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Clinical Practice Yr1 > 2nd Opinion, Referrals & Specialists > Flashcards

2nd Opinion, Referrals & Specialists Flashcards

1
Q

From the COC, what 8 factors are considered to gain informed consent?

A
  1. The procedure/treatment
  2. Likely outcomes
  3. Don’t make assumptions
  4. Financial estimates + limits
  5. The diagnosis is tentative
  6. Any questions?
  7. Avaliability of other treatments
  8. Consent for deviations
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2
Q

What does ‘procedure/treatment’ mean, when gaining informed consent from a client?

A

The nature, purpose + benefits of any treatments + procedures

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3
Q

What does ‘likely outcomes’ include when informing clients upon a procedure, when gaining consent?

A

Given a clear indication of both common + serious risks, in a way that they client understands

Including explaining any clinical terms etc

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4
Q

Why should the VS avoid making assumptions when gaining consent from clients?

A

This refers to not making assumptions about:
* The client’s finanical constraints
* Client’s understanding of the possible side effects + potential complications
* Faliure to achieve the desired outcome, with the agreed treatment

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5
Q

Where should finanical estimates + any agreement on any financial limits be recorded?

A

On the consent form +/or on an attached detailed estimate

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6
Q

What does it mean by ‘the diagnosis is tentative’ mean when gaining consent from a client?

A

This means that an appropriate explanation is given to the client to explain that a diagnosis, if tentative, can be subjected to further investigation

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7
Q

Why should you ask client’s if they have any questions when you gain consent from a client?

A
  • To check they fully understand what has been explained to them
  • To see whether they have any questions or concerns regarding the diagnosis, treatment or costs
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8
Q

Why is it important to inform clients - where appropriate - what other treatments are avaliable?

A
  • Give the client a greater potential benefit or choice
  • Makes the client feel more in control
  • Most important in refferals + second opinion practices
  • May be benefical for the VP
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9
Q

Why is it important to get consent for deviations, from clients?

A
  • To ensure that consent can be obtained for any potential deviations as possible, includings costs
  • Ensure smooth treatment in case of emergency
  • Also to ensure that the practice has the client’s emergency contact details are accurate + up to date
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10
Q

What is a referral?

A

1.2 “A referral may be for a diagnosis, procedure and/or possible treatment, after which the case is returned to the referring veterinary surgeon”

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11
Q

What is a second opinion?

A

“A second opinion is only for the purpose of seeking the views of another veterinary surgeon”

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12
Q

What 2 things should VS consider when they refer a patient + client?

A

They should be satisfied they are competent to carry out the investigations or treatment involved, and to:

  • Recognise when a case or a treatment option is outside of their area of competence
  • Be prepared to refer them to a colleague, organisation or institution
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13
Q

What 5 things should VS’s take into consideration when they are referring clients + patients?

A
  1. Ability + experience of the referral VS
  2. Location of the service
  3. Urgency of the treatment
  4. Circumstances of the owner
  5. Avaliability + any limitations of insurance
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14
Q

True or False.

VS should be prepared to justify their referral decisions + should record the reasons for their decisions.

A

True

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15
Q

True or False.

The VS is not required to inform the client about the level of expertise of the VS the are reffering them to.

A

False, they should, in principality!

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16
Q

True or False.

In principality, a VS cannot describe a referral VS as a specialist or advanced practitioner, unless they are on the respective list.

A

True

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17
Q

Can the referring VS set up the appt w/ the client + referral VS or should the referral VS?

A

The referral VS should always arrange the appt with the client, not the referring VS

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18
Q

What 4 pieces of information does the referring VS need to share with the referral VS?

A
  1. Client data (once client agrees to referral)
  2. Case history
  3. Diagnostic results
  4. Any other necessary information
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19
Q

Name as many criteria as possible that a Specialist VS require to maintain their qualification?

A
  • Postgraduate qualification at least at a diploma level
  • Must satisfy the RCVS that they can make an active contribution to their specialty
  • Must be avaliable for referral by other veterinaryy colleagues
  • Have a national + international acclaim
  • Publish widely in their field
  • Must be a current active practitioner within the specialised field
  • Must reapply for recognition every 5 years
  • Must be acknowledged by peers in the area of specialization
  • Maintain an acceptable CPD
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20
Q

Give a few examples of what types of CPD a Specialist VS can use to obtain

A
  • Teaching
  • Reviewing
  • Examining
  • Publications
  • Attendind + participating in national + international meetings within the specialised field
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21
Q

According to the COC, section 21, how is a VS certification acquired?

A
  • A written statement made w/authority
    (Authorirty in this case, coming from a VS professional status)
  • Not all certificates contain the word ‘certificate’
    (Some documents may involve the same level of responsibility, even if they do not contain the word ‘certificate’)
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22
Q

Give 5 examples of VS certification formats

A
  • Forms
  • Declarations
  • Insurance claims
  • Witness statements
  • Self-certification documents
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23
Q

True or False.

VS are frequently required to sign certificates as part of their day-to-day professional duties.

A

True

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24
Q

Name 5 examples that VS’s require to sign on a regular basis

A
  • Pet passports
  • Equine passports
  • Fitness to travel certificates
  • Fitness to bread certificates
  • Equine pre-purchase examination (PPE) certificates
25
Q

What does the abbreviation ‘‘OV’s’’ refer to?

A

Official Veterinarian’s

26
Q

Who are Official Veterinarian’s?

A

Practitioners who are authorised by the UK government to carry out certain duties, including certification responsibilities

27
Q

Who gives Official VS’s the pay?

(OVs)

A
  • UK Government
  • DEFRA
  • Executive agencies (Like APHA)

  • DEFRA = Department for Enivironment, Food & Rural Affairs
  • APHA = Animal, Plant and Health Agency
28
Q

What are OVs commonly asked to sign?

A
  • Certificates that relate to live animals or products of animal origin
  • Including meat, diary products, animal by-products + genetic material
29
Q

True or False.

VS’s do not have a responsbility to ensure the integrity of veterinary certification.

This includes the simple act of signing their names on documents, should be approached w/care + accuracy.

A

False, they do!

30
Q

True or False.

According to 21.3 of the COC, Veterinary certification plays a significant role in the control of animal health and welfare, the continuity of European and international trade and the maintenance of public health

A

True

31
Q

True or False.

21.4 of the COC states that VS’s must certify facts + opinions honestly and with due care, taking into account the 10 Principles of Certification set out below.

They should not sign certificates which they know or ought to know are untrue, misleading or inaccurate.

This applies equally to hand-written, printed and electronic certificates.

A

True

32
Q

How many principles of certification are there?

A

10

33
Q

What is the 1st principle of certification?

A

A VS should certify only matters which are ;

  1. Within their own knowledge
  2. Can be ascertained by them personally
  3. Are the subject of supporting evidence from an authorised VS who has personal knowledge of the matters in question or;
  4. Are the subject of checks carried out by an Officially Authorised Person (OAP)
34
Q

What is the 2nd principle of certification?

A

VS’s should not issue a certificate that might raise questions of a possible conflict of interest

35
Q

What is the 3rd principle of certification?

A

A VS should only sign certificates that are written in a language they understand

36
Q

What is the 4th principle of certification?

A

A VS should not certify that there has been compliance with the law of another country or jurisdiction unless the provisions of that law are set out clearly on the certificatte or have been provided to them by the Competent Authority in writing

37
Q

What is the 5th principle of certification?

A

A VS should only sign original certificates. Where there is a legal or official requirement for a certified copy or duplicate (marked as such) these can be provided.

38
Q

What is the 6th principle of certification?

A

When signing a certificate, a VS should ensure that ;

  1. The certificate contains no deletions or alterations, other than those which are indicated on the certificate to be permissible, and subject to such changes being initialled and stamped by the certifying VS;
  2. No section of the certificate is left incomplete
  3. The certificate includes not only their signature but also, in clear lettering, their name, qualifications and address and (where appropriate) their official or practice stamps
  4. The certificate includes the date on which the certificate was signed and issued and (where appropriate) the time for which the certificate will remain valid.
39
Q

What is the 7th principle of certification?

A

Certificates should be written in simple terms which are easy to understand.

40
Q

What is the 8th principle of certification?

A

Certificates should be:

  1. Clear and concise
  2. Integrated, whole and indivisible
  3. Given a unique identifier
  4. Copied and retained with all relevant records
41
Q

What is the 9th principle of certification?

A

Certificates should not use words or phrases which are capable of more than one interpretation.

42
Q

What is the 10th principle of certification?

A

Certificates should clearly identify the subject being certified

43
Q

What are the 4 C’s of certification?

A
  1. Caution
  2. Clarity
  3. Certainty
  4. Challenge
44
Q

What is the importance of caution in the 4 C’s of certification

A
  1. Scrutinise the document, whatever its title, before adding their signature to this
  2. Be clear as to whom they are responsible in exercising their authority when they sign the document
45
Q

What is the importance of clarity in the 4 C’s of certification

A
  1. Read and understand any explanatory supporting material
  2. Check carefully for any ambiguity which should be clarified with whoever has issued the certificate
46
Q

What is the importance of certainty in the 4 C’s of certification

A
  1. Be sure that they attest only to what to the best of their knowledge and belief is true
  2. Do not attest to future events
  3. Take great care when attesting to what others have declared or asserted

(VS’s may attest to what another VS has certified. They may also attest to the fact that a declaration or assertion has been made by another person without attesting to its validity).

47
Q

What is the importance of challenge in the 4 C’s of certification

A
  1. If they have gone further in what they have attested, VS’s must consider what their defence would be if challenged, and keep appropriate written records made at the time of the decision to sign. For example, if challenged under the Animal Health Act 1981 (as amended) with false certification could they show (in the words of that Act):
  2. That he did not know of that falsity and that he could not with reasonable diligence have obtained knowledge of it;
  3. That the commission of the offence was due to a mistake or to reliance on information supplied to him or to the act or default of another person, an accident or some other cause beyond his control; and
  4. That he took all reasonable precautions and exercised all due diligence to avoid the commission of such an offence by himself or any person under his control.

21.37 When faced with a certificate that does not conform to the 10 Principles, VS’s should take a professional, reasonable and pragmatic approach, bearing in mind the general advice above.

48
Q

What is a Certification Support Officer (CSO) or Trade Certification Support Officer (TCSO)?

A

They work under the direction, authority and responsibility of the certifying OV

49
Q

What is an official auxiliary?

A

They work under the direction or supervision of the certifying OV and/or for whom the OV has responsibility (as defined in UK legislation)

50
Q

What is a portal assistant?

A

They work under the direction or supervision of the certifying Portal Official Veterinary Surgeons (P-OVS) and/or for whom the P-OVS has responsibility (as defined in UK legislation)

51
Q

What is a Food Competent Certifying Officer (FCCO)?

A

They are designated by the UK Competent Authority to provide official Export Health Certification

52
Q

What is a Fish Health Inspector (FHI)?

A

A person authorised by the relevant Competent Authority in the UK to carry out official controls for aquatic animals. FHIs may provide evidence to OVs which includes clinical judgement or diagnosis relating to aquatic animal health

53
Q

What is a Official Bee Inspector?

A

A person authorised by the relevant Competent Authority in the UK to carry out official controls for exports of honey bees (Apis mellifera) and bumblebees (Bombus species). BIs may provide evidence to OVs which includes clinical judgement or diagnosis relating to bee health

54
Q

What are the 4 main hazards for VS when they are certifying documents?

A
  1. Negligence
  2. Criminal offences
  3. Professional misconduct
  4. Loss of OV status
55
Q

What is considered negligence when it comes to certifying documents?

A
  • A breach of the duty owed to a relevant party with consequent damage.
  • Negligence may arise from a failure to disclose all of the material facts or supplying incorrect information. The consequence may be civil court proceedings.
56
Q

What is considered a criminal offence when it comes to certifying documents?

A
  • Criminal offences may be committed under trade descriptions legislation, legislation controlling animal exports and by aiding and abetting a third party.
  • They may include fraud, or knowingly or recklessly supplying false information.
  • Any conviction brought to the notice of the RCVS may be considered in relation to the fitness of the veterinarian to practise.
57
Q

What is considered a professional misconduct when it comes to certifying documents?

A
  • Even if no criminal charges are brought, an aggrieved party or enforcement authority may make a formal complaint to the RCVS.
  • Any action by a veterinarian which brings the integrity of veterinary certification into disrepute is considered seriously by the RCVS.
  • If the complaint is judged to be justified, penalties may follow.
58
Q

What is considered a loss of OV status when it comes to certifying documents?

A
  • Misleading, incomplete, inaccurate, or untrue certification in the context of official work can adversely affect animal welfare and public health;
  • result in the spread of disease;
  • result in financial loss to clients and exporters;
  • and, potentially cause inter-Governmental difficulties. Veterinarians may therefore put their status as an OV at risk if they do not follow certification compliance requirements set out by the relevant Competent Authority.
59
Q
A

Clinical Practice Yr1 (19 decks)

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