OOH Vets - how can this be right ?

[Highmileagecob]

Back in the 80s, a colleague moved to another practice out of area. He moved from working a night call after a full day's work and being expected back in the office at 9am the following day, to working a night call after a day's work, take the following day off to recover, and keep 50% of all out of hours call out fees. However, times have changed. Rolling out of bed at 3am to open up the surgery, not knowing if this is going to be a hoax call or worse has definitely had an impact on OOH services. I wouldn't like to think of a lone female vet or nurse doing that in this day and age.

 

[pistolpete]

I left my job as a vet receptionist of 27 years due to corporate take over. Total farce it became. All about money and people not the animals. Terrible! I have same here but up to now luckily I’ve nursed my dog at home after surgeries. Drips are a worry though. Last time she was ill I syringed fluids into her. Kept her out of hospital!

 

[EventingMum]

I had a fantastic mixed practice for our animals but sadly the owner/senior vet sold out to a corporate company and then retired. Shortly after they stopped doing large animals and OOH. The only option for OOH from them is going into the centre of Glasgow which is now a LEZ zone which could prove problematic for some people and is probably 45 minutes away from us. Fortunately we managed to transfer the cats and dogs to a local family practice (father and his 2 daughters) and they do OOH. They provide a wonderful service and we are lucky to be registered with them however their current waiting list is 3+years. The practice we transferred the horses to was fine but then stopped covering our area as they couldn't provide OOH cover but fortunately Glasgow university vet school started a first opinion practice. The beauty of this is that it is based with the equine hospital and both work together which makes things very easy.

 

[meleeka]

I understand that it’s not cost effective to provide OOH, but I’d rather the dog stayed at the emergency vet if it’s admitted there OOH. My vet is a hospital and when my dog was admitted at 11pm she stayed there until she was discharged. Why doesn’t it work like this for normal vets when OOH is used? Why do they have to keep going backwards and forwards, rather than just stay there?

 

[druid]

I understand that it’s not cost effective to provide OOH, but I’d rather the dog stayed at the emergency vet if it’s admitted there OOH. My vet is a hospital and when my dog was admitted at 11pm she stayed there until she was discharged. Why doesn’t it work like this for normal vets when OOH is used? Why do they have to keep going backwards and forwards, rather than just stay there?

Some are not staffed in normal working hours making transfers necessary. Some, like mine, are 24/7, 365.

 

[blackcob]

Some are on the model ycbm referred to where they occupy a practice overnight only.

Ours is an also a 24/7 hospital so animals stay until they are discharged to their owner.

 

[meleeka]

So if the dog has a life threatening illness/accident, what happens then? I can’t imagine collecting a critically ill dog and driving them to another practice can be anything other than extremely risky. What happens if the dog needs emergency surgery overnight?

 

[rara007]

Surgery is done overnight, it’s fully staffed by night workers. Critical cases don’t move (unless via ambulance, with vet and oxygen generally to specialist hospital) but ‘stable’ ones do.

 

[cbmcts]

I had to do this with my little dog last summer. He had what is assumed to be an acute bacterial infection - like the Exorcist, blood spewing from both ends! But to my surprise, I quite liked that I'd get to see and spend half an hour, twice a day with him especially as at one point, there was no certainty that he'd survive. While the OOH were good, I do think that vets who knew him and fabulous nursing during the day really helped.

Previously, I've always chosen vets based on them providing their own OOH/having a hospital after a very bad experience with driving an hour away with a dying cat years ago. I use the vet I have now because a) they are fantastic, all their staff go above and beyond b) they are willing to work with me to deal with idiot big dog and C) perhaps unfairly I've never forgiven my previous practice for losing another dog through inaction during the first lockdown and they are now the only practice locally that do their own OOH.

 

[SkylarkAscending]

I choose my vet accordingly I must admit - (1) who the vets are (I follow The Best Vet Ever round from practice to practice!) and (2) what their OOH provision is.

Yet again the practice I’m registered with has sold out to new partners without informing its clients - drives me mad! - but they still offer their own OOH at the moment, and there is only one vet there that I’d see over my dead body….

 

[SusieT]

It's not right - the answer is to use the vet with the 24/7 cover on side and use them all the time - support the practice that invests in 24/7 care and the one that insists on yo yoing clients about should be not supported.

 

[SusieT]

This happens round here a lot. I was lucky when Ruby was very poorly on a BH weekend. My wonderful vet missed a wedding to stay back and care for her and another dog who were in and really unwell. He was amazing. He also phoned me several times a day to update me.

She had had an exploratory laparotomy because her bowel was paralysed though no one knew why. The laparotomy showed nothing but it was still major surgery. She had IVs and antibiotics etc as well as pain relief and he felt she would be better with him than OOH. A 4 night stay with surgery and meds, an ultrasound, bloods, xrays and drips cost me 2.5k. Goodness knows what it would have cost at OOH.

This is why I love my vet. Usually they would have transferred her, they told me, but I am unconvinced. I think where possible they keep their own patients. There was only him all weekend - no nurse as they should have been closed. I bought him some very nice wine to say thank you. We are lucky. The local OOH charges over £300 for a basic look at an animal - all treat is extra and very expensive compared to my vets.

out of interest- do you think he was with your poorly dog 24/7 for that cost - I would guess that she was alone and unsupervised a fair bit of the time which I wouldn't want to be paying for... Most vets doing this leave at x time and come back at y time and the patients are either alive or dead...

 

[AmyMay]

It's not right - the answer is to use the vet with the 24/7 cover on side and use them all the time - support the practice that invests in 24/7 care and the one that insists on yo yoing clients about should be not supported.

Have you read the thread?

 

[cbmcts]

It's not right - the answer is to use the vet with the 24/7 cover on side and use them all the time - support the practice that invests in 24/7 care and the one that insists on yo yoing clients about should be not supported.

I do agree with you in theory and did do just that for many years. I could have left my dog at the hospital as they are a general practice as well for the whole time he was ill without any huffing or puffing from my vets. But I wanted them overseeing his care because they know him, I trust them and they are great. But they are a small practice, only 3 vets and it recently took them 6 months to replace one. There is no way they could staff OOH and tbh, I know that they would be poorer vets if they tried to.

 

[skinnydipper]

It's not right - the answer is to use the vet with the 24/7 cover on side and use them all the time - support the practice that invests in 24/7 care

and where does one find one of those? Not in this town.

We had 3 independent vet practices, 2 of those did their own OOH, now none do. One practice, the one I have gone to for decades, has sold out to corporate vets and OOH is now 45 mins away at best.

 

[druid]

It's not right - the answer is to use the vet with the 24/7 cover on side and use them all the time - support the practice that invests in 24/7 care and the one that insists on yo yoing clients about should be not supported.

Not always possible, my OOH is a refferal level hospital who run OOH 24/7, 365 for the practices they work with in a dedicated Emergency unit. They do not do any routine work.

 

[oldandgold]

Our vets is a corporate and I know that they have been taken for a ride with new clients who have had surgery done and then refused to pay. I think now if you are a long established client they are happy to treat with no upfront payment, but for newer clients they do ask for part payment - can't say as I blame them for doing that.

Our original vets stopped doing there own ooh service as it was just not viable, current vets now do have their own ooh's but it is approx 20 - 30 minutes away from us, not ideal but I don't think many of our local vets cover their own ooh.

 

[PurBee]

We're lucky our OOH vets are still fairly local to the main vet practice. Although a few months back we had a ‘lost in translation’ episode and were huffing and puffing for a while how we were meant to travel an animal 3+ hours away, (weird minor symptom cat - called for advice really), but that was because the heavy irish accent vet combined with terrible phone line said “im not available right now as im a’calvin’” - which we understood to be he was busy in Cavan county, rather than calving cows locally

A relative had to travel a dog while under GA from the local vets, who realised the proposed surgery wasnt possible for them once they opened the dog up, and told him to travel an hour away with the dog to a specialist OOH hospital in the middle of the night. 1st vets advised pts on the table, 2nd vets did the surgery successfully.

 

[Umbongo]

It has been a thing for years, but is certainly more common now with the widespread opening of OOH providers such as VetsNow and Minightvet. There is more focus on the metal health and well-being of veterinary staff now than there used to be too. It is not necessarily a corporate thing either. Private practices may pay an external OOH provider as they are not able to provide their own OOH.

To provide OOH care there a a few options that clinics can do:
- A vet/nurse would be on call for emergencies. Patients may be by themselves overnight for periods of time.
- A nurse/vet there all night. The nurse may be there all night, and call in the vet if needed.
- Have their own OOH team in practice all night.
- Use an external OOH provider that either has their own building, or uses another vets building. So pets have to be transported back to their own clinic for the day.

Most practices may not have their own OOH staff due to:
-Staffing (they may not be able to spare any of their day staff).
-Costs (salaries would need to be a lot higher)
-Expertise (some vets may not be confident with OOH, depending on that vets experience and areas of interest/specialism)
-Equipment (some emergencies may require equipment or drugs that the practice doesn't have, as they don't see those types of cases during the day eg. a ventilator)

The reason why pets may need to be transported back to your own vets for the day, is because most OOH providers are solely night staff. If they have their own building then it will be closed during the day. If they use another vets building, then that vets will have their own client base. They may have a full day of pre-booked consults/procedures and may not have the physical space/staff/equipment/expertise to care for X number of sick OOH patients too. Your vets contract will be with the OOH provider, not with the vets that are hiring out their building to the OOH provider. Or your OOH provider may be the local big referral hospital such as the RVC, Langford etc that are open 24/7. They may keep your pet there until treatment is over. Especially if your pet needs CT/MRI, or requires something that may need referral anyway. But you will be paying $$$ and many owners opt to take their pet back to their day clinic anyway because of costs. Equally if it is something that the your own vets can sort, then the OOH may send the patient back to the GP vet anyway. It depends on their policy and the contract they have with each other.

Most OOH providers will always ask you to pay fully upfront, a deposit and/or take down your insurance details. OOH care is expensive, and unfortunately too many people over the years have abused the system and not paid for their veterinary treatment. So sadly most vets have to take this approach now or they will go bust.

Most of the time it does work fine even though it's frustrating, but sometimes it's not ideal for very sick patients. I have on occasion been in the back of the vets car, monitoring a sedated patient going to/from the OOH provider. As it was not ideal for the owner to do so. The regular vets and the OOH provider do try to make sure that patients are in a stable condition prior to transportation, but obviously situations can change on the journey. It is less than ideal, but because of this I would recommend that anyone looking for a new vets to explore the vets website. Ask them about their OOH service and make sure YOU are happy with it. If they use an external OOH provider, how close are they? If too far away, is there another OOH service closer to you that you can use instead? Some vets may also have their own pet ambulances that can transport pets in situations like this, or know of some pet taxi companies that can help.

 

[meleeka]

Our vets is a corporate and I know that they have been taken for a ride with new clients who have had surgery done and then refused to pay. I think now if you are a long established client they are happy to treat with no upfront payment, but for newer clients they do ask for part payment - can't say as I blame them for doing that.

Our original vets stopped doing there own ooh service as it was just not viable, current vets now do have their own ooh's but it is approx 20 - 30 minutes away from us, not ideal but I don't think many of our local vets cover their own ooh.

That’s another plus of being a client of the vet hospital. They’ve never asked for money in advance. Last time I was there somebody outside was frantically trying to find a friend who could lend them the consult fee as the vets wouldnt see them without the payment in advance.

 

[SusieT]

Not always possible, my OOH is a refferal level hospital who run OOH 24/7, 365 for the practices they work with in a dedicated Emergency unit. They do not do any routine work.

Thats poor. Do they not look after any first opinion?

 

[SusieT]

So drive for it?

and where does one find one of those? Not in this town.

We had 3 independent vet practices, 2 of those did their own OOH, now none do. One practice, the one I have gone to for decades, has sold out to corporate vets and OOH is now 45 mins away at best.

 

[ycbm]

That’s another plus of being a client of the vet hospital. They’ve never asked for money in advance. Last time I was there somebody outside was frantically trying to find a friend who could lend them the consult fee as the vets wouldnt see them without the payment in advance.

The vet hospital I use demand a credit card number from clients they don't know before a first treatment and payment on the day for all the work they do at the hospital.
.

 

[druid]

Thats poor. Do they not look after any first opinion?

I don't think you understand what a refferal level hospital is. Of course they don't see any first opinion work, that is not their scope. They provide specialist services on a refferal basis and OOH care via the EMERGE unit (Veterinary Specialists Ireland if you want to look them up).

 

[skinnydipper]

So drive for it?

What I plan to do is change to one of the remaining independent vets. For OOH cover both use a referral hospital with 24 hour emergency unit and which is nearer than the corporate vets OOH practice..

 

[CorvusCorax]

I've used OOH before at the closest vet to me (literally five minutes drive).
It's an old house converted so I know there are bedrooms above. I've actually started using it lots more since it was majorly renovated as the original layout was just too tight, it was a literal house and everyone was on top of each other.
My young one was in overnight and was very well taken care of, they were present when she ripped her drip out and ate her vetbed

It's not sleepysville but I've never, ever heard about/considered the vets being at risk. I didn't even know it was a thing until I read this thread.
When I rang at 10pm for the old (then young) dog swallowing a magnet it was a young male vet who was obviously out in the 4x4) and he was there very quickly to give the bokey jab.
One of the partners lives about five minutes away in a palatial gaff on a massive farm.

I appreciate I am very lucky.

 

[druid]

It's not sleepysville but I've never, ever heard about/considered the vets being at risk. I didn't even know it was a thing until I read this thread.
When I rang at 10pm for the old (then young) dog swallowing a magnet it was a young male vet who was obviously out in the 4x4) and he was there very quickly to give the bokey jab.
One of the partners lives about five minutes away in a palatial gaff on a massive farm.

I appreciate I am very lucky.

I've got a friend who worked in NI in a mixed practice that had 4 locations. One of those was broken into 7 times in her few year stint there and staff threatened.

 

[blackcob]

The vet hospital I use demand a credit card number from clients they don't know before a first treatment and payment on the day for all the work they do at the hospital.
.

The last referral centre I went to as a client rather than an employee had a keypad barrier to exit the car park; you got the code at the point of payment.

Part of my role is in credit control and I must admit I did think this a very neat solution!

 

[Umbongo]

Also wanted touch on the fact that yes, a lot of vets did used to do their own OOH. Because practices used to all be privately owned back in the day. Legally, vets HAVE to make sure there is OOH cover and external OOH providers weren't so much of a thing back then so they had to do it themselves, now it is more common to use an external company that may/may not be on-site. Also a vet who owned a practice would have a financial interest in it, they would want to make sure that all revenue was contained within their clinic, and want to make sure they kept their clients and grow their client base.

Vets who don't have a dedicated night team and do their own OOH may work all day, be on-call all night, and have to work a 12-hour shift the following day on no sleep, leading to poor mental health and a potentially lower standard of patient care. With many staff leaving altogether and the profession having quite a high rate of suicide; mental health and well-being is something that practices are trying to take a bit more seriously now and do more to help. A lot of practices are also short staffed generally. With daytime vacancies sitting open for months/years. It would be impossible for them to cover their own OOH too. Also a dedicated OOH team/provider would normally have a team of vets/nurses/assistants who specialise in emergency care and have undergone further training to deal with emergency situations that may not always be seen routinely in day practice.


Also re: safety concerns. I once worked as a sole night nurse in a 24/hour hospital in a quite nice area. If I took dogs out for a wee I had to carry a baseball bat just in case. If a someone was at the front door with an emergency and the vet wasn't there yet, I had to let them in to the waiting room so I could triage the animal. Many times I felt unsafe whilst I was alone with clients in the hospital. I've also worked in places where a single member of night staff, had to lock themselves in the toilet and wait for police to arrive whilst idiots tried to break in. So some practices may not provide their own OOH if they cannot ensure the safety of their staff. I would work nights again, but only as part of a bigger, dedicated OOH team.

 

[CorvusCorax]

Just to add I wasn't disputing the safety issues at all, I just naively never considered it.