Clevedon Veterinary Hospital, part of the Veterinary Hospital Group, proudly became the first Zero Pain Clinic in Auckland and Northland at the end of last year. It is a small rural clinic located in Clevedon village. The team comprises senior vet Robyn Jarrett, the clinic manager, the group’s clinical educator Bronwyn Armstrong, diploma nurse Bella Small, and front-of-house Amanda. Since the clinic moved into a renovated original settlers’ villa over 12 months ago, opportunities have arisen to utilise the team’s expertise in providing exceptional care, particularly in exploring ways to enhance pain management for all patients. 

To become a Zero Pain clinic, several sections on pain management must be completed to achieve the necessary points for accreditation. This includes staff possessing accredited postgraduate qualifications and current pain management CPD, such as completing the WSAVA Pain Certificate, which Bronwyn finished in 2024. The clinic’s pain control must involve regular use of anti-inflammatories, opioids in premedication, continuous rate infusions, local anaesthesia and other interventions as required, guided by validated pain scores. Clevedon Vet Hospital scored an impressive 120 out of 140 to obtain their accreditation; this score is a benchmark for the clinic’s standards. The accreditation is reviewed biannually, and a clinical audit is required to retain the accreditation title. 

Although accreditation as a clinic wasn’t the original plan, it became a goal once we understood what was required and integrated these standards of care into the clinic's daily practice. As a collaborative team, various developments contributed to achieving this unanticipated goal.  

Several essential elements of the clinic’s work contributed to obtaining accreditation. While not a scoring element, collaboration is integral to the team’s success. The team discusses each case, planning each anaesthetic procedure for every patient individually to ensure a successful outcome.   

Team education is mandatory for achieving Zero Pain accreditation. To support this, the clinic has provided evidence of ongoing internal or external training for all team members. This required that one team member, either a veterinarian or veterinary nurse, be appointed as the lead Zero Pain practitioner. Bronwyn was chosen for this role. Her postgraduate qualifications, the completion of the CertVNECC, the WSAVA pain course, and the NCertAnesthesia modules have equipped her with the necessary knowledge to lead the team.  

Acute pain assessment is a necessary section, and the clinic provides comprehensive pain scales, demonstrating the use of the Short Form Glasgow composite pain scale, a validated tool for all patients experiencing acute pain. Evidence of feline pain assessment is mandatory and is presented using the Feline Grimace Scale. Acute pain management includes the use of NSAIDs, local anaesthetics, pure mu agonists, and constant rate infusions. In this clinic, all procedures receive local blocks, which the team is deeply committed to, ensuring that the veterinary nurses are trained to carry out these procedures.  

Chronic pain assessment is essential, and the clinic provides a nurse’s clinic for chronic pain management. Following the veterinary consultation, the veterinary nurse consistently monitors patients experiencing chronic pain. The LOAD pain scale was utilised during the initial consultation, and it was subsequently followed up. Veterinary nurses administer Beransa or Arthropen under vet authorisation while offering advice and support to pet owners, educating them on managing their pets' discomfort.  

What does receiving accreditation as a Zero Pain clinic mean for the team? This accreditation affirms our team's relentless commitment to providing exemplary veterinary care. We are eager to advance on our Zero Pain journey, challenging the limits of outstanding patient care.  

Written by: Bronwyn Armstrong

Clinic Manager and Clinical Educator, Clevedon Veterinary Hospital (part of Veterinary Hospital Group), Auckland, New Zealand.