VetTeamAMR: How the SMART goals tool and Noah’s Livestock Vaccine Guideline can improve antimicrobial stewardship

Speaker 1:

Welcome to this Vet Team, AMR podcast from RCVS Knowledge, leading responsible antimicrobial use in farm, companion and equine teams.

Fiona:

Really great pleasure here to start talking with Lucy Coyne, who is now the senior technical policy manager for NOAH. Lucy, hello. Good to speak.

Lucy Coyne:

Hi, Fiona. Hi. It’s really exciting to talk to you from a bit of a different perspective.

Fiona:

Yes. So now let’s just untangle this for people listening. So you used to work for RCVS Knowledge and so all about Farm Vet Champions?

Lucy Coyne:

Yes. Yeah, that’s right. So yeah, I worked with Fiona at RCVS Knowledge on Farm Vet Champions and moved across to NOAH at the end of last year, at the end of 2022, to work on, I mean, pretty similar themes to Farm Vet Champions really. So my role, I work very closely with NOAH vendors on things around antimicrobial stewardship. And also looking at things like the bigger picture on health, which is where the vaccination guidelines really come into play and sit very closely as well with Farm Vet Champions. And I believe Fiona, you are involved in the vaccination guidelines, is that right?

Fiona:

Yeah. So that makes it even more tangled, doesn’t it? So yes, so the vaccination guidelines were, I think we put them together a year ago and there were three authors, Jonathan Statham doing the dairy, Joe Henry writing beef cattle and myself writing the sheep section. So yes, it’s hard to know who’s interviewing who here, Lucy. But anyway, brilliant to be talking about them. So we’re talking about the NOAH livestock vaccination guidelines. Lucy, can you just summarize what the document is or who’s it for?

Lucy Coyne:

Yeah, so I mean it all came about when we’ve all heard and we’re all very familiar with a lot of the things around antimicrobial use. And we’ve got those that we should be using last option, those that we are reserving for when we’ve got culture and sensitivity testing to support those, those that are considered really quite important to human medicine. And then we’ve got other antimicrobials that we can use more full treatments for things that we’re seeing commonly on farms. So we’ve got these different categories of those that are absolutely core, that we are using on farms to treat things that unfortunately have either not been prevented by other ways or bacterial infections that have arisen. And then we’ve got those that we really don’t want to be using unless we can justify that, we know that that’s the only option.

But there’s just not been really very much thought around that sort of thing on vaccinations. And certainly as a newly qualified veterinary surgeon and going on to beef, I did mainly beef and sheep, going on to beef and sheep farms and looking at vaccination programs on different farms, there just seems to be so much variation in what everybody’s doing. And this is where the NOAH vaccination guidelines really come in. So they’re using this approach for thinking about with antibiotics in there. We’ve got a lot of vaccinations, they’re fantastic. We’ve got some really, really good tools there in the armory to help prevent disease on farms, but which are core and which not? Which should all herds and flock be doing? And which should be done in more individual circumstances? So the NOAH guidelines, they look at those and they identify as those that are core for, as Fiona said, for dairy farms, beef farms and sheep farms, as well as given a bit more specific information for things like beef farms which might be more appropriate for young stock, sucklers, et cetera.

And it uses that approach to think about what we should definitely be vaccinating for and what ones will be a bit more on an individual farm basis. And the guidelines are really there to support the industry. It’s about supporting farmers, it’s supporting vets, it’s supporting those in animal health STPs to actually help to give farmers the advice. Or for proactive farmers as well to just have those conversations with the vets. Similar to Farm Vet Champions, they’re just another bit of armory that give us a bit more information, a bit more support and provide a bit of evidence behind what we’re doing really.

Fiona:

Okay, brilliant. And I remember we had the brief, when we were asked to write about this, it’s not just for a veterinary audience, but there’s different people who are interested or keen to know what’s what. So we categorized them into a category one and a category two vaccine and I can remember being really excited about it, because actually as we thought it through and a category one as the highest priority vaccinations, I think we’ve changed the rhetoric to instead of you can consider using these vaccinations, actually if you’ve got a flock or a herd who doesn’t have good veterinary input or maybe hasn’t thought about it, then what is the default?

And certainly, a few years ago the default would be if you’re not really being proactive then nothing happens. And actually we’ve changed this to say a category one vaccination, the default should be that these are used unless you otherwise have discussed it with your vet, which switches the whole argument round, doesn’t it? I think that’s actually really helpful. Because certainly from my point of view, from a sheep point of view, I would not use category one vaccines in all the flocks I work with by any stretch of the imagination. But I have had that conversation with every flock I work with. So I’ve discussed why we are not using a certain vaccine and we’ve justified it, which is that’s where category one, that’s the importance. Do you see it the same way, Lucy?

Lucy Coyne:

Yeah, definitely. I think you’ve got that written guidelines, it says these core ones, these you should be using, if you’re not using, there might be, as you say, a very good justifiable reason, but it’s that, “Okay, these are the core ones, these are what we can speak to our vet about. Yes, we’re using it.” Or, “No, we’re not, but the reason is…” For example, it might be that you are a really high health flock or herd or for various reasons of where you buy from or whatever or geographic reasons. But you’ve got those core ones and you can say, “Right, tick, tick, tick, yes, I’m using them.” Or potentially, “No, I’m not.” But as you say, it’s the, why are you not using them? These are the core ones. And it gives that written guidelines, it’s something actually you can share with farmers, you can have those conversations with STPs, with your vet, with your veterinary consultant to actually then discuss those core vaccines.

And then I think having, as you say the tier, we’ve got the core ones and then we’ve got the non-core as well, I think there’s some really useful… I found just reading through, it’s been a while since I’ve been in beef practice for example, to actually go back and think, “Yes, okay these are infections and diseases that I knew I could vaccinate again.” So it’s a really useful summary of information as to why you may or may not vaccinate. And I think it’s really helpful as well to support that vet/farmer conversations. I imagine Fiona, it’s been useful for you to… You’ve got something there to support what your opinions are, you’ve got that evidence and you can have those conversations about flocks a bit more proactively.

Fiona:

Yeah. And I think yes, and in the same way as for many of our Farm Vet Champions, we’re not all… Well, there’s very few of us who are dealing with a single species and it’s easy to be an expert in a small area, but actually most of us are treating multiple species and we may be an expert in dairy cattle or whatever, but actually we still have to treat sheep or beef. And this is one way to look into what the details are or the other way around. Personally, I’m quite happy with my sheep, but to go onto a beef farm, it’s brilliant to read through what the advice is. And I think that’s a bit the reality, isn’t it? And it’s nice to have it all set out in the same way. Joe and Jonathan and myself work quite closely in ensuring that we were on the same line, but brilliant to learn from each other and take top tips from the other sectors. Okay.

Lucy Coyne:

I guess it’s really helpful, for instance, if you’re a specialist dairy vet, you’ll get a lot of dairy farms that may have a suckler herd or may raise young stock and your primary interest might be dairy and you also look after for example the suckler herd on that farm. It gives you just a little bit more to get your dairy herd, you’re quite happy with the dairy herd, that’s something that you manage day to day, but you may have less frequent contact on the beef side. You’ve got the guidelines there and it follows the same way as the dairy as well. So it’s nice to have that to support, as you say, mixed enterprises as well.

And to just start those conversations, because you may… I don’t know whether it’s still the case, certainly when I was in practice there were probably more dairy farms that had a more robust health plan in place and vaccination protocols than possibly some of the beef and sheep farms. But there’s absolutely no reason why we can’t have fantastic herd and flock health across the farms. Vaccination, it’s just one little thing that you can do that actually can really help save you money and improve your productivity and it’s part of that plan, prevent, protect as well. It fits so closely with the Farm Vet Champions network for vets as well.

Fiona:

Yes, that was perfect timing then, the plan, prevent, protect. So sometimes we come in for a bit of criticism I suppose, if we just hone straight into vaccinations and don’t deal with everything else. And that in my eyes, why we do talk about plan, prevent, protect and planning ahead. Golly, if you didn’t plan your vaccination schedule you’d get yourself in all sorts of a pickle. But the prevent side of it, and I think the document brings it out quite nicely, there’s the whole management, the controlling, vaccine is one of the tools in the box, it’s not the only thing. And certainly when I think of specific examples, say in the sheep sector, so arguably dealing with lameness, no one would ever say forget everything else and just go to use a vaccination against foot rot, because we know full well we need to put everything in place.

But it’s an extremely valuable tool within that five point plan, which is why we have the plans and stuff. And arguably, well, actually that’s that vaccine in dealing with lameness is one of the things that farmers, merchants, vets really see a clinical difference. It just helps, but not in isolation. So in terms of a Farm Vet Champions, when you’re trying to work around planning to use appropriate medicines, planning to prevent disease, planning to have healthy animals preventing disease coming in and then protecting the flock and herd, I would put this as a key document in there as one of the ways we can protect flocks and herds. And also just to see what expert opinion is, what are other people doing? What’s something that may be as a vet I’d not thought of? But actually that’s what best practice is considered. So yeah, and in terms of how this is going out to the industry, Lucy, how do you see it from a NOAH point of view, the use of this document?

Lucy Coyne:

So from a NOAH perspective, it’s something that we launched back in September last year. And it’s something that we’ve presented it to the major stakeholder groups, NOAH supports all of the major ones across the ruminant species. So we’ve presented and shared it with the major groups and it’s something that we just want… There’s an online pledge that you can go on our NOAH livestock vaccination guidelines website, which I’m sure we can pop underneath in the information underneath the podcast. And you can actually go and sign up your pledge to support the guidelines and to promote them. And we just want people to really start to use them and we want that very slow uptake where… Well, a fast uptake would be brilliant, but we just want everyone to tell their friends about it really. Similar to Farm Vet Champions really, that the more people that have heard about it and are using it and are talking about it.

And it just fits so well into this plan, prevent, protect, one health environmental improving, it’s a piece of that jigsaw puzzle where we are getting towards where we want healthy animals as you say, how do we reduce using antimicrobial use? We have healthy flocks, we have healthy herds. And this is just a really helpful jigsaw piece and part of that all the different things that farmers and vets are doing every day on farm, it just gives, as you say, a little bit more expert opinion, a little bit more support for those conversations with farmers, for those conversations with farmers and their SVP prescribers, for those conversations at those farmers meetings of, “Oh we’re doing this, did you know that this is a core vaccine?” I think it’s just part of this much bigger picture, it’s not about it in isolation. It’s part of everything that the industry is doing.

And I think there really is quite… I mean Farm Vet Champion shows it, they’re just community. And farmers are wanting to change, they’re wanting to listen, they’re wanting to think differently. We want productive animals, we want birds and flocks that are economically viable, that are on farms where we’re able to manage the environment. And I just think this sits so well with that really, it’s that bigger picture really. And I think NOAH see that as a really essential piece in that jigsaw and it really sits well with our aims to support NOAH members, the livestock industry in efforts towards one health and sustainability. It’s something that we’re really, really proud of what the industry is doing and we want to support the industry as we move forward, especially with the changing landscape of livestock policy as the UK has left the EU. I think this is such an essential part of it, really.

Fiona:

Okay-doke. Then so in terms of availability then, so say I’m a Farm Vet Champion, I want to set a smart goal.

Lucy Coyne:

Yeah.

Fiona:

So in the first instance reading through the guidelines or accessing and reading through the guidelines would be a great start for that. Is it freely available? Can I get hold of it quite easily?

Lucy Coyne:

Yeah, yeah, absolutely. So it’s freely available on our specific NOAH livestock vaccination guidelines website, which we’ll share as well with people listening to the podcast. So that, if you pop it into Google you’ll find it very easily. And yeah, so it’s-

Fiona:

noahlvg.co uk. We’ll make sure you have that on the podcast.

Lucy Coyne:

Yes.

Fiona:

Definitely.

Lucy Coyne:

Yes, absolutely. Yes, so it’s very easy to find online. It’s something that’s a PDF document, so if you want to print it out and have a paper copy that option’s there. But it’s very easily visible online, very user-friendly and it’s split up to the species as well, so you’re not reading through everything if you’re just interested in… You want to go and have a look at it for say, the sheep visit you’re doing this afternoon. It’s nice and easily accessible. It’s something that you can then get up on your phone, on your tablet or have a paper copy to actually take on farm with you and start those conversations.

Particularly helpful and supportive alongside things such as the animal health and welfare pathway from DEFRA that’s a new opportunity for farmers to actually have a funded vet visit and to work towards herd and block planning. I think it’s a really, really useful that thing then to have as part of potentially a visit for that. Maybe you’re a farmer and you’ve never had a herd health plan, but actually this is an opportunity to build in and rethink how you’re doing vaccinations. But in terms of smart goals, I think it’s a really good one to set a smart goal around, maybe how many farmers can you get a conversation around core vaccinations and reviewing herd health plans. It links so much with so many of the plan prevent mantra and activities.

Fiona:

So there I am, Farm Vet Champion, I’ve got my practice team who have also been involved in some of it, in accessing some of the Farm Vet Champion CPD. And we may want to either do some more herd health plans or flock health planning and we can set those as a smart goal as well. 10, 20 farms or have a farmer’s meeting talking about health planning including vaccination schedule. And actually just communicating the different rhetoric around category one and category two vaccinations. So what is appropriate and how we can have this conversation. And then in terms of our practice team and our smart goals, actually setting up reminders for people for that vaccination, that sort of thing, with a very specific, very time bound… That’s one way I could see this working quite nicely and it’s just a brilliant resource. So freely available on the NOAH, N-O-A-H, lvg.co.uk is the website.

Lucy Coyne:

Yeah.

Fiona:

And then of course, if you’re not already signed up as a Farm Vet Champion, you really should be.

Lucy Coyne:

You absolutely should be.

Fiona:

Go to ask rcvsknowledge.org uk/amr, or/fvc for Farm Vet Champions. But if you Google Farm Vet Champions, it comes up straight away. No one has any excuse, do they Lucy, see for not finding either?

Lucy Coyne:

No, no they don’t. And they are just another example really of how there’s some really fantastic, proactive, knowledgeable people and including you Fiona, alongside obviously Jonathan and Joe who’ve created and worked with NOAH on the content of the livestock guidelines. There’s just so many resources available there and as you say, they’re free to access. The smart goals are really good useful addition for the whole practice team to actually focus and think about what they’re doing. And in terms of timings and making smart goals time bound as well, you’ve got fantastic opportunities with lambing and calving coming up to actually get those vaccination guidelines into those smart goals.

Thinking about how you might help to support health planning around calving and lambing and vaccination schedules for the year going forward for farms. And actually it’s about changing the mindset around vaccinations really around those as you say, those core, if you’re not doing them, why not? And as you say, there might be a very justifiable reason why you’re not using those particular vaccines. But those are the core ones that actually experts say including you Fiona, that they are really, really the important ones for flock health or for herd health.

Fiona:

Yeah, I mean it is true, in the guidelines the detail is there, isn’t it? So if you are deliberating as a vet, you’re Farm Vet Champion, you are working out whether for this flock you can justify not using one of the category ones, then there is quite a lot of detail in the report that will help people make that decision, aren’t there? And then there’s summaries for each of the species aren’t there.

Lucy Coyne:

Yeah, there’s a nice little quick summary if you just want to have a quick look as to what these category one vaccines are, what the other category two vaccines might be, you can just see it. Or if you want to then read a little bit more detail, it’s nicely laid out and you can easily follow and find the color coded species that you’re interested in.

Fiona:

Great. Well, that’s brilliant. Great resource, great forum vets and practice for anyone trying to find out more farmers, vet students fantastic if you’re writing an assignment or something.

Lucy Coyne:

Absolutely. And I have to say it’s a really good… For vet students, it’s a very good little revision summary of the major things that you can vaccinate against and a little bit of information about the diseases. I was actually reading through it the other week thinking, “This would have been really useful when I was revising and I’d be on farm and they’d be talking about diseases.” And I’d go back home and I’d be looking it up in my veterinary manual, is there a vaccination available? So I think it’s really, really, really helpful. Really good materials as well for new graduate vets as they’re going on to farms for the first time, looking at herd health plans, flock health plans and working with farmers.

Certainly as a new graduate vet, I found it quite daunting to go on a farm and to actually try and I didn’t feel that… Why would I be qualified to actually look at the herd health and try and find evidence to support it? This is a really, really useful resource. Every farmer and vet, they want to promote health and welfare in the flock and herds. They want to prevent disease, they want to use plan, prevent, protect, it saves everybody money. We get more productive animals at the end of the day. So this is just another resource that fits in that all those different resources, such as Farm Vet Champions. They’re available free of charge, it’s really, really fantastic.

Fiona:

Yeah. And actually, not confined to just new graduates, are they?

Lucy Coyne:

Oh, no.

Fiona:

Those of us who are a bit longer in the tooth can, it’s always great to have all the up-to-date information in one easy to access place, isn’t it?

Lucy Coyne:

Absolutely.

Fiona:

We never grow out of needing that.

Lucy Coyne:

And also when you’ve sometimes also got those farmers that maybe are less proactive, don’t want to change, it gives you a really useful resource to say, “Well, actually this is what the experts are saying that you should do. And I as your vet, I really want to promote your flock health, I really want to promote your herd health. This is what I think we should be doing. This resource supports me.” So it just really helps as well, in those conversations that hopefully will then lead to those behavior changes, those lasting behavior changes. Make it a habit, make Farm Vet Champions a habit, make the NOAH vaccination guidelines a habit. Make them part of what you are doing day-to-day within your veterinary practice, within the veterinary practice team.

It’s a resource as well that’s useful for the whole practice team to be aware of that. It’s something that’s available, as you say, free and easy to find online. Yeah, I just think it’s a really good resource, that we’re really keen at NOAH, that people know about it. With the unfortunate passing of the Queen last year, I think it was difficult for us to… Our media campaign, we didn’t maybe share it and do as big a promotion as we were going to. So I think now’s a really good opportunity to, as we’re coming into lambing and calving time, to actually share that it is a resource that’s available. And again, it does reinforce, plan, prevent, protect, and fit very well with Farm Vet Champions.

Fiona:

Brilliant. Yeah, I think if people aren’t at least interested enough to click into the Farm Vet Champion site and the NOAH livestock vaccination site, then yeah, find out more about it. I’m not sure we could have pushed it more than we have, Lucy. I really appreciate talking to you and hearing it from your perspective. Thank you very much.

Lucy Coyne:

Yeah, thank you very much. Final note, this is a resource alongside Farm Vet Champions for everybody, for the veterinary practice team, for the new graduate vets, for the vets that are a bit longer in the tooth, for the veterinary students. It really is a really good resource for everyone. And yeah, we just want to share it and get people out there to access it, really.

Fiona:

Brilliant. Thank you, Lucy.

Lucy Coyne:

Thank you.

Speaker 1:

Thank you for listening to this Vet Team AMR podcast from our RCVS Knowledge. Visit rcvsknowledge.org/amr for free CPD, benchmarking and audit tools to improve your antimicrobial use.