Practice Life Magazine Issue 8 June:July 2015 by The Magazine Production Company

June/July 2015 www.practicelife.biz

Harnessing the Power of Video Top tips for practices

Feedback? Or Feed Forward? Alternative team assessment

Stress, Burnout, Compassion Fatigue Which one is it? Recognising signs

Insurance Fraud Why it costs everyone in the long run

THE MAGAZINE OF SPVS AND VPMA

In the Spotlight: Susie Coughlan, MD of CPD Solutions SPECIAL PREVIEW:

FOCUS ON HUMAN RESOURCES

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EDITORS’ LETTERS

Editors’ Letters

elcome again to another edition of Practice Life Magazine. By the time you read this the General Election will be becoming a distant memory and the political marketing probably changing from ‘Why you should vote for us’ to ‘This is what we are planning for the country now we’re in Government’. Both during and after the campaigning there have, of course, been various political videos produced (serious and satirical!) If you’re wondering about using videos to enhance your practice’s image this edition features an article and some real life experiences to give you some tips and ideas. Additionally, if like the politicians you’re worried about finances, we have a review of the differences between gross/net profit, mark-ups and margins and why you should care about these which may be useful. At BSAVA congress the SPVS Officer team met with the BVNA Officers; amongst items we discussed was the issue

n 9th April I found myself entering the spectacular Town Hall building in Birmingham and a world of the great and good from the veterinary community including lords and ladies, professors and sirs, vets, nurses, support staff and managers. The 2015 Petplan Veterinary Awards was a night to remember and lived up to its reputation of being as near to a Hollywood Oscar event I am ever likely to get to. Apart from the surprise of even being nominated for an award, the process in which a finalist then finds him/ herself involved in, several weeks before “the big night”, is a bit of a whirlwind. Discovering you have been nominated is one thing, making it to the short-listed top 3 of each category makes for a highly motivated bunch all eagerly awaiting the results! Winner or runner up, no one could be disappointed as the four hours flew by. Petplan clearly have the event

of the shortage of qualified veterinary nurses. Of course many SPVS members are in senior positions in veterinary practices and potentially able to influence areas such as nurse training and recruitment. Summer is the time when many of those potential students seeking to embark on VN training are looking for employment or placements. If your practice is looking for a new member of its nursing team can I urge you to consider getting involved in VN training and taking on a trainee? As usual, if you have any suggestions for future topics that you’d like to see included, or any comments about Practice Life Magazine, I’d be very pleased to hear from you. And don’t forget that the Practice Life website (www.practicelife.biz) has lots of current news from the veterinary world as well as a portal to archived copies of all editions of the magazine accessible exclusively to members of SPVS and VPMA. Have a lovely summer!

Stephanie Writer-Davies, SPVS editor

honed to perfection, having managed it for a number of years and have a brilliant team of liaison and PR folks who calmly guide finalists from practice to platform. While I did not win the overall title of Practice Manager of the Year (read our 5 minute interview with worthy winner Valerie Marsh on page 11), the evening left me feeling proud to be part of a profession that celebrates all the roles in veterinary practice that are so important to the smooth and successful running of veterinary business – maybe all practices should run their own awards – it’s great for boosting staff morale! But it wasn’t all play – I did do some work whilst at BSAVA Congress, and caught up with several students enjoying their dedicated stream of lectures. Find the link to the audio recording of my chat with them on page 42. Enjoy!

Ian Wolstenholme, VPMA editor

Practice Life is the magazine of SPVS and VPMA. If you are interested in joining either or both associations, visit www.spvs.org.uk and www.vpma.co.uk www.practicelife.biz z June/July 2015 z Practice Life

Contents Editors

UPDATE: NEWS & VIEWS 5

VPMA NEWS

SPVS Stephanie Writer-Davies BVSc MRCVS steph@practicelife.biz VPMA Ian Wolstenholme, Practice Manager ian@practicelife.biz

Take the CVPM quiz! g

Tel +44 (0) 1727 859259 info@mojoconsultancy.com www.mojoconsultancy.com Advertising and Sales Enquiries Libby Sheridan MVB MRCVS libby@practicelife.biz Tel:01727 859259

Practice Life is the magazine of the Society of Practising Veterinary Surgeons and the Veterinary Practice Management Association. It is distributed quarterly to the members of both associations as well as a wider mailing list of veterinary practices annually. www.spvs.org.uk www.vpma.co.uk The magazine contains articles on veterinary business and management as well as other topical updates and relevant features. The information contained within these articles is intended for general information only and does not replace the need for advice from qualified professionals in the relevant field. Articles and photographs are welcomed for submission, though publication is not guaranteed and is at the discretion of the editors.

Practice Life is edited, designed, and published by Mojo Consultancy Ltd. No part of Practice Life Magazine may be reproduced, transmitted, stored electronically, distributed, or copied, in whole or part without the prior written consent of the publisher. A reprint service is available.

NURSE TALK

COLLEGE CORNER

11 20

Vet Futures Update g

LEADERSHIP

Lightening the load g

IN THE SPOTLIGHT

MD of CPD Solutions, Susie Coughlan g

WELL-BEING

Stress, burnout and compassion fatigue g

HOT TOPIC

Investigating insurance fraud g

MANAGING PEOPLE

Feed Forward Interviewing g

CLIENT CARE AND MARKETING

Harnessing the power of video g

BUSINESS HEALTH AND FINANCE

27 36

All about margins g

PRACTICE DEVELOPMENT

Should you buy in additional services? g

CPD SHARED

BSAVA Congress special feature g

Equine Nursing Symposium and BVNA Congress

Sales Administrator Eva Lambe eva@practicelife.biz

SPVS NEWS

New member benefits

Publisher Mojo Consultancy Ltd 181 Sandpit Lane St Albans AL4 0BT

CPD DIARY

Preview of Focus on on HR day g

WHAT’S COMING UP

CPD Programme for 2015 and what’s in next issue

45 28

Opinions expressed in this journal do not necessarily reflect those of the associations, the editors, Practice Life Magazine or its publisher, Mojo Consultancy Ltd. ISSN 2053-1877

Practice Life z June/July 2015 z www.practicelife.biz

News & Views WEIGHT MANAGEMENT CLINIC CELEBRATES 10 YEARS OF FIGHTING OBESITY

This year, Royal Caninâ&#x20AC;&#x2122;s Weight Management Clinic at the University of Liverpool is celebrating its 10-year anniversary. In addition to providing a specialist referral service for managing overweight and obese cats and dogs, the centre coordinates various clinical studies aimed at improving our understanding of the pet obesity epidemic. Using a combination of an individualised diet plan and lifestyle changes, the clinic has seen that cases under their care lose an average 20% of body weight, with the most successful losing over 40%. These results eclipse weight loss performance for people who use a diet to lose weight, where 5-10% of weight loss equates

with success. The clinic has also pioneered the use of dualenergy X-ray absorptiometry (DEXA) to determine the amount of body fat lost by each patient. To date, the combined fat loss from all patients exceeds a tonne! The next 10 years will see the University of Liverpool weight management team take greater strides in tailoring weight loss, obesity prevention and improving the quality of life of UK pets. Information about the key clinical trials carried out over the past 10 years is available.

Centaurâ&#x20AC;&#x2122;s new Community of Practice to help independent practices prosper Veterinary wholesaler Centaur Services is launching a new service for independent veterinary practices, Community of Practice, which is designed to provide commercial support to help practices overcome the challenges posed by online and larger, multi-site competitors. The Community of Practice will be delivered by veterinary consultancy, Vet Dynamics. It is a unique service to Centaur customers in which they have the opportunity to participate in a benchmarking, indexing and analysis process designed to improve every aspect of practice performance. By analysing monthly data automatically retrieved from a practiceâ&#x20AC;&#x2122;s practice management www.practicelife.biz z June/July 2015 z Practice Life

system, Community members will be provided with invaluable insight and advice on all areas of the business, including clinical performance, finance, marketing, industry trends and the competition. There will be a particular emphasis on setting strategies to maintain and grow independent businesses in the face of stiff competition from online retailers and larger corporate veterinary chains. A series of Community of Practice roadshows, open to everyone, is taking place during June and early July. To find out more or to book a place, contact community@cvws.co.uk

NEWS IN BRIEF

RCVS President’s marathon run raises £13,000 for charities Professor Stuart Reid, the President of the Royal College of Veterinary Surgeons (RCVS) and Principal of the Royal Veterinary College (RVC), has raised nearly £13,000 (including Gift Aid) for mental health and animal welfare charities by running the Virgin Money London Marathon. Stuart completed the 26 mile and 385 yard run in four hours and 51 minutes and, in the process, raised money for three charities with a particular focus on mental health and wellbeing, beating his target of £10,000. The money will be split between his three nominated charities – the RVC Animal Care Trust which will use the funds to assist the student bodies at the UK vet schools; the Veterinary Benevolent Fund which, through its 24/7 Helpline and Health Support Programme, provides support directly to the profession; and, mental health charity Mind. Stuart comments: “To be perfectly honest it was probably a bit daft to run a marathon in my presidential year but when I see how much we have raised I know it was the right thing to do. “I have been utterly humbled by the generosity and the words of encouragement on my Virgin Money Giving website and via text and Twitter and it is clear my chosen charities have touched a chord with many. I am so very grateful to everybody who chipped in. There’s plenty to do so let’s get on with addressing our mental health issues.” Donations can still be made to these charities via Stuart’s Virgin Money Giving website – http://uk.virginmoneygiving.com/StuartReid

PRACTICES ENCOURAGED TO SHARE VETERINARY NURSE VIDEO The Royal College of Veterinary Surgeons (RCVS) has launched a short film animation to help raise awareness among the general public of the vital role played by veterinary nurses in animal care and treatment. The animation aims to explain to the general public what registered veterinary nurses do, the education and training that they go through to gain their status and what it means to be part of a regulated profession which abides by a Code of Professional Conduct. The video also tackles the fact that, currently, ‘veterinary nurse’ is not a protected title, meaning that it is not illegal for someone to call themselves a veterinary nurse even if they do not have the requisite training and qualifications and are not registered with the RCVS. This is something which the RCVS, in partnership with the BVNA and British Veterinary Association (BVA), raised when Lord Trees submitted a Bill to Parliament to protect the title. Unfortunately it was drawn 36th in The House of Lords ballot which meant that it did not get aired. The RCVS is hopeful that the Bill will still benefit from some discussion in the House, and will continue to lobby parliamentarians for their support. Template letters will be produced

shortly which interested parties can use to write to their MPs, and a formal e-petition will be launched to formally bolster the campaign. Kathy Kissick RVN, Chair of VN Council, welcomed the new video, saying: “It is important that the public understand that veterinary nurses are not ‘junior vets’ but that they complement the work of veterinary surgeons and enhance animal health and welfare in different ways. “I would encourage all veterinary nurses, as well as vets and other veterinary professionals, to share this video on social media and with their clients so that they can find out more about the profession and understand how crucial it is that we secure protection of the title. Having untrained and unqualified people calling themselves veterinary nurses is not only misleading but potentially detrimental to animal health and welfare.” The video can be found on the RCVS website at www.rcvs.org.uk/vntitle, together with details of how to support the protected title campaign. It is also available to view on the RCVS YouTube channel (www.youtube.com/rcvsvideos) and Facebook page (www.facebook.com/thercvs) and can also be found on twitter via the hashtag #vntitle.

Don’t forget you can send us your press releases on practice successes and initiatives. Suppliers are also welcome to send information on management-related products and services. Email to libby@practicelife.biz Practice Life z June/July 2015 z www.practicelife.biz

VPMA News

VPMA NEWS

VPMA President,

VPMA webinar tackles 24/7 provision

I would first like to take this opportunity to reassure members that I am no longer the “space cadet” many of you met during VPMA/SPVS congress in January – hopefully the new photo proves this! While I am still undergoing physiotherapy, I am making good progress with my recovery and I would like to thank all of you for your concern during the difficult months following my car accident last November. Following our own joint congress, I attended BSAVA where it was humbling to receive warm and sincere comments of congratulations and encouragement from the whole veterinary practice community. However I receive these messages on behalf of the whole of VPMA and in particular acknowledging the work of the association past presidents, who have set the course of the association’s journey in driving best practice in management and veterinary business development. Further, I‘d like to congratulate Val, Ian and Mandy, finalists in the Petplan Practice Manager of the Year award and all three VPMA members, on their achievement. Val was announced as overall winner for the second time, testament to her skills as a manager. Read our 5 minute interview with her in this issue. Whilst at BSAVA, I was delighted to attend the BSAVA President’s amazing 7 course dinner which gave me the opportunity of further networking with other associations and I’d like to thank everyone at BSAVA for a wonderful evening and congress. One of my goals for the year is strengthening the VPMA regions and it is great to see that these are progressing well with increased attendance throughout. I would like to encourage everyone to support these local valuable events. For those who are not able to attend meetings, we offer lunchtime webinars exclusively to members, with the aim of giving bite size topical updates on issues relevant to veterinary practice management without you ever having to leave the office. As well as our own regional CPD, VPMA and SPVS together offer a calendar of management events which you can read more about in our Upcoming section towards the back of this magazine. I was fortunate to attend one of these recently – the Marketing Masterclass – giving me the opportunity to catch up on the thoughts, ideas and concerns of the attendees, many of them members, which I will share at our next council meeting. Finally, as an industry we can be guilty of being insular and not looking externally to better understand other opportunities or threats to our business. It was looking outwards that led me to attend events hosted by both the Pet Food Manufacturers Association (PFMA) and National Office of Animal Health (NOAH). These events gave valuable insight into the industries that overlap ours, with the common ground of the consumer – our clients. I learned about the fantastic work of the Mayhew’s charity TheraPaws in London and I would encourage you all to find out about and support any charitable activities going on in your local community. As we approach the summer months, I will continue to wear my president’s chain with pride and honour and I would love to hear from members (and non-members) who wish to share their thoughts and ideas of how our association can continue to develop and support our profession. I can be contacted on president@vpma.co.uk

Membership of the VPMA gives many beneifts, one of them being the Lunchtime Management Updates webinars. May’s topic was ‘24/7 Provision: RCVS update on current guidance’ which was presented to us by Chris Barker MRCVS from the Standards Committee and Gordon Hockey Registrar, and head of legal services. (See also VPMA regional meetings). The bite size session, designed to fit into a lunch hour, started with a great overall summary of how the RCVS code impacts on Veterinary Practice Managers with Chris explaining “the code, the rules of how you behave in a professional way, can only be applied to vets and vet nurses. However, the delivery of any veterinary practice service is a team effort and it is necessary to have team members who are not vets or nurses. These members can have quite significant input into the day to day running of the business. Although the RCVS has no way of controlling non-vets and non-nurses, due regard needs to be given when a new protocol is arranged, to allow the professionals who are governed by RCVS to be able to adhere to their responsibilities”. It was this tone that set the format for the rest of the webinar. Gordon spoke to dispel some of the concerns from practices when running an Out Of Hours (OOH) Service and explained that in the event of a complaint, the RCVS accepts that practices “can only plan for the expected workload and they accept that one-off events do happen”. The complete webinar covered planning, protocols and staff, contracting out, informing clients of OOH service, limited service providers, dealing with nonclients, financial issues and home visits & personal safety and was certainly very informative and reassuring. Managers should be confident that the recently revised code has addressed many of the profession’s concerns. Together with highlighting our professional responsibilities, the speakers made clear that the pet owner is ultimately responsible for their pet’s well-being. This is not passed to the vet or vet nurse at the point of a phone call. However, if a vet or RVN behaves in a way that could be described as a “wilful disregard for animal welfare” this could become a conduct issue.

Howard Brown

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The webinar covered much more (as you can see from the above list) so if you are a member and missed it, you can listen to the recording in the VPMA Members section of the website. If you are not a member yet, these monthly lunchtime topical bite size webinars make the membership fee worthwhile, even without all the other benefits you receive. For more details visit www.vpma.co.uk

VPMA NEWS

Regional Co-ordinator,

Renay Rickard The regions have been very busy during the past few months, with meetings arranged throughout the country. We have had some varied events, from some multi speaker CPD meetings to some “round table” discussions over a coffee and cake during which a diverse range of subjects was discussed, including practice management systems, radios and GPS trackers for lone workers, pricing / invoicing, credit control and the use of credit companies, security and theft by employees, CCTV and TB testing. Having spoken to many attendees it is apparent that the main benefit of these regional meetings is to network and meet with other managers as they give reassurance that we are not alone and we all share the same challenges in practice. So I urge you all – support your regional meetings; with 14 regions, you shouldn’t be far from some great CPD and support. We are pleased to have welcomed new joint organisers for the North West region – Janet Hughes and Janie Clare. Their first meeting has been arranged for the beginning of July, details of which can be found on the VPMA Website. From those organising their first meeting now to one organising her last. I would like to personally thank Rita Dingwall who is standing down as regional organiser for the East Sussex area after many years. Thank you for all of your hard work arranging meetings on behalf of all the VPMA members who have benefited from them. If any members would be interested in becoming a regional organiser, or working with others in their region to hold meetings, then please contact me or the VPMA secretariat. Best wishes and hoping you all manage to get some relaxation this summer!

Renay Rickard – RVN CVPM – VPMA Junior Vice President / Regional Co-ordinator.

MEET YOUR REGIONAL ORGANISERS If you are not in touch with your local regional group and would like to get more involved, please contact the VPMA Secretariat. CUMBRIA Pauline Graham Tel: 07803 228720 ro3@vpma.co.uk

NORTH EAST/CO DURHAM Claire Bake Tel: 01388 602707 ro16@vpma.co.uk

HERTS/BEDS/NORTHANTS Denise Whitham Tel: 07837 058155 ro4@vpma.co.uk

NORTH WEST REGION Janet Hughes & Janie Clare Tel: 07964 505226 ro17@vpma.co.uk

GLOUCESTERSHIRE/SOUTH WALES Melvyn Wilkins Tel: 07887 895274 ro5@vpma.co.uk

BUCKINGHAMSHIRE Julie Beacham Tel: 07710 317310 ro17@vpma.co.uk

EAST ANGLIA Cath Grimsey & Mark Day ro6@vpma.co.uk

SOUTH WEST Suzanne Headington Tel: 01242 680000 ro20@vpma.co.uk

LONDON mark harwood Tel: 01242 680000 ro7@vpma.co.uk

CORNWALL/DEVON Renay Rickard Tel: 01208 872254 ro21@vpma.co.uk

EAST SUSSEX RITA DINGWALL Tel: 01435 866058 ro9@vpma.co.uk

ESSEX LIZ LA-PAGE Tel: 07772 382465 ro22@vpma.co.uk

OXFORDSHIRE/WILTSHIRE/BERKSHIRE Helen Sanderson Tel: 07765 338607 ro13@vpma.co.uk

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VPMA NEWS

REGIONAL MEETING REPORT:

MIDLANDS & WALES

A sunny afternoon in March saw a mix of Practice Managers, owners, nurses and administrative staff attend the Midlands & Wales VPMA regional meeting. While regional events such as this are usually well attended, this one saw its highest attendance with 31 delegates including “new faces” journeying to Clent Hill’s Veterinary Practice in Bromsgrove, which had kindly hosted the afternoon of management CPD. Melvyn Wilkins had ensured delegates both old and new, had an interesting and thought provoking afternoon with three topics – and 3 cakes! First we heard from Mark Hedberg DVM MRCVS from The College of Animal Welfare on the topic of “Recruitment for Veterinary Practice: Are you Hunting or Fishing?” Mark asked people to answer honestly and raise their hands if they had ever recruited the vet they really wanted from the job advert they placed – no one raised their hand. Mark’s enthusiastic nature had all attendees thinking about their often reactive recruitment process – “I need to plug a gap so you’ll do” – trap that we can fall into and suggested different ways to deal with recruitment. Job adverts are often all written the same way, and rarely stand out from each other. Mark took us through various suggestions including using the practice website for potential recruits to view and learn more about the practice, which says more than an ad ever can. When it comes to interviewing, make sure enough time is allocated, after all this is a major investment for your business. Mark recommended involving more of the team in the process, so that different viewpoints are collected, as well as seeing how they fit in to your existing group. Next Natalie Weatherley, National Key Account Manager at Henry Schein spoke about the importance of stock control. No-one could say they had perfect stock control and those with systems in place to try to ensure the perfect stock control all agreed that the difficulties lie with staff; in particular large animal/equine cars! Natalie reminded us about the importance of stock value and insurance cover on vehicles and that too high a stock value in a car can invalidate the insurance should you have need to make a claim. In an ideal world one person should be in charge

of stock and using the “bleed rate”, keep a continual check on your top 20 products to ensure your practice is not losing out on stock and money. After a short break to enjoy a slice of cake with a cuppa while catching up with other delegates, the final presentation of the afternoon was from Mike Brookes, Director at dsl, about “Bad Debt – Prevention and Cost Effective Cure”. Mike opened with an entertaining summary of how he went from a chip shop owner with Bailiff’s on his door-step to become a Bailiff himself! He now runs a debt management company purely working with the veterinary industry and he shared the following insight with us: the importance of having up to date details of clients – Mr, Mrs, first name and correct address – are often the details that are incorrect and make dealing with debt a lot more difficult. When agreeing a payment plan, it should be normal to request proof of ID and a utility bill as you would need to do for any other credit agreement. Alongside ensuring we have the correct information from clients, Mike spoke about the importance of making sure our own practice Terms and Conditions are up to date and “water tight”. Rebekka Fiorani shared her experience of having to get their Ts and Cs updated after a solicitor had picked holes in the previous version. This created a discussion about the way in which practices shared their Ts and Cs and how one could prove they had received them through using Mailsoft, a company that offers recorded email for as little as 50p per mail. The main message from Mike was that in a dispute over payments, people will look for wiggle room – so don’t give them wiggle room! The theme of the afternoon was to be more proactive than reactive – from recruitment to stock control and debt management, we can all take more of an active role in ensuring our businesses are not affected by these issues. This meeting was one of the first to trial the new free-to-members system for regional meetings. Was this the reason Melvin had his highest turnout or was it the interesting content? Whatever the reason, no-one left that afternoon without having learnt valuable and useful information to take back to their practice.

Not yet a member and would like to join? Contact: secretariat@vpma.co.uk or call 07000 782 324 to find out more or visit www.vpma.co.uk/join-the-vpma/membership-categories-a-prices.html www.practicelife.biz z June/July 2015 z Practice Life

VPMA NEWS

CVPM Syllabus Insights GENERAL MANAGEMENT In this first in a series of articles on the Certificate in Veterinary Practice Management (CVPM) syllabus, we thought we would look at General Management. General Management makes up the bulk of what veterinary practice managers do all day every day. In the syllabus General Management is divided into three sections: Office Management, Information Technology and Statutory & Ethical considerations. Office Management is the same as office management everywhere: managing cash, understanding the essential components of a reconciling system, credit control, bookkeeping, data storage, maintenance of premises and standard office equipment, etc. Information Technology is divided into Practice Management Systems and the Internet. Understanding the application of IT in practice management systems, the equipment needed, the suitability of available software, the management of security and the storage of digital records is obviously very important. The use of the Internet safely, including social media, email and other uses, both for work and private use is fundamental.

Statutory and Ethical considerations include ensuring staff fulfil their ethical responsibilities, especially with regard to the RCVS Code of Professional Practice, Import and Export regulations, the Veterinary Surgeons Act and the importance of Informed Consent. Health and Safety comes in here, including COSHH, local rules, Radiation Safety, and security of staff, patients and the premises. Also relevant are medicines, their storage, prescribing and dispensing, as well as the VMD regulations, practice insurance, professional indemnity, and how to deal with complaints professionally. The Data Protection Act and how to respond to requests for data held by the practice is also an important consideration in this section. The examiners expect you to demonstrate your knowledge of general management throughout the exam and you should reference it into your answers whenever you can. Also they will set a number of oral questions on this area. They don’t expect massive detail: just to know that you understand your responsibilities, where to go for further information, that Health and Safety and Ethical considerations are always in the back of your mind, and that analysing what has gone wrong and preventing it occurring again is very important.

If you would like more information about the CVPM, take a look at www.vpma.co.uk/education/cvpm.html and maybe give our test question in this issue a try! Roger Wilson, MRCVS

Take the Quiz! CVPM Exam Example Question 1 You might run a practice but would you pass the CVPM exam? Candidates tell us the hardest part of the CVPM exam is answering 10 questions on common practice problems orally in thirty minutes – that’s 3 minutes a question. You can write notes, but the answer has to be oral. There are two examiners facing you and you are being taped so that if your answer is borderline other examiners can listen and mark your answer as well. So, why is it oral and why do you have no previous knowledge of what the question will be? Because that’s what we face in practice every day and competent managers have to just deal with it! So, how would you do? Have a go at answering the question below. Answers should be videoed or recorded and must be less than 3 minutes long. You should read out the question before you start giving the answer. Remember you should cover all 6 sections of the syllabus if relevant, so you need to

think about General Management, Personnel, Communication, Financial Management, Marketing, Strategic Management and considering what changes, if any, are needed in the future to your policies. Submit your answer to: c&t@vpma.co.uk This issue’s quiz question is: Your receptionist has just been informed by one of the nurses that a dog that was booked in for neutering has escaped from the surgery and run off down the street. She has gone running after it and her parting words were “I’ll get it if I can, can you sort something”. What actions would you take? All entries marked and feedback given! Names of Top 3 entrants published in the next issue.

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VPMA NEWS

5 MINUTES WITH... Val Marsh of Blacks Vets, Petplan Practice Manager of the Year 2015 Q How does it feel to have been awarded Practice Manager of the year for a second time? A I truly feel that for me, winning this award for a second time is a personal achievement to surpass all others. It is most definitely the highlight of my career and to be nominated by my colleagues and clients, then judged and recognised in a professional capacity by the hierarchy of the veterinary profession, is indeed an overwhelming honour. Q How have your day to day duties changed from your first day as practice manager of Blacks and since winning for the first time in 2006? A. My first day as practice manager was quite an eye opener and I must admit I did wonder what I had walked into and what was expected of me! There was my completely empty office (the only room on the first floor that had been painted) so that was a bonus because the rest of the floor was to say the least derelict, apart from one smoke filled office that was sublet to a taxi firm. My remit was: there is your office, source what you need, your role will evolve and you can develop it as you see fit but most importantly, take away all the admin, staff problems, HR, deal with anything official looking, keep the clients and staff happy and develop a strong working relationship of trust and confidence with the partners. Well thankfully I seized the opportunity and the challenge that came with it.... that was then and this is now! 2015 and the practice has grown beyond all recognition. 28 staff have now increased to between 85-90 with successful growth, turnover and profitability, encompassing Dudley Hospital and independent branch surgeries at Lye, Sedgley, Oldbury and Quinton. Q Where did you work prior to working as a successful practice manager and what skills were you able to transfer to this job role? A I joined what was then Black and Partners nearly fifteen years ago with a background in property management and development which over the years involved my setting up several successful companies. My background has given me the vision and confidence to pursue development and growth within the practice as part of the management and decision making strategy. I feel my personal strengths have always been business skills, leadership and people management, which combined with a strong work ethic, is pivotal in motivating and encouraging others to excel personally and professionally. Q Staff well-being is a hot topic at the moment and we know your team suffered the tragic loss of one of the partners you had all worked very closely with over the years. If you are able to answer this, how did Blacks Vets cope during this very difficult time and still manage to win Best UK Vet 2015? A The death of senior partner Ian Orr had a dramatic impact on the whole practice team and it would have been so easy to have let his passing adversely affect the business, but instead everyone realised the only way they could pay tribute to his memory was to ensure the successful business model he had played such an important role in creating, should continue. Together with the other partners, their vision and plans for the future development of the practice were to create new strong foundations for greater success and growth. Sadly Ian never saw the completion of the extended and refurbished Dudley Hospital, which

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we have proudly dedicated to his memory but in turn I know he would have been very proud of all we have achieved. We know Ian would have been driving us every step of the way to build on our success and for this reason, the importance of our winning ‘Best UK Vets 2015’ made our achievement even more poignant. It was a team contribution towards guaranteeing the future success and development of a business we are all fiercely proud of. Q You have certainly had a busy time with the redevelopment of the Dudley Hospital and opening event in October 2014 with Christopher Timothy. What part do other members of your team play in the running of Blacks Vets? A We now have a strong management team comprising of 4 directors, practice manager, marketing manager, branch managers, head of nursing, head of reception and insurance manager. Nothing is more rewarding than being part of a successful management team that actively encourages growth and development of both the business and employees for the benefit of our clients and their pets. As a business we strive to exceed our clients’ expectations of us at all levels and we are always looking for ways to enhance, educate and improve the client experience. Q As the only double recipient of the Veterinary Practice Manager award, what are your 3 top tips to pass on to other managers or aspiring managers? A Very difficult to single out just 3 but I do feel all these to be very important: 1. I believe in open-style management and leading by example 2. Always be aware and supportive of anything affecting individuals and address immediately, whether emotional/work related or personal issues likely to affect performance or moral within the team. Listen and always treat everyone fairly 3. Management is about encouraging everyone in your team to achieve their full potential, never taking anyone for granted, acknowledging individual achievement and ensuring your whole team feel appreciated. I personally enjoy working in a position where I feel I can make a difference by managing expectations and ensuring every member of the practice team feels confident of their professional ability, happy with their work/life balance and appreciated and encouraged by way of training and support to maintain the high standards that are expected by the profession. After all, we know our business is only as good as the people we employ – and I consider we have the very best. This ethos ensures we successfully provide exceptional levels of care to our clients and patients. I think everyone knows I am here for them whatever problem or crisis they have in their lives – they know I will make time for them. I will try to find solutions, but above all give my support. This is the only way to ensure a happy working environment and I know we have that. There are so many strong friendships that will stand the test of time. ...Finally and most importantly I feel so proud to have won this award but very humbled by the support and love that has been demonstrated by my colleagues. I just don’t know how to express my feelings of pride and happiness but I do feel truly blessed to have them as a very important part of my life. This brilliant team of caring, compassionate people who come to work every day, enjoy what they do and inspire each other to achieve and ensure every pet in their care is treated as if it were their own. This award is not just for me; it is for my wonderful ‘Blacks Family’ and this is the only way I can attempt to say, “thank you” to them all. My only other wish would have been to share this special achievement with my dear husband Norman and friend and colleague Ian Orr, both of whom I sadly lost last year; they would have been so proud.

SPVS News VETERINARY PRESCRIBER Puts evidence in the context of clinical practice Evidence-based medicine is becoming increasingly more important in veterinary practice. Using Veterinary Prescriber is an excellent way of cutting through the sometimes confusing amount of information to quickly get to the essentials. Veterinary Prescriber will save you time and effort in doing your own research, and keep you up to date with the latest treatments. It is an independent, unbiased, reliable source of information on veterinary medicines that is invaluable to the busy practising veterinary surgeon. Veterinary Prescriber articles are based on a review of the evidence integrated with the views of clinicians to give advice about veterinary medicines that is relevant in clinical practice. A key feature of the editorial process is circulation of draft articles to a range of commentators, including topic specialists, practising vets, regulatory agencies and pharmaceutical companies. Our editorial team has particular skills in critical appraisal and making sense of evidence by integrating it with opinion and practical information. We make a clear distinction between evidence and opinion and all the articles are fully referenced so readers can always refer to the original sources of information.

infestation from ESCCAP, you can use the product guide to find the most suitable products.

Keeps you up to date

Online and easy-to-use

Three recent Veterinary Prescriber articles deal with treatments for canine atopic dermatitis. One of these is a helpful summary of the main recommendations from the international guidelines on the treatment of canine atopic dermatitis. The summary puts the advice in the context of UK practice (e.g. pointing out if a recommended treatment is not authorised in the UK). The guidelines were published before oclacitinib (Apoquel) came onto the market, so another article looks at the evidence for the efficacy of oclacitinib compared to other treatments for atopic dermatitis. This article also looked at the comparable cost of treating a dog with oclacitinib compared with prednisolone or ciclosporin. Another article is about shampoos for dogs, which examined the clinical trial evidence on their use in the treatment of skin diseases. This article can help you decide which shampoos to stock in your practice. So, with these succinct articles, in a short time you can be up to date on many aspects of the management of canine atopic dermatitis. You can also use Veterinary Prescriber articles for your CPD. To help with this there are multi-choice questionnaires accompanying articles to test your knowledge, feedback on your answers and a certificate for your records. Apart from articles, Veterinary Prescriber also has unique searchable product guides. Go to the Free Content section on www.veterinaryprescriber.org and watch the 2-minute video that will show you how the ectoparasiticide guide will help you choose the most appropriate products for cats, dogs, ferrets and rabbits. ESCCAP UK & Ireland (European Scientific Counsel Companion Animal Parasites) has given Veterinary Prescriber fellowship status in recognition of its independent product information. So after getting information on risk assessment and management of parasite

All Veterinary Prescriber’s information is available online at www. veterinaryprescriber.org. The articles are written in a succinct simple style, avoiding jargon and unnecessary acronyms. They are presented in a format that is easy to read and find your way around, and can be viewed on desk-top computer, laptop, tablet or smartphone. See our short video on getting around articles (in the Free Content section of the website www.veterinaryprescriber.org).

Andrea chatting to Hazel at Congress in January

Independence is at the heart of Veterinary Prescriber The great advantage of Veterinary Prescriber is that it is independent. It was founded by Andrea Tarr, a pharmacist with outstanding experience in producing independent information on medicines for doctors. Veterinary Prescriber takes no commercial sponsorship and carries no advertising. Pharmaceutical companies understandably want to focus on the benefits of their products. Being independent, Veterinary Prescriber is free to be critical and give unbiased information.

SPVS member benefit From the start, Veterinary Prescriber received strong encouragement and constructive advice from practising vets, in particular Hazel Bentall, Iain Richards and Stephanie Writer-Davies through SPVS. In recognition of this we are offering SPVS members a recurring 20% discount on an annual subscription. All you have to do is visit the website, click the Subscribe button, choose annual subscription and complete the subscription process by checking the box for terms and conditions and entering your SPVS membership number, and clicking next. You will then get the chance to enter a coupon code. Use the code SPVS20 and then hit “apply”. This will give you 20% off an annual subscription. Practice Life z June/July 2015 z www.practicelife.biz

SPVS NEWS

President’s column Nick Stuart The highlight of my Presidential year so far has undoubtedly been Snowscene in the Dolomites which was an amazing week of blue skies, excellent snow, delicious food and wine, and great company. Oh yes, and of course, the opportunity to learn a thing or two from Mark Patteson and Alan Robinson along the way. You can read more in Martin Aktinson’s excellent article on page 16. Opportunities like this, that allows members to socialise, network and share experiences, is what SPVS is all about and this year our SPVS ski trip is just one of three ‘scenes’. In September, Brian Faulkner will lead ‘Cyclescene’ to the Luberon Valley in the South of France and I can’t wait. For anyone tempted to join us, be reassured that there will be gentle meandering trips to vineyards as alternatives to attempts to cycle up Mont Ventoux! CPD will be from Brian and James Cronin of Legal Eight who will focus on staff performance and development as well as how to navigate the tricky waters of employment law. As I write there are still a few places left to join us. Our final ‘scene’ of 2015 in October will be an altogether more relaxing affair but with some top level CPD. We are delighted to announce that Katherine Eitel, who wowed delegates at Congress 2014 is coming across from California for our inaugural ‘Spascene’ at the luxury Hoar Cross Hall Hotel in Staffordshire. I hope you will join Anna Judson for a weekend of serious pampering in this fantastic venue while Katherine delivers a master class in Leadership. More detail about this on page 15. Being SPVS President isn’t all about pleasure, there is some hard work in there too. I have very much enjoyed being part of different working parties or discussion groups tackling some of the challenges faced by the profession. These have included contributing to discussions about the governance of BVA and how we, and their other ‘sister’ organisations, can work together more effectively and efficiently. Another working party that it is a privilege to be part of is Mind Matters, the RCVS initiative to tackle mental health problems within the profession and to promote better mental wellbeing within practice. This is something I am personally very committed to. Stress, anxiety and depression are all growing problems in our society and are much too prevalent in our profession. It is our duty as practice owners and managers to try to understand why this is so and work towards finding ways to improve the mental health of those who work for us. This isn’t just a moral imperative, it also makes good business sense. After all, a happy practice is not just a better place to work, it is also more likely to be productive. Mind Matters will co-sponsor our mental health stream at Congress 2016 and contribute to our Focus on HR Day in October. I’m not doing this all on my own though. SPVS Officers and Council members are all working on their different projects from our surveys to the new benchmarking service; from helping members with enquiries to overseeing our email discussion group; from co-editing the magazine to the society administration. My sincere thanks go out to all of them.

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SPVS Dates For Your Diary 2015 July 3rd to 7th – The Lancaster Student Seminar Many SPVS past and current Council members will be there supporting this popular event aimed at helping new graduates as they embark on their careers July 20th and 21st – SPVS Officers and Council Meetings If there are any issues you’d like to raise for discussion at either of these meetings please contact the Hon Sec, Hazel Bentall, via the SPVS Office September 13th to 19th – Cyclescene, The Luberon Valley, France For details or to book contact the SPVS Office October 16th – 17th – SPASCENE Hoar Cross Hotel Staffordshire

March 5th – 12th 2016 – SNOWSCENE Village Montana Hotel in Tignes, France

For more information contact the SPVS office

Hoar Cross Hotel

SPVS NEWS

Denplan and SPVS are delighted to announce their new partnership that gives exclusive benefits to SPVS members Chantelle Brandwood, National Affinity and Corporate Manager from Denplan said: “Vets, Practice Managers and their teams are increasingly aware of the value of promoting plans in their practices, both for the health of their clients’ pets and for seeing satisfied clients coming in regularly. We look forward to working with SPVS members because we know that they care about the future of their practices and with our support, advice and motivation, we can help make a real difference.”

enplan Pet Health Plans offer practices bespoke preventive health plans for dogs, cats, rabbits and horses. By having a plan in your practice, it enables you to benefit from increased regular income, improved client loyalty and healthier pets. This is all available for no up-front cost – Denplan Pet Health Plans makes the investment in you, not the other way around. As a Denplan member you will have your own local Business Development Consultant who will be available to help you design, price and set up your Pet Health Plan. They will also provide ongoing support and training to make sure that your Pet Health Plans are a success for you, your practice and your clients. In addition, there is a dedicated Customer Service team available on a free-phone number for both your staff and your pet owners. Each Pet Health Plan is bespoke and is set up to meet the needs of your practice. Our new partnership means there are two packages available to SPVS members; allowing practices to pick from the flexible benefits based on what suits them best. These benefits apply whether you are launching health plans for the first time, transferring from your own plans or from another provider as long as you are a member of SPVS. SPVS members can now choose for their practices either to benefit from a reduction in starting monthly fees when they set up a plan with Denplan Pet Health Plans or if they already have a plan in place, to instead receive additional SPVS membership for a member of practice staff when hitting pet recruitment milestones. In addition to these great benefits, both packages available to practices will allow them access to mystery shopping, client profiling and training courses for practices on business issues and support. This would be available once practices have reached monthly revenue of £3,000 as opposed to the normal rate of £4,500. The service from Denplan Pet Health Plans makes the difference as Haven Vets, Llanelli will testify. Susie Ackroyd, partner and practising veterinary surgeon from Haven along with her receptionist, Debra Williams, took part in Denplan Pet Health Plan’s presentation at the recent SPVS/VPMA Congress. Susie said: “We would definitely recommend Denplan as our preferred provider. We wanted a provider to help us promote our plans and Denplan were

very accommodating with this – they even helped us design a new logo for our practice which was brilliant. It was really appreciated and you couldn’t fault it. We have also found that having a health plan provider like Denplan really keeps us motivated and keeps everyone’s interest going in the plans. They remind us to promote it and give the practice team realistic targets and incentives for hitting these targets as well – we were recently able to take the whole team out to see Rock of Ages! The success of our plans is really driven by this support as it would be a full time role for a member of staff to make it work otherwise”. The first step towards enjoying these special benefits is to contact Denplan Pet Health Plans on 0800 169 9958, say you are a SPVS member and we will arrange for your local Business Development Consultant to visit you.

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SPVS NEWS

SPVS MEMBER SPOTLIGHT LEIGH-ANNE BROWN

eigh-Anne Brown was brought up in a small town in Ayrshire and graduated from Glasgow in 2000. Immediately after graduating she accepted a locum role in an independent small animal practice in Bradford. The placement was for a two week period, which turned into eight years!. Leigh-Anne was then approached to become a joint venture partner at Vets4Pets in Harrogate. She joined in 2008 and has grown the business from a sole vet practice to a team of four vets and has just opened a second Harrogate practice. Leigh-Anne joined SPVS last year and explains why: “I have always been aware of SPVS – in fact the SPVS Final Year Students’ Seminar in Lancaster is the most valuable CPD I have ever done. The seminar did more to prepare me for my first year in practice than my five years at vet school. And, perhaps more importantly, it made me see how cool it is to be a vet in terms of what you do and what it means to people. Now, 14 years later. I’m chairing a session at the seminar and enjoy seeing the penny drop when today’s students realise what being a vet is going to mean to them. “The seminar has become a bit of a hobbyhorse for me in terms of trying to prevent the drop-out rate that is afflicting the industry. Today’s students have the same aspirations they

have always had and are prepared to go out there and prove themselves. But all too often they go hell for leather, work too hard and burn themselves out after five years. At SPVS we are constantly talking about wellbeing and mindfulness and the fact that newly qualified vets should be treated decently to keep them in the profession long-term. It was good to see mental health and wellbeing having such a high profile at this year’s Congress. “Congress is absolutely brilliant and totally what I need as a business manager. This year’s mental health session was invaluable and the partnership with VPMA is a good one. The same is true of the CPD and I would advise anyone who has yet to experience the programme to do so. It really does stand out as being the best choice for practising vets. “While I have known about SPVS for a long time, it was one of the Council members – Brian Faulkner – who inspired me to join then co-opted me onto Council! I find the networking aspect particularly beneficial and it helps me get more of a handle on where we sit within the profession, both as a practice and as a corporate. I love the SPVS list – as well as the lively discussions, it makes me realise how lucky I am to be where I am. We still hear people saying that SPVS is an ‘old boys club’ but anyone who has experienced the email discussion group or attended a Council meeting will realise just how wrong that perception is. Rather than being rooted in the past, SPVS is 100% about looking at the present and the future and helping to shape that future.”

KATHERINE EITEL IS BACK! SPASCENE 2015 Hoar Cross Hotel, Staffordshire, 16th - 17th October Relax and learn to be a leader all at the same time in the calm and tranquil surroundings of one of the UK’s finest Country Spa Hotels... OK, so we’ve had Scubascene, Snowscene and now Cyclescene. But how about something altogether different and a lot less physically demanding? We’re really excited to have persuaded Katherine Eitel, from internationally renowned ’Lioness Learning’, across from California to join us on a very special two-day CPD event taking place at the luxurious Hoar Cross Hotel in the beautiful Staffordshire countryside. Attendees of SPVS/VPMA Congress 2014 will remember that Katherine wowed everyone with her inspirational leadership talks and team communication strategies. We will take this to the next level at Spascene, with 5.5 hrs of leadership CPD in an intimate and relaxing environment. The chosen venue for our inaugural ‘Spascene’ is Hoar Cross Hall Hotel. We have built in lots of time between lectures so you can chill in the spa, indulge in a relaxing treatment, or opt for a range of more energetic alternatives from golf to tennis to a whole range of free classes from spinning to zumba; yoga to tai chi. www.practicelife.biz z June/July 2015 z Practice Life

PRICES (EXCLUDING VAT): Delegates (SPVS members)

£485.00

Delegates (non SPVS members)

£535.00

Partner/Guest – sharing a room with a delegate, but not taking part in CPD

£280.00

Partner/Guest – sharing a room with a delegate and taking part in the CPD*

£450.00

The delegate price includes 5.5 hours CPD, 2 nights dinner, bed and breakfast, lunch, teas and coffees and full use of the spa all day Friday, Saturday and Sunday and a welcome drink on Friday night. Partners/guests rate includes 2 nights’ dinner, bed and breakfast, lunch and free coffee and tea all day plus full use of spa Friday, Saturday and Sunday and welcome drink on Friday night. *includes 5.5 hours CPD.

For a booking form or further information please contact the SPVS Office, 01926 410454 or email office@spvs.org.uk Places are limited so book quickly! We are expecting this to be a very popular weekend.

SPVS

A well earned break with a view

SPVS SNOWSCENE 2015 ‘The Heart of the Matter in the Heart of the Dolomites’ Martin Atkinson BVSc MRCVS

PVS Snowscene is the longest continually running overseas conference combining quality CPD with skiing and some great networking. This year it was held in Covara in Badia, part of the Sella Ronda, Italy from 7th – 14th January. Covara is in the heart of the Dolomites, the stunningly beautiful mountain range in North East Italy, on the Austrian border, which was appropriate given the theme of Snowscene this year: Insights into the heart of the pet and the heart of your business. The Dolomites was the choice of SPVS President, Nick Stuart and hats off to him. Corvara is the largest town in the Sella Ronda, which links 1,200 km of pistes with 450 lifts on a single ‘Super Dolimiti’ ski pass. The Sella Massif (it is shaped like a saddle) is the name given to spectacular mountain formation which forms the centrepiece of this breathtakingly beautiful World Heritage Site national park. While it is clearly difficult to ski every single run even in a week, it is practical to ski around the circuit in a day, following either an easy anticlockwise blue route or the more difficult clockwise orange route both of which are clearly marked with a few little forays off to the side. However, every area within this region has its

own attractions and it is possible to spend a day in each, some providing more challenging skiing than others. There is also a tour of the First World War battle sites, much of which is possible on skis (this area was fiercely and bloodily fought over by the Austrians and Italians). For the truly adventurous there is the Via Ferrata, an extreme tour which involves climbing fixed iron ladders which were originally placed during the war but have been largely renewed to ensure safety. While this is an activity probably best suited to summer climbing, for the truly adventurous it is possible to do this with skis! In addition, some delegates took a day off from downhill skiing and donned cross-country/touring skis for a change. A quick look at a piste map before travelling was not encouraging for advanced skiers as the area consists of largely blue and red runs. However, this is misleading; there are a good scattering of blacks and this, combined with a week of unmitigated blue skies, meant everyone of every ability had a fantastic time. And even if the skiing was relatively easy the scenery took the breath away and more than compensated. The beauty of this part of the Alps is often spoken of in awe but it is impossible to appreciate how spectacular it is without being Practice Life z June/July 2015 z www.practicelife.biz

SPVS

SPVS President Nick Stuart regards the stunning mountain scenery

of echocardiography in practice it may be easy to forget that radiography and ECG still have a place and we were reminded that they may be indispensible in diagnosis of certain conditions. Even simple things like monitoring resting respiratory rate, which must be the easiest and most productive of observations for clients to perform at home, seem to be often ignored as a diagnostic tool. Alan proved that even experienced practice owners can learn more about management by taking us through a series of case studies and practical examples. He acknowledged that we were all hit hard by the recent recession, but while in previous downturns, the economy has bounced back, there is no guarantee that this time it will come back quickly – if at all – to the level it was before. Our client base is changing to more price and service conscious individuals and we face many challenges from outside the profession as well as within it. We lose 6% of our patients every year purely by attrition before considering loss from other factors such as competing practices, internet pharmacies and more knowledgeable clients empowered by the internet treating their own pets. We can no longer rely on a steady stream of new clients and need to work harder to attract new custom and to retain and create more opportunities from those we have.

there to see the towering sheer cliff walls, deep valleys and the way the mountains change from pink to orange with different light conditions due to iron oxide in the Dolomitic Limestone. Due to its position on the border with Austria, après-ski activity was somewhat more orientated to the Austrian model with dancing on the tables to Euro-pop. The best après-ski bar in the Alps just happened to be on the direct route back to the hotel and as the week went on, more and more ‘snowsceners’ made this an obligatory stop until the final day when it was packed with revelling delegates and partners. Those whose tastes in après-ski activity were more ‘reserved’ enjoyed an earlier finish to the day, with afternoon tea and cakes in our excellent Hotel Col Alto. For partners or those who made it back before lectures, there was a superb spa and pool facilities. Morning and evening CPD was provided by Mark Patteson, Specialist in Veterinary Cardiology at HeartVets, based at Vale Referrals, Dursley, Gloucestershire and Alan Robinson, Veterinary Business Consultant from Vet Dynamics, who perhaps has an advantage over many other similar providers as he still runs his own veterinary practice. Mark took us through what is new in diagnostics and treatment in cardiology with some interactive case-based illustrations to enable us to advance our knowledge and diagnostic ability. There was particular emphasis on the adoption of multi-modal treatment and monitoring progression of cardiac disease through clinical assessment and the use of diagnostic aids especially echocardiography and biomarkers. The latter, NT-proBNP and Troponin in particular, are becoming increasingly useful tools in assisting NO FUSS, COST-EFFECTIVE diagnosis and monitoring cardiac disease, PAYROLL MANAGEMENT yet are surprisingly under-utilised in general Specialists in vet practice payroll practice where they are easy, inexpensive, reliable and readily available with no special 01908 377448 / www.payrolloptions.com equipment. With the increasing availability

FREE YOUR TIME

TO DO WHAT YOU DO BEST

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Nurse Talk 18

NURSE TALK

In association with

Celebrating fifty years of the BVNA 2015 sees the BVNA celebrating its golden anniversary – and what a year. We are delighted that the RCVS new Royal Charter has come into effect, meaning that the whole of the veterinary nursing profession is now regulated. Fiona Andrew – BVNA president summed up this momentous event saying, “We are thrilled that the new Royal RCVS Registrar Gordon Hockey and Policy Charter has come into effect. Successive Consultant Jeff Gill with councils have worked tirelessly over the the new Royal Charter, years to have veterinary nursing recognised recognising veterinary as a profession and this is a true victory nursing as a profession for everyone who has been involved”. Both the RCVS and BVNA are keen that this charter goes towards improving recognition of Registered Veterinary Nurses (RVNs) both within the veterinary profession and the animal owning general public. With this integral change in the landscape of the profession, come some other changes for RVNs. One of these is taking responsibility for their own continuing professional development (CPD). At a recent congress, several veterinary nurses approached the BVNA stand concerned that they were going to have to do 45 hours of CPD a year. Our staff and council members were able to reassure

them, as we would now like to reassure anyone reading this, that this is not the case. The CPD requirement is to be spread over three years, giving an average of 15 hours a year. However it made for interesting anecdotal research! As well as CPD, RVNs must read and understand their code of conduct that they now work by and are accountable to (www.rcvs.org.uk/advice-and-guidance/code-of-professionalconduct-for-veterinary-nurses/pdf/). There are implications to this accountability that extends out of work and into personal actions with social media immediately springing to mind. RVNs must remember to treat their colleagues and the wider veterinary community, professionally and not succumb to petty or insulting back chat on the internet which may bring the profession into disrepute. Initially it’s possible that some may see the code of conduct as a drain on resources, complicated or even unnecessary however the BVNA would argue strongly that it is clear and necessary. It is only through this Royal Charter that we can work to secure the safety and well-being of animals under our care and that is a clear victory alone, without consideration of the improved standing and recognition such a move brings to the profession. It’s here to stay, it’s part of our life and it can only move the profession forward. So come along for the ride, read the code of conduct, ask questions if you don’t understand any part of it and celebrate with BVNA as it moves into the next fifty years of representing Registered Veterinary Nurses.

Keeping the Voice of Veterinary Nursing at the Table… The main role of the BVNA is to represent veterinary nurses across the UK and ensure that their voices are heard. It’s a role that all the members of BVNA council take very seriously and we participate actively on a wide range of projects that involve Registered Veterinary Nurses (RVNs). Recently, members of our council have worked alongside colleagues in the redevelopment of the Royal College Practice Standards Scheme (PSS). Kirstie Shield, our current Senior Vice President and an experienced veterinary nurse, was very familiar with the original standards scheme and how it worked in practice. When it was clear that this scheme needed redevelopment, Kirstie was thrilled to be able to participate fully in conversation and consultation; ensuring that RVNs were considered in every part of the process. The same attitude is taken by all other members of BVNA council as they sit on various boards and committees across the country. One of these is the Links group (http://www.thelinksgroup.org.uk/), which is working hard to develop essential resources to support vets and nurses throughout the UK should they have cause for concern about vulnerable people possibly suffering from domestic abuse.

Another is the RCVS / VBF initiative ‘Mind Matters’ that will serve to drive and support fundamental mental health and wellbeing projects over the coming three years and BVNA is delighted to have representation in this group too. As well as these initiatives, BVNA representatives meet regularly with officers from other associations such as BSAVA, BVA, SPVS and the VDS, to ensure that the voice of veterinary nurses is heard. As with other ary representative e veterin in equin uties rk d o e w in u e equ organisations, Do yo m o s s e v a or h don’t mis nursing le? Then BVNA works hard g ro in r rs u u o y n f equine y as part o a -d o on its members’ ying stic tw for all pa our fanta It’s free behalf and will . s as m n iu ru s o ss and symp re g n o me. c f continue to ensure so program delegate ll 3-day ra . e v w o w e w that the veterinary part of th an be found on A N V c B s e il nursing profession or on th Full deta k .u o .c s gres . keeps its deserved bvnacon a.org.uk ww.bvn w e it s b we seat at the table.

ESS STOP PR

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NURSE TALK

MANAGEMENT CPD FOR £50!!

To mark the Golden Anniversary of the BVNA, this year the association is proud to invite members of the profession to attend their congress for £50 per day•. As the BVNA looks to reward those who support the association, this is a member’s only rate so, if you are thinking about becoming a member, now is the time. BVNA Congress takes place from

the 9th -11th October at the Telford International Centre. Attendance for the 3 days will earn you 15 hours of first-class, bang-up-to-date CPD for only £150. We are particularly proud of this year’s management stream. Never an organisation to shrink away from the big issues, this year sees speakers tackle some of the more difficult aspects of practice management; In particular, managing those employees who are not performing well. At BVNA we know that many practice managers and head nurses were firstly veterinary nurses and while in that role they often excelled. What doesn’t always

A unique two-day symposium dedicated to equine veterinary nursing

EQUINE NURSING SYMPOSIUM

BVNA CONGRESS

2015 Friday 9th – Sunday 11th October Telford International Centre, Shropshire

follow is that they are natural leaders of a team. As with all new skills, management must be learnt, tricks of the trade shared and advice sought. Dealing with a member of the team that is not pulling his/her weight can be one of the most difficult situations for a manager to deal with. Carolyne Crowe Veterinary Coach and Mentor will ensure that you have the tools to tackle such a problem in an organised and professional manner. Mental health and well-being is something that has recently been highlighted by both the RCVS and BVNA as a topic in need of addressing within the profession. BVNA is pleased to present relevant content within its stream to help deal with the emotional aspects of our working role. Emotional intelligence is a complex topic with its fair share of controversy but potentially a concept that could be utilised to aid leadership and management. In her lecture Dr Mandi De Mestre will examine the subject and apply it to leadership within the profession. As well as tackling the personnel side of management the stream also incorporates business management with a lecture on utilising veterinary nurses to their full potential. As Registered Veterinary Nurses (RVNs) start to take control of their own professional development through registration and application of the code of conduct, developing joint goals that benefit both the practice and the RVN are also beneficial for the individual’s mental health and wellbeing and the successful running of a team. The last lecture of management day is the Tracy Mayne memorial lecture, with a subject that the congress committee feel sure that Tracy would have approved of. This lecture will aim to provide veterinary professionals with an insight into the customer experience in veterinary practice, taking time to consider being on the other side of the reception desk. So, this year our management stream covers a huge range of subjects which we hope will cater to all interests, plus with the celebratory rate of £50 per day, it’s excellent value – we look forward to welcoming you to Telford. Book now on www.bvna.org.uk! *For bookings up until the end of July.

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COLLEGE CORNER

College Corner

Vet Futures: SHAPING YOUR FUTURE We are currently half-way through our UK roadshow for the Vet Futures project, a joint venture between the Royal College of Veterinary Surgeons (RCVS) and the British Veterinary Association (BVA), having visited Belfast, Exeter and Cambridge, with Manchester, Edinburgh and Swansea still to come.

The project aims to help the profession prepare for, and shape, its own future, and was launched at the BVA Congress within the London Vet Show in November last year. By taking control and enabling the veterinary team to face its future well prepared, the project hopes to create a profession that is sustainable and relevant, while maintaining animal health and welfare at its core. The roadshow is part of phase two of the project – and it has been fascinating to hear the views of vets, VNs and practice managers so far. But where does this fit into the project overall? Well, the first step has been to establish a robust evidence base from which to develop a report and action plan. The project’s independent consultants have completed a literature review, looking at the current issues facing the profession both at home and abroad, as well as looking at trends in other comparable occupations. The issues were considered under the headings of demographic and economic changes, the competitive forces in the marketplace, client behaviour, mental health and wellbeing, and food supply and global imperatives. Qualitative research was also carried out among vets, VNs, practice managers and stakeholder organisations, together with end-users of veterinary services, such as farmers, pet owners and those in the food chain. The initial findings were reflected back to a meeting of the wider Vet Futures Group in January – which comprised representatives from across the veterinary team and also users of veterinary services – and challenged them to name goals for the profession to meet by 2030.

On the road The roadshow is part of phase two, which is about refining and testing our findings and direction so far. In addition to the three meetings mentioned above, we also included Vet Futures topics at an RCVS Regional Question Time in Guildford in March, and at BSAVA Congress in April – so we are aiming to gather as much feedback as possible. The structure of the meetings has been to update delegates on the first phase, including the six emerging themes to come of the research, which are: • For vets to be the recognised leaders in animal welfare • Less stressful, more varied career options for a diverse profession • Speaking with one voice on the value of vets to society • Delivering higher levels of customer service and better meeting clients’ needs • Responding positively and innovatively to market changes • For vets to be acknowledged as key contributors to matters of public health, One Health, food supply and global issues We then asked delegates to tell us about their visions for the future, and potential issues that might be faced, before challenging them with six scenarios for what might happen by 2030, asking them to focus on opportunities for the profession. We won’t tell you what those scenarios are here... you will just have to come to a meeting to find out! You can sign up at www.vetfutures.org.uk/events.

Topics to ponder

A varied list was forthcoming, including the need for greater diversity, a call for a portfolio career to become the norm, for the profession to be the most trusted in the country and the concept that the vet practice should become a one-stop-shop for all information, advice and support on animal welfare issues.

In order to stimulate further debate, we have posted a controversial ‘Topic of the month’ on the website (www.vetfutures.org.uk/ discuss) each month since the launch, together with a relevant poll question. Previous topics have included mental health; whether VAT on vet fees for pets should be dropped; ethnic diversity; women and leadership; and whether vets working outside of clinical practice feel ‘second class’. You can still comment on all of the past topics, together with new ones as they are posted.

Throughout the project we have also been collecting data via the internet, surveys, meetings and social media. Reports are published at www.vetfutures.org.uk.

The Vet Futures report and action plan will be launched in the autumn. If you have any questions about the project, please email us on info@vetfutures.org.uk. Practice Life z June/July 2015 z www.practicelife.biz

LEADERSHIP

Do you own and/or are involved in running a veterinary practice? Do you struggle to try to manage to do everything? Nick Steele explains why broad shoulders should not be a leadership prerequisite:

’ve been working alongside veterinary practices for nearly seven years and there’s one thing that I’ve observed in almost every practice leader – a belief that everything rests on their shoulders! Within my own organisation, I previously held a position developing our leaders and this was never a behaviour I supported. Instead, I used a validated model that aims to make leadership a behaviour exhibited by all members of a team providing the advantage of developing accountability and responsibility amongst team members. This model, ‘Exemplary Leadership,’ (developed by Kouzes and Posner from research published in their 1995 book, ‘The Leadership Challenge: How to Keep Getting Extraordinary Things Done in Organisations’) looked at successful leadership experiences in hundreds of different organisations and, despite the differences between organisation and experiences, the same leadership actions outlined below emerged. I have included my own interpretation under each one.

Challenging the Process Leaders search for opportunities to change the status quo. They look for innovative ways to improve the organisation. In doing so, they experiment and take risks. Because leaders know that risk taking involves mistakes and failures they accept the inevitable disappointments as learning opportunities. Don’t be afraid to try something different and certainly don’t let a fear of failure stop you. It’s better to make a few small mistakes and learn from them than the one big mistake of not embracing change. Inspiring a Shared Vision Leaders passionately believe that they can make a difference. They envision the future, creating an ideal and unique image of what the organisation can become. Through their magnetism and quiet persuasion, leaders enlist others in their dreams. They breathe life into their visions and get people to see exciting possibilities for the future. This is about having a very clear vision (i.e. goal) for your practice with specific measures of success supporting it. It’s also about gathering people around that goal so they understand what it is and their individual contribution towards achieving it. Enabling Others to Act Leaders foster collaboration and build spirited teams. They actively involve others. Leaders understand that mutual respect is what sustains extraordinary efforts; they strive to create an atmosphere of trust and human dignity. They strengthen others, making each person feel capable and powerful. Trust your team to make the right decisions and collaborate with them to achieve www.practicelife.biz z June/July 2015 z Practice Life

business success. Trust is such an important feature of successful teams, but often I see ‘top-down’ leadership which doesn’t foster trust. It’s also about not believing that all the ideas (good or bad) need to come from you!

Modelling the Way Leaders establish principles concerning the way people should be treated and the way goals should be pursued. They create standards of excellence and then set an example for others. Because the prospect of complex change can overwhelm people and stifle action, they set interim goals so that people can achieve small wins as they work toward larger objectives. They unravel bureaucracy when it impedes action, they put up signposts when people are unsure of where to go or how to get there; and they create opportunities for victory. You need to “walk-the-talk”. Your team won’t respect or trust you if they don’t see you acting in the way you want the whole team to behave. This leadership behaviour is of particular importance when guiding the practice through change. Encouraging the Heart Accomplishing extraordinary things in organisations is hard work. To keep hope and determination alive, leaders recognise contributions that individuals make. In every winning team the members need to share in the rewards of their efforts so leaders celebrate accomplishments. They make people feel like heroes. This is such an important behaviour, often done badly, but not deliberately so. It’s about recognising performance and rewarding it. To do this, you need to clearly understand an individual’s contribution so you can provide them with positive, constructive feedback that helps them to understand why it was so good. Reward isn’t necessarily about money, it’s about understanding what reward will motivate the individual and be of value to them. So how do you bring all these behaviours together? I have a relatively straight forward solution. These behaviours make up the elements that any well-executed performance management process should include: • Organisational goals communicated clearly to the team • Knowing your individual contribution towards the goals • Having development plans aligned to organisation goals • Receiving ongoing, informal feedback on performance • Having an annual, formal performance appraisal •R eward and talent development linked to individual performance Adapting your leadership approach to demonstrate the five behaviours outlined will help take some of that weight off your shoulders by enabling your team to take more of the responsibility and accountability for what happens in your practice, something I know a lot of you would welcome. For further information contact Nick via www.zoetis.co.uk/businessconsulting.

IN THE SPOTLIGHT

in the This issue, we catch up with Managing Director of CPD Solutions Susie Coughlan about the instrumental role her company has played in driving accessibility to veterinary CPD. Susie, you were one of the pioneers in the provision of CPD to the veterinary profession. Tell us a little about what drove you to set up CPD Solutions. S: I started CPD Solutions to help fill the gap that existed in veterinary CPD provision at the time (1998). I was working full time in small animal practice and I really struggled to find any CPD courses to go on. All of the ones I was interested in were full! I was looking for more flexibility as I had a one year old son and never seemed to see him or my husband, and I was prepared to work much harder in the short term while setting up the business so that I could control my own time later on. So I set up a few one day attendance courses while continuing with my full time job. You started CPD solutions with a PC and a printer. Describe the company now S: My first PC and printer were bought with an interest-free loan. They sat in the ‘office’ corner of our bedroom and I produced the most amateur flyers you have ever seen! Sadly they have perished in the many moves the business has undergone since but I remember them well- clip art rabbits, dogs and cats in black and white on standard copy paper. After printing several hundred of these I folded them, put them in envelopes and stuck stamps on by hand. Fortunately things have changed. Today CPD Solutions has a team of 12 excellent staff and a 7 figure turnover. We work from modern offices near Chester, and have a dedicated Training Centre for practical courses near Birmingham. We have more computers than staff and I don’t have to lick stamps any more.

How has CPD provision to the profession changed over the years? S: The main change without a doubt has been the increased choice of CPD provided by the internet. In 1998 there was no internet to speak of and we didn’t use email until 2000. When I started, attendance courses and congresses were the only real option for vets and nurses in practice. CPD Solutions has offered online veterinary CPD since 2004 when most people were still on dial-up connections. The lack of broadband was a limiting factor then; today the internet provides a huge opportunity for vets and nurses to access high quality CPD in a fully flexible way.

How do most people access their CPD now: attendance courses or online? S: A combination! Most people will combine online learning with attendance courses. Online learning has so many advantages- the main ones are flexibility and the ability to take control of your time. This is especially important for vets and nurses with busy work lives who are juggling professional and family commitments. For learning hands-on practical skills, small group practical attendance courses with direct help and guidance from specialist tutors cannot be beaten. Online learning has its place here as well though, especially with platforms that allow the inclusion of

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IN THE SPOTLIGHT

clinical and surgical videos and review of the online course material.

and convenience for the learner will be paramount in these developments.

How does CPD in the veterinary profession compare to that for other professions? Are there similarities or differences in the way in which it is accessed, given the long working hours in our profession? S: One big difference with other professions is the lack of regulation or accreditation in the veterinary profession. Not all professions have an accreditation system but many do. I am not convinced that accreditation would increase the range and quality of CPD on offer to the veterinary profession – and it would certainly be a huge administrative exercise.

Work-life balance is a hot topic in the profession. You seem to manage to run a successful business alongside representing GB in in Triathlons and other competitor sports. How important do you think it is to have something other than work to concentrate on? How do you make time for all the training? S: To put this in perspective, for many years I really had no work-life balance. I think that this is true of everyone who is setting up a business. From 1998 to 2005 I was fully committed to establishing CPD Solutions and having three children! Initially I also worked full time in practice, and then did locums after that. My husband was taking Diploma Exams in Glasgow on the day my second child was due; 5 days after he was born I was looking after delegates on one of our practical courses. At the same time my husband was starting his referral business, Northwest Surgeons. When you are starting and growing two businesses and have a young family it is impossible to have a real work life balance- you just do what you have to do. Basically I worked and spent time with my family and slept occasionally and that was about it. I started doing triathlons in 2005 as a way of getting fit again after years of work and small children. I think it is essential to have areas outside work to focus on when you can – there are some stages of a busy professional life and raising a family that make it very difficult. I am very fortunate today in that I can largely control my own time and choose which areas to work on within CPD Solutions. Our fantastic team take care of the day to day running of the business, and this allows me to fit in training when it suits me. Triathlons are great because you have to do 3 sports so you don’t get too bored with the training. Being selected to represent the GB age Group Team is a fantastic bonus and motivator.

What are the top 3 subject areas that vets and veterinary nurses choose? Have you seen a change in areas of interest over the years? S: The most popular subject areas do change from year to year. They are very often practical, so hands-on surgery courses for vets and nurses, imaging and laboratory techniques. Updates and cutting edge clinical management recommendations are also popular. There have been definite changes over the years as new treatments and procedures become available and I’m sure this will continue. Have you seen changes in the CPD uptake of vets and nurses since CPD has become mandatory for both vets and nurses? S: There was an increase in uptake with mandatory CPD, but it wasn’t that striking. I think CPD Solutions courses and memberships tend to attract vets and nurses who are already committed to keeping up to date and developing their clinical and professional skills on an on-going basis. In my experience that is true of the overwhelming majority of vets and nurses in practice. We had (and still have) face-to-face training, then online, and a huge increase in the popularity of formats such as webinars for CPD delivery. What’s new on the horizon? S: There will be innovative new online formats and more combinations of face to face and online learning. Flexibility

If you hadn’t set up CPD solutions, do you think you would still be working as a vet in practice? S: Very hard to say. It would have to have been my own practice as I’m not very good

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at having people tell me what to do. I didn’t follow a standard practice path as I have also completed a PhD in Immunology and a Post Doc in vaccine development before returning to work full time in small animal practice. I don’t really miss clinical work and do feel that I am still very much involved with the veterinary profession. Leaving a career you spend years qualifying for is quite a leap of faith; do you have any advice for other vets or veterinary nurses reading this who may be thinking of doing something different? S: Starting my own business was one of the best things I have ever done. I have never regretted it. So if you are passionate about doing something else and you can start it without going bankrupt I would say just do it. You do need to be realistic though as you will work harder for yourself than you have ever worked in a job if you are going to establish a successful business. What’s the next step for CPD Solutions? S: CPD Solutions aim has always been to provide the highest quality, fully flexible CPD to help vets and nurses fulfil their CPD requirements and develop their skills. We pioneered online Veterinary CPD in 2004, way before webinars! We are always looking at new formats for both attendance and online learning that will make completing their CPD easier for veterinary professionals. For example we initiated a retraining course, GP Refresh, last year to help those returning to practice or moving to small animal practice. Marketing has been an on-going focus here at CPD Solutions and we now offer marketing assistance to veterinary practices, including the customised Pet Health Videos for practice websites (www.pethealthvideos.co.uk) and help with internet marketing, specifically Facebook and Lead Generation (www. susiecoughlan.com). We also have a brand new Marketing Webinar Club for practice owners, partners and practice managers (www.marketingwebinars.co.uk) . We will continue to innovate and find new ways to help vets in practice develop their skills and grow their businesses.

WELL-BEING

Is it Stress, Burnout or Compassion Fatigue? Qualified Counsellor and Psychotherapist Teresa Mulvena helps us to decode which it is, and how to counteract it. Probably most of us at some stage have experienced feeling unmotivated and unsure about our current jobs. But how do you know if it is a passing mood, or a sign that something needs to change? And indeed how do you decide what to change?

f you are lacking enthusiasm, feeling worn out, or are tired of caring for others in distress, you may be suffering from one of these conditions. There are steps you can take to deal with them. Stress, Burnout, and Compassion Fatigue are on the same spectrum, but have some differences. Here we distinguish between them and give some pointers for how to tackle them.

Stress

Stress is a general term for when demands exceed your ability to cope. It follows then that stress occurs when people are overwhelmed by external pressures such as a high work load, or are more susceptible to stressful circumstances because of personal problems or lack of resources to cope. There has been a lot written on stress and so I am only briefly touching on it in order to differentiate it from burnout.

Burnout

Burnout is a particular kind of stress where there are feelings of emotional exhaustion, and decreased motivation, along with losing the ability to be optimistic and care about your work anymore. The term originates from the image of a burnt out building, where all that is left is a shell that is no longer functioning effectively. It is caused by organisational dynamics (such as bureaucracy, lack of autonomy, high workload, and being unfairly treated). The opposite of burnout is engagement (enthusiasm, commitment, optimism, energy, involvement). Remember the feeling you had when you first started your job, and were ready to change the world?

How Bad Is It? Stages of Burnout 1. Idealisation: Having unrealistic expectations about work and how fulfilling or perfect it will be. Similar to the honeymoon stage, and you are setting yourself up for

Causes of Burnout: • Work overload – Too little time or a lack of resources • Lack of control – having little influence or autonomy • Insufficient rewards relative to the demands of the job – for example poor pay or lack of appreciation for a difficult job. • Insufficient team cohesion – A busy work environment prevents opportunities for connectedness, knowing each other well, and having a laugh, which all contribute to job satisfaction. • Unequal or unfair treatment – If evaluations, promotions and benefits are not applied fairly, the organisation cannot be trusted by the employee. • Conflict of values – If aspects of the job go against your ethics or values it can cause a lot of distress.

(Maslach & Leiter, 1999)

disappointment. No matter how good the job is, we all need relationships and a sense of meaning outside work. Work cannot fulfil those needs for us. 2. Disillusionment and Growing Dissatisfaction: Cracks appear, the bubble is burst, and disenchantment with the job begins as inevitably the job cannot live up to expectations. For most of us work is a mixed experience of good and bad; the hope is that it is good enough to be sustaining. 3. Frustration Dominates: Questioning systems and complaining; now you are easily irritated by bureaucracy, policies, and decisions you disagree with. 4. Defensive Withdrawal: going through the motions, you begin to feel separate and not so loyal, and may have more sick leave. You develop a negative attitude towards work and don’t want to be there. 5. Hopelessness: Resigned to not caring, no optimism, low morale, cynical. (Koskinen et al., 1992)

Differentiating between Stress and Burnout STRESS

BURNOUT

Characterized by pressure, rushing, feeling overwhelmed and too busy

Characterized by disengagement, disenchantment, and cynicism

Over-responsive, irritable, anxious

Emotions are blunted, cut off

Produces urgency and hyperactivity

Feels powerless and hopeless

Loss of energy

Loss of motivation, ideals, and hope Practice Life z June/July 2015 z www.practicelife.biz

WELL-BEING

In Association with the Veterinary Benevolent Fund

Who is most vulnerable? Mostly burnout is not down to personal or individual factors, but much more about the external stresses coming from the organisation, such as whether the work itself is rewarding, or traumatising, or boring, and how supportive the work environment is. However the following personal characteristics can make you more susceptible to burnout: • Perfectionistic tendencies; getting easily upset when things are not ideal. • Pessimistic view of yourself and the world i.e., a negative mind-set, glass half empty. • The need to be in control; reluctance to delegate to others • Achievement being your main goal in life. • Younger people, (usually correlates with less experience). • Single people, less support, more likely that the job holds a lot of meaning. • Working fulltime rather than part time. This is about how much space in your week work occupies. • Work giving you a lot of your sense of meaning in your life, not balanced by an outside life.

Compassion Fatigue

Compassion fatigue can sometimes be referred to as Secondary or Vicarious Traumatisation. It has similar symptoms to burnout in that it presents as a sense of weariness but the cause is not work conditions, but rather caring itself. It occurs in workplaces where there is a caring element to the job, where you are required to have empathy and involvement with people (and animals of course!). It comes from interactions with people and absorbing their distress. It is most common where death, suffering, and trauma are part of everyday working life, and when you feel powerless to do anything to change this suffering.

Compassion Satisfaction This is the opposite of compassion fatigue. It is the feeling of doing a good job, making a difference, and having a sense of meaning from the care that you provide. Some people argue that if you give your all as a caring professional you cannot avoid some degree of compassion fatigue because dealing with other peoples’ emotions inevitably takes its toll. As author and doctor Rachel Remen puts it: “The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” She suggests that if you don’t develop ways of dealing with this kind of ongoing compassion fatigue there will be no room left to care. It is not a solution to become hardened to the extent that you are not affected and no longer care about distressing situations. Then you would become a person who cannot relate to others with empathy, and this makes you distant from the ones you love too. In the veterinary world you are dealing with distressed and demanding owners a lot and you are faced with situations that you can’t always make better – despite owner’s expectations that you will! This gap between their expectations and what you can deliver can leave you feeling rather helpless and this is very stressful because you want to be able to make a difference. Sometimes you can’t. It can take its toll if you don’t look after yourself. www.practicelife.biz z June/July 2015 z Practice Life

When you are overwhelmed for any of the above reasons (stress, burnout, compassion fatigue) it may show itself in two very different ways: 1. You may be very obviously overwhelmed and not coping – getting upset more easily, irritable with others, over-involved with clients and taking on too much 2. You may look like you are calm and coping but underneath you have become quite cut off from feelings, are numb, and have lost your sense of caring about people, animals, and you may be distant with colleagues. Both of these types of responses are a problem because they lead to the inability to deal with and therefore recover from difficult work experiences. The cumulative effect of not coping means people either leave or become a negative influence at work. However the second presentation looks like you are coping and so it may go on for a longer period of time before you realise you need to change something. Often we mistake someone’s professional calm for coping, when really underneath they are just a bit empty and distant, and no longer engaged with the job. Would you be able to tell the difference between someone who is calm because they are coping well and someone who is calm because they are distant and detached?

How to prevent and recover from Stress, Burnout, and Compassion Fatigue At Work • Talk through difficult situations with people who are able to give you support. • Create a culture of support in your workplace. Have each others’ backs. Don’t be afraid to ask others if they are OK after something difficult. When things go wrong look at improving systems to prevent it reoccurring, rather than blame individuals. • It is often easier to see changes in others rather than ourselves. Develop the kind of trusting relationships where colleagues could let you know if you seem stressed. • Connect with your team (including having fun together) • If you are in a leadership role lead by example showing good self-care, and attend to tasks and the wellbeing of staff. Highest levels of burnout are when your immediate supervisor is more focused on tasks and not mindful of the employee’s needs. (Health and Safety Executive research) • Give staff some control and autonomy over their work as much as this is practical. It improves morale enormously. Health and Safety Executive research on stress shows that a heavy workload does not cause stress to the same degree if there is good support from team leaders, and some control/autonomy. • Thank others and show appreciation. • Review how much you care about the work, the animals, and your colleagues. You need enough distance to be useful and not too affected by your clients’ distress. Too much caring will leave you exhausted and not looking after yourself, but too little leads to being cynical and unenthusiastic and is not satisfying, even it feels like you are trying to protect yourself from further distress.

WELL-BEING

• Notice and challenge any perfectionist thinking. No workplace is perfect. Things go wrong. People are disappointing. You can’t always get it right. Try to believe being ‘good enough’ is good enough, and then you will avoid too much disappointment. • Deal with negative feelings: Dissatisfaction and negative thinking can spread to others, so do something constructive when you feel upset such as telling management about your concerns, rather than complain to colleagues. Of course there has to be confidence that management will listen to your concerns and take them seriously! Perhaps you can have a bigger impact if you gain support from others for the things you want to change. • Reconnect with what work means to you, and the positives. If there aren’t any positives it might be time to think about change. The change might involve getting some support to talk through whether the problem is your own stress levels and unhappiness, and see if this can be altered, or whether you need to make an external change with a different job.

At Home Be responsibly selfish This does not mean becoming uncaring towards others, but rather keeping in mind that self-care is not an optional extra if you want to survive in a demanding job. It is a priority. Invest time and energy into nurturing yourself, in order to be able to keep on caring for others empathically. This involves Medivet_PracticeLife_June15.pdf 1 27/04/2015 establishing a self-care plan that is relentlessly carried out 15:25 in an

attempt to enhance a calm state (Jones, 2005). Welsh (1999) termed this practising responsible selfishness.

These have the biggest impact: • Building resilience with leisure activities that really do replenish you, including fun. • Getting a sense of meaning and purpose outside work • Stay connected with others (family and friends) Getting Help Asking for help is not a weakness. It takes strength, courage, and trust to let others know what is going on for you. It shows maturity to know your limitations. No-one is immune from feeling overwhelmed. If you recognise the symptoms of stress, burnout, or compassion fatigue don’t just leave it, seek support. References on request. For more about well-being, see www.vetlife.org.uk/ wellbeing. VBF, the registered charity that supports the veterinary profession, offers free, confidenmtial and professional support through the Veterinary Surgeons’ Health Support Programme to anyone in the profession who is struggling with depression. The National Co-ordinator of the programme can be contacted at VSHSP@vetlife.org.uk or 07946 634220

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HOT TOPIC

INVESTIGATING INSURANCE FRAUD... Simon Wheeler is Managing Director of Agria Pet Insurance Ltd (API) and has worked in the pet insurance industry for 25 years. In this issue’s Hot Topic he highlights the issue of fraudulent insurance claims and why it costs everybody in the long run.

raud is both a civil and a criminal offence. This means a victim may sue the perpetrator for compensation and the perpetrator may be prosecuted and imprisoned by the authorities. We are continually bombarded with high profile media coverage about busted “crash-for-cash” fraud rings or the latest sophisticated internet phishing scam designed to tease personal information from the unsuspecting public. But this all seems a far cry from our little industry, surely? With over 95% of pet insurance claims both in £ terms (value) and the physical quantity (volume) for veterinary fees, can there be that much scope for fraudulent activity as pets will either be healthy or unwell? Oh, were it that simple.

Identifying Fraud Towards the end of 2012 we saw national headlines claiming certain big brand insurance providers had seen a 400% increase in pet insurance fraud in the year. Not so. As we so often see, statistics had been twisted to sensationalise a situation that should, more correctly, have stated that pet insurance had become a significant part of these www.practicelife.biz z June/July 2015 z Practice Life

insurers’ businesses and with claims costs escalating, proper due diligence was now going into pet claims assessment and fraud prevention. And guess what, as with any insurance product, if you look for fraud you’ll find it. Insurers feature significantly among the 320 members of the Insurance Fraud Investigators Group (IFIG) which has developed sophisticated networks and processes for sharing intelligence for the sole purpose of fraud prevention and investigation. IFIG is affiliated with the Association of British Insurers’ (ABI) Crime and Anti-fraud bureau and has strong links with the Insurance Fraud Bureau, Financial Conduct Authority and various law enforcement agencies like the Insurance Fraud Enforcement Department (IFED). Insurers have also invested time and money training claims teams to be more effective at identifying fraudulent activity and sharp practice. Increasing the technical skills within their organisations and engaging lawyers specialising in animal insurance fraud from the Animal Fraud Intelligence Group (AFIG) have also helped. Deploying a battery of anti-fraud tools including cognitive interviewing and questioning techniques, advanced social media interrogation and cross referencing suspected fraudsters makes life increasingly difficult for those engaged, opportunistically or otherwise, in this criminal activity. Moreover, as the profile and impact of fraud in society increases, the general feeling of moral outrage grows together with an accelerating inclination for and incidence of ‘whistle blowing’.

Types of Fraud When we think of fraud, we often assume it’s the calculated, premeditated actions of someone who ‘understands the system’ and can exploit the weaknesses in process. In the pet industry, it is breeders and vets, far more than individual pet owners, who have the in-depth understanding. They work with insurance on a daily basis. They have the knowledge, experience the benefits, understand the weaknesses

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and see the loopholes… and a few have been tempted to exploit those loopholes. In August 2013, following extensive IFED investigations, a judge at the Old Bailey jailed a veterinary surgeon for two years for pet insurance fraud. Over a three year period the vet in question had made fictitious claims for veterinary treatment for dogs and cats he claimed had undergone surgery. At the trial he admitted 53 bogus claims against 4 insurers amounting to just under a staggering £200,000. But dishonesty doesn’t have to be on this vast scale to be fraud. The assistant who fails to submit the particular page of veterinary history identifying a condition as pre-existing, or the diagnosis that miraculously changes as the maximum benefit ceiling for a condition approaches, are equally fraudulent. Sometimes such actions are misguidedly motivated by what’s perceived as the client’s best interests, but in aggregate, will detrimentally impact all insured clients as fraudulent activity has to be paid for. Premiums are driven up and, as we all know, as premiums rise some clients will hit their price elasticity threshold and cancel their cover… which ultimately impacts their vet’s freedom to diagnose, treat and refer. What a vicious circle for the unthinking.

Collusion Another definition – ‘secret or illegal cooperation or conspiracy in order to deceive others’ – and teasing evidence of collusion is part and parcel of a pet insurers’ daily lot. Take the owner whose new £1,000 pedigree puppy disappears from the back garden and prompts a loss or theft claim for the purchase price supported, of course, by a purchase receipt from the breeder. On the face of it this is a devastating loss for a family, but infuriatingly it can be the preferred ruse of a few unscrupulous breeders in association with friends or relatives to defraud the insurer – perhaps to cover the loss of a faded puppy, perhaps pure greed. Where insurers suspect fraud they will endeavor to determine if the puppy ever existed and then, if it was really sold on. Some comfort could come from Kennel Club registration and an important fraud indicator for the latter could be a lack of any veterinary records or photos of the pet and new owner together (like babies, in this digital world there are usually copious smartphone pictures, often posted on social media, within nanoseconds of a new pet arriving home). Many of these frauds are opportunistic. Poorly prepared and badly executed. As insurers’ anti-fraud skills and experience develop, it is not uncommon to reveal gaping holes in the chain of events leading to claims being repudiated – surprisingly common, for example, is where the lost pet is dubiously insured for twice as much as its litter mates! Pure analysis of claims patterns can also provide interesting insight. A vet routinely identifying problems and advising clients to ‘come back when you’re insured’ will ultimately stand out in, for example, a straightforward review of the average number of days from policy incept to first claim set against national and regional comparisons.

“Sometimes such actions are misguidedly motivated by what’s perceived as the client’s best interests, but in aggregate, will detrimentally impact all insured clients as fraudulent activity has to be paid for.” Partnership I choose to believe however that this type of abuse is the exception not the norm. Vets are a key part of the solution, often as not identifying fraudulent activity by clients, staff and peers and then alerting insurers. Agria contributes to the BBC’s ‘Claimed and Shamed’ TV series. One of my favourite case studies was an owner claiming the purchase price for a dog washed out to sea by a freak wave while they were away on holiday. Quite rightly the owner’s vet at home couldn’t substantiate the story and had to refuse to sign the death certificate. Despite tears, pleas and threats on the phone to Agria, and face to face with the vet, the claim was repudiated. Three months later imagine the indignant call we received from the vet advising that a practice 20 miles away had just had the same dog registered with them and was requesting the veterinary records! Fraudsters can be so brazen. An attitude that sadly does not celebrate the fact that ‘no claims’ is testament to the pet’s good health and their good fortune – but one that expects to make a profit, like a savings plan, and sees no wrong in chasing that goal! www.agriavet.co.uk

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MANAGING PEOPLE

Feedback?

Or feed-forward? Veterinary Coach and Mentor, Carolyne Crowe, describes an alternative way of approaching team performance assessment.

e are all aware that feedback should focus on the positives as well as the negatives, but how often does this actually happen? Maybe the positives are stated, but the recipient is so focused on the negative comments that they haven’t heard the good bits? And so your colleague leaves the room feeling deflated. Feedback can be a tricky thing to get right. Many people put off giving it hoping that people will figure it out for themselves and do better next time (assuming they realised something wasn’t right in the first place!). Perhaps you have given feedback and had a defensive reaction because your words were taken as criticism rather than as advice on how to improve. Providing feedback is an essential skill for all partners, practice managers and head nurses – in fact for all team members. It ensures that practice goals are met and helps team members do what they are meant to do, with performance in line with expectations. Feedback is essential for every member of your practice team to receive; everyone needs to learn what he or she has done well and what they need to improve on. However for feedback to be effective the environment in which it is given needs to be right – an open, honest conversation where expectations are proactively managed and people feel supported and comfortable is essential. Traditionally, feedback has had a top-down approach – from bosses to employees. However just as employees benefit from this, bosses also benefit from feedback from their team. Your employees are a vital source of information on the practicalities of how processes and procedures work, how effectively messages are communicated within the practice and where leadership improvements can be made. This “upward feedback” has become increasingly common with the advent of 360-degree assessments. Many practices have adopted this 360-degree feedback process during appraisals, and it is certainly an effective way for partners and managers to find out how they are doing. Although it can be hard, (being forced to take a look in the mirror can be daunting) surely it’s better to know and be able to do something about it, rather than go around blind to what is happening in your own clinic; potentially making your

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life harder, having to deal with the consequences of your ignorance? However there is a fundamental problem with feedback – it focuses on the past. As you can’t do anything to change the past feedback remains limited and static. If instead we focus on the future, there are infinite possibilities and our options become dynamic and expansive. Just take a moment and think about how people leave your office following “a quick chat” with you, or from their appraisal. Deflated or excited? Squashed or seeing potential? It is much better for them to leave with a smile and thoughts whirling around their head about how they can improve and deliver over the coming six months. So how do you ensure this is the outcome? Feed-forward could be the answer.

What is feed-forward? Feed forward is a way of communicating that suggests ideas for achieving a more positive outcome for the future. It puts you as the giver into a coaching role – identifying the current situation of where your colleague is now. It allows the recipient to identify how they want the future to be, understand what needs to be changed in order to achieve that and creates ideas to enable them to succeed. Rather than focusing on the negatives of the past, it looks at possibilities as to what could be done differently giving suggestions for the future based on what you believe the recipient’s strengths and skills to be. In turn they are given hope – focusing on their potential puts them in control to make changes and take action. How do you feed-forward? Simply, one person gives the feed-forward and another receives it. Importantly, the receiver needs to be in a position and environment to listen to suggestions to learn as much as they can from it. Feed-forward techniques can be used to grow, learn and develop. For example: Giver: Pick a behaviour or situation you would like to change in order to make a positive difference in your life – “how to handle an angry client” for example. The Giver then presents two suggestions for the future that may help make a positive change. If you have worked with the person before, no feedback is allowed regarding anything

MANAGING PEOPLE

“However there is a fundamental problem with feedback – it focuses on the past. As you can’t do anything to change the past feedback remains limited and static. If instead we focus on the future, there are infinite possibilities and our options become dynamic and expansive.”

that has happened in the past, only how it could be done in the future. The receiver shouldn’t comment or critique the ideas just listen to the suggestions and take notes and thank the Giver. The receiver may repeat this process with other people to accumulate more ideas and suggestions. By reviewing everything they have heard, they now have lots more suggestions on how to handle angry clients when they next arrive in their consult room. The choice for the receiver is then – what action will I take? What am I going to do? A slightly different scenario could be a weekly meeting with a member of your team, where historically you would have provided feedback on how they have got on. You can replace the usual feedback structure with a feed-forward interviewing technique. Here your role as the boss or manager, is to elicit your employee’s thoughts about their skills and strengths, along with thoughts as to how these can be used for future improvements. Psychologists have found this to be more effective in improving self-efficacy (feelings of being able to take action and be successful) and goal attainment (actually achieving what’s important to you) than feedback. For example: 1. Elicit a story of success. Focus the person on a positive situation; concentrate on the emotions involved. A positive mood is linked to greater creativity and willingness to cooperate. Use questions such as “What has worked well this week?” “Tell me about some of your good cases over the last couple of days” “How did this make you feel?” 2. Focus on the peak moment. Encourage the person to focus on the most positive part of the situation, what made them Practice Life z June/July 2015 z www.practicelife.biz

MANAGING PEOPLE

feel the most happy/proud/in control (whichever emotion they described in step 1). This will help them foster positive emotions and a positive evaluation of themselves. 3. C larify the conditions. Ask what else was going on at that moment? Get them to think about the environment (was it because they felt prepared and organised and had all the equipment in the consult room, enabling them to spend a little more time with the owner and achieve a better result?) What was the rest of the team doing? How were they feeling that day – did they feel more able to cope with the difficult surgery becasue they had just had a day off so felt rested and ready to take on the challenge? By finding out the answers to these sorts of questions, you will help colleagues recognise what they need to take charge of, identifying which conditions are important and lead to good outcomes. 4. F eed forward to the future. Ask your employee to identify how they want things to be in the future, what would need to happen for all outcomes to be as successful as the one just described –“what do you need me and others to help you with”? What actions will you take?

What are the benefits of feed-forward communication? • Feed-forward helps people to reframe the current situation and focus on a positive future, not a failed past. What has happened has happened, but each of us has the ability to change the future – by focusing on what is in front of usand giving others ideas of how their future can be more successful. • We know that all vets, all nurses, in fact all of us, are different. We each have our own techniques and style, and often there isn’t only one way of doing the same thing. Feedback at times can be interpreted as telling someone ‘my way is better than yours’ (even if it wasn’t meant in that way). It can focus on mistakes, concerns and negatives. In contrast, feed-forward always focuses on improvements and solutions, not problems. • Working with and DISC profiling hundreds of people in practice, I am aware that our profession has a high proportion of sensitive, critical, analytical thinkers. We strive to do our best, have perfectionist tendencies and in turn all too frequently take criticism and feedback personally. We can blame ourselves for the not-so-perfect outcomes and then ruminate on these negative thoughts -not a healthy way of working. Feed-forward helps these personality styles by acknowledging the current situation and then focusing on solutions, it gives hope that changes can be successfully made, that a different outcome can be sought. It puts people in control by giving them the ideas and tools to do something about it. • Feed-forward is particularly suited to successful people. Successful people generally like receiving ideas as to how they can improve further, understand what needs tweaking and identify ways to get better. Successful people often have a positive self-image, and a mindset that wants and desires growth. Feed-forward techniques address these needs. • Feed-forward can be given by anyone who has knowledge about the task that needs to be performed. You don’t need to know the person or what has already happened. This means fellow colleagues can provide ideas as to how you can improve. Adapting feed-forward principles in your practice www.practicelife.biz z June/July 2015 z Practice Life

“When feedback is received, often there is a period of time where the recipient tries to prove it to be wrong. With feedforward, you are simply saying “here are four ideas, you choose which works best for you.”

aids collaboration and idea sharing for problems you are all having. For example, in a practice meeting, rather than critiquing a situation that has gone wrong, why not talk about future scenarios? Ask everyone for their ideas, opening up conversations and collecting suggestions for action. • Recipients of feed-forward frequently implement ideas quicker than those receiving traditional feedback. When feedback is received, often there is a period of time where the recipient tries to prove it to be wrong. With feed-forward, you are simply saying “here are four ideas, you choose which works best for you.” Individuals are more receptive as they are in control of the choices they make and are likely to take action more quickly. • Feed forward covers the same points as feedback. For example, imagine you have just taken an x-ray. You want a colleague to review it, but it’s non-diagnostic. Rather than belittling you and telling you to repeat it, instead, your colleague could help by giving suggestions of techniques they use and tweaks to make it better for the future. A guiding and supportive approach is more appropriate than a critiquing and negative one.

Feedback and feed-forward Everyone needs feedback, to know what they are doing right and understand where they can improve. However, the effectiveness of feedback is determined entirely by how it is delivered. This article isn’t proposing that feedback should never be given, or saying that performance appraisals aren’t of use – rather it demonstrates how feed-forward can be a preferable form of communication on a daily basis. Feed-forward ensures the right message is conveyed, and that it is received in the right way. Thus, by adopting this way of communicating we achieve a more dynamic and open practice; one where the team are focused on growth and improvements for the future. www.carolynecrowe.co.uk

CLIENT CARE & MARKETING

HARNESSING THE POWER OF VIDEO Martin Ison, CEO at Micomms Ltd is a leading communications consultant. Here, he shares his top tips on video marketing for vet clinics.

Put that Gerbil down and grab a coffee – I want to tell you something important…

t’s no surprise to learn that video can increase your practice sales by well over 60% and that websites featuring videos can double their traffic. Videos can increase the time spent on your site by 400%… and boost click-rates by 300%… and… don’t ask me where I got these figures because I pinched them – but that’s not really the point. The point is this: we’re all fed up reading stuff aren’t we? We just don’t have the time (apart from right now that is – I hope you’re enjoying your coffee). Speaking as someone who has actually read the entire internet from start to finish, I can tell you that 99.999% of it is boring. That’s why video is coming of age. Also, social networking is coming of age, and the internet age is coming of age … and, because we’re all time poor, ‘showing’ people instead of ‘telling’ people is now what it’s all about. Plus, these days, we now don’t have to wait until someone can find a DVD player, if they can be bothered to keep the promise: “Of course I’ll watch your video. I’ll put it just here on my desk (under my coffee cup)”. Now everything is instant. Click on a link and there it is. Not just instant – but also instantly obsolete… NEXT! And there’s the rub (to quote Shakespeare, himself a keen videographer)… (1) Videos can help increase sales income… (2) decent videos are expensive to make… (3) social media needs more, more, MORE, DAMMIT! … (4) more money is needed to make videos… revert to (1). See the problem? Solution: make them yourself! ‘What?!!’ I hear you splutter as you exhale your coffee through your nose. ‘But… but… Martin… I can’t do it myself … what about all the equipment? The editing? The music?’ Ah… but you can… in fact, you have everything you need right there in your pocket (not that – I mean your mobile phone) and on your desk: your laptop.

On the Video-Making for Social MediaTM workshop (see: www.training.micomms.co.uk) which, clearly this shameless self-promotional article is all about, we show you all the tricks of the trade to enable you to make wonderful feature-length movies worthy of miniature Oscars. Last month, I tested the course on a roomful of 30 vets and, I’m pleased to say, they purred with delight. But in case you weren’t there, here are the obligatory 7 Steps, 7 Secrets, 7… well... bits of advice… (why always 7?) I can give you to put you in the right direction:

1. Write a decent script You can tell a video that didn’t start with a script… you’re left thinking: So What? Or they’re so lengthy that you clicked away long before the end. It was either that, or flinging yourself through the surgery window to make a mess in the car park. Or they consist of lots of jaunty muzak and no speaking, with people looking important, shaking hands, running a race, or smiling at a conference – but you don’t know why. Your script is your structure; it helps you plan the length, it helps you get to the point, and it makes you economical with words. It’s also your plan… and everyone knows what happens if you fail to plan… you may as well plan to… well, send round a car park clean-up team. Every Hollywood movie starts with a script: your video should too. 2. Start with why the viewer should watch Have a look at the beginning of this blog. In my first line, I got you to read the next lengthy paragraph of facts, which may have piqued your interest to read a bit more. Well, you can do this with your video: ‘I’m going to tell you something that may change your world…’ ‘Here are three facts you didn’t know about brushing dogs’ teeth…’ Most people unconsciously ask: why am I watching this? What am I going to get out of it? Well, tell them… then show them. 3. Always take pictures and video clips in ‘Landscape’ The next time I see someone trying to take mobile phone video-footage in portrait (not landscape) I swear, I shall personally visit their local cinema and demolish it, then rebuilt it with a tall thin screen… then, while they’re at work, I’ll visit their home and glue their TV down sideways… then, while they’re at home, I’ll visit their office and glue their laptop and monitor to their desk sideways. There’s a very good reason to have films and videos in landscape, which I shall Practice Life z June/July 2015 z www.practicelife.biz

CLIENT CARE & MARKETING

not explain to you unless your eyes are set one above the other. If you think you’re about to take a picture that may be used in a video, make sure that it’s landscape too (even if it’s a portrait of the boss).

4. Treat your mobile phone like an expensive Movie Camera If you want to make a video worthy of an Oscar, treat your mobile phone with the greatest respect. If it’s a fairly recent model, it can do so much more than you probably realise. With an HD lens, low-light capability, your mobile is a camera that video-makers would have died for 15 years ago. So look after it and explore it: with some time and creativity, you’ll get it to pay for itself within your first video. 5. Make it short, sharp and to the point Make your video short: 2-3 minutes tops. Any longer and you’ll need to change the voice and tone or add another person, like a ‘happy customer interview’ to refresh interest. Think pop-songs, not classical symphonies: people don’t have the time. But most of all remember this formula: I=B+C That’s Interest = Benefits + Curiosity. Which means you will only gain interest if: (a) you arouse their curiosity and (b) if the thing that they find out because their curiosity was aroused, will enhance their world. 6. Make use of still pictures You probably have about 3,000 or so pictures dotted around on your hard drive that you perhaps will never even look at again. Pictures of people in the surgery; animals looking fluffy; product shots; installations; conferences; parties; awards… and so on. There’s a heckuva lot you can do with all those still pictures for your next video. Choose

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the LANDSCAPE ones, and at the editing stage, you can create panning movement across your piccies for added interest using the so-called ‘Ken Burns effect’. Sometimes it looks better than a panned video clip. Make sure you have: LANDSCAPE pictures (did I already say that?); lots of people (to show human-factor, scale and empathy); and lots and lots of pictures (allow 2-4 seconds use per picture – sometimes more, but not often).

7. Use music … but use it sparingly Ahhh… my favourite bit. You can easily find copyright free music. Music helps people remember things; opens the mind and plays with the emotions. Music is the thing that really gives your video a lift, but ONLY if it’s used wisely and sparingly. Too much and it’ll start to sound like a 1970’s soap opera about a women’s prison. Make sure it doesn’t drown out your voice-over and any other things you’d like to be heard. You can achieve this by using a recording and sound editing programme such as Audacity, which is a very easy-to-use and free to download (I love free things, don’t you?). Use this to record your voice-over and then use it to add music and other sound-tracks like gerbils barking and cats squeaking, adjusting the sound of each to suit. We train people on how to use this extensively on our training courses… But absolutely… definitely… most of all… DON’T post a video online unless you’re proud of the result. It’s like a loaded gun: great to have a good quality one in your marketing armoury. A poor one, however, could shoot your reputation to pieces. Get another person’s opinion on it first. If you get a green light, you’re good to go! So – don’t be shy. Use your mobile phone and your laptop to create your next corporate video and save yourself £000s. Let me know how you get on: martin@micomms.co.uk

CLIENT CARE & MARKETING

CASE STUDY: CLENT HILLS VETERINARY GROUP Practice Manager and Partner Rebekka Fiorani from Clent Hills Veterinary Group in Bromsgrove outlines how she uses video to highlight the practice’s excellence at customer care.

e are an 11 vet practice with 2 small animal surgeries and a purpose built equine unit giving us the ability to offer an extensive range of treatments to our patients. While constantly striving to offer these treatments we also know it is important to ensure we offer our customers great care. Traditionally this only happens over the phone or when clients bring their pets in to see us, or when we are out visiting them, but, through the use of videos, our customers can experience our excellent standard of customer care in the comfort of their homes. We have a range of videos that our clients can view from our website. The Introduction video gives our clients the opportunity to see behind the scenes benefiting both old and new clients as they get to see the team caring for their pet, in action. We believe the video fulfilled its aim of showing the human side of our practice and gives a friendly, open and warm feeling to the viewer as we know that clients can be anxious when they come to visit us – especially if they have never met us before. The interview style videos show the key roles within the practice with interviews with one of the veterinary directors, the practice manager, head nurse and receptionist as well as the Equine Unit team. These also enable us to answer some common concerns that clients may have such as about veterinary fees, parking issues as well as the many benefits and show our practice ethos to our clients. As well as these, we have a series of “How to” videos ranging from how to give medications (the most popular, how to tablet a cat) to putting a cat in a basket and also a video telling clients what they can expect when they come for their pet’s annual health check. While we all like to believe our messages are heard in practice, we know that is not the case often due to too much information being given to a stressed client in a short time. The ability to direct clients to the videos when they get home puts their mind at rest and helps reduce their concerns of having to remember everything, and, from our point of view (and the pets) this aids compliance. Video gives us many opportunities to interact with our clients and we have plans to add to our video library. They also enable pet owners that may not have yet visited one of our surgeries to get to know us before they pick up the phone or walk through the door. We find that using videos to promote our team and help our owners enables us to deliver that next level of customer care alongside our clinical care.” “

“The ability to direct clients to the videos when they get home puts their mind at rest and helps reduce their concerns of having to remember everything, and, from our point of view (and the pets) this aids compliance.”

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07/05/2015 Practice Life z June/July 2015 z www.practicelife.biz

17:09

CLIENT CARE & MARKETING

Get the Most from Multimedia Have we whetted your appetite for video? Susan McKay from veterinary communications agency, Companion Consultancy, urges you to embrace video and digital content to boost your practice marketing

isual content – such as video, photos, infographics and memes are playing a big role in many marketing plans this year and there are some very good reasons for that. You Tube has more than one billion users and video in particular is becoming hugely important. So what’s the best way to make the most of the opportunity? 1. A two minute practice video might seem like a huge undertaking but in terms of spend, it’s a great way to make your services come alive for viewers. Also it has genuine longevity compared to a newspaper ad if made well. 2. Pop your practice video on You Tube and you can embed direct from there into your practice website and share it across all your social media platforms. 3. If you want to keep your content more exclusive and share only with selected users – perhaps only those who have signed up to your Pet Club – then you can use video hosting sites, such as Vimeo. There is however, a charge for using these sites, whereas You Tube is free.

4. You Tube has more than one billion users and creating your own You Tube channel is easy. As well as posting your own videos on the channel you can also include other people’s videos with relevant content. Link it to your website and you have a great client resource. 5. Consider actively searching out suitable content, or ask your suppliers for content. For instance, Hill’s Pet Nutrition has some great body condition scoring videos aimed at cat and dog owners. For video hosted on You Tube, just select the embed code and use the content in your practice website. By preferentially selecting known suppliers you can ensure that the information is reputable and falls within UK guidelines on promotion of veterinary medicines. Sharing supplier content also helps build relationships with the people you are already doing business with. 6. Snap and tweet because using visual content in social media increases interaction; tweets with images receive 18% more clicks, 89% more favourites and 150% more retweets. 7. As well as posting links to video on Twitter consider using Vine – the video equivalent of Twitter. 8. The use of photos and video in Facebook news feeds has increased hugely and this year there are 75% more video posts per person compared to the previous year. So liven up those Facebook feeds! 9. Think about using other platforms such as Pinterest and Instagram for photos. Storify is also well worth a look to bring it all together. 10. Customise your content: if you have good photos and a way with words there are many websites that allow you to create memes (photos with captions; often witty) which can be really popular with pet owners. Same with video – adding captions and graphics can give a professional polish to the finished article. www.companionconsultancy.com

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BUSINESS HEALTH & FINANCE

Margins are Margins

Are They Not?

Mark Harwood is a Director at Hazlewoods Accountants and a Regional Organiser for the VPMA. Here, he takes a look at margins and why it’s important to get them right. When we talk about a margin, what do we mean? “Gross profit margin” and “net profit margin” are commonly referred to, but what is the difference? Mark-ups and margins are also all too often confused as being the same. In this article we aim to try and put these terms in context and explain why you should care about the differences.

Financials “Profit margin” is the most commonly used financial term when talking about margins. A profit margin is a ratio of profit to turnover (sales excluding VAT) and is expressed as a percentage, giving an indication as to how much out of every pound of turnover is generated as profit. Margins are frequently talked about without the type of profit having been defined. Let’s consider a practice with the following profit and loss account (P&L), with a comparison of a company structure versus a partnership. Perhaps confusingly both profit before tax and profit after tax (which are of course very different figures) are sometimes referred to by people as net profit. Arguably though in the company case, profit after tax is really the net profit. In a partnership, LLP or sole trader arrangement, there is no corporation tax and the P&L stops at profit before tax, which is often called net profit. It is therefore very easy to not be comparing like with like when looking at net profits.

Whatever net profit is being considered, the net profit margin is simply the net profit figure divided by turnover, expressed as a percentage. Three different profit margins are highlighted below (Fig.1). Whilst these margins are illustrative only, there are a number of key points that can be taken away: l When looking at a practice’s margin trends over time, it is important to ensure that like for like is being compared. If costs are allocated differently in one year, e.g. lab fees are included in cost of sales in 2014 but in other overheads in 2015, then this will distort the comparison. A practice that has a gross profit margin of say 80% is not necessarily better financially than this example (gross profit margin of 75.3%) if the margins are not calculated on a consistent basis. This also needs to be considered when comparing margins to benchmarks or other practices. l In our calculation of gross profit we have excluded staff costs. For a veterinary practice, the gross profit will largely be driven by pricing, charging, the work mix, speed of work as well as the practice’s buying power and negotiations with suppliers. l Comparing your practice’s results against external benchmarks such as from a veterinary accountant can be invaluable, but these still need to be considered in the context of your practice’s own internal benchmarks as there may be a very good reason as to why your practice is above, below or at an external benchmark.

Fig.1

£000 £000 Company Partnership

Turnover

1,500

Cost of sales Drugs and consumables

Lab, clinical waste, referrals

Gross profit

Gross profit margin % Staffing and other overheads Profit before tax

Profit before tax as % of turnover Corporation & deferred tax (company) Profit after tax Profit after tax as % of turnover

(310)

(60)

(370)

1,130

75.3%

(755)

375

25.0%

n/a

MARGIN

335

Not shown after tax

22.3%

MARGIN

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BUSINESS HEALTH & FINANCE

A change in work mix can impact on the margin significantly. For example, a mixed practice may move towards undertaking more small animal and less large animal work due to the much higher proportion of drugs billed relative to fees in large animal work; all other matters being the same, the gross profit margin will increase. On the flip side, the need for nursing in small animal work would mean that the staffing bill is likely to increase which would reduce profit before tax. The extent to which these factors offset and interact with each other needs to be considered carefully when making any strategic practice decisions so that the impact on margins and profitability generally, as well as cash flow, are fully understood and projected. When considered in isolation, the profit before tax and profit after tax margins tend to give a distorted view of a practice’s financial performance. This is because they include costs that can be easily manipulated, such as depreciation, amortisation and rent to name just a few, which may be influenced by tax and commercial considerations specific to a practice. In addition, they can be influenced by factors that to some extent are outside of a practice’s control, e.g. the government sets the tax rates, albeit of course setting up a tax efficient structure is one that a practice should work closely with their accountant on. Therefore you can adjust for these items as follows Fig. 2 (following on from the company example above, although the principles remain the same for a partnership, LLP or sole trade): Fig.2

£000

Profit after tax 335 Profit after tax as % of turnover

22.3%

Interest

Tax

Depreciation

Amortisation

Rent – adjust to market level Directors’ remuneration Imputed owners’ salaries Non-recurring repairs

(45) 18 (180) 18

EBITDA 266 EBITDA as % of turnover

17.7%

An EBITDA (Earnings Before Interest, Taxes, Depreciation and Amortisation) is shown above. EBITDA gives a broad www.practicelife.biz z June/July 2015 z Practice Life

indication of the cash generation of a practice, before capital expenditure, the repayment of capital on debt, e.g. bank loans, hire purchase etc and owner remuneration. EBITDA is the key figure when calculating the goodwill or Gross Enterprise Value (goodwill and equipment combined (GEV) which is increasingly used on the open market) of small animal work and is becoming increasingly important for other work types. In these cases, EBITDA drives the value of the practice on a sale / purchase. If we said that on a sale a practice achieved a multiple of say 5.0 being applied to EBITDA to give GEV, then a 2% improvement in the EBITDA as a percentage of turnover (which could arise for example from a 2% rise in the gross profit margin) can have a significant impact on the GEV. An example is set out in Fig.3. Fig.3

Increase

£000

EBITDA 266 296 EBITDA as % of turnover 17.7% 19.7% 2.0% Multiple (illustrative only)

5.0

Gross Enterprise Value

1,330

1,480

11.3%

A seemingly small 2% increase in the EBITDA % has had a significant impact on the GEV, with over an 11% rise. In practice, the multiple applied to EBITDA on a sale / purchase will depend on a whole host of factors, which are worthy of discussion in their own right and are not considered here.

Budgets and Projections Setting a budget helps you to plan your expenditure and cash flow, as well as helping to quantify exactly what is needed to reach a particular target. Let’s continue our example and compare the current figures with a projected turnover for the year ahead being 5% higher than the current year (£1,575,000) and an alternative projected turnover for being 2% higher than the current year £1,530,000). (Fig.4). It is all too easy to set a gross profit projection (in pounds) without considering this in the context of turnover. The alternative projection in our example provides a case in point with the same absolute gross profit projected as the initial projection but at a margin over 3% higher than the current year. It pays to consider whether the practice’s pricing strategy, and how this is followed through in charging, means that such changes are actually likely to be achievable in practice.

BUSINESS HEALTH & FINANCE

Fig.4

Fig.6

Initial Alternative Current projection projection

Original

Revised

Turnover 1,500 EBITDA as % of turnover 17.7%

1,575 19.7%

1,530 2.0%

Mark-up

Cost of drug

Gross profit

1,130

1,202

Mark-up

Gross profit margin %

75.3%

76.3%

78.6%

Increase in gross profit from turnover rise at current margin 56 22

100% 50

Sale price of drug

50% 25

100

Gross profit

Increase in gross profit from improvement in the margin 16 50

£ Variance

Total projected increase in gross profit v current year 72 72

Sale price of drug

100

(25)

Cost of drug

(50)

Let’s now consider this.

Gross profit

(25)

Pricing We often get asked, “What is the difference between a profit margin and a mark-up”? We defined profit margin above as a ratio of profit to turnover. A mark-up is the amount added to the cost price of an item. Let’s explore this difference with an example with a 50% mark up on the cost price of a drug. In this case it gives a 50% gross profit margin. (Fig.5).

Gross profit margin

50.00%

33.33%

Fig.5

Original

Mark-up

Cost of drug

Mark-up

100%

Sale price of drug Gross profit

100

Sale price of drug

100

Cost of drug

(50)

Gross profit

Gross profit margin

50%

considered with all drugs it can be significant. A useful exercise would be to consider the impact of changing mark-ups on the drugs contributing greatest to turnover, as this would help to assess the impact on the profit and cash position of the practice.

Final word When talking about margins, it is crucial to consider what definition is being applied to the margin in question. Once this is determined, trends can be monitored over time and margins looked at as an integral part of a practice’s pricing setting and budgeting process. As we have seen, a small change in a margin can have a significant impact on the overall profits and therefore ultimately the cash position of a practice. The author welcomes questions from readers and can be contacted on 01242 680000 or mark.harwood@hazlewoods.co.uk This release has been prepared as a guide to topics of current financial business interests. We strongly recommend you take professional advice before making decisions on matters discussed here. No responsibility for any loss to any person acting as a result of this material can be accepted by us.

What if we reduced the mark-up say to 50% instead of 100%? (Fig.6). The gross profit margin falls to 33.33% on this particular drug. However, the actual value of the gross profit has reduced by £25 from £50, meaning that £25 has be to be found from somewhere else in order for the level of gross profit to remain the same. Looking at it another way, the margin has fallen by around 17% however this has halved the gross profit on the sale of that drug. Let’s say this particular drug contributed £30,000 to turnover per annum, then this 17% reduction in the gross profit margin, would reduce overall gross profit, profit before tax and EBITDA (i.e. all the same reduction) by £5,000 over the year. In isolation, the impact might not be great, but when Practice Life z June/July 2015 z www.practicelife.biz

PRACTICE DEVELOPMENT

Beyond the Vet:

Should you Buy in Additional Services? John Bonner investigates....

iving your customers what they want is the basis for any successful enterprise. But as many veterinary practices have found, there are clients who may want more for their pets than is offered with traditional clinical services. In those cases, a practice that is able to provide adjunctive treatments, such as physiotherapy or hydrotherapy, can create the opportunity for a happier owner, a more comfortable patient and a new income stream for the business. The Oathall Veterinary Group in Haywards Heath, Sussex was probably the first in the country to appreciate the contribution that osteopathy could make for canine patients. More than 25 years ago thier staff were introduced to a local human osteopath Anthony Pusey by clients who wanted him to try the technique out on their dog. Senior partner Graham DeBaerdemaecker recalls that this new venture had an inauspicious beginning. Having never treated an animal before, Mr Pusey was worried how the dog would react and asked the vets to give a general anaesthetic. Unfortunately, the dog was one of those rare cases that didn’t recover consciousness but the team was undeterred and tried again in another patient, with rather more success. Mr Pusey went on to pioneer veterinary osteopathy in both canine and equine patients and his methods quickly became a valuable addition to the practice’s therapeutic options. Sadly, he died a few years ago but his successor usually visits the practice twice weekly, holding three to four hour long surgeries with half hour appointments. Osteopathy is used mainly in treating chronic or acute lameness in dogs which their owners will often attribute to the effects of age. When told that the condition is treatable, clients will happily consent to osteopathic treatment rather than take on the worry and expense of surgery, or commit to their dog spending the rest of its life on analgesic drugs. “

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Curiously, those clients that have experienced osteopathic treatment themselves may be least likely to sanction it for their pet. “They perhaps don’t realise that in dogs, treatment will not involve the vigorous twisting movements used in human patients. It is a much more gentle process, just using light pressure in the right places and so the transition from examination to treatment will be almost imperceptible,” Graham explains. Most canine patients start moving more freely after a single treatment although it may take at least three sessions to establish a pain-free spine or joint. Some patients will also benefit from an occasional maintenance therapy appointment. Ideally, these sessions should take place at the host practice as there will be vets and nurses close by for the very unusual cases when an animal may need sedation. It would also mean that details of the treatment will be included on the clinical notes, Graham explains. “We pay the osteopath and the client pays us, with a small additional charge for our administration fee. This makes it a lot more straightforward when organising an insurance claim,” he adds. When senior staff at the Brentknoll Veterinary Centre in Worcester decided to bring in a chiropractor to treat their patients, it was also at the behest of their clients. “We had a few people mention the work of a lady called Paula Stokes who was a chiropractor working locally who had achieved some good results in treating agility dogs. One of them suggested that we give her a ring,” explains the clinical director Dave Fisher. That was in 2003, Ms Stokes was called in for a chat and 12 years later she is still working there for one day a week. But it is now as Paula Fisher-Stokes, the name she acquired when Dave gave her another ring two years ago. In 2005, the practice was able to add hydrotherapy to its adjunctive therapy options when it moved into new premises formerly belonging to a company which sold swimming pools and hot tubs. “We found that we had got quite a large outdoor pool and a smaller jet pool. Both have proved useful in the rehabilitation of orthopaedic cases; stifle or cruciate surgery patients or those with osteoarthritis. Of course, in many of these patients we will use both chiropractor and hydrotherapy. “Like many practices, we have a subset of clients who have very strong ideas about the sort of treatment that their pet receives. These techniques are also very good for pets that are simply wearing out with chronic spine and lumbosacral problems.

PRACTICE DEVELOPMENT

Often surgery is not a realistic option and the benefits of drug treatment can be limited. We can keep these animals more mobile and it can make a huge difference to their quality of life,” Dave explains. However, any practice that is contemplating adding these established complementary therapies to their standard offering cannot expect a huge return. “Neither the hydrotherapy nor the chiropractor service is a big profit centre. Yes, they help to differentiate us from other practices in the area, especially if they are ones that are mainly focussed on routine preventive therapies. But does it make a huge difference to our turnover? No, I don’t think it does, although it does make the practice a much more interesting place to work,” he suggests. As well as offering something unusual, these non- routine services can more than cover their costs, and make small contribution to expanding the client-base. At opposite ends of Wales, the Cibyn Veterinary Clinic in Caernarfon and the Forest Veterinary Group in Neath, both run grooming services from their premises. Anna Hill, clinical director at the former and Tim Ingham, a partner in the south Wales practice both insist that they will often register clients who came in purely for the grooming service and liked what they saw. The two practices run their services in slightly different ways – Tim’s practice merely rents out a room that a former member of their auxiliary nursing staff uses as her base. At Anna’s practice

both the grooming service and a hydrotherapy facility are sited in a building adjoining the main clinic but the staff there are employed directly by Cibyn and the accounts are fully integrated into those of the main business. When setting up this sort of service, it is important to have good communications with clients so that they understand that the grooming staff are not clinically qualified and they are not able to provide a full MOT service for the pet, Anna explains. But at the same time, the staff at both centres, have some experience of nursing duties and will be alert to the possibility of spotting parasite infestations or skin and ear conditions when handling the pet. They will therefore be able to draw this to their colleagues’ attention and ensure prompt treatment. Another key advantage over standard dog grooming parlours is that there is skilled back-up for those occasions when something does go wrong. “I think that our clients understand and appreciate that if, say there is an accident and the dog gets a nick from the scissors, then we have nurses at hand who can deal with it. There are also some dogs that are so anxious or aggressive that they cannot be groomed normally and would need to be muzzled or given physical restraint. In those cases, it is a real advantage to be able to provide the dog with a sedative, which, of course, would not be possible if there were no staff there with any veterinary training,” Anna notes.

A better approach to client communications

Rapport integrates directly with your practice management system, so you and your clients can benefit. Establishing Rapport with your clients increases practice efficiency, improves patient care and attracts more clients to your practice.

Rapport is the only client communication tool that works directly with your practice management system

Email: rapport@vetsolutions.co.uk Tel: 0808 178 4028

www.hsrapport.co.uk

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PRACTICE DEVELOPMENT

CASE STUDY: TYNDALE PARAPROFESSIONAL SERVICES Chris Hayes qualified from Sheffield Hallam University in 1994 and Bristol Business College in 2002. He joined Tyndale Vets as manager in 2010.

e are a 10 vet, 100% farm animal practice and following a number of requests from clients to offer a foot trimming service, we decided to research the idea in 2011. Being a member of XL Vets meant that we were able to easily go and visit a fellow member and see what they did and get their view, ‘warts and all’. Having not been scared off, we spoke to a local herdsman who was looking for a new job and employed him so that we were able to launch our service from new premises in Gloucestershire during the Autumn of 2011. Ensuring we employ the right people who have the right attitude is key to all that we do, so we set about training our first paraprofessional to obtain National Association of Cattle Foot Trimmers (NACFT) Diploma status, which also includes regular ‘check days’ to retain the standard. In addition to the right staff, we also invested in a Wopa Hydraulic Crush, quality tools and consumables to offer a quality, rather than speedy service. Word of our additional services soon spread and we started diversifying into freeze branding, lameness scoring and disbudding. As the workload increased we employed another technician last year and “

“

we continue to grow. As our works takes us further afield we are able to offer our services to fellow XL Vet practices and their clients. Through the use of the bespoke ‘Herdkeeper’ software that aids lameness control by providing mobile applications for mobility and lesions scoring that simplify the data capture process, we are now able to record individual cow treatments and produce reports that can also be used by other ‘on farm’ consultants and vets. Business continues to grow and we have attracted new customers to our veterinary work having initially done some paraprofessional work, as well as retaining existing customers by being able to offer more services, so clients don’t need to go elsewhere. Herdsman Mr Barrett says “We have been using the Severn Farm Services team to do our foot trimming for a year now. They do a good quality job and as a result the problems we had previously with lameness have significantly reduced, resulting in higher milk yields. We now have a regular routine visit to make sure we are always on top of things, which pays for itself”. We will be looking at diversifying and developing our services further this year, as customers realise the benefits of good mobility in their animals and the increased milk yields that produces, as well as a reduction in other costs.”

CASE STUDY: PHYSIOTHERAPY SERVICES AT PEARL VETERINARY GROUP Emma Dainty is a self-employed full time Chartered Veterinary Physiotherapist in the equine and the small animal sector working part-time at Pearl Veterinary Group in Shrewsbury.

ur client and pet services are enhanced by the inclusion of paraprofessional services offered by myself as a physiotherapist and another colleague Alexa Bardell BVSc MRCVS who provides accupuncture and herbal remedies. I take referrals from Stewart Bedford BVSc CertSAS MRCVS for physiotherapy assessment, treatment and management advice following surgical intervention or for conservative management for chronic pain and obesity from within our primary client group. The inclusion of a canine hydrotherapy treadmill has led to the veterinary nurses who work at Pearl Veterinary Group also getting involved in rehabilitation care. A new case will have an initial assessment at approximately 2 weeks post operatively which includes a veterinary post op check, a physiotherapy assessment, exercise prescription and a session of hydrotherapy to assess the animal’s suitability and “ability” to exercise in water. If clients wish to continue with the hydrotherapy, a follow-on plan is designed and experienced nurses will oversee these follow-up hydrotherapy appointments for a predetermined number of sessions with intermittent reassessment by me. Additionally Alexa offers acupuncture for pain relief and her interest in herbal remedies can be invaluable for some clients. The benefits of offering this comprehensive service are plentiful – it’s a one-stop shop and as some of Pearl’s referral “

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clients are travelling from miles away, these appointments can be managed for the client’s ease to encompass all their needs whether veterinary, physiotherapy, hydrotherapy, acupuncture or pain management. If Stewart or the team feel they could benefit from my input, invariably I can see the animal there and then, even if just to assess the feel of a soft tissue problem quickly. A rehabilitation programme means that in-patient care can be progressed faster and clients often notice the speed of recovery is greatly enhanced with our approach, especially when they have had surgical interventions previously without any rehabilitation. If I feel that pain is not being managed effectively, there’s always a team vet to discuss the case with and make the appropriate changes as required. Alexa will often give acupuncture to a patient before I treat them (or after if I’ve made them sore!) and this is really helpful, especially with anxious animals (and clients!). The benefits of in-house paraprofessionals is the face-to-face discussion of cases within the team and knowing how we all work there is no ambiguity, we can plan, progress and set goals knowing that if the nurses aren’t happy they will refer them back to me, and likewise, if I’m not seeing the progress I’d expect I can get a veterinary assessment there and then. Feedback received from clients tells us that they like the multidisciplinary approach as it instils confidence that we are all on the same page for the benefit of them and their pet.”

CPD SHARED

BSAVA Student Stream 2015 Review Practice Life VPMA Editor, Ian Wolstenholme, visited BSAVA Congress in April and caught up with both speakers and vet students in the dedicated Student Stream. Let’s just say that it’s been a little while since I was a student in any capacity! On the Friday morning at congress I was looking forward to going “back to school” if only for a short time and joined around a hundred student vets in the Telford Room in Austin Court away from the thronging exhibition visitors. The day was to be presented by eight leading speakers from the vet profession covering topics as diverse as stress in practice, which type of practice to choose after university and triage of the first opinion emergency, to social media and work-life balance. As is always the case, unless you are able to attend full congress, time is always a pressure and with several invitations to attend stands, unveiling and drinks, I chose a lecture by Mark Hedberg DVM and a subject that I knew would be of interest to the audience entitled “Help... I’ve been hired”! Mark is an American vet who was “thrown in the deep end” after qualifying and as such has a keen interest in mentoring and supporting new graduates. In his forty-five minute presentation Mark talked about the transition from student to staff member, how to lead and work with more experienced staff, what to do when the job is not what you expected and confidence issues. I had never come across “imposter syndrome” but this psychological phenomenon is all too common amongst people who are unable to accept their accomplishments – feeling that they don’t belong or are unworthy – and a typical group to experience this fraud syndrome are of course new grad vets. In the light of a show of hands regarding EMS placements and how much practices allowed students to undertake, I decided to have a quick chat with a few of the students and if you want to hear their thoughts as they head out into the big wide vet world shortly, just type this link into your browser http://1drv.ms/1J3YW2B There’s been a sea-change when it comes to talking about stress in the workplace and Practice Life has been at the forefront both in print and addressing this issue at VPMA/SPVS Congress over the past couple of years. Rosie Allister offered real practical guidance to students and touched on this crucial area. Unsurprisingly, stress and depression has always been prevalent in the veterinary field with long hours, heavy workload, difficult client relations, euthanasia and financial issues. Her key message in the lecture “Stressbusters: who ya gonna call?” was that a graduate vet is never alone and in particular the Vet Helpline confidential 24hr rapid response service offering non-judgemental listening and emotional support to vets, vet students, vet nurses and other professionals in the industry is available on 0303 040 2551 or at www.vetlife.org.uk On a lighter topic, Susie Samuel discussed what, as a new graduate, you could bring to the social media activity in practice.

I was once described as a digital immigrant, so when I see a picture of a camera with an LCD screen, I would describe it as a “digital camera”. However to a digital native on the other hand, the same picture would be described as just a “camera”. All the students in the room were digital natives and not surprisingly were knowledgeable and savvy with most of the current social media platforms and as a result in practice will often be called upon to run the entire social media presence. As Susie noted without the appropriate allocation of time, you are unlikely to do a good job. Qualifying as a vet brings new responsibility online just as it does offline and the new RCVS Code of Conduct is quite clear on this point www.rcvs.org.uk/advice-and-guidance/code-ofprofessional-conduct-for-veterinary-surgeons/pdf. From a practical stance Susie mentioned that being a new grad social media advocate can be a real advantage in getting to know your clients and by writing about veterinary medicine and surgery in a way that clients can relate to can be extremely useful in the consulting room. Other speakers during the stream were Nicolette Hayward BVM&S discussing referral work and options, Karen Humm MA (Triage and stabilisation of the first opinion emergency), Jill Hubbard speaking about work-life balance and Gareth Jones on the ten minute (or 15 if you’re lucky!) consultation. All in all, the day’s stream dedicated to our future colleagues was packed with useful tips to help them when they enter their new life as a Veterinary Surgeon. My own practice has recently moved into new premises and during the planning stage, we were fortunate to work to an almost blank canvas. This meant that, amongst many other considerations, we could implement several of the suggestions and recommendations of the International Society of Feline Medicine (ISFM) when thinking about cats and their owners. That said, in our old practice, we did what we could to make it as comfortable and stress-free for felines. This was the point of a presentation by Martha Cannon from the Oxford Cat Clinic, backed up with videos of needs and demands from some cat owners from Onswitch. If you have a spare moment, Martha suggested a look at the Bayer Veterinary Usage Study of 2011. Key take home points from the lecture: no scruff, no stress, respect me and my cat, give me some space and take time, be patient and handle cats gently. Even the most compact of reception areas can be divided in such a way as to separate dogs and cats or if all else fails, sensible diary booking by reception. So that is a whistle-stop tour of just one stream from Congress this year. Due to travel arrangements I was unable to stay until the bitter end and lectures sadly overlooked included Facebook and the Client, Driving Compliance Digitally, Geriatric Pets and Client Care at End of Life. I do know that several of the speakers from across the two days have made their presentations available on the VPMA-SPVS Events websites and certainly are worth reviewing if you have the chance. Practice Life z June/July 2015 z www.practicelife.biz

CPD SHARED

Just because we can... Helen Tottey caught up with the ‘Just because we can...” debate at at BSAVA Congress which ran over several sessions

BSAVA Congress saw the ethics of veterinary practice and in particular, the topic of ‘Just because we can, does that mean we should?’ being discussed through two different sessions. Firstly, the theme was kicked off at a panel discussion with Petplan’s National Relationship Manager Howard Brown, Hilary Orpet RVN, MsRCVS David Catlow, Professor John Innes, and then-PresidentElect of the BSAVA, Patricia Colville. The second session took the form of a debate on Saturday that was open to everyone. In his introduction Dr Mark Goodfellow highlighted that practices are working in an era with fewer clinical constraints and asked, “When is too much cost or therapy too much for the benefit of the pet?” Various scenarios were discussed, from first opinion to common referral options and the impact that veterinary shows on the TV have on client expectations! Discussions circled back to the underlying question of whose responsibility it was to make any decision re advanced clinical steps: the pet owner or the vet? It was agreed that whilst the vet can guide the owner, the ultimate responsibility lies with the owner, so good communication between all parties is vital. Saturday’s debate hosted a different panel that included Sheila Crispin FRCVS, MsRCVS Jacqui Molyneux, James Yeates, Sophie Adamantos and Louise O’Dwyer RVN and was facilitated by Sally Everitt. During this second session, open to congress attendees, the audience were given voting pads and asked their views on levels of agreement with a fictitious series of treatments from blood & kidney donation, the use of stem cells, and injections given to cats to help combat the owner’s allergy. 92 per cent agreed that blood transfusion is generally acceptable, but when the terms changed to feline transfusion, 60 per cent of the audience agreed there were ethical concerns. Panellist and critical care specialist Sophie Adamantos regularly uses transfusion but advised careful donor selection is appropriate. Kidney transplant when tabled had 79 per cent of the audience disagreeing with its use where a live donor is involved. RCVS councillor Sheila Crispin summed up: “It is not difficult surgery. The problem is management after surgery. We are light years away from what happens in human medicine in long term care for patients with multiple problems.” Stem cell therapies while showing promise suffered from lack of evidence in the panel’s eyes, while an audience vote on the prospect of transplanting stem cells from one animal to another showed 39 per cent agreed it was suitable, but almost as many (38 per cent) felt neutral about it. www.practicelife.biz z June/July 2015 z Practice Life

One theme that came through clearly in both days was that with all the options available to the profession and the trend towards ever more complex/ advanced treatments, the option of euthanasia should not be forgotten, where it is in the animal’s best interests. Patricia Colville highlighted that we as vets worried about how euthanasia as an option is perceived and it can take good consulting skills to be able to interpret what the owner wants, as they often don’t say or state it clearly enough. Saturday’s debate saw euthanasia more fully discussed with emphasis on the difficulties faced by new graduates or inexperienced vets and nurses, when supporting owners through making this difficult decision. Belinda Johnson from the charity Our Special Friends stated that more support was needed for clients facing the prospect of losing their beloved pet. This in turn led to discussion on the use of Quality of Life Assessment to help owners with an objective assessment of their pet, which, when in discussion with their vet, helps make that decision a little easier. Prof John Innes explained that he was he was himself ‘in client’s shoes’ at the moment, and in the position of having to make decisions on the treatment of his own dog, and it was difficult. Retired practitioner Des Thompson stated on Saturday that one of the hardest decisions a vet will have to make is to euthanase their own pet. With these two well-regarded veterinary professionals sharing similar views, the question was: should we be offering more support to our team so that when the client is told “we could do or try this” and we are met with the answer of NO, we are still able to support them and treat the pet in his/her best interests. Novel approaches are always going to lead to questions on their appropriateness or sometimes ethical positioning, but I myself am sure that whoever performed the first thyroidectomy in a cat, or hip transplant in a dog was questioned for taking things too far. As advances in treatments and procedures continue, ultimately it is our responsibility as veterinary professionals to ensure our pet owners are able to give consent that is as fully informed as possible for whatever treatment is chosen.

FOCUS ON HR DAY

Focus on

HUMAN RESOURCES 14th October Chesford Grange, Warwickshire

We’re delighted to announce a new Focus Day for 2015. Building on the success of our Focus on Technology and Diagnostics days from previous years, we have planned a whole day on human resources. We are really excited to welcome Katherine Eitel back to the UK for this event. Katherine runs the internationally renowned ‘Lioness Learning’ and wowed delegates at SPVS/VPMA Congress 2014. This day will be of particular interest to practice managers, head nurses and those involved in leadership roles within the practice. Read on for the low-down… Successful human resourcing allows you to attract, select and recruit the right people, train them effectively, reward them appropriately and motivate them to adopt any changes you introduce… all within the confines of current

HR WORKSHOP HIGHLIGHTS Auditing & Acquiring the Skills, Knowledge and Attitudes required for Effective Veterinary Practice

employment law! Easy huh? Not really! Most

BRIAN FAULKNER

managers would agree that HR is one of the most

VetPsych BSc (Hons) BVMS MBA MSc (Psych) Cert (GP) SAM MRCVS

challenging and difficult aspects of managing their business. As if that isn’t hard enough, the veterinary profession is facing an unprecedented challenge in recruiting experienced vets and veterinary nurses. Our ‘Focus on HR’ day is SPVS-VPMA’s response to that challenge. The aim of this day is to bring as many of the companies who offer these HR services and solutions to the veterinary profession in touch with the managers and leaders of veterinary practice who are working at the coal face of HR management.

One of the most challenging aspects of recruitment, training and development is knowing what skills, knowledge and attitudes your new hire actually has and how far away they are from where you want them to be. Whilst there is no foolproof way to be sure who you’re getting, how much training will need to be done or how responsive your new recruit will be to that training, there are some simple systems that you can use to help audit current status as well as identify and address the inevitable gaps. In this session Brian will share the mechanisms he uses to explore the breadth and depth of skills, knowledge and attitudes of his staff so that they can be effective across the various roles within veterinary practice as well as how improvements can be made.

Sponsored by Zoetis, the day will be a mixture

Setting Up a Performance Management Process

of workshops along with an exhibition featuring

LYNN MCKEOWN, ZOETIS

companies offering training, recruitment, and legal services. We are really excited to have persuaded Katherine Eitel across from California for this event. Katherine runs the internationally renowned ‘Lioness Learning’ and wowed delegates at SPVS/VPMA Congress 2014. As well as / in addition to Katherine Eitel, other speakers include Nick Steele from

Performance management is often considered a bad thing and surrounded by bad connotations. In fact, it’s probably the most important driver of team engagement as it facilitates the leverage of the other key drivers – leadership and team effectiveness. In this seminar, Lynn McKeown will examine the role performance management plays in helping you embed a culture of engagement in your practice. She will go on to look at the three-step process required to establish a performance management process and illustrate this with real world examples.

Zoetis and Brian Faulkner from VetPsych. Practice Life z June/July 2015 z www.practicelife.biz

FOCUS ON HR DAY

Managing Change in Practice

Telephone training

NICK STEELE, ZOETIS

ALISON LAMBERT, ONSWITCH AND LINDA DEMETRIOU, DEMCO COMMUNICATIONS

For many businesses, change is the only constant. Increasingly, the same is felt in practice with technology and an evolving world requiring us to change how things are approached and done. Change can be an unsettling time for the team and individuals will react to it in different ways. Despite the often reluctance to change, it is a very necessary process and managing change should be something practice leadership is well able to execute and manage. In this seminar, Nick Steele will examine the theory behind change management and share proven techniques to manage change and handle the differing reactions of the team.

Alison and Linda help you get the most from your phone. How your practice deals with calls directly impacts on your bottom line – if callers are not offered appointments, paid consult numbers slump, and fewer procedures follow, along with a fall in turnover and profits. Delivering excellent customer care over the phone requires three things: • The right kit. An appropriate number of inbound lines and a robust call reporting system highlighting peak times and numbers of lost and abandoned calls

Becoming a great leader

• The right people. The latest equipment is no use if the person answering is vague and unhelpful and does not convert callers into clients

KATHERINE EITEL, LIONESS LEARNING HR pure and simple is the implementation of a strategy to drive innovation and productivity by optimising the performance of your workforce. By definition, therefore, excellent HR starts with excellent leadership. Katherine believes everyone can be a good leader, it is just about your state of mind, the tools you develop and the skill sets you master. Here she will help you understand how you can access the leader within, think like a leader, connect vision to action and inspire those around you.

Staff Contracts, top 10 do’s and don’ts JAMES CRONIN, EIGHT LEGAL Do your staff contracts give you the necessary protections you need? How long a probation period can you have? Can you ensure your binding out clauses are binding? Can you rewrite staff contracts that are badly written? James shares his experience of working with a range of vet practices of the common pitfalls and how to avoid them.

Meaningful Meetings KATHERINE EITEL, LIONESS LEARNING It is difficult enough for a busy vet practice to even organise a meeting and staff may be giving up valuable free time, so it is essential you don’t leave them feeling they’ve wasted their time. Good meetings are where real learning happens, things get done and decisions get made that are then followed through. Katherine describes the 4 essential types of meetings for a successful practice.

www.practicelife.biz z June/July 2015 z Practice Life

• Measurement of performance – what gets measured gets better

Getting the right person GEORGINA HILLS, PRACTICE MANAGER, VALE VETS AND VALE REFERRALS With a shortage of qualified nurses and experienced vets, the recruitment process has never been more challenging. George Hills is Practice Manager of a large first opinion and referral practice operating out of two RCVS hospitals. She shares her experience of the whole recruitment process from where she advertises, how she run interviews, the initiation process and, crucially, how to learn from members of staff when they leave! Brian Faulkner will chair the session, adding his experience to the mix and also encouraging an exchange of experience from the audience.

Don’t miss out! Book now! Don’t forget that alongside our workshops there will be a comprehensive exhibition so you can find the answers to your questions from the industry experts. Leading providers of HR products and services will be available throughout the day which includes CPD certificates, lunch and refreshments. The day costs just £100 + VAT for SPVS and VPMA members, and non-members: £150:00 + VAT.

To book your place, contact Charlotte Lodge on 01453 872731 or complete the online registration form on www.vpma-spvs-events.co.uk

HEADING

WHAT’S COMING UP... 2015 REGIONAL CPD, SPONSORED BY

1 July

The Consulting Nurse, Brian Faulkner and the Royal Canin Team

Preston

8 July

Appraisals and Recruitment, Helen Frewin

Staverton

22 July

Moving Up, Zoetis

9 September

Moving Up, Zoetis

Edinburgh

7 October

Coaching Skills, Nick Steele – Zoetis

Surrey

21 October

Training the Veterinary Receptionist, Brian Faulkner

Preston

4 November

The Colourful Consultation, Brian Faulkner

Harrogate

NEW DATE

Belfast

FOCUS DAYS SPONSORED BY ZOETIS 17 June

Focus on Technology for Profitable Practice

Staverton

14 Oct

Focus on Human Resources

Warwickshire

PSS UPDATE IN PARTNERSHIP WITH RCVS 24 September

Practice Standards Scheme Update

Coventry

Fall into Autumn with Practice Life

September/October issue SPECIAL FEATURES: Employee contracts Building your cat business Equine benchmarking

Practice Life z June/July 2015 z www.practicelife.biz

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National Veterinary Specialists

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Representing in excess of 550 practices all across the UK, our benchmarking and comparative data allows us to provide a unique service to our Veterinary clients. We offer a free of charge, no obligation initial meeting and discussion, anywhere in the UK. • Financial and management accounts • Practice management and development advice • Practice structuring, restructuring and finance • Taxation planning, advice and strategies • Full outsourcing service and payroll bureau • Computerisation and Sage® supply & support • Full Benchmarking service & KPI reporting • Forensic services including practice valuations and resolution of partnership issues or disputes Veterinary team partners:

Andy Moore andy.moore@moore-scarrott.co.uk Marcus Longbottom cmsl@moore-scarrott.co.uk

Steve Headon steve.headon@moore-scarrott.co.uk Nick Lawrence nick.lawrence@moore-scarrott.co.uk

www.moore-scarrott.co.uk Head Office: Calyx House, South Road, Taunton, Somerset, TA1 3DU Wolverhampton Office: 4 Compton Road, Wolverhampton, West Middlands, WV3 9PH

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Telephone: 01823 282100 Fax: 01823 254396 Regulated by the Institute of Chartered Accountants in England and Wales for a range of investment business activities.

Incorporating:

Bertram Kidson & Co

Accounts, Taxation & Business Development Specialists

Our Service is completely flexible which enables us to fit within the practice management team at any level in a cost effective way.