SOUTH AFRICAN VETERINARY COUNCIL
1. GUIDELINE DOCUMENT FOR THE AUTHORISATION OF ANIMAL WELFARE ASSISTANTS TO PERFORM VETERINARY AND PARA-VETERINARY PROCEDURES IN TERMS OF SECTION 23(1)(c) OF THE VETERINARY AND PARA-VETERINARY PROFESSIONS ACT, 19 OF 1982
The South African Veterinary Council (SAVC) approved the authorisation of Animal Welfare Assistants (AWAs) in 1999 in order for AWAs to legally perform primary animal health care work, which was required in areas where there were no veterinary services available, and to regulate the activities of AWAs.
The approval followed after consideration of a request submitted by the Animal Welfare Organisations (AWOs), as well as several discussions and meetings with various role players.
The SAVC held a strategic workshop on the 31st of May and the 1st of June 2005 where SAVC members discussed various aspects of improving access to primary animal health care services to the public and in particular to previously disadvantaged communities. The SAVC is committed to ensure that the South African public has access to quality primary animal health care.
However, there have been several concerns and debates on:
Ø The future requirements for AWAs;
Ø The demand for services by AWAs;
Ø The relationship between AWOs, private and state veterinary and para-veterinary professions; and
Ø The services to be rendered by each sector
The authorisation of AWAs to perform primary animal health care services is a special dispensation granted in order to ensure that the public has access to these services. However the use of AWAs is not intended to replace the use of qualified veterinary and para-veterinary professionals. It is therefore critical that in the review of the policy on the authorisation of AWAs cognisance must be taken of the number of para-veterinarians (Veterinary Nurses and Animal Health Technicians) that have qualified since the approval of authorisation of AWAs by the SAVC.
The future vision for and intention of the SAVC is for registration and regulation of AWAs as a fully-fledged para-veterinary profession. In this regard, the SAVC has resolved that as of the year 2012, AWAs will no longer be authorised by the SAVC on the current system. AWAs will require an SAVC approved qualification in order to register as para-veterinary professionals. The onus is on the AWA profession itself to ensure that a suitable course is established well in time for the deadline on the cessation of AWA authorisation in its current form. The role of the SAVC is to register professionals, regulate the practising of the profession and set and maintain professional standards.
B REASONS FOR AUTHORISING ANIMAL WELFARE ASSISTANTS
1. To promote animal welfare and primary animal health care;
2. To enable AWAs to perform veterinary and para-veterinary procedures where there are no other veterinary and/or para-veterinary services available; and
3. To regulate the activities of AWAs.
C MINIMUM CONDITIONS OF AUTHORISATION
An AWA must, regardless of the procedures that the individual will perform, be able to perform all the procedures listed in paragraphs 1.1 – 1.6 under Criteria for assessment of competency for authorisation of Animal Welfare Assistants.
The optional procedures listed under paragraphs 2.1, 3.1 – 3.4 and any other additional procedures could be authorised on motivation and confirmation of competency.
1. The applicant must be in the service of a bona fide AWO.
Ø The AWO must be registered as a non profit organisation with a fund raising number;
Ø The AWO should submit its constitution to the SAVC ; and
Ø Have at least one veterinarian in its employ or in its service or under contract under whose direction the AWA will be working.
2. The application to be submitted by an AWO is to be accompanied by:
a) A list of procedures that the applicant will routinely be required to perform indicating whether or not these procedures are to be performed at a registered veterinary facility or from a mobile unit, and in what species they are to be performed;
b) A list of scheduled medicines that will be used to perform these procedures and the reasons for the need to use the scheduled medicines;
c) A letter of recommendation from the veterinarian employed by or in the service of or contracted to the AWO confirming the following:
- That s/he is satisfied that the AWA will be able to perform the listed procedures;
- The level of supervision i.e. continuous (veterinarian employed full-time by the AWO) or intermittent (please specify e.g. daily telephonic contact, weekly visit etc);
- Nature and location of the AWA’s work e.g. consulting owners from a mobile clinic, consulting owners at the AWO, assisting in the hospital etc.;
- The name of the registered facility that will support the AWA;
- That in the case of authorisation to euthanase the AWA is competent to handle and store the relevant medicine and understands the importance thereof; and
- That s/he will monitor the record keeping by the AWA of all procedures performed and scheduled medicines used, in line with the rules and regulations of the veterinary and para-veterinary professions and the relevant Medicine Control Council (MCC) legislation;
d) A certified copy of the MCC permit to keep scheduled medicines, if applicable;
e) Copy of an advertisement for the services of a para-veterinary professional placed in either the SAVC newsletter or in a relevant publication of the para-veterinary target groups (Veterinary Nurses and Animal Health Technicians) dated not more than six months before the date of the application; and
f) Proof that a para-veterinary professional (Veterinary Nurse or Animal Health Technician) could not be employed in the position;
g) A motivation for the need to use an AWA specifying the area (details of the exact location to be included, or a separate motivation as in (k) below) where the applicant will be performing the procedures and must include support from:
- A minimum of two of the closest private practitioners in the same area; and
- The state veterinary services responsible for the area.
h) An SAVC approved assessment of the AWA’s competence;
i) Proof of payment of the assessment fee determined by the SAVC;
j) Payment of the authorisation fee determined by the SAVC;
k) Motivation to work in a wider geographical area, where applicable (refer point D 1.2 below).
3. AWAs performing intravenous catheterisation
Applications to perform intravenous (I/V) catheterisation will only be considered upon receipt of:
a) a motivation setting out the merits of the application;
b) documented proof that the AWA was trained to perform the procedure;
c) documented proof that the competence of the AWA to perform IV catheterisation was assessed and it is confirmed that the AWA is competent to perform the procedure; and
d) confirmation by a veterinarian that the procedure will only be performed upon instruction of a veterinarian whilst there is a veterinarian available on the same premises
4. SPCA inspectors appointed by the NSPCA: Authorisation for euthanasia only
Authorisation for euthanasia only will be considered upon receipt of:
a) an application;
b) confirmation of competency to perform euthanasia, to handle and store the relevant medicine and understanding of the importance thereof. (i.e assessed by a designated veterinarian);
c) confirmation of appointment as an inspector in terms of Act 169 of 1993;
d) a motivation setting out the particular need for euthanasia in the area; and
If the inspector is not working under any veterinary supervision
(Also refer to SAVC policy guidelines on MRA permits)
Inspectors should apply for renewal of authorisation every three years having re-submitted proof of competence.
D CONDITIONS OF AUTHORISATION
1. 1.1 Authorisation will be restricted to specified procedures, scheduled medicines and geographical area/s that the SAVC approves for a period of 3 (three) years only.
1.2 If it is envisaged that an AWA will be rendering services in a wide geographical area, this must be separately motivated.
2. Every three-year cycle will end on the 31st of March to coincide with the SAVC’s financial year, which runs from 1 April to 31 March.
3. Authorisation will lapse automatically when the AWA is no longer working under the direction of a veterinarian or when the AWA’s services are terminated by the AWO that submitted the application for authorisation.
E EXTENSION AND/OR RENEWAL OF AUTHORISATION
1. Should an AWO require an extension of the AWA’s authorisation for either the procedures to be performed or the change of geographical area a further application as set out in paragraph C2 is required.
2. An application for the renewal of authorisation will be required after expiry of the 3-year period. When applying for renewal of authorisation paragraph C2(h), C2(i) and C2 (j) must be complied with. However, on receipt of written confirmation by the supervising veterinarian that a re-assessment is not required and/or if the Council does not deem it necessary the requirements of paragraph C2(h) and C2 (i) may be waived.
In the event of misconduct the provisions of the Veterinary and Para-Veterinary Professions Act will mutatis mutandis apply.
Authorisation only permits the AWA to perform approved procedures and the use of listed scheduled medicines in a specific geographical area. Therefore the performance of any other procedure and usage of any other scheduled medicines or the rendering of services in other geographical areas is not permitted and could result in an inquiry in terms of the Veterinary and Para-Veterinary Professions Act and the possible withdrawal of authorisation.
AWAs are accountable for their own actions as persons authorised under the Act. Supervising veterinarians cannot be held responsible for the actions of AWAs as long as their own actions are reasonable and justifiable.
G MOBILE CLINICS
All mobile clinics must be staffed by a veterinarian, veterinary nurse, animal health technician or AWA and must be directly linked to a registered veterinary facility. The principal of the facility in whose name the facility is registered must ensure that both the facility and mobile facility comply with the rules pertaining to the veterinary and para-veterinary professions.
H THE ROLE OF THE AWA, THE AWO AND THE VETERINARIAN
AWAs must know the conditions of their authorisation, their responsibility and accountability to the SAVC and render only services that fall within their authorisation in terms of section 23(1) (c) of the Veterinary and Para-Veterinary Professions Act. All veterinary services must be carried out under the supervision or direction of a veterinarian as outlined in the criteria for assessment of competency for authorisation of AWAs.
AWOs are responsible for
a) applying for authorisation on behalf of candidate AWAs;
b) maintaining authorisation for as long as is needed, while AWAs remain employed by the organisation in the specified geographical area;
c) clearly communicating to AWAs the services they are entitled to render in terms of authorisation;
d) monitoring the AWA to ensure that they render only the services authorisation has been obtained for; and
e) ensuring that AWA services are limited to stray animals and indigent persons.
The veterinarian employed by or in the service of or contracted to the AWO (supervising veterinarian) should:
Explain to the AWA his/her responsibility and accountability to the SAVC;
Monitor the AWA to ensure that s/he complies with the terms of his/her authorisation; and
· Advise the SAVC when the supervising veterinarian is no longer the supervising veterinarian.
I ASSESSMENT OF ANIMAL WELFARE ASSISTANTS
AWAs must be assessed by SAVC-accredited assessors to ensure objectivity and uniform evaluation. The assessor should be independent where practically possible, i.e. the responsible veterinarian under whose supervision the AWA will work after authorisation should preferably not assess the same candidate.
J SPCA INSPECTORS
SPCA inspectors who are required to perform euthanasia only are authorised as per SAVC decision of 24 January 2006. If SPCA inspectors are required to fulfil other functions pertaining to those of an AWA, they must apply for authorisation as an AWA.
2. CRITERIA FOR ASSESSMENT OF COMPETENCY FOR AUTHORISATION OF ANIMAL WELFARE ASSISTANTS (AWAs)
“The veterinarian” refers to the veterinarian employed by, in the service of or contracted to the relevant AWO who is responsible for the activities of the AWA.
“Direction” means that the veterinarian gives the AWA directions but is not necessarily present when they are carried out.
“Supervision” means that the veterinarian is present on the same premises and in a position to assist, yet is not necessarily at the AWA’s side or in the same room.
1. Procedures that Animal Welfare Assistants may perform under direction of a veterinarian-basic primary health care
1.1 Examining a patient and recognising a healthy animal
The AWA must be able to:
Ø take a relevant history of the patient;
Ø restrain the patient adequately and humanely to perform his/her duties;
Ø be able to recognise clinical signs of a healthy animal;
Ø demonstrate that s/he can evaluate the temperature, pulse, respiration, colour of mucous membranes and hydration status of the patient;
Ø be able to describe clinical signs to the veterinarian and follow instructions from the veterinarian;
Ø keep correct patient- and treatment records and understand their relevance;
Ø make a blood smear; and
Ø effectively communicate the principles of primary health care to animal owners.
1.2 Basic husbandry
The AWA must demonstrate basic knowledge of:
Ø correct feeding;
Ø appropriate housing / confinement / restraint;
Ø hoof / claw / nail / coat / tooth care;
Ø the role of sterilisation / castration where applicable;
Ø general principles of prevention of cruelty to animals.
1.3 Administration of medicines
The AWA must:
Ø know how to handle and store the relevant medicines s/he will be directed to use by the veterinarian;
Ø know the possible side effects of the relevant medicines;
Ø be able to measure correct dosages of oral and injectable medications as directed by the veterinarian;
Ø be able to administer medicines per os (solid and fluid e.g. dewormer);
Ø know how to handle sterile needles and syringes;
Ø be able to give a proper subcutaneous injection aseptically;
Ø be able to advise the owner concerning the further administration of dispensed medication; and
Ø keep accurate records of all medicines administered.
1.4 Vaccinations, deworming and external parasite control
The AWA must:
Ø know the correct care, handling and storage of vaccines;
Ø vaccinate and deworm animals according to a programme supplied by a veterinarian;
Ø be able to keep records of vaccinations and deworming;
Ø dip animals according to a protocol supplied by the veterinarian; and
Ø educate the owner on the importance of external parasite control, vaccination and deworming.
1.5 Dealing with injured animals
The AWA must:
Ø know how to transport a sick or injured animal;
Ø be familiar with the basic principles of aseptic techniques;
Ø be able to clean superficial wounds;
Ø apply ointments as directed by the veterinarian;
Ø be able to stop severe haemorrhage with a pressure bandage as a first aid measure; and
Ø be able to assess the degree of pain in order to involve the veterinarian at the earliest stage possible.
The AWA must understand the concept of zoonoses.
2. Optional procedure that Animal Welfare Assistants may perform under direction of a veterinarian
2.1 Administering an intramuscular (IM) injection
The AWA must
Ø be able to give a proper IM injection aseptically.
3. Procedures that AWA’s may perform under supervision of a veterinarian (when authorised)
3.1 Radiographs (assisting)
The AWA must:
Ø be able to assist with restraint;
Ø have knowledge of the dangers of radiation.
The AWA must:
Ø demonstrate the ability to administer euthanasia by intravenous injection in a competent and humane manner;
Ø know how to handle and store the relevant medicines;
Ø know how to handle a failed intravenous injection that leads to haematoma;
Ø show an understanding of appropriate methods of carcass disposal.
3.3 Administering an intravenous (IV) injections
The AWA must
Ø be able to give a proper IV injection aseptically.
3.4 Performing intravenous (IV) catheterisation (separate application required, authorisation granted by special dispensation only)
Ø demonstrate the ability to place an intravenous catheter aseptically in a competent manner;
Ø know how to maintain an IV catheter; and
Ø know how to monitor and adjust flow rate when instructed by the veterinarian.