUPPLY

If a veterinary surgeon supplies a POM-V or POM-VPS medicine, in addition to the

requirements for prescribing generally they must:

• Advise on its safe administration and, as necessary, on any warnings or contra-

indications on the label, package leaflet;

• Not supply more than the minimum amount required for the treatment

(see exemptions in Schedule 3 paragraph 7 of the VMRs).

C / ALL

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

[A Suitably Qualified Person (SQP) under the Veterinary Medicines Regulations is

under similar requirements for the prescription and supply of POM-VPS medicines.]

SUPPLY IN THE ABSENCE OF THE VETERINARY SURGEON

Having prescribed a POM-V or POM-VPS medicines, if the veterinary surgeon is not

present when the medicine is handed over, they must:

• Authorise each transaction individually before the medicine is supplied;

• Be satisfied that the person handing it over is competent so to do.

SUPPLY OF NFA-VPS MEDICINES BY A VETERINARY SURGEON OR SQP

If a veterinary surgeon or SQP supplies an NFA-VPS they must:

• Be satisfied that the person who will use the medicine will do so safely, and

intends to use it for the purpose for which it is authorised;

• Each time the medicine is supplied, advise on its safe administration and on any

warnings or contra-indications on the label, package leaflet;

• Not supply more than the minimum amount required for the treatment (see

exemptions in Schedule 3, paragraph 7 of the VMRs).

SHEEP DIP

In the case of supply of sheep dips, the customer/user must provide a certificate of

competence in the safe use of sheep dips and must be provided with two pairs of

gloves with every product prescribed and supplied, as well as a laminated notice.

A veterinary surgeon could meet the requirement

to authorise each transaction by:

• Handing over a medicine personally following

a consultation, or instructing a fellow member

of staff to supply the medicine;

• Making a note on a client’s records that

repeat prescriptions could be supplied to the

client;

• A member of staff taking a call from a

client and putting a medicine aside for the

veterinary surgeon to authorise before being

supplied;

• In the case of a client unexpectedly coming

into the practice, by a phone call to the

veterinary surgeon to authorise the supply.

C / ALL

The inspector will ask to see appropriate

protocols, certificate records and/or a random

sample of clinical records for evidence of

compliance with all these requirements. Re

SQPs, the inspector will ask to see SOP for

procedures for supplying POM-VPS/NFA-VPS.

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Sheep dip certificate numbers must be retained for at least three years.

8.5 All containers and outer packs must be dispensed by the practice

legibly and indelibly labelled with the following information (L/BP)

MEDICINES OTHER THAN POM-Vs

All such medicines supplied by the practice must be labelled in accordance with the

VMRs. Generally, such medicines must be supplied in a container (with labelling)

specified in the marketing authorisation for the medicine. It is advised that, in

addition, such medicines are labelled with the name and address of the practice

supplying the medicine.

For supply under the Cascade see below.

POM-V

All POM-V medicines supplied by the practice must be labelled with the following

information:

• The name and address of the animal owner;

• The name and address of the veterinary practice supplying the medicine;

• The date of supply;

• The words “keep out of the reach of children”;

• The words “for animal treatment only” unless the package or container is too small

for it to be practicable to do so;

• The words “for external use only” for topical preparations;

• The name and quantity of the product, its strength and directions for use.

MEDICINE SUPPLIED FOR USE UNDER THE CASCADE

Medicines for supply under the Cascade, must include the following additional

information:

• Identification of the animal or group of animals;

• Name of the veterinary surgeon who has prescribed the product.

And, unless already specified on the manufacturer’s packaging:

• Any special precautions;

C / ALL

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

• The expiry date;

• Any necessary warnings for the user, target species, administration or disposal of

the product.

The inspector will ask to see a practice label produced and evidence that medicines

for supply are labelled appropriately.

Child-resistant containers must be used unless otherwise requested. Paper or

plastic envelopes are unacceptable as the sole container for dispensing of medicinal

products.

Tablets and capsules must be dispensed in crush-proof and moisture-proof containers.

Sachets and manufacturers’ strip or blister pack medicines should be dispensed in

paperboard cartons or wallets, or paper envelopes.

All labels must be mechanically or machine produced. Handwritten labels are not

acceptable.

8.6 Practices must make clients aware that they can request a prescription

(L)

Veterinary surgeons must:

• Ensure clients are able to obtain prescriptions, as appropriate (a veterinary surgeon

may prescribe a medicine of category Prescription Only Medicine, Veterinarian,

[POM-V] only following a clinical assessment of an animal under his or her care;

a prescription may not be appropriate if the animal is an in-patient or immediate

treatment is necessary);

• Subject to any legal restrictions, ensure there is adequate provision on information

on medicine prices, including the current prices for the ten relevant veterinary

medicinal products most commonly prescribed during a recent and typical three-

month period, to provide clients with a fair and representative illustration of the

practice’s medicines prices;

• Provide the price of any relevant veterinary medicinal product stocked or sold, to

clients or other legitimate enquirers making reasonable requests;

• If requested, inform clients of the price of any medicine to be prescribed or

dispensed;

• Where possible and relevant, inform clients of the frequency and charges regarding

C / ALL

VH / ALL

The inspector will ask to see evidence that the

practice complies with this guidance and that the

correct code of practice for prescription writing is

available for veterinary surgeons.

C / ALL

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

further examinations of animals requiring repeat prescriptions;

• Provide clients with an invoice that distinguishes the price of relevant veterinary

• Medicinal products from other charges and, where practicable, provide clients with

an invoice that distinguishes the price of individual relevant veterinary medicinal

products;

• Advise clients, by means of a large and prominently displayed sign or signs (in the

waiting room or other appropriate area), with reference to the following:

* “Prescriptions are available from this practice.

* “You may obtain Prescription Only Medicines, Category V, (POM-Vs) from your

veterinary surgeon OR ask for a prescription and obtain these medicines from

another veterinary surgeon or a pharmacy.

* “Your veterinary surgeon may prescribe POM-Vs only for animals under their

care.

* “A prescription may not be appropriate if your animal is an in-patient or

immediate treatment is necessary.

* “You will be informed, on request, of the price of any medicine that may be

dispensed for your animal.

* “The general policy of this practice is to re-assess an animal requiring

repeat prescriptions every [xx] months, but this may vary with individual

circumstances. The standard charge for a re-examination is £[xx].

* “The current prices for the ten POM-Vs most commonly prescribed or supplied

during [xx] (a typical three-month period were:

* “[The ten drugs and prices listed];

* “Further information on the prices of medicines is available on request.”

• Provide new clients with a written version of the information set out in the sign or

signs referred to above, which may be set out in a practice leaflet or client letter or

terms of business document.

• On a continuing basis, take reasonable steps to ensure that all clients are provided

with a written version of the information set out in the sign or signs referred to

above, which may be set out in a practice leaflet or client letter

C / ALL

Precise wording need not be followed, but all

points should be covered in the sign.

The Prescription Notice/List of Top Ten Drugs

must be placed in a prominent position. The

Inspector will expect that any notice will be at

least A4 size, and clearly visible.

Reasonable steps may include a combination of

practice leaflets, client letters, information on

practice websites

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

8.7 Medicines must be used in accordance with the legislation commonly

referred to as “the Cascade” (L)

The prescribing Cascade is contained in the Medicines (Restrictions on the

Administration of Veterinary Medicinal Products) Regulations 2004. If there is

no suitable authorised veterinary medicinal product in the United Kingdom for a

condition in a particular species, in order to avoid unacceptable suffering veterinary

surgeons may exercise their clinical judgement according to the “Cascade”, whereby

they select in the following order:

• A veterinary medicinal product authorised in the United Kingdom for use with

another animal species, or for another condition in the same species;

• If, and only if, there is no such product that is suitable, either:

* A medicinal product authorised in the United Kingdom for human use or

* A veterinary medicinal product not authorised in the United Kingdom but

authorised in another European Member State for use with any animal species

(in the case of a food-producing animal, it must be a food-producing species)

(see Special Import Certificate VMD Guidance Note 7);

• If, and only if, there is no such product that is suitable, a veterinary medicinal

product prepared extemporaneously by a pharmacist, a veterinary surgeon or a

person holding a manufacturing authorisation authorising the manufacture of that

type of product;

• If a veterinary surgeon considers that there is not a suitable veterinary medicinal

product authorised in the UK or another EU Members state to treat a condition

then it is possible to apply for a Special Treatment Certificate (STC) to import a

suitable authorised product from outside the UK. A STC will not be issued if a

suitable product is authorised and available in the UK or in another EU Member

State.

The inspector will wish to see evidence that off-

label medicines are clearly identified to owners

who give informed consent for their use. Written

forms for signature are expected. Human generic

preparations must not be used other than under

Veterinary Medicines Guidance Note 15 (VMG15)

which allows for the welfare of animals to be a

primary consideration in the choice of treatment.

It is not acceptable to use an all embracing

“general” lifelong consent for any and all off-

label products that might be given to any animal,

though it would be acceptable where there is

a specific ongoing condition requiring off-label

drugs for a lifelong consent form to be used.

Similarly in the case of eg exotics where there

are no licensed products available, this would

be acceptable. The inspector will ask to see

completed off-label forms – not just that a stock

of blank forms is held.

Records of products administered to food-

producing animals under the cascade should

contain the following information, going back five

years:

• The date the veterinary surgeon

examined the animals;

• The name and address of the owner;

• The identification and the number of animals

treated;

• The result of the veterinary surgeon’s clinical

assessment;

• The trade name of the product if there is one;

C / ALL

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

8.8 The practice must have access to advice from a service providing

veterinary specific advice on management of poisons .

Evidence of a current contract should be provided or an SOP must show how to access

the information in an emergency.

8.9 A practice must be able to access SARSS report forms (L)

Adverse reactions in humans or animals to medicinal products must be reported

promptly to the Veterinary Medicines Directorate and/or to the manufacturer. A

protocol is required that recognises when the use of SARSS forms is necessary.

Completed copies should be retained and form part of the clinical records.

8.10 The practice must have a Wholesale Dealers Authorisation (WDA) if

over 5% of the Veterinary Medicinal Products annual turnover is from

wholesale trade

• The manufacturer’s batch number; shown on

the product, if there is one;

• The name and quantity of the active

substances;

• The doses administered or supplied;

• The duration of treatment; and,

• The withdrawal period.

Where a whole herd/flock is treated with a

medicine, it may be acceptable to record ‘whole

herd’ or ‘whole flock’ and not every individual

animal’s number.

GP / ALL

It is not necessary to have a formal annual

contract. An SOP to show how information is

being assessed, for example, via websites on a

‘pay-as-you-go’ basis would be acceptable.

The inspector will ask to see the protocol so as

to be satisfied that the practice will be able to

recognise any adverse reactions and also ask the

practice about the frequency of reporting. If there

have been any such reports, the inspector will ask

to see copies.

C / ALL

The inspector will ask to see a copy of any WDA

and evidence that Veterinary Medicinal Products

are supplied only to approved businesses (WDA

holder, veterinary surgeon, SQP, pharmacist).

C / ALL

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

9 SAFETY PROCEDURES

9.1 The practice must set out its policy for Health and Safety (L)

Under the Health & Safety at Work Act 1974, employers are required to have a policy

setting out how they ensure that risks to Health & Safety to employees, contractors

and customers are kept as low as is reasonably practical.

Where five or more people are employed (even if this is only temporarily) this policy

must be set down in writing. Such a written policy must include:

• A statement of general policy;

• Delegated responsibilities for dealing with specific areas

(eg equipment, substances, training, first aid, fire, reporting of accidents etc);

• General instructions to staff arising out of the significant findings of the risk

assessments.

Such a document must aim to be concise, pointing the reader to more detailed

guidance where necessary.

9.2 The practice must undertake Health & Safety risk assessments (L)

The Management of Health & Safety at Work Regulations 1999 requires employers

and the self-employed to identify:

• The hazards arising from their work;

• Who could be affected by those hazards;

• The measures to control the risk of those hazards causing harm.

The law applies when people are at work so will

also apply to farm/equine practitioners working

mainly from vehicles but also from home, and

where locums are used. Employers have duties to

ensure the health and safety of their employees

and this includes situations where work is carried

out at, or from, home.

Veterinary surgeons who are self-employed also

have duties towards their own health and safety

and that of third parties (eg their family/locum)

therefore, health and safety requirements do

apply in this situation (it would be unacceptable

for a home-based veterinary surgeon, for example,

to store veterinary drugs in a domestic cabinet

with other medication intended for the family:

suitable storage would be required). Equipment

used at home for work purposes also needs to

comply with health and safety regulations and

would be subject to maintenance and testing.

C / ALL

This includes employees, part-time staff,

trainees, clients, contractors and others who may

be affected by work activities.

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L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

The measures identified by the risk assessment will include the need to comply

with other regulations (eg Ionising Radiations) as well as those to deal with specific

hazards not covered by regulations (eg the hazardous behaviour of animals). They

must, in order of priority, seek to:

• Eliminate the hazard (eg substitute a disinfectant containing glutaraldehyde with a

less hazardous one);

• Physically control access to the hazard (eg prevent entry into areas where ionising

radiations are being used);

• Provide information, instruction, training and supervision to ensure people work in

a safe manner (eg SOPs, safety signs, local rules, proper training);

• Consider if personal protective equipment needs to be provided (eg face masks or

goggles).

Where five or more people are employed, these significant findings of the risk

assessment must be recorded (often as an attachment to the Health & Safety policy).

Risks from the activities of work areas commonly found in veterinary work should be

assessed, and local rules formulated.

Activities/work areas to be considered would include both physical and psychological

health, for example:

• Cleanliness/tidiness;

• Disinfection;

• Handling and restraint of animals (including the use of on farm facilities);

• Manual handling and lifting of weights (with particular reference to aids for moving

heavy/paraplegic animals);

• Slips/trips/falls;

• Veterinary medicines/pharmaceuticals;

• Anaesthetic gases;

• Injection procedures (risk of self-injection);

• Risk to pregnant workers;

• Risk of work related stress;

• Proper use of work equipment:

* Display screen equipment;

* Office electrical equipment;

* Portable electrical appliances;

* Autoclave;

C / ALL

Risk assessments must still be undertaken and

policies formulated even where a practice has

five or less employees, but these do not have to

be in written form, although this is encouraged

in all cases. Where a practice with five or fewer

employees has no written risk assessment,

it should be able to explain the assessments

undertaken to the inspector.

Please note: these are examples only and

practices should refer to the HSE for further

information/consideration to be given to specific

matters that may affect their individual practices.

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* Dental machine;

* X-ray machine;

Anaesthetic equipment;

* Laboratory equipment;

• Laboratory procedures;

• Dental procedures using mechanical scaling;

• Security of staff, including provisions for lone/night working;

• Dealing with members of the public;

• Personal protective equipment;

• First aid, recording and reporting of accidents;

• Disposal of sharps, clinical, pharmaceutical, chemical and other waste (including

safe handling of spillages/leakages, broken and unwanted containers);

• Infectious disease/biological agents;

• Zoonoses; (eg fungal - ringworm; bacterial - salmonella; viral - birdflu)

• Working at height;

• Water supplies/air-conditioning maintenance;

• Transport and storage and use of gas cylinders;

• Vehicles and driving for work

• Risk assessments for the employment of young persons (under 18 years of age) are

required;

• A Risk Assessment assessing whether the practice premises does, or is liable to,

contain asbestos, any risk arising therefrom and action taken to manage risk, may

be required (Control of Asbestos at Work Regulations 2002 & 2006).

These rules must be displayed or have been drawn to the attention of all members of

staff and regularly reviewed.

C / ALL

Proper safety precautions must be taken for staff

on duty at night. An appropriate protocol for

dealing with night-time callers must be in place.

Suitable means must be available to enable staff

to call for immediate assistance when necessary.

In addition to undertaking risk assessments for

storage and transport of drugs and firearms, other

veterinary aspects of working out of a vehicle,

such as bio-security and waste disposal also need

to be considered.

Other considerations should include: is the

person a competent driver/appropriately licensed

for the vehicle they will drive? Are they aware of

the employer’s policy on work-related road safety?

This list is not exhaustive and would equally

apply to small animal practices providing vehicles

to staff members.

Under the 2006 Regulations, owners and

tenants with leases that include responsibility for

building maintenance must carry out a survey to

locate asbestos containing materials and record

their condition, which can then be used to assess

risks and decide what action is required. (See

HSE leaflet INOG223 (rev 3).)

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9.3 The practice must make arrangements to consult with staff on matters

of Health & Safety (L)

Employers have a legal duty to consult with their employees regarding Health &

Safety. This should include:

• The regular circulation of the Health & Safety policy amongst staff, including the

significant findings of risk assessments;

• The regular circulation of the results of any monitoring of Health & Safety

standards in the work place and action for their improvement;

• Not only giving information to employees but also listening and taking into account

what they say before making any health and safety decisions.

The inspector will ask to see evidence that staff have free access to the practice

Health & Safety policy, risk assessments and its regular updates. This evidence will

require staff to sign and date policies and reviews to confirm they have been read.

Updates may be annual or more frequently if hazards/risks change.

C / ALL

Consulting employees on health and safety

matters is a legal requirement and is more than

simply having health and safety documents on

site for staff to refer to and is very important

in creating and maintaining a safe and healthy

working environment. Through consultation, an

employer should motivate staff and make them

aware of health and safety issues. This helps to

improve efficiency and reduce the number of

accidents and work-related illnesses.

Consultation with employees must be carried out

on matters to do with their health and safety at

work including:

• Any change which may substantially

affect their health and safety at work ie in

procedures, equipment or ways of working;

• Changes to an employer’s arrangements for

getting competent people to help him or her

satisfy health and safety laws;

• Information must be given to employees on

the likely dangers arising from their work,

measures to reduce or eliminate these risks

and how they should deal with these risks;

and,

• Information on planned health and

safety training and any health and safety

consequences in introducing new technology.

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9.4 The practice must have a completed Health & Safety law poster, which

is displayed for all staff to see (L)

9.5 The practice must have appointed, in writing, a Safety Officer/Health

& Safety Representative amongst the staff (L)

9.6 The practice must have undertaken a thorough assessment of the risks

arising from the use of veterinary medicines substances hazardous to

health within the practice (L)

The risk to Health & Safety from veterinary medicines and other substances has to

be assessed under the Control Of Substances Hazardous to Health Regulations 2002

(COSHH). There is wide variation in risk – many are low to medium risk but there are

some substances in veterinary practice, which pose a very serious risk to health.

Implementing measures to control the exposure to low or medium risk substances

can be adequately achieved when they are assessed by their therapeutic group/type/

route of administration etc. The practice can set out standard measures to control

exposures, for example:

• Injectable anaesthetics;

• Pour-on anthelmintics;

• Steroidal compounds;

• Antibiotics.

Practices should note that an updated poster was

introduced with effect from April 2009. However,

the ‘old’ version issued in 1999 remains valid

until April 2014. As an alternative to a poster a

practice may give its workers a pocket card (as

approved by HSE). (The ‘old’ leaflet also remains

valid until April 2014.)

C / ALL

As part of the practice arrangements for

communicating with employees about issues

that may affect their Health & Safety, a Safety

Officer/Health & Safety Representative must be

appointed and have drawn up a written list of

duties.

C / ALL

Safety data-sheets are not legally required

for veterinary medicines and many medicine

companies do not produce them. Practices

should therefore ensure that they have access

to the current version of either the Summary of

Products Characteristics (SPC) or a data-sheet

for each authorised medicine used or stored

in the practice. Copies of the current NOAH

Compendium of Data Sheets are acceptable

to fulfill this requirement for those medicine

companies that participate. See www.vmd.gov.

uk/ProductInformationDatabase/Default.aspx (for

veterinary SPC) and www.emc.medicines.org.uk

(for non-veterinary SPCs).

It should be noted that the lists mentioned are

not exhaustive and practices should consider

their own individual medicine/substance usage.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Within these groups, practices must identify any specific medicines or substances that

could have longer-term health risks, such as allergies eg Penicillin, or sensitivities eg

latex.

Specific and detailed assessments and the resulting measures to control exposure

must be made for high-risk substances such as:

• Any hormones;

• Oil-based vaccines;

• Cytotoxic drugs;

• Gluteraldehyde disinfectants;

• Micotil (tilmicosin);

• Large animal Immobilon (etorphine);

• Zoonoses

9.7 The practice must have appointed, in writing, a Fire Officer, and

drawn up a written list of the practice Fire Officer’s duties. A Fire Risk

Assessment must have been drawn up (L)

The inspector will ask to see a list of the practice Fire Officer’s duties and the Fire

Risk Assessment, including procedures for raising the alarm and evacuation. Where

gas/oxygen cylinders are being transported in practice vehicles, a 2kg dry powder

fire extinguisher is required in the vehicle. Evidence should be provided of suitable

hazard training.

C / ALL

The responsible person (eg employer, owner,

occupier) must carry out a fire safety risk

assessment and implement appropriate fire

precautionary and protection measures, and

maintain a fire management plan. For guidance,

see: www.communities.gov.uk/fire/firesafety/

firesafetylaw/aboutguides.

Hazard Training is any suitable instructions given

to the user. A risk assesment by a competent

person, with instructions on this given to any

staff carrying cylinders would be sufficient.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Stored pressurised gas cylinders must be kept securely outside the building unless

authorised by a fire officer. Stocks of explosives or inflammable agents must be stored

in locked metal cupboards.

Smoke detectors, which provide a warning in the residential accommodation, must be

installed in the kennel area.

9.8 There must be evidence of the annual servicing of fire extinguishers

and alarms (L)

The inspector will ask to see annual service records.

Best practice is to store cylinders of oxygen

and flammable gases outside in the open air,

which allows vapours to be dispersed effectively.

Storage outside should be secure.

If storage has to be located within a building, an

adequate level of ventilation should be provided

either by mechanical ventilation or the presence

of a sufficient size and number of permanent

openings. Flammable gases, such as LPG, if

stored inside, may only be stored in purpose-built

compartments or buildings with fire-resistant

walls and explosion relief. Only limited quantities

should be stored and should not be placed under

stairs, near waiting rooms or compressors.

Risk assessments should be undertaken to take

into account compatibility of substances stored

and the suitability of the arrangements made.

Smoke detectors must be placed in the

residential accommodation.

VH / SA

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

9.9 The practice must have an accident book, and all staff must know

where it is located (L)

An accident book is required by law and must meet the requirements of the Data

Protection Act. It must record the following:

• Date and time of accident or occurrence;

• Full name and address of the person involved and the injury or condition suffered;

• Where the accident or occurrence happened;

• A brief description of the circumstances;

• In the case of a reportable disease, the date of diagnosis, the occupation of the

person concerned and the name or nature of the disease.

Records should be removed and stored securely and information kept for at least three

years.

9.10 The practice must have a procedure for the Reporting of Injuries,

Diseases and Dangerous Occurrences as required by RIDDOR

regulations 1995 (L)

Any injury, accident or work-related illness which keeps an employee off work or

unable to do their normal job for more than three days must be reported to the

Incident Contact Centre (ICC) within 10 days. The Incident Contact Centre is the

single point of contact for all incidents in the UK.

C / ALL

The duty to report falls on employers and the

self-employed and those on control of premises,

and covers everyone at work and non-workers

such as visitors, members of the public.

Examples of what should be reported include:

death; major injuries such as broken arm/leg,

poisoning, electrical shock, amputation injury;

any injury where a person is away from work and

unable to do their normal job for more than three

days; certain cases of work related disease.

C / ALL

Incidents can be reported by:

T 0845 3009923

F 0845 3009924

Post to ICC, Caerphilly Business Park, Caerphilly

CF83 3GG (HSE) or via the internet at

www.riddor.gov.uk.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

9.11 There must be a suitably stocked first-aid box, as required under

the Health and Safety (First Aid) Regulations 1981, and a person or

persons must have been appointed to take charge should someone fall

ill or be injured, and to restock the first-aid box as required (L)

There must be an appointed person to take charge should someone fall ill or be

injured, and to restock the first-aid box. A second person must be appointed to take

charge if the first appointee is off duty.

A first aid box is required for each practice vehicle.

There is no standard list of items to be included in the first-aid box, although there is

a suggested minimum:

• A leaflet giving general guidance on first-aid;

• 20 individually wrapped sterile adhesive dressings (plasters);

• Two sterile eye pads;

• Four individually wrapped triangular bandages;

• Six safety pins;

• Medium-sized individually wrapped sterile unmedicated wound dressings;

• Two large sterile individually wrapped unmedicated wound dressings;

• One pair of disposable gloves;

• Tablets or medicines should not be kept in the first-aid box.

The inspector will ask to see the first-aid box, the

list of contents and will check that the contents

are in date and checked regularly.

An ‘Appointed Person’ is an individual nominated

by their employer to take charge when someone

is injured or falls ill. Their responsibilities

include looking after the first aid equipment,

eg restocking the first aid box and calling an

ambulance. Appointed persons should not

administer first aid unless trained to do so.

Note: Nomination of an appointed person is a

minimum requirement, but practices should

consider if an appointment of more than one

person is necessary or if a first aider should be

appointed. (A first aider is someone who has

undergone a training course in administering

first aid and holds a current first aid at work

certificate (these are time-limited to three years).

A first aider can undertake the duties of an

appointed person.)

For further guidance, see HSE leaflet INDG214

(rev 1).

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

9.12 The practice must have Employers’ Liability Insurance. The certificate

must be displayed for all members of staff to see (L)

9.13 The practice must have Public Liability Insurance (L)

9.14 There must be a written programme of formal visual inspection of

electrical equipment within the practice, as required under the

Electricity at Work Regulations 1989 and provision for safe installation

and maintenance of gas appliances (Gas Safety Installation & Use)

Regulations 1998 (L)

The practice must have a written programme for the inspection and testing of all its

electrical equipment. For the electrical installation in the building, the frequency

of the inspection (by a competent person) should be as directed by that competent

person. A formal visual inspection of portable appliances, cables and leads, should be

carried out at least annually, with a combined inspection and test recommended every

two years. Advice should, however, be sought from a competent person regarding the

appropriate frequency for combined inspection and test as this will depend upon the

individual circumstances of a practice. Equipment should be labelled with the date

of inspection, failed equipment must not be used and repaired equipment must be

tested before use. Residual Current Devices are required for any equipment used in

wet conditions.

All gas appliances require to be maintained in a safe condition. Advice should

be sought from a suitably qualified person regarding an ongoing programme of

examination.

C / ALL

The inspector will check that the certificate is

suitably displayed.

C / ALL

The inspector will ask to see the insurance

certificate or policy.

The inspector will ask to see:

• The PAT testing & visual inspection records

• Evidence of inspection of the electrical

installation by a competent person

• Gas safety certificates

Practices are referred also to their own insurers

for any requirements imposed by them.

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

9.15 Hazardous (special*) waste must be appropriately segregated, safely

stored and disposed of by a suitably permitted waste contractor

The inspector will ask to see evidence of:

• A contract with a permitted waste contractor(s);

• Policies and practice to segregate waste into appropriate streams and to store it

hygienically;

• Consignment notes for hazardous waste disposal, which form the basis of a

hazardous waste register for those practices in England and Wales;

• Hazardous waste registration for those premises in England and Wales that

produce more than 500kg of hazardous waste per annum.

*hazardous waste is referred to as special waste in Scotland

9.16 Non-hazardous (non-special*) waste must be appropriately

segregated, safely stored and disposed of by a suitably permitted

waste contractor

The inspector will ask to see evidence of:

• A contract with a permitted waste contractor(s);

• Polices and practice to segregate waste into appropriate streams;

• Waste transfer notes for non-hazardous waste disposal.

*Non-hazardous waste is referred to as non-special waste in Scotland

For both hazardous and non-hazardous waste,

practices may wish to refer to the BVA Good

Practice Guide to Handling Veterinary Waste

for guidance. However, local variations exist

and practices should consult the Environmental

Agency or their own local waste management

authority for information.

The inspector will ask to see:

• The PAT testing & visual inspection records

• Evidence of inspection of the electrical

installation by a competent person

• Gas safety certificates

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

9.17 The practice must be aware of The Lifting Operations & Lifting

Equipment Regulations 1998 and must carry out the necessary

examination/testing of any equipment covered by the Regulations prior

to use and thereafter have the equipment inspected regularly (L)

9.18 The practice must pass inspection by a Duty Firearms Officer in

respect of any firearms/tranquillizer and dart guns held at the practice

for the purpose of euthanasia/tranquillization of animals. Individual

veterinary surgeons must have been issued with the relevant firearms

certificate (L)

C / ALL

The Regulations require that lifting equipment is:

• Sufficiently strong, stable and suitable for its

intended use;

• Positioned or installed to prevent risk of

injury;

• Visibly marked with appropriate information

for safe use;

and that lifting operations are planned and

supervised and carried out by competent

operators.

Lifting equipment should be examined prior

to first use and thereafter inspected regularly

in accordance with recommendations of a

competent person who shall issue a certificate of

inspection and report of any action required.

An example of equipment covered by the

Regulations is overhead gantry cranes for lifting

anaesthetised horses. It is unlikely that height-

adjustable operating tables for use with small

animals where no ‘lifting’ as such takes place,

will be covered.

The inspector will ask to see the original firearms

certificate(s).

C / ALL

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

10 EMERGENCY SERVICE CLINICS

10.1 Staff

All clinical staff must be provided with guidance notes on emergency practice policies

before commencement of work. There must be formal evidence of induction of staff at

the outset of their employment.

A one-year CPD plan must be provided for the ESC team.

A full-time veterinary surgeon must be employed by each ESC premises who shall

have overall responsibility for all professional matters within the clinic.

A full-time Registered/Listed veterinary nurse must be employed by each ESC

premises, whose primary role is the responsibility for the nursing and clinical care of

the clinic’s patients and who shall be directly involved in such care.

At least one on-duty veterinary surgeon, directly responsible for the care of in-patients

and any new admissions or out-of-hours appointments must be on the clinic’s

premises at all times during all of the hours of operation of the clinic.

In addition to the veterinary surgeon, at least one other on-duty member of staff whose

role is the active involvement in nursing and medical care of patients must be on the

premises during all the hours of operation of the clinic.

Any on-duty staff member on a ‘rest break’ must at all times be readily available for

active duty during the hours of operation of the clinic.

A written agreement must be entered into with client practices which includes a

written policy on surgical complications of client practice cases and daily reporting of

clinical records back to the client’s practice.

There must be a written policy on answering the telephone, including how to answer

call outs, transport concerns and fee estimates.

There must be an animal ambulance service or agreement with a local animal

transport company for animals to be brought to the clinic.

A dedicated land-based telephone line for the emergency service must be provided.

A practice fulfilling the following requirements

IN ADDITION to all GP Small Animal Standards

may be accredited as a Small Animal Emergency

Service Clinic (ESC) and provide 24-hour

emergency cover to a SA Hospital.

GP / ESC

The aim for the future is that ESCs will be

required to increase the number of Registered/

Listed veterinary nurses employed by them.

Please refer to the Code of Professional Conduct

and Guidance note 3. While no acceptable

time or distance is specified, as each will be

influenced by local conditions, when making

arrangements for the provision of 24-hour

emergency cover, practices should give

consideration to these factors. Practices should

check carefully that their written contract/

agreement with another practice or Accredited

Emergency Service Centre (ESC) establishes

clearly who is responsible for out-of-hours home

visits, on the rare occasions that such visits may

be necessary

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

10.2 Clinical governance

The ESC must have a system in place for monitoring and discussing the clinical

outcomes of cases and acting upon the results. It is expected that outcomes will be

actively followed up with daytime practices/clients.

10.3 Premises and out-patient facilities

Emergency lighting must be provided to allow the ESC to continue to function in the

event of a power-cut or electrical failure. Additional emergency lighting to permit the

completion of essential tasks such as operative surgery, may be provided by back-

up generator, portable rechargeable lighting units, uninterruptible power supplies or

similar devices. Simple torches are not sufficient as emergency back-up in operating

areas.

10.4 In-patient facilities

Suitable facilities for neonatal care must be provided.

An ESC must have the ability to isolate an infectious animal from all other patients.

Isolation facilities must have:

• Separate air space;

• Ventilation that produces a negative air pressure in the facility to reduce the risk of

cross-infection;

• Hand-washing facilities;

• Separate drains to avoid cross-infection.

Isolation facilities can mean either a special area, which has limited access, or a

separate ward. It is recommended that there is a written policy which details the

procedure for isolation and care of cases including barrier nursing requirements.

The written policy must be displayed in an appropriate place and staff must be fully

conversant with its contents.

It is recognised that the ESC’s case-load will

differ from that of a SA GP/VH practice.

GP / ESC

Continuous lighting which is suitable to complete

operative surgery must illuminate automatically

in the event of power failure.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

There must be an ability to provide close control of fluid replacement by an infusion

pump or syringe driver suitable for infusion of high volumes rapidly or low volumes

slowly.

Facilities must be available for the intensive care of critically ill patients, to include:

• Intravenous fluid therapy;

• Blood transfusion;

• Oxygen therapy;

• Maintenance of body temperature.

Electrosurgery and suction must be available for surgical use and a clock with a

sweeping second hand must be visible from within the operating area.

There must be adequate primary and reserve supplies of oxygen.

10.5 Suitable monitoring of anaesthetised patients

Monitoring must be available, including pulse oximetry and capnography, blood

pressure measurement facility, and oesophageal stethoscope. Records of vital signs

and agents employed must be retained. Evidence of staff training in the use of

monitoring facilities must be provided.

There must be adequate post-anaesthetic monitoring. An anaesthetic monitoring

room or area must be available and records must be maintained until the animal

has recovered. Proper ventilation must be provided to limit staff exposure to exhaled

gases.

10.6 Diagnostic equipment and facilities

The following equipment must be available on site:

• Electrocardiography (ECG) - recordings must be suitably filed and stored;

• Ultrasound system, capable of providing diagnostic quality images of the full range

of species treated;

• Endoscope(s) of an appropriate quality suitable for the workload of the clinic.

GP / ESC

The criteria should not be interpreted to imply

that every piece of monitoring equipment is

required for every operation. What is required

should be based on a risk assessment and will

depend on the number and nature of operations

performed – practices should ensure that

equipment provided is adequate for the work

actually undertaken.

Evidence must be provided of training or CPD for

staff in use of all equipment. Reference material

must be available.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

10.7 Laboratory facilities

Laboratory facilities for routine diagnostic tests must be available at all times.

Suitable arrangements must be made for the following detailed investigations:

• Biochemistry;

• Haematology;

• Parasitology;

• Bacteriology.

The following equipment must be provided on the premises:

• Binocular microscope with mechanical stage, electric light source and oil

immersion facility;

• Centrifuge suitable for PCV, blood separation and urine sedimentation;

• Urinary refractometer;

• Biochemistry analyser to include Creatinine, Urea, Glucose, Total Protein and

Calcium;

• Electrolyte analyser.

There must be the ability to look at smears on

site. Evidence must be provided of training or

CPD for staff in use of all equipment and in the

interpretation of results. Reference materials

must be provided.

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

APPENDIX 1

Additional resources to be provided by GP-level practices wishing to apply for

accreditation as a Veterinary Nursing TP.

In-patient facilities

There must be a minimum of six kennels or cages for the hospitalisation of patients.

Clinical governance

Relevant caseload for completion of training portfolio by Student VNs.

Minimum caseload requirements include:

• 100 small animal cases/consultations per week;

• 20 general anaesthetic cases per week;

• 10 radiographic exposures per week;

• Level 3 students – 10% of time or one half-day per week to be spent on each of

radiography (including positioning, processing), and biochemistry (including blood

chemistry);

• 10 cases/consultations per week;

• 10 radiographic exposures per week.

(The figures are for guidance only and may vary depending upon the range of cases

and number of students in training.)

Diagnostic equipment and facilities

The practice must have either:

• A range of endoscopes of appropriate quality;

• An ultrasound system capable of providing diagnostic quality images,

and must provide SVNs with access to whichever equipment is not on site through

secondment to another practice/hospital.

GP / SA

GP / EQ

GP / SA &

.EQ

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable

Laboratory facilities

Laboratory facilities for routine diagnostic tests must be available, and the following

equipment provided on the premises:

• Centrifuge and centrifuge tubes;

• Haemotocrit;

• Glass slides;

• Stains for blood films;

• Blood biochemistry analyser.

GP / SA &

.EQ

C Core Standards GP General Practice VH Veterinary Hospital SA Small Animal FA Farm Animal EQ Equine ESC Emergency Service Clinic

L Legislative Requirement ++(FA) The Standard is to be met by GP/FA, if applicable