Practice Life Issue 11 March/April 2016 by The Magazine Production Company

March/April 2016 www.practicelife.biz

The VN shortage Getting to the root of the problem

Taking stock Making sure your stock taking and audit is up to scratch

Letâ&#x20AC;&#x2122;s get physical Encouraging exercise at work

THE MAGAZINE OF SPVS AND VPMA

Collaborative practice: It can benefit your veterinary business LEARNING FROM THE LIONESS: INSPIRATIONAL SPEAKER KATHERINE EITEL IN THE SPOTLIGHT

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EDITORS’ LETTERS

Editors’ Letters

elcome to this edition of Practice Life, my first as co-editor, having joined SPVS’ Council two years ago. Getting involved with SPVS has enriched my own practice life through getting to know practice owners and managers from throughout the profession. I’ve been a veterinary surgeon since 2000, a practice owner since 2008 (through my first joint venture with Vets4Pets) and, with the opening of my second surgery in 2014, have just employed my first dedicated practice manager. The support and camaraderie offered by SPVS and VPMA has been invaluable through the learning curves of my career. This goes right back to the final-year Lancaster seminar I attended at the end of the last century – still some of the most valuable learning I have ever experienced. Please encourage any EMS students you host to attend; it reaches the parts that vet school can’t. Together SPVS and VPMA offer some of the most relevant business CPD available. I’ve been proud to represent SPVS at Lancaster, VDS new graduate reunions, Celtic Manor and at regional courses. The focus on wellbeing and mental health at the annual Congress in January was particularly thought-provoking. The power of the professions working together to de-stigmatise mental health problems is immense and crucial to our

ometimes it’s a great idea to sit back and take stock of business life and thinking. Little did I realise just how relevant that concept was going to be for me personally as 2015 drew to a close. It’s true that whatever our role in practice, and no matter how good we think we are at keeping up to speed with the buzz words of business, occasionally you completely overlook the brick wall that you are about to crash into! Due to unforeseen events within my own “practice life” I was forced to start afresh with a new small animal employer, turn the page and start a new volume and chapter in our wonderful profession. It’s at times like these you value support and friendship from industry colleagues. Running virtually in parallel with my personal challenges, the VPMA board spent a day (and what a valuable day) of blue sky strategic thinking and planning. This was a new concept for many in the group and helped to make sense of the huge changes that have affected the association since those “founding father” days. You may not be surprised to

development. Indeed, learning from keynote speaker Alistair Campbell that some of the greatest achievers in history – including Winston Churchill and Florence Nightingale – were mental health sufferers helped effect a subtle shift in my thinking to conclude that what we have traditionally perceived as disabilities can become enhanced abilities and the altered perspective they lend can even lead to the development of “super powers”. Our profession is evolving at the same rapid pace as society. Listening to Rick DeBowes at Celtic Manor talking about paradigm shifts – with an analogy to portable music players – made me reflect on my listening habits, which have progressed from clunky Walkman and magnetic tapes to streaming music from the ether through my phone. Looking ahead, as practice owners and managers, will fulltime 24/7 working look as outdated in a new era of flexible, “family friendly” careers as my old hi-fi does now? There are challenges ahead for sure and being part of SPVS and VPMA will help keep us aware and ahead of these shifts as they evolve. I hope you enjoy our SPVS pages and thanks to Ian for the warm welcome to the Practice Life team. Best wishes to Steph and Renay as they get into the swing of their presidencies in 2016.

Leigh-Anne Brown, SPVS editor know that the same values of support, sharing and learning are at the core of VPMA and to help the delivery, there is a need to continue to seek out new blood at board level to help raise the profile of the organisation to become the first respected voice and leader in practice management. Could that be you? Our congress seems a distant memory now, but this is the first edition of the magazine since the Celtic Manor event and, as such, there is a large amount of looking back. Crucially, it’s what we do with our learning and experience and, once again, it was great to meet friends old and new in a buzzing business and social setting. My son’s former high school had a great mission statement “We succeed because we learn together” and I felt that more than ever at January’s congress. Finally, it’s great to have a new co-editor at Practice Life in Leigh-Anne Brown, as Steph embarks on her SPVS presidential year.

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 March/April 2016 z Practice Life

Contents Editors

UPDATE: NEWS & VIEWS 5

VPMA NEWS

SPVS Leigh-Anne Brown, MRCVS leigh-anne@practicelife.biz VPMA Ian Wolstenholme, Practice Manager ian@practicelife.biz Publisher Mojo Consultancy Ltd 181 Sandpit Lane St Albans AL4 0BT Tel +44 (0) 1727 859259 info@mojoconsultancy.com www.mojoconsultancy.com Advertising and Sales Enquiries

VET Fest preview; CVPM question 4 g

SPVS NEWS

The question of veterinary nurses again; SPVS member wins life coach award g

NURSE TALK

Not the end of the VN title campaign g

COLLEGE CORNER

The RCVS concerns process explained

Libby Sheridan MVB MRCVS libby@practicelife.biz Tel:01727 859259

Why are so many VNs leaving the profession?

Sales Administrator

Eva Lambe eva@practicelife.biz

Learn from the Lioness, Katherine Eitel

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

HOT TOPIC

IN THE SPOTLIGHT

WELL-BEING

Exercise and physical activity at work g

MANAGING PEOPLE

CLIENT CARE AND MARKETING

Making the most of your data

Articles and photographs are welcomed for submission, though publication is not guaranteed and is at the discretion of the editors.

Collaborative working between practices

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.

Making the move into management

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.

BUSINESS HEALTH AND FINANCE

30 21 32

Stock management g

PRACTICE DEVELOPMENT

CPD SHARED

SPVS/VPMA Congress 2016 review g

CPD DIARY

WHATâ&#x20AC;&#x2122;S COMING UP

Details of the Summer 2016 issue

39 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 March/April 2016 z www.practicelife.biz

News & Views Mind Matters panel at congress The RCVS Mind Matters mental health stream at SPVS/VPMA Congress broke new ground by incorporating a panel session that was chaired by Radio Four’s Claudia Hammond and included prominent mental health campaigner Alastair Campbell, together with two vets who had personal experience of mental health issues, and a practice manager who had organisational experience. Emma Mamo, Head of Workplace Wellbeing at Mind, completed the line-up for the day, which was packed to 200-strong capacity. The joint SPVS/Mind Matters Wellbeing Award for practices was also announced at congress. A wellbeing checklist can be found on spvs.org.uk/wellbeing, and more details, including how to enter, will be available in due course.

Head Nurse Congress: an event not to be missed! The College of Animal Welfare is holding its Head Nurse Congress in May, an essential event for all aspiring and in-post head VNs. Being a head nurse is a challenging position and the conference is designed to walk delegates through some of the big issues facing practices today. How to motivate your staff, make the most of your team, manage your practice workload and get clients on your side will all be discussed. The two-day event will offer 12 hours of CPD in a range of tailored topics, including “Spinning plates: effectively balancing management and your daily work”, “Help, I’m a head nurse! What now?” and “Managing social media as a head nurse”, all delivered by top-class speakers who are experts in their fields. The Head Nurse Congress is sponsored by VPMA; the association’s president, Renay Rickard, a VN herself, was keen to get involved. Renay is running a session entitled “Help, I’m a Head Nurse! Now what?” – something, she says, that is both thrilling and scary. Renay draws on her own experiences of being a head nurse and will take delegates through the highs and lows and offer tips that she wished she had known before starting the role. Renay said: “VPMA is proud to sponsor this event as Head Nurses play a vital role in the management of a

Early bird discount until March 31 book now!

veterinary team. My lecture at the congress will be around the lessons I learned (sometimes the hard way) as I progressed from a clinical nurse through the head nurse role and into a full-time management position, and hopefully will provide some vital support for those nurses out there going on the same journey as it can be a rocky road at times!” The Congress dates are May 14-15 and the venue is the Whittlebury Hall Hotel and Spa, Whittlebury, Towcester, Northamptonshire NN12 8QH. An early bird discount is available until March 31; book now to benefit. Early bird cost is £169+VAT; the full rate is £199+VAT. Accommodation at Whittlebury Hall’s Paddock Suites has been agreed at a discounted rate of £70.83+VAT; book directly with the Hall. State reference “CAWBB” when booking by telephone (01327 850489) or add it to the promotion box when booking online.

Alternative accommodation includes Travelodge Towcester Silverstone and Premier Inn Silverstone Hotel. Visit www.caw.ac.uk/events/head-nurse-congress/

Vet Futures – and now VN Futures! The Vet Futures report – Taking Charge of our Future – was launched within the BVA Congress at the London Vet Show in November. Now, its 34 recommendations are being turned into actions: a Vet Futures Action Group has been convened to accomplish this, and an action plan will be launched at the Vet Futures Summit on July 4, 2016.

Meanwhile, one of the recommendations of the report was to “encourage VN leaders to develop a report and recommendations which are directly relevant to VNs and their future...” A VN Futures project has now been kicked off to achieve this, and will also present an action plan at the summit. A series of meetings to engage the VN profession will take place over the coming months – keep an eye on www.vetfutures.org.uk for more information.

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 www.practicelife.biz z March/April 2016 z Practice Life

VPMA NEWS

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: secretariat@vpma.co.uk

I hope that those of you who made it to Congress had a good time and learned lots! But maybe more importantly found time for a catch up with each other. We are all so incredibly busy that sometimes putting time aside for ourselves does not take priority... but it should. One of the main benefits to the members of VPMA is the network of people available to support, help or just answer mundane queries on one of the best washing machines to buy! One of the best ways to find this support network is through the VPMA Regions. Throughout 2015 the regional organiser team grew so there will be more regional meetings than ever in 2016. We are also organising a “VPMA Roadshow” during 2016 to try and ensure that most of our membership has a chance to attend a meeting at regional level. We are hoping from getting more of you together we can increase the support and information network that is available and maybe encourage some more regions to take off. If anybody is interested in being involved with regional meetings, either as an organiser or a speaker then please contact me, or the VPMA secretariat for further information.

Renay Rickard – VPMA President & Regional Co-ordinator.

CUMBRIA Pauline Graham Tel: 07803 228720 ro3@vpma.co.uk

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

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

BUCKINGHAMSHIRE Julie Beacham Tel: 07710 317310 ro18@vpma.co.uk

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

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

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

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

LONDON mark harwood Tel: 01242 680000 ro7@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

MANCHESTER Kate Mincher Tel: 01633 745294 Ro2@vpma.co.uk

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

YORKSHIRE Lisa Winter Tel: 0777 2682617 Ro8@vpma.co.uk

ated d p u p e e K chtime n u l r u o with dates! p u t n e s managem webinar 30min f o s e i r A se embers. m A M P for V out

heck ore and c m t u o d ars on Fin st webin a p f o e the archiv .uk

ma.co p v . w w w

Practice Life z March/April 2016 z www.practicelife.biz

VPMA News President’s Welcome Thirty years ago I walked into my local veterinary surgery with a handful of mediocre “O” Levels and a desire to work with animals, and asked for a job. It seems like yesterday and as I start my presidential year I’m wondering how I got here! I am very proud to take on this role and have some very big boots to fill. I would like to say thank you to Howard for his help in preparing me for the role while being his junior. 2016 is going to be an exciting year for VPMA as we are involved in some new events and ventures. We are a key sponsor of the Head Veterinary Nurse Congress, which will take place at the College of Animal Welfare in May – an event close to my heart as we look at developing nurses into leadership and management roles. We are also sponsoring and chairing the management stream at Vetfest in June. Anybody who knows me will know this is an event that is just made for me... a veterinary conference and a music festival all in one. Perfect! I attended the VN Futures meeting in January of this year, which considering it was the first week back to work after the festive break, was incredibly well attended by delegates from across the veterinary nursing profession. It was a very productive meeting with plenty of discussion around where we hoped the profession would be in five years’ time. It is something that I hope to remain involved with on behalf of VPMA, but I think if we want to retain our nurses we must make sure we are reviewing and developing and growing their role so that they become feeearning in their own right. Let’s aim for a goal that is to make our VNs part of the profit and growth of a practice, rather than part of the costs. VPMA continues to work closely with SPVS to hold our very successful joint management congress, which by the time this goes to print, will of course have happened. To remind you of the highlights, see the reports on pages 38-40. Our joint CPD programme for 2016 has been released and we hope to see as many of you as possible at these events. The role of VPMA president is to represent the association and its members, and to ensure we have a voice within the veterinary industry and business management as a profession, so please contact me at president@vpma.co.uk with any issues you would like raised or if I can be of any help in any other way. So sleeves rolled up... Renay Rickard RVN CVPM VPMA President

www.practicelife.biz z March/April 2016 z Practice Life

VPMA NEWS

CVPM Syllabus Insights Take the Quiz! CVPM Exam Example Question 4 Candidates tell us the hardest part of CVPM is answering 10 questions on practice problems orally in 30 minutes. Why is it oral and why do you have no previous knowledge of the questions? Because that’s what we face in practice every day and competent managers have to just deal with it! Have a go at answering the question below. 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.

Communication – The holy grail of veterinary practice! How many times have you heard the criticism “poor communication” levelled at a practice, team, bosses or with external stakeholders? Being a successful communicator and facilitating that throughout your practice is a highly important (but possibly the toughest) part of a practice manager’s role. A whole section of the Certificate in Veterinary Practice Management (CVPM) syllabus and exam is dedicated to it. The section is broken down into four key areas for a candidate to prove competency in: 1) Professional Communication • Be able to liaise with professionals such as accountants, solicitors, consultants and insurance advisors. • Be able to relay pertinent information from discussions with professionals to practice owners in an appropriate format.

2) Commercial Communication • Be able to liaise with companies, suppliers and their representatives. • Where necessary, be able to act upon information received within the practice.

3) Client Communication • Be able to communicate effectively with clients • Understand the importance of standards and procedures for client complaints, client suggestions, feedback and good customer service.

4) Staff Communication • Understand effective communication methods and their importance. • Implementing effective practice communication to include written, verbal, electronic and other communication methods with and between staff. • Organising, chairing meetings and preparing agendas and minutes. Throughout the process of sitting the CVPM, consideration and explanation of the communication process in all areas of daily work must be evidenced; in fact, the process of the exam itself is a demonstration of communication skills. The entry report “How I have used my knowledge to benefit the veterinary environment in which I work”, is both an opportunity to discuss communication in the individual’s work place and also establishes the candidate’s clarity of written communication. The set topic presentation section allows the candidate to showcase his or her “public speaking” and PowerPoint skills (the topic is sent in advance) and the oral sections reveal his or her professional communication skills and ability to convey information and thoughts under pressure. The examiners are looking for knowledge and use of each section throughout the exam and so it should be referenced where ever possible.

See below for an example question about communication You are aware of an underlying problem in your workplace. You have realised that the problems stem from poor communication between members of staff. What steps would you take to correct the situation and prevent it from recurring? Remember you only have approximately three minutes in the oral question section to answer this so give an overview of how you would approach and assess the problem and your ideas for solving it and how you would then consider implementing them. You may email your answer to: c&t@vpma.co.uk; all entries will be marked and feedback given. For more information on the Certificate of Veterinary Practice Management, visit vpma.co.uk/education/cvpm

FEATURING LIVE MUSIC ON BOTH NIGHTS

A CELEBRATION OF VETERINARY LEARNING DYNAMIC

Conference Programme UNT ISCO : D 10% E CODE EN US 0 WH * 1 A VPM OKING BO

TIME

8:45 AM - 9:30 AM

ORTHOPAEDICS

LEARN

Ground breaking lectures Listen to over 20 globally to stretch your learning and renowned professionals Saturdary 4th June ideas, chosen to be of practical driving innovation across relevance to your daily life the industry

MANAGEMENT & MOTIVATION

ONCOLOGY &

NEUROLOGY

NURSING

SOFT TISSUE

FELINE MEDICINE

Noel Fitzpatrick

Nicolas Granger

Nick Bacon

Diego Castineiras

Brian Faulkner

Pelvic Limb Lameness Exam:

Epilepsy: A practical guide to

Thoracotomy: Tips for

Anaesthesia of the critical care

Sources of turnover

20 years' experience in

appropriate medical

procedures you can do in

emergency case: You are the

haemorrhage from your practice

45 minutes

management

practice

diﬀerence between life and death!

9:40 AM - 10:25 AM

Michael Kowaleski

Break

Phillip Mayhew

Break

Ernie Ward

Stiﬂe stabilisation in cruciate

Thoracoscopy: Tips for

5 Physical exam hacks to

disease: What would you do if it

procedures you can do in

improve diagnostic accuracy

was your own dog?

practice - now or in the future

and communication eﬀectiveness

10:35 AM - 11:20 AM

Break

Nicolas Granger

Break

Julius Liptak

Spinal cord injury: When should

Principles of surgical oncology:

we operate and can we repair?

What every nurse should know

Break

FRIDAY 3rd JUNE 2016

How to advise your client

11:30 AM - 12:15 PM

Russell Tucker

Clare Rusbridge

Nick Bacon

Phillip Mayhew

Brian Faulkner

Radiography vs CT vs MRI in

Syringomyelia and Chiari-like

Mammary tumours in dogs and

Principles of mimimally invasive

10 leadership beliefs that

orthopaedics: When and why?

Malformation

cats: What you need to know

surgery: What every nurse

undermine our ability to lead

should know

12:25 PM - 1:10 PM

Mathilde Granger

Break

Laurent Findji

Break

Ernie Ward

Managing osteoarthritis as a

Skin Flaps: What you need to

Blurred Lines: Doing good

team: Surgery, pain

know about wound closure

while doing well - making peace

management, rehab and

between proﬁt and charity

beyond

1:20 PM - 2:05 PM

2:15 PM - 3:00 PM

3:10 PM - 3:55 PM

Lunch

Nicolas Granger

Lunch

Sarah Girling

The ageing dog and cat: What

The Ortho Examination: What

can we do when nerves age?

every nurse should know

Lunch

Michael Kowaleski

Clare Rusbridge

Julius Liptak

Nicolas Granger

Elise Robertson

Canine Fractures:

How I approach chronic and

Tumours of the skin:

The Neuro Examination: What

Upper Respiratory Disease in

Why puppies are special!

neuropathic pain

Sarcomas and Mast Cell

every nurse should know

cats: The emerging role of

Sarah Girling

Break

tumours - What if it were your

endoscopy for accurate

dog?

diagnosis and treatment

Laurent Findji

Break

Elise Robertson

Feline Fractures:

Tumours of the face:

GIT Disease in cats: The

Why Cats are special!

What can be achieved in 2016

emerging role of endoscopy

- What if it were your dog?

for accurate diagnosis and treatment

4:05 PM - 4:50 PM

Break

Kristin Kirkby-Shaw

Noel Fitzpatrick

Clare Rusbridge

Physical rehabilitation for

Tumours of the limb:

Epilepsy: What every nurse

neurologic diseases of the dog

Amputation vs limb salvage -

should know

and cat

What if it were your dog?

5:00 PM - 5:45 PM

Break

Conference Keynote To be announced

6:30 PM - 11:00 PM

BOOK NOW: www.vetfestival.co.uk

ONELive LIVE–Music Vetfest BandsFestival and Disco

#VETfestival *Discount applicable to Vet prices only. Programme correct at time of going to press.

DELEGATES CAN ATTEND ANY OF THE 5 EDUCATIONAL STREAMS ACROSS THE 2 DAYS

LEARN, GROW AND BE NETWORK

Social events schedule with wonderful friendship and networking opportunities for you and your colleagues

INSPIRED

ENJOY

A fun festival atmosphere – bespoke outdoor CPD marquees, fresh air, great food and live entertainment

Conference Programme TIME

ORTHOPAEDICS

MANAGEMENT & MOTIVATION

ONCOLOGY &

NEUROLOGY

NURSING

SOFT TISSUE

NUTRITION

Conference Welcome: Noel Fitzpatrick

8:30 AM - 8:40 AM

8:45 AM - 9:30 AM

Friday 3rd June

Noel Fitzpatrick

Russell Tucker

Nick Bacon

Kristin Kirkby-Shaw

Joseph Wakshlag

Thoracic Limb Lameness Exam:

Neuro imaging in 2016:

Laparotomy: Tips for

Veterinary Rehabilitation:

Feeding raw, homemade,

20 years' experience in 45

Tips and tricks to improve

procedures you can do in

The practical application of

canned or kibble: Myths, truths

minutes

diagnostic information

practice

modalities with a team

and misconceptions

approach

9:40 AM - 10:25 AM

Michael Kowaleski

Break

Phillip Mayhew

Break

Joseph Wakshlag

Hip Dysplasia: What would you

Laparoscopy: Tips for

Feeding the Geriatric Patient:

do if it was your own dog?

procedures you can do in

Mobility, Mind and Muscle

Clinical examination,

practice – now or in the future

diagnostics, treatment

10:35 AM - 11:20 AM

Break

Tom Harcourt-Brown

Break

Russell Tucker

Neuro Exam 1:

Obtaining optimal radiographs

Localising Brain Diseases

in your practice and when CT or

Break

SATURDAY 4th JUNE 2016

MRI is useful

11:30 AM - 12:15 PM

Kristin Kirkby-Shaw

Tom Harcourt-Brown

Paddy Mannion

Michael Kowaleski

Brian Faulkner

Do Physiotherapy modalities

Vestibular Disease:

Radiography and CT in cancer

Arthritis: Diet management,

Motivation - To do what?

work? Laser, shockwave and the

When the world is spinning

and soft tissue surgery:

supplements, rehab, drugs or

Recruiting, developing and

rest - or just rest?

around

What’s expected in 2016

surgery - What you need to

appraising staﬀ

know

12:25 PM - 1:10 PM

1:20 PM - 2:05 PM

Joseph Wakshlag

Lunch

Russell Tucker

Lunch

Ernie Ward

Nutraceuticals: Everything you

MRI in cancer and soft tissue

Refueling the Energy Slump:

ever wanted to know but were

surgery:

Principle-centered motivation

afraid to ask

What's expected in 2016

Lunch

Colin Driver

Lunch

Joseph Wakshlag

Neuro Exam 2:

What's in the petfood? The vital

Localising Spinal Diseases

role of nurses in client

Lunch

education

2:15 PM - 3:00 PM

Michael Kowaleski

Colin Driver

Phillip Mayhew

Elise Robertson

Brian Faulkner

Patellar Luxation: What would

Diﬀerentiating neurologic from

Hernias of the diaphragm:

Diabetes in Cats - Diagnosis,

How to have a diﬃcult

you do if it was your own dog?

orthopaedic weakness

Traumatic, pericardioperitoneal

Dilemmas, Drugs and Diet: Why

conversation with a colleague

and hiatal

nurses are vital for success

or client

Julius Liptak

Break

Ernie Ward

Clinical examination, diagnostics, treatment

3:10 PM - 3:55 PM

Kristin Kirkby-Shaw

Break

Physical rehabilitation for

The principles of surgical

5 Steps to cure conﬂict before

canine athletes

oncology: A summary of what

it kills you

you need to know in 2016

4:05 PM - 4:50 PM

Joseph Wakshlag

Noel Fitzpatrick

Feeding the Canine Athlete:

A Pain in the Neck or a Pain in

Break

Kelvin Kow Chemotherapy administration

Beyond Fat

the Ass: How to examine and

and safety - What’s involved

diagnose wobblers and

from a nursing perspective

Break

lumbosacral disease in dogs

5:00 PM - 5:45 PM

Conference Keynote To be announced

5:45 PM - 6:45 PM

7:00 PM - 11:00 PM

BBQ

Vetfest BandsFestival and Disco ONELive LIVE– Music

MANAGEMENT STREAM SPONSORED BY

VPMA NEWS

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THE SECRET TO A SUCCESSFUL PRACTICE VET Festival (Veterinary Education for Tomorrow) is to return on June 3-4 with the promise of “happier staff and increased profitability”. Practice Life was pleased to catch up with one of the speakers, Dr Ernie Ward, founder of Seaside Animal Care in North Carolina, USA, to explain all.

ET Festival is daringly different. Not only has it scooped a stellar cast of world-class speakers to deliver clinically relevant information and practical advice, but all presentations are staged outdoors in marquees creating a fun, “fresh air” festival environment in the stunning grounds of one of southern England’s finest stately homes, Loseley Park near Guildford. This combination of “healthy living and healthy learning” is one of the many reasons VET Festival succeeds in attracting high-calibre speakers such as Dr Ernie Ward, who joins the line up this year to help deliver a new lecture stream focusing on management and motivation. Known as America’s Pet Advocate, Ernie has dedicated his long and illustrious career to improving veterinary medical standards and promoting healthier habits for pets and people. He is a recognised leader in the fields of pet nutrition and weight loss, diagnostic test protocols and evolving pet technologies, and is a passionate promoter of senior pet care and of advancing veterinary practice standards and staff training. At the VET Festival, Ernie will address common practice issues, such as conflict, motivation, morality over money and raising diagnostic standards. Speaking about his overall aim for the sessions, Ernie said: “I hope to teach delegates how to better cope with daily stress, provide higher standards of care and recharge their enthusiasm! “Working in a practice is emotionally draining and financially challenging. It’s too easy to become disconnected. I hope that by sharing my passion and love for veterinary practice, I will remind everyone why we do what we do and why it’s important so that it will become more enjoyable and rewarding.” In his talk “Refuelling the Energy Slump: Principle Centre Motivation” Ernie will share his top eight energy injections to restore motivation within any practice. “Motivating people requires a lot of energy! Encouraging a team to have positive attitudes, creativity and to deliver exceptional client service and patient care demands constant input and focus from practice leaders. These days not everyone can do it. “The stress of daily practice life takes its toll and the result is often emotional burnout. When employees and veterinarians are emotionally spent they provide poor service, aren’t focused on patient care and, ultimately, damage the reputation of the practice and its revenues. Practice leaders need to understand the connection between staff morale and success – an energised, motivated and emotionally strong team will out perform a less enthusiastic competitor every time.

“If we want sustainable growth and happiness, we must be guided by our core principles and beliefs – those we use to navigate life’s challenges and that remind us why we work hard. The real test is whether you can survive the trials and tribulations of practice life with your core beliefs intact; I believe we can!” The old adage “misery loves company” is too true for many veterinarians and support staff. In “Five Steps to Cure Conflict Before it Kills You”, Ernie will provide practical advice on how to deal with negative issues in the workplace. He said: “Sour team morale, sagging revenue, and complaints from clients and co-workers create tense workplaces. Despite doing better economically, many veterinary teams lose enthusiasm and team members. Team morale, energy and harmony can be directly influenced and every practice should have a strategy for creating this excitement and excellence to ward off conflict. I’ll be sharing mine with delegates to hopefully inspire them to formulate their own.” Moving on to “Five Physical Exam Hacks to Improve Diagnostic Accuracy and Communication Effectiveness,” Ernie will challenge the importance placed on technology in the physical examination. “The physical exam is the foundation of veterinary medicine and is perhaps the most important service we provide, but it’s becoming a lost art as high-tech replaces touch, feel, and talk,” he said. “My goal with this presentation is to reveal why the physical examination is more important than ever and equip delegates with five hacks to improve and enhance their expertise and compliance.” Ernie will also tackle veterinarians’ ongoing battle of morality over money. In “Blurred Lines – Doing Good While Doing Well” he aims to help veterinarians find the peace between profit and charity. “Why do we veterinarians have an agonising association with money?” he asks. “It’s a struggle we often ignore within our profession as it’s very difficult to draw a line between profit and compassion. But why shouldn’t we be able to do good for animal welfare while doing well financially? “I believe the answers may be both simpler and more complicated than most of us think; in this session I plan to review how we got into this mess originally, and I’m pointing my finger at Dr James Herriott!” The Management and Motivation lecture stream is one of five offered at the VET Festival. Each lecture stream has been organised for maximum impact, led by practitioners who are considered the best in the world in their subject areas. Other streams include orthopaedics, neurology, soft tissue and oncology, and nursing. Delegates may attend any lecture or stream they wish.

For further information on VET Festival visit www.vetfestival.co.uk. Don’t forget to use your VPMA10 code when booking online to get your member discount! For more information on Dr Ernie Ward visit www.drernieward.com Practice Life z March/April 2016 z www.practicelife.biz

SPVS News President’s letter Stephanie Writer-Davies This year’s joint SPVS VPMA Congress, once again held at the splendid Celtic Manor Resort in Newport, was another excellent event. Two days of stimulating CPD and a great social programme, alongside a commercial exhibition including some 60 exhibitors offering products and/or services to help enhance and facilitate the running of our practices. There’s no doubt in my mind that what sets our Congress apart from others is the special atmosphere; friendly camaraderie where the delegates all seem to “get it” (it being the particular pressures, challenges and rewards that come with the responsibility of being a senior decision maker in, or owner of, a veterinary business). It’s this type of networking and support that I consider one of the main benefits of SPVS membership. The 2016 Congress was special for me as I took on the SPVS presidency for the next year. I am honoured to have been asked to take on the role and believe SPVS is a great society. For me it is the society for veterinary business owners and runners, the people with the weight of responsibility on their shoulders, with whom the buck stops – and those people looking to become such. In the time since I joined SPVS Council, the society’s profile has been raised and it is a respected organisation; our views are sought regularly and we are becoming the go-to society when comments on matters relating to the business of veterinary practice are required. Additionally, veterinary commercial companies, seeing a relationship with SPVS as the way in for introductions to the decision makers and purse-string holders in practices, are keen to work with and support us. This means the society is financially sound, which itself opens up future possibilities; over the next year this includes investing in and improving our surveys in partnership with Veterinary Insights, building on those we currently offer and adding new ones. I’d like to encourage you to participate; the more data we are able to collect the more accurate the results and the greater their validity (Peter Brown has more detail in his piece on page 14). At the AGM, the proposal to make some minor amendments to the society’s constitution, removing the requirement for associate members to submit a CV to apply to join, was carried with a unanimous vote. I’m pleased that now non-vets who are currently, or have spent a substantial proportion of their career, working in veterinary practice will be able to join as associate members as easily as vets can join as full members. While SPVS is a veterinary organisation at heart, the veterinary landscape is changing and more non-vets are in senior positions in practice and it makes sense to me that we should engage with such people, who will have different perspectives from ‘us vets’. Yes, there may be areas around which we disagree, but there may be others where we will be able to learn and benefit from their input (and they from ours) – how much better could it be if we try to understand different views and influence each other in positive ways. I look forward to welcoming these individuals to SPVS and hope that the society will become an even more inclusive voice for the whole of practice in this way. As you open this March edition of Practice Life I will be involved in one of my first big duties as President and it’s one that I’m looking forward to. I’ll be hosting the annual Snowscene trip and enjoying what promises to be great CPD and, hopefully, plenty of skiing in Tignes, France. A nice break before work starts in earnest with my first SPVS Council meeting as President in April.

SPVS NEWS

SPVS Dates For Your Diary 2016 April 11-12 Officers’ and Council Meetings If you have any items that you would like to put forward for discussion, contact honorary secretary, Hazel Bentall, or the SPVS office. July 1-3 Lancaster Student Seminar Many past and current SPVS council members will be there supporting this popular event aimed at helping new graduates as they embark on their careers. July 18-19 Officers’ and Council Meetings If you have any items that you would like to put forward for discussion, contact honorary secretary, Hazel Bentall, or the SPVS office. Cyclescene and Spascene will be repeated in 2016 after the success of both inaugural events last year. They are likely to take place in September and October, respectively. More information will follow in the next edition of Practice Life.

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PLEASE NOTE SPVS’ new address: Stephanie Writer-Davies, SPVS President

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Unit 19a, Hatton Country World Hatton, Warwick CV35 8XA

SPVS NEWS

LIFE COACH OF THE YEAR AWARD GOES TO A VET – AND A SPVS MEMBER AT THAT! Congratulations go to Carolyne Crowe for being named Life Coach of the Year 2015 at the International Coaching Awards last December. Carolyne beat stiff international competition from experienced coaches working across a wide range of disciplines to win the award for her work with veterinary teams and individuals. Carolyne, an experienced equine vet, is a highly respected personal performance coach, mentor, international speaker and lecturer in the veterinary sector and was nominated for the award by her clients. In addition to her one-on-one life coaching, Carolyne also runs regular workshops and training sessions across the UK, focusing on leadership, team building, communication skills, personal effectiveness and stress management techniques to help professionals get the most out of their lives and careers. Commenting on the award, Carolyne said: “I am absolutely delighted and honoured to receive this prestigious award from my peers. I feel very privileged to do a job I absolutely love, helping practices look after and optimise the most important resource they have – their team. “Ultimately, my aim is to have a positive impact on everybody I work with; to help others get the most out of their life and career, to empower and inspire clients to make changes that work for them, to fulfill their potential and achieve their ambitions. Making a positive difference to others is an exciting, rewarding and very fulfilling job and something I will never tire of.”

For more information on Carolyne’s work, visit www.carolynecrowe.co.uk

PRACTICE LIFE ARTICLES NOW AVAILABLE ON SPVS’ WEBSITE Articles from Practice Life magazine have been archived on our website. They have been set out under the same section headings as in the print version, with a search facility to allow the reader to search for keywords in article titles. To access the digital articles, visit www.spvs.org.uk and login as a member (you’ll need your membership number, which the SPVS office will be happy to provide if you don’t have it) and click the Practice Life link in the Member Benefits section. At the bottom of the page there is another link to the articles. All future articles will be added as they are published so, over time, this will grow into a useful library-type resource for members. Additionally, all editions of Practice Life are available in their entirety at www.practicelife.biz The current copy may be read by anyone registering to use the site, but the archived editions are only accessible to SPVS and VPMA members (if you need member login details use the contact details on the website and they will be provided).

GOT A QUESTION? TRY THE SPVS DISCUSSION LIST! The Discussion List is a service provided free of charge exclusively to SPVS members. Only SPVS members may join the list or, exceptionally, other prominent members of the profession at the discretion of SPVS council. The list is intended for conversations relating to any aspect of the management of veterinary practice, and also any political issues that impact on the veterinary profession. But be assured that no subject is prohibited or discouraged and many clinical questions are posed (and answered!). The Discussion List can be really helpful; all members are either actively involved in practice or have spent a significant proportion of their careers in that environment and the chances are that one or more of them will have experienced similar issues and have advice to share. Postings and discussions are monitored by the moderator to ensure that the “list etiquette” is followed and a welcoming and open forum is retained. If you would like to get involved, send an email to: listowner@spvs.org.uk including your name and postal address. Once it has been confirmed the applicant is on the SPVS list, he or she will receive an email with further instructions on how to join the conversation. There is now an “idiot’s guide” to how to use the Discussion List, which is available through the SPVS website. Visit www.spvs.org.uk and login as a member (if you don’t have your membership number the SPVS Office will be happy to provide it for you) and click the Discussion List link in the Member Benefits section.

VN APPRENTICESHIPS ARE CHANGING – AGAIN Apprenticeships are being reformed through employer-led “trailblazers” (groups working together to design apprenticeship standards and assessment approaches to make them world class). The current apprenticeship standards will end in 2017 and new ones are in development. The intention is that these standards will be designed by employers, making them more relevant – and therefore more attractive – to businesses or professions that need staff with such qualifications. It is hoped that these employer-designed standards will be short and easy to understand, encompassing skills, knowledge and behaviours that an individual needs to be competent in their occupation. This should mean those employers already offering apprenticeship training will continue to do so and it ought to encourage new employers to get involved. The first meeting of the veterinary nursing trailblazers took place in late November, and SPVS was represented along with other major veterinary societies and BVNA. The SPVS representatives are all VN employers and are also all involved in veterinary nurse training so are well placed to help ensure the new standards will be fit for purpose and workable in practice. If you have any comments you’d like to make about veterinary nurse training or anything specific that you’d like to see included (or indeed left out!) please get in touch via the SPVS office.

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SPVS NEWS

THE QUESTION OF VETERINARY NURSES AGAIN... Why aren’t there enough and why don’t they stay in the profession, asks Stephanie Writer-Davies

his edition’s Hot Topic tackles this issue and, as the SPVS editor, I was asked for a short comment to go with the article. I thought it might be useful to request input from the SPVS Councillors. Here I have summarised what were often very heartfelt responses, to give a flavour of what the profession is thinking. Most replied and several asked their nurses for their opinions, which resulted in rather more input than I had anticipated! There appears to be a general feeling that qualified veterinary nurses are an asset to practices; however as employers, many of us find the cost of training them, both financially and in terms of other staff members’ time, a concern. Then there is the difficulty of what to do once you have trained a nurse; do you keep them on (after all you trained them so they should fit into and work well for your practice) or do you let them move on to make space for a new trainee (but that means all that work again)? Keeping them on potentially slows the rate of new recruits to the profession but it can be frustrating to invest in training a nurse and then not keep that asset in your practice. As far as the nurses themselves are concerned, all of those questioned had similar thoughts. The consensus was that there are lots of potential students available who are enthusiastic about a career as a nurse but there doesn’t seem to be enough training places available. Then, unfortunately, those who are successful in achieving the qualification find that they have entered a profession where there is low salary, relatively few opportunities for career progression and where their skills aren’t always recognised by their employers. These issues are compounded by the fact that the vast majority of veterinary nurses are women and many go on to have children and often don’t return after maternity leave because the low wages and frequently unsociable hours make it less enticing. There were some suggestions about how these problems might be addressed. Proffered by both vets and nurses, interestingly, they had a business-based focus. Is it reasonable to reduce the costs of training to practices by paying very low (or occasionally even zero) wages? Veterinary nurses appeared to consider this was acceptable; after all, if they chose to follow the university route they’d be paying £9,000 per year fees so, as long as they are receiving the training that the practice is expected to provide and not being ‘used’ as full-time employees with inappropriate levels of responsibility, minimal income in exchange for a qualification seemed fair. Costs can be more significant for mature students but, with the majority of trainees being school leavers, perhaps practices shouldn’t have to find veterinary nurse training a particularly big financial commitment. It was also suggested that it would be helpful for the veterinary nurse training to include some aspects about how

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veterinary businesses work; most veterinary nurses didn’t appreciate the costs involved in running a veterinary practice and had no idea about what proportion of the money taken at the till is left over after all expenses have been met. Certainly the college course could help with this but so could practices; perhaps sharing financial information with staff, being more open about business costs, encouraging the whole team to work together to improve practice profitability, and rewarding staff fairly for the work they do would result in better staff engagement and retention. Could the answer be as simple as having well-run, progressive, training practices with commercial attitudes to providing training, open financial discussions used to create clearly understood visions and goals for the business resulting in an engaged team of employees working towards those, who are remunerated fairly for their contributions? Isn’t that what so many of our SPVS and VPMA courses are aimed at helping us achieve? Just a thought!

SPVS NEWS

SPVS SURVEYS: AN UPDATE

here have been some exciting developments regarding the surveys offered by SPVS. Members will already be familiar with our popular surveys about veterinary fees and salaries. Last year, in partnership with Veterinary Insights, we set up the SPVS/Vetviewer website pages, which provide insightful data directly from a practice management system (PMS). Vetviewer is unique in being able to interrogate nearly all the major PMSs used in the UK, safely extracting data that enables practices to make meaningful comparisons of a whole range of key performance indicators (KPIs); see Box 1. A free service is available to all practices, with a more detailed analysis available exclusively to SPVS members. To complement Vetviewer we have just launched our Profitability Survey, and are delighted to welcome John Sheridan as a consultant. John has long been a passionate advocate of the need for practices to understand profitability, and this simple survey provides the key statistics required. As a society we are fully committed to this project and are making the survey freely available to all veterinary practices to establish a database that will enable them to critically evaluate their performance on an ongoing basis. (Fig 1).

Meanwhile our existing fees and salaries surveys haven’t been forgotten. This year we are introducing improvements to the way data is entered and results presented through a dedicated website, again developed in conjunction with Veterinary Insights. Significantly, this will simplify the process of entering data, which we hope will encourage more practices to participate. Practices will be able to view results online, using interactive tools to drill down into the data, or print out a hard copy if required. The surveys already offer the most comprehensive analysis of their kind in the UK, and with these developments we plan to broaden their appeal, making the data they offer even more valuable to our members and the profession as a whole. To run a successful veterinary practice it is important to know how it is performing financially, and with this suite of products from SPVS – PMS analysis through Vetviewer alongside the Profitability, Fees and Salaries Surveys – we now have a comprehensive set of tools to enable you to objectively assess your own business. As a SPVS member you will be notified when surveys go live, or for more information, visit http://www.spvs.org.uk/

Fig 1. The results page from the new Financial Benchmarking Survey

Box 1. KPIs SPVS/ Vetviewer can offer: • Active clients/pets per FTVE • Average spend per client/pet • Average transaction value • Fee: product ratio • Client spend and % buying

- Vaccines

- Parasiticide

- Foods

• Income from preventive care versus income from ill animals • Breakdown into categories, such as dentistry, neutering, inpatients • Diagnostics as a proportion of turnover

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Nurse Talk

NURSE TALK

In association with

NOT THE END OF THE VN TITLE CAMPAIGN

NURSING BODY SPEAKS OUT BVNA was very disappointed to read the Government’s response to the Protect the VN Title petition, released on January 9, 2016. BVNA feels the Government has overlooked the emotions of the British public towards animal welfare and maintenance of trust within the veterinary profession. With no restriction on the use of the title “veterinary nurse” it is confusing for the general public and for the veterinary profession. BVNA feels this is not the end of the campaign to protect the veterinary nurse title and the response from the Government

will only serve to increase awareness of the issues faced. This should help to increase public awareness of the potential issue their pet could face next time they go for treatment in a veterinary practice. As the representative body for veterinary nurses, BVNA will continue to work alongside the RCVS and with BVA to raise awareness of this campaign. If you are an RVN or SVN who is not already a BVNA member and you would like to join with us to have your voice heard, then please contact the BVNA office or visit our website.

Inaugural meeting of the British Association of Veterinary Nurse Students (BAVNS) The inaugural meeting of the BAVNS committee was held in December 2015. The aim of the association is to provide representation, support and guidance for our student membership. While BVNA has always had a student membership category, we are hoping the development of BAVNS student members and college/ university representatives will make them feel more supported. Keep a look out for more information on the BVNA website or by following BAVNS directly on Facebook and Twitter @BAVNS_UK

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College Corner

A PRACTICE-BASED APPROACH TO THE RCVS CONCERNS PROCESS Although concerns can only be raised with the Royal College of Veterinary Surgeons in regards to the professional conduct of individual veterinary surgeons or veterinary nurses, clearly having an employee who is subject to a complaint can place a number of strains and pressures on the practice as a whole. Eleanor Ferguson, Head of Professional Conduct at the RCVS, looks at how practice managers can constructively engage with the process. in a similar way to a court of law. Ordinarily the committee will hear evidence from the complainant(s), the veterinary surgeon or veterinary nurse, other witnesses involved in the case and, if necessary, expert witnesses. The committee will make a decision on whether the case constitutes serious professional misconduct and may direct the registrar to remove or suspend the individual from the register, issue a formal reprimand, or dismiss the case. In 2014, significant changes were made to the RCVS’ concerns investigation process, particularly around how and how often we communicate with those who have concerns raised against them. So, for example, they are assigned a case manager to be their primary source of contact and to help manage expectations by indicating likely outcomes. They are also kept better informed at each stage of the process with regular communication via telephone and email. The aim is to reassure and make sure that they, and the complainant, don’t feel left in the dark.

Preventive measures Every year the RCVS deals with around 800 concerns raised about the professional conduct of veterinary surgeons or veterinary nurses – in all likelihood, most veterinary practices will have to engage with our concerns’ investigation process at one point or another. Although this can be an understandably stressful and fraught time for both the individual and the practice, the good news is that the vast majority of concerns are closed at the initial investigation stage. Around 20 per cent of cases are referred on to our Preliminary Investigation Committee (PIC), which decides whether to close the case (which is often done with professional conduct advice being given to the individual) or to refer on to the Disciplinary Committee (DC). However, just one or two per cent of the concerns we receive warrant a DC hearing.

Overview of the concerns process The concerns process has three stages. Stage 1 is the assessment and investigation stage where the concern will be examined by a Case Examiner Group comprising a case manager, a veterinary case examiner and a lay case examiner. If considered sufficiently serious it will be referred to the PIC which will scrutinise and investigate the available information on the case and decide whether to close it (with or without advice), hold it open or refer it to the DC. Disciplinary Committee hearings are held in public and function

Probably the easiest and most stress-free way to engage with the college’s concerns’ investigation process is to not have any contact with it at all! While, of course, this may not be entirely possible, there are many actions that practices can take to reduce the likelihood of a member of staff being complained about. The majority of complaints we receive involve an issue related to poor communication. If clients feel left in the dark about an aspect of their animal’s treatment or if a mistake is made and the practice’s natural reaction is to take up a defensive posture rather than admit the error, then they may, naturally, go elsewhere for recourse. Therefore, one way to head off a concern being raised with the RCVS is to implement a comprehensive and thorough internal complaints handling policy at your practice, to ensure that concerns raised by clients are listened to, investigated, discussed among the team and responded to promptly. If there are grounds for concern, don’t be afraid to make an apology – being sorry that someone is upset or that something hasn’t gone according to plan isn’t the same as admitting liability. You might also like to discuss with your insurers the possibility of making a goodwill gesture to the complainant. Even if you believe there are no grounds for the complaint, listening to the individual’s concerns may still help defuse the situation and help you to retain their custom in the long term. All staff, both clinical and non-clinical, should familiarise themselves with the complaints-handling policy. We also recommend that practices have a system of recording complaints and Practice Life z March/April 2016 z www.practicelife.biz

COLLEGE CORNER

What can practice managers do? If a concern is raised about an employee or a colleague the key advice is not to panic – as the stats given earlier demonstrate, it is unlikely that a concern will result in a DC hearing. Nevertheless, there are a number of practical steps a practice manager can take to assist with and constructively engage in the process. For example, we recommend that practice managers familiarise themselves with our concerns’ investigation procedure so that, if a concern is raised, they have an idea of the timings, the stages and what kind of information will be required and from whom. This will allow them to plan in advance and put together contingency plans. Practice managers can also assist in gathering the data and evidence needed for the submission; for example, clinical records, x-rays, email exchanges between the complainant and practice and recordings of telephone calls. Practice managers should also emphasise the need for staff to keep good, and contemporaneous, clinical records so that, if a concern is raised, they can be easily accessed and are of good quality. It’s important to note that the evidence we are looking for is not just to support the complaint, we want as full a picture as possible, including mitigating evidence.

However, practice managers should also bear in mind that because concerns are raised about individual veterinary surgeons or veterinary nurses we want an account of the incident in question to come directly from them, without interference from management. Practice managers may also coordinate the process in terms of checking to make sure that the individual, and any other staff who may have to submit witness statements, are submitting their evidence promptly. Persistent failure to respond to requests may be considered a professional conduct issue itself and therefore an aggravating factor in the case. Practice managers can also play a vital role in terms of support for the individual who has been complained about, as well as any other staff who may be called on as witnesses. Having a concern raised against them can be understandably very upsetting and stressful for the individual and so practice managers can help them keep things in perspective and support them through the process, for example, by providing sufficient time for them to gather evidence and compile their submissions. Practice managers can also signpost staff towards sources of emotional and practical support, such as the Vetlife Helpline (0303 040 2551), as well as indemnity insurers, such as the Veterinary Defence Society, which offers legal guidance.

Contact us You can find further information on these issues our website (www.rcvs.org.uk). For more detailed or specific advice and guidance, however, you are welcome to contact the Professional Conduct Department on 020 7202 0789 or profcon@rcvs.org.uk

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disseminating any lessons learnt from them with their staff; for example, at clinical governance meetings. Another preventive measure is to make sure veterinary surgeons and veterinary nurses are fully aware of their responsibilities as set out in the RCVS’ Code of Professional Conduct and that they know to consult our supporting guidance if they have any concerns or questions.

HOT TOPIC

THE BURNING QUESTION: Why are so many VNs leaving the profession? The reasons why veterinary nurses opt to pursue other careers have been long-debated on nurse forums and at congresses, but little appears to have changed. RVN Helen Tottey posed questions to a VN group on facebook and received some honest – if uncomfortable – answers as to what could be done to stop the attrition.

Liz Cox, Chair of VN Council “More training practices overall, but particularly in areas such as Wales, where there relatively few, would be welcome and help more people enter the profession. However, encouraging people to stay in the profession in the long-term is the real key to tackling the shortage of VNs. From the feedback I have received from fellow members of the profession since becoming Chair of VN Council, some of the main issues cited have been lack of career progression, poor pay, balancing work and family life and veterinary nurses feeling under-valued in clinical practice. The VN Futures project, a companion project to Vet Futures, will be looking at finding solutions to the issues surrounding retention of veterinary nurses.”

n September 2015, the Vet Futures monthly blog asked: “Where are all the veterinary nurses? Is there a need for another training option?” This blog post received one of the highest numbers of comments and voters to the poll, proving this really is a “hot topic”. So where are all the veterinary nurses and why are they leaving the profession they work so hard to become part of? Thinking back to when I qualified, I remember being both excited to put on my green uniform and feeling uncertain as to what this meant for me over the coming years – and I certainly couldn’t have predicted the path my career did take! I couldn’t rely only on my experiences, so I asked nurses on the Vet Nurse Wish List, a facebook page, and the results have formed the basis of this article. To uncover why there is a veterinary nurse shortage I think it is first important to understand who veterinary nurses are. Have you ever thought about the characteristics of a veterinary nurse? We know they are passionate about the patients they care for, work hard, often finishing work later than their scheduled hours to help out colleagues or patients, and are good cleaners(!), but is that all? Most student nurses come in to veterinary practice from school, but already a key characteristic has shown itself before they work their first shift, and that is determination. With 39 per cent of VNs reporting they applied to 13 or more

practices for a training position, this career has not been entered into lightly. But gaining that placement doesn’t mean plain sailing from there onwards, as 30 per cent of respondents told me they subsequently moved training practices. The comments included: • “Didn’t get on with the people in my training practices” • “ Poor commitment to training from the practice, and difficult working environment” • “No support, bully of a clinical coach. Generally unhappy” But with perseverance as another personality trait, the student nurses continued to work towards gaining their veterinary nurse qualification.

Role of the training practice The training of student VNs has changed a lot over the years, with varying degree of responsibility on the training practice (TP) to ensure all areas of the nurse progress log (NPL) are completed in accordance with the RCVS’ requirements. Students need a lot of support and help from the veterinary team to learn the skills to enable them to pass the exams and, from a practice owner perspective, this time can be costly. Some practices even state it is a full-time job to train student nurses. However, a vet student will also need time and even patients to practise on, and the same goes for a new graduate. The difference is, the effort put into vets’ training seems to Practice Life z March/April 2016 z www.practicelife.biz

HOPT TOPIC

VPMA’s comment on VN training “As practice managers, we need to ensure that our nurses are being developed to their full potential. Some clarity is required at times as to what RVNs can actually do under the current “Schedule 3” legislation, and this should be made clear to the whole veterinary team. I think it is important we, as managers, speak to our nurses and ensure we have a robust review and development programme in place so that a clear career path is available. This is essential if we want to retain our nurses. we need to make them fee-earning in their own right, so that they become part of the profit-making area of our balance sheets – not remain as part of the costs!”

be more readily accepted by vets, who seem to find the time to do it, so why is it any different when it comes to training nurses? Is it, as the VNs on facebook report, because they feel less valued so less time and effort is afforded them in their training and development compared to a veterinary surgeon? Is it because, in the mind of the practice owner, a vet will earn the business thousands, but a nurse…? I believe the way practices think about training students and the benefits they bring needs to be re-thought if the profession is going to find a solution to the shortage of veterinary nurses. It doesn’t stop there, though – it is not just a change in the way of thinking about nurse training that is needed, what about those who are already qualified? The VN qualification enables the holder to perform a range of clinical and non-clinical aspects of patient care, and it is this variation that nurses value. This comment sums it up: “I absolutely love my job; not necessarily because of where I work, but because of the type of work an RVN can do.” But VNs’ experiences differ according to the type of practice they’re in. Referring to the question: “As an RVN, has the job role met your expectations?” one nurse commented “It is practice dependent; some vets have and do utilise my skill set as an RVN, some use me as a glorified cleaner”. The type of work undertaken by a VN can impact job satisfaction and contribute to the reason why he or she will leave a job or even the profession altogether. Most nurses train in one practice so only ever experience one work environment and type of work. For example, a student training in a one-vet or small branch practice will not learn the same as one who has a placement in a large hospital. Broadening VNs’ training experiences may help give a clearer picture of what type of work appeals to an individual. This might help the 20 per cent of respondents who answered that the VN job had not met their expectations. The biggest question, however, still remains. When the facebook VNs were asked: “are you, or have you ever, considered leaving veterinary nursing?” shockingly, 54 per cent answered yes. The reasons given included: “I thought RVNs would be more respected;” and “[leaving for] better pay, more chances of responsibility, extended scope of role and career progression – nursing’s pretty much a dead-end job”. After qualification these ambitious and determined individuals, who want to develop and continue learning and www.practicelife.biz z March/April 2016 z Practice Life

contributing to their profession, find there is little career progression. For this reason, 52 per cent of participants said they would look for work outside of the veterinary industry. The top three reasons for considering leaving practice were: •P ay: “I get paid less than the receptionists where I work currently.” •L ack of recognition: “Increased recognition of RVN capabilities by vets and the public.” • Weekend working: “Less on call/weekends.” It may not surprise you to read that pay is a reason for nurses leaving the profession, but it may surprise you that in our responses, it was tied in place with a lack of recognition. I believe this is further evidence of the positive character traits of veterinary nurses, who do not expect a large salary, rather they are motivated by appreciation and the opportunity to progress their career. One nurse commented: “Appreciation with a small pay rise. The opportunity for promotion.”

So what is the answer? The way to encourage more VNs to stay in the profession is to treat them as the professionals they have become or are aspiring to be. The shortage of veterinary nurses cannot be changed overnight, but I believe there is something that you can do to start to make a change. Find time to take a look at those hardworking students and VNs and ask yourself what it is about that individual character and colleague of yours that is contributing to your business. Then go and ask them what they think; what their ideas are and let them know they are valued. Ensure they know they are an important part of the team while at the same time making sure all the other colleagues know that you feel this way about your team. Promoting a culture of value and support won’t cost anything, but it will mean a lot to those working with you. And together, over time, your practice can inspire new students who will go on to train future generations of nurses in the way they were trained. A happy VN is a productive VN and is worth a lot, not only to patient welfare and care, but also to a veterinary business. Without them, the future of the veterinary profession would look like a much poorer place.

SPVS’ view on VN training SPVS would encourage its members to offer VN training in their practices. Some practice owners are put off by the financial implications, but there are several options that help to keep costs down. Nurse retention is likely to be better in well-run, happy practices with good profitability, where morale is good, salaries are fair, career development is encouraged and funded, and where there is a sensible approach to staff members’ work-life balance. RVNs are an asset to veterinary practices and without the support of vets their numbers won’t increase to the level required for all practices in the UK to be able to employ at least one!

Helen Tottey, RVN, worked as a consulting nurse before owning her own practice and now works for Mojo Consultancy and Onswitch.

HOT TOPIC

CASE STUDY: WHERE HAVE ALL THE VNS GONE, ASKS TRUDY LANGDALE Trudy Langdale, a vet at Porchester Vets in Hampshire, discusses how her practice tackled the issue of a shortage of veterinary nurses by liaising with their local training college and becoming a TP.

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We opened our practice in January 2014 with three staff – a vet, a vet nurse and a practice manager/ receptionist. After a few months we advertised for another part-time VN but to no avail. Other local vets were reportedly having the same issue of not being able to find a VN. It appears that many nurses in our area have turned to locum and night work as these fit better around family life. Some have been absorbed by referral hospitals and others have taken the company rep route. Some have sadly given up completely. It seems we now have a situation where fewer nurses are being trained, even though the actual need for VNs has not reduced at all. Our supplies are drying up! We thought one solution to our problem might be to become a training practice, but when we looked into it, we found the costs of becoming a TP were very high, especially for a new practice with obvious financial constraints. We had enough cases coming through our doors to be able to train a student nurse, lovely new premises and plenty of equipment (our practice is RCVSaccredited), but were not in a position to easily increase our outgoings to cover the full-time salary and training fees. We have gradually increased our staff numbers over time, but slowly and not in the strategic way we had planned for our business: a year on, we have one full-time VN, a part-time VN, a part-time ACA and a new vet starting soon. Very happily for us, Sparsholt College has now waived the fees that a practice would pay for placement of a degree student, so we are becoming a TP and have a student nurse lined up to join us in January for her first two-month stint. She approached us directly last summer when she could not find one practice local to her who could give her a two-week work experience placement before she started college. We are looking forward to having her back with us; it will be good for us and will help us stay current with our practices and CPD. This kind of gesture by Sparsholt may help relieve the general situation over time, but for the effect to spread, other colleges will need to follow suit. They have been really helpful regarding our clinical coaching, doing as much as

What the BVNA says “BVNA agrees that retention in the VN profession is an issue that needs to be looked into and addressed. There are a number of reasons stated in the RCVS 2014 Survey of the Veterinary Nurse Profession, including: • 71 per cent cited that poor pay led to difficulties making ends meet • 54 per cent said that they did not feel valued or rewarded in non-financial terms. • 48 per cent were dissatisfied with veterinary work (eg, hours/stress). • 46 per cent had thought about a career change • 40 per cent said there was a lack of career opportunities However, it is not as simple as just paying more. While salary is always cited as a big factor, nurses really want an opportunity for progression and recognition of their abilities. This recognition may be in terms of advanced qualification, more responsibility within the practice, or defined areas of interest, such as clinical coach training, consultation skills and community work. There needs to be a clear pathway within the profession that allows progression not only in practice, but also to other roles across the wider profession for those RVNs who want more after qualifying. Encouraging a more diverse range of skills within practice and a recognised and structured educational framework for nursing to work within will open up clear routes of opportunity. There could also be scope for RVNs to develop teaching careers alongside practice hours. There is of course the allowance of being more family friendly with working hours and allowing flexible working arrangements for young families that will encourage mothers and fathers to come back in to the profession after maternity or paternity leave. BVNA will continue to work alongside other representative organisations, such as SPVS and VPMA, to encourage these changes within the owners of practices and the regulatory and educational institutions to develop opportunities for RVNs post-qualification.”

possible in the practice. We have heard from our student that a good percentage of her year group did not have a placement arranged by the October deadline, which is crazy – we want VNs, we need VNs, but the cost of training them, both financially and in time spent teaching, has been so onerous that we aren’t training them or making student placements available. I am concerned for the future of the profession and the safety of our patients if this lack of VNs continues. I will be watching with interest what happens over the next few years.” Practice Life z March/April 2016 z www.practicelife.biz

IN THE SPOTLIGHT

in the SPVS President Nick Stuart caught up with Katherine Eitel, whose leadership approach is to empower individuals to lead instinctively, to reflect on the week she spent with UK vets and managers at two SPVS events

SPVS Spascene delegates share their top take-home messages • Challenge belief systems about employees’ potential • “Get into the flow” ie, get into the right frame of mind before team meetings and particularly ahead of difficult conversations • Don’t approach difficult situations with a “here we go again” attitude • Avoid saying “but”, try to replace with “and”. As in “you’re doing a great job there, but…” • Take time out to plan what to say and rehearse the language you’ll use • Don’t assume that failings are someone else’s fault; analyse and take responsibility for your part

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Veterinary owners and managers are a highly intelligent bunch of committed and passionate people who want to make their businesses work,” was Katherine Eitel’s conclusion after talking at two SPVS regional meetings: SPVS/VPMA Focus on HR Day and the two-day inaugural SPVS Spa Scene. Katherine, who lives in California, is the brains behind Lioness Learning, a successful consultancy that works largely with the US dental profession. It was interesting to hear her reflections of a week spent with UK vets and managers on the differences and similarities between the two profession and the two nationalities. A recurring theme was vets’ reluctance to be seen – by staff or clients – as having increased profitability as a key objective. Katherine tackled this from a leadership rather than a business perspective, encouraging practice leaders to see that making money was a legitimate goal, particularly if they and their staff could

• Don’t assume that failings are all your fault; involve the whole team in assessing what went wrong and agreeing how to avoid it in the future • Mature as an adult in order to become a good leader; you owe this to your staff • Work hard at leadership; good leaders are not necessarily born that way and it can be learnt and continually fine tuned • Have a vision; write it down and share it with the team. Continually review it and let it evolve and develop over time

see that this would, in turn, lead to achieving further goals and ambitions, such as buying better equipment or employing more support staff. At the Herts and Beds regional SPVS meeting, Katherine dispensed with her planned presentation and had a big conversation with the audience of vets and managers, a number of whom were from equine or mixed practice. These vets, she discovered, were finding it even more challenging than those in small animal practice to open a discussion about money with their clients and to ask for payment up front. Her suggestion was to present this to the horse or pet

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owner as something that was in their best interest. “How about if you were to put to them that that by getting the money conversation out of the way first, you can move on to the important issue of doing the best job you can for their animal?” Katherine also pointed out the difference between quoting a price to a client and having a full financial conversation. A happy client is one who feels he or she has received a good service at a sensible price. For that to happen, a client needs to be fully informed and their expectations must be met. It is not fair to put your reception staff in the position where they have to explain to a

IN THE SPOTLIGHT

client why a bill is £2,000 rather than the £500 they were expecting. A full financial conversation, Katherine explained, is one that covers not only how much the bill comes to, but why, how it is broken down, when payment should be made and how it will be made. If that conversation isn’t handled properly with the client it can become a defensive justification of a perfectly reasonable bill, followed by a prolonged period of chasing an unhappy client for money. Your whole relationship with that client changes and, in a small community, that can mean a client who might otherwise have been singing your praises, telling her friends that she feels you have ripped her off!

Develop good leadership skills These might not sound like conventional leadership issues, but Katherine explained that good leaders are those who can themselves have difficult conversations and who realise the potential in their staff to operate in the same zone. A good leader is one who thinks about and prepares for every conversation with their staff or clients and who is always “in the flow”. Being “in the flow” is where you are in control of what you say, how you feel and how you react at all times. Someone in the flow doesn’t accidently open a difficult conversation by the water cooler or snap at a member of staff in the middle of reception, provoked or not. And they won’t approach challenging situations with a sigh and a feeling of here we go again. Good leaders are almost always in the flow and recognise quickly when they are not. Perhaps most revealing is that Katherine believes good leaders are not necessarily born, but are made, and the true sign of a good leader is someone who realises just how hard you have to work at it and keep working at it. Keeping up momentum through the open chat session, appraisals were discussed along with general conversations about how to help your staff reach their potential. Katherine believes that good appraisals shouldn’t solely judge past performance, they should focus on creating a plan for the

future. She refers to her appraisal model as a “growth conference” – both manager and employee complete a form that asks each to describe areas where the employee is performing well and not so well (no less than two, no more than four) to identify where there could be some improvement or further training. “It’s amazing how often you agree on performance and improvements. Starting an appraisal with agreement is a fabulous place to begin the conversation of growth,” says Katherine. On the form she asks for specific examples of each high-performance area as well as specific behaviours required for each improvement. The next review period is agreed between the employee and the manager and always held within a year, maximum.

Spascene feedback One of the biggest take-home messages quoted by the Spa Scene delegates was the revelation that it is our duty as owners and managers to encourage, enable and share with our staff. Katherine encouraged us to develop a vision for our practice and to share it with the whole team. Staff, in turn, should be encouraged to share their personal vision, which must also be in the interest of the practice. One manager questioned whether personal ambitions were always realistic and gave the example of a nurse suggesting in her appraisal that she would like to go on a dog psychology course. Katherine said that if the nurse felt part of the vision for the practice she would be more likely to say “Should we be offering dog behaviour classes because the vets and receptionists say clients ask for them, and perhaps I could take a qualification in dog behaviour?” Suddenly the conversation becomes about how realistic that is within the practice – is market research required to assess the demand? Is there suitable space within the practice? How much time and money it would it take to train? And how much should the practice charge for consults? The nurse and the owner are working together towards a shared vision of making the practice more client focussed and more profitable.

A simple device that Katherine uses with her own staff, particularly at a first appraisal, is to ask them what is great about their job and what they really enjoy. That might lead on to asking them what isn’t so good and what they would like to change.

Invest in staff training Another observation from Katherine’s week spent with the veterinary profession was that she heard several people complain that it was so difficult to fit in staff training because the surgery always had to be open. She felt the reluctance to close a practice’s doors was something she hadn’t seen in the US. She asked why a practice couldn’t just stick a notice on the door and on their website to say they are closed Wednesday afternoons for staff training and will answer emergency calls only. One delegate admitted that one of the practices in their neighbourhood did that and as far as they were aware it hadn’t impacted their footfall. Katherine is a firm believer that leaders within a service industry should apply their leadership skills to dealing with clients as well as staff as the rules are the same. Vets, in particular, can apply the same techniques of being a good listener and tuning in to what clients actually mean as well as what they say. Pet owners want to make informed decisions and don’t want to be judged regardless of the decision they make. The role of a good vet is to help clients make the right decision for both them and their pet at a price that suits. Katherine concluded by saying she’d had a fantastic week in the UK and felt privileged to have had an insight – both on this trip and her trip to SPVS/ VPMA Congress 2014 – into the veterinary profession in the UK. “It is very obvious to an outsider that you are in the midst of a revolution. I can see for many of you this can feel quite frightening, but you will come through the other side saying ‘I can’t believe we went through that, but we did and we survived!’” You can read Katherine’s blog, Monday Morning Stretch, at lionesslearning.wordpress.com.

Practice Life z March/April 2016 z www.practicelife.biz

WELL-BEING

EXERCISE AND PHYSICAL ACTIVITY AT WORK: WHAT’S THE EVIDENCE? Evidence suggests that higher levels of activity can bring both mental and physical benefits and employers should help encourage employees to be more active, writes Rosie Allister.

cruel irony of veterinary practice is that while we are often great at preventive medicine for our patients, our lifestyles and work demands don’t always leave much time for us to look after ourselves. In the typical veterinary day, free time is often short and multiple competing demands mean our own health can come low on the priority list. [If you could take back just a few minutes a day to look after yourself, what would be the best-evidenced thing you could do? There’s lots of advice on this; when talking with vets about wellbeing I sometimes look at ways to incorporate the five ways to wellbeing (fivewaystowellbeing.org) into the working day. Connecting, taking notice, learning, giving, and being active might sound simplistic, but there is good evidence that they can help with mental and, in some cases, physical wellbeing. Perhaps the largest evidence base lies with the last one of the five: being active. If you’ve just spent all day on your feet operating, or lifting obese and poorly packaged pets in nonergonomically designed carriers onto a consult room table, I know from experience the most appealing way to spend your small amount of free time may be with your feet up, but the evidence for activity for health is compelling.

Benefits of exercise So what is the evidence for the benefits of physical activity? The government and chief medical officer issue recommendations for physical activity based on a large and detailed evidence base (Figure 1). There is a causal relationship between the amount of physical activity people do and all-cause mortality. Physical inactivity is now the fourth biggest risk factor for global mortality. Regular physical activity (30 minutes of moderate intensity physical activity on at least five days a week) can reduce the risk, and help to manage more than 20 chronic conditions, including coronary heart disease, stroke, type-II diabetes, cancer, obesity, mental health problems and musculoskeletal conditions. Even small increases in physical activity are associated with some protection against chronic diseases and an improved quality of www.practicelife.biz z March/April 2016 z Practice Life

Figure 1. Physical activity: definition and current UK recommendations. Reproduced edited from CMO (2016) and NICE (2016) Definition Physical activity includes everyday activities, such as walking and cycling and work-related activities, such as housework, DIY and gardening. It also includes recreational activities – working out in a gym, dancing, or playing active games, as well as organised and competitive sport. National recommendations The CMO’s recommendations for physical activity state: Adults 19 years and over should aim to be active daily. Over a week, this should add up to at least 150 minutes of moderate intensity* physical activity in bouts of 10 minutes or more. - Alternatively, comparable benefits can be achieved through 75 minutes’ of vigorous intensity activity spread across the week or combinations of moderate and vigorous intensity† activity. - All adults should also undertake physical activity to improve muscle strength on at least two days a week. - They should minimise the amount of time spent sedentary (sitting) for extended periods. - Older adults (65 years and over) who are at risk of falls should incorporate physical activity to improve balance and coordination on at least two days a week. - Individual physical and mental capabilities should be considered when interpreting the guidelines, but the key issue is that some activity is better than no activity. * Moderate-intensity physical activity leads to faster breathing, increased heart rate and feeling warmer. Moderate-intensity physical activity could include walking at 3 to 4 mph, and household tasks, such as vacuum cleaning or mowing the lawn. † Vigorous-intensity physical activity leads to very hard breathing, shortness of breath, rapid heartbeat and should leave a person unable to maintain a conversation comfortably. Vigorous-intensity activity could include running at 6 to 8 mph, cycling at 12 to 14 mph or swimming slow crawl.

life. Benefits of physical activity can also extend beyond health, improving workplace productivity (WHO 2010; Chief Medical Officers, 2011) There is a curvilinear dose-response relationship between physical activity and diseases such as coronary heart disease and type-II diabetes; it generally holds that the higher the level of physical activity or fitness, the lower the risk of disease (Department of Health, 2004). There isn’t enough evidence yet to recommend specific amounts of activity to prevent conditions, but as the evidence base grows we understand more about what types of activity can help.

WELLBEING

Exercise and mental health Having worked in veterinary practice, and spoken to a lot of vets in different areas of veterinary life through Vetlife Helpline and my research, one of my areas of interest is how physical activity can benefit mental health and wellbeing. Physical activity can have a positive effect on wellbeing, mood, sense of achievement, relaxation and release from daily stress (Chief Medical Officer of England, 2011). The Royal College of Psychiatrists makes recommendations for the types of exercise that can help with mental health and wellbeing, (Figure 2), emphasising how exercise can give back feelings of control, offer an escape from other pressures, and be a source of companionship. For those living with symptoms of a mental health condition, meta-analysis and reviews suggest that exercise and physical activity may also bring benefits. Physical activity may reduce depressive symptoms across a range of mental health conditions (Rosenbaum and others, 2014). We still need to understand more about what can help people with mental health conditions adhere to an exercise plan as it may be difficult to function at all when affected by severe depressive symptoms and fatigue, and exercise may not feel achievable. The Royal College of Psychiatrists recommends using SMART goals and to increase exercise gradually (RCPsych, 2016). S – Specific M – Measurable A – Achievable R – Relevant T – Time-based

Sacrifices and barriers to exercise There is some guidance on understanding the barriers to physical activity (NICE 2008, CMO 2011). When I’ve talked with vets in practice about their options for exercise, time is often felt to be a major obstacle, or physical factors such as ease of access to safe exercise when working long hours on call. I’m often struck when talking with new graduates or final-year vet students about their involvement in sport and exercise by how many of them have sacrificed activities they were talented at, and got great pleasure from, in order to prioritise their studies. Veterinary work is vocational and when things are going well in the practice all is good; however, if there is a problem at work – a bad clinical outcome or complaint for example – and somebody has no outside interests, they may be vulnerable to developing wellbeing issues.

How employers can help Employers can help task-saturated, time-poor veterinary staff to increase their physical activity. The National Institute for Health and Care Excellence (NICE), publishes guidance on physical activity in the workplace (NICE, 2008). It recommends employers in organisations of all sizes should develop an organisation-wide plan or policy to encourage and support employees to be more physically active. It should be supported by management and have dedicated resources. An organisation-wide, multi-component programme to encourage and support employees to be physically active is recommended by NICE, including the following:

In Association with Vetlife

Figure 2. Activity for Wellbeing, from Royal College of Psychiatrists (2016): Physical Activity and Mental Health Activity for mental health should: – Be enjoyable – if you don’t know what you might enjoy, try a few different things – Help you to feel more competent or capable – Give you a sense of control over your life – that you have choices you can make (so it isn’t helpful if you start to feel that you have to exercise). The sense that you are looking after yourself can also feel good – Help you to escape for a while from the pressures of life – Be shared. The companionship involved can be just as important as the physical activity

• flexible working policies and incentive schemes; • policies to encourage employees to walk or cycle to work and to do these activities outside work; • communication (including written information) on how to be more physically active and the associated health benefits of such activity. This could include information on local opportunities to be physically active (both within and outside the workplace) tailored to meet specific needs, for example, the needs of shift workers; • ongoing advice and support to help people plan how they are going to increase their levels of physical activity; and • the offer of a confidential, independent health check administered by a suitably qualified practitioner and focused on physical activity. The evidence this guidance is based on is interesting: one study on workplace activity found that posters to encourage stair climbing may have an effect, but only short-term; others found that using pedometers and setting goals may increase step counts; that workplace screening and health checks can help to increase physical activity; and that health information may help in some situations. It may not be possible for vets to avoid driving to calls or to work if they need a car for being on call, but providing safe facilities for exercise, whether that be through subsidised gym membership, or facilities at work for people who have to work long hours and/or be on call. Evidence suggests sedentary behaviour is independently associated with all-cause mortality, type-II diabetes, some types of cancer and metabolic dysfunction. There’s also an association between sedentary behaviour and being overweight and obese. Interestingly, these relationships are independent of the level of overall physical activity, so, spending large amounts of time being sedentary may increase the risk of some health outcomes, even among people who are active at the recommended levels (Sedentary Behaviour and Obesity Expert Working Group, 2010). Standing desks, facilitating brief activity breaks and periods of walking to break up periods of sedentary work can help (Figure 3). Practice Life z March/April 2016 z www.practicelife.biz

WELL-BEING

Figure 3. Tips to increase physical activity • Buy a pedometer or activity band/monitor – some people find pedometers, wearable tech or apps that measure physical activity through the day can be motivating and help increase activity and energy expenditure. • What’s available for free? – there are lots of free schemes that can help with community and group participation in exercise, for example: Parkrun offer free weekly 5K timed runs, currently at 379 locations around the UK. Visit www.parkrun. org.uk Sustrans is a UK charity enabling people to travel by foot, bike or public transport for more of their journeys. They can work with employers to promote active travel and work to develop high-quality walking and cycle networks. www.sustrans.org.uk • Take the stairs – as simple as it sounds. • Stand up – also simple. Consider standing desks, stand up while talking on the phone. • Walk – even five-minute walking breaks can help physical and mental health. Have walk meetings where you can; turn meetings with others in the practice into a short walk. Difficult conversations can be easier when walking too! • Find a sport you love – as well as increasing daily physical activity in general, structured exercise like sport or fitness training can bring further benefits.

The University of Edinburgh offers a free online course in increasing physical activity, starting in May 2016. More details may be found here https://www.coursera.org/learn/get-active For confidential emotional support call the Vetlife Helpline: 0303 040 2551, or email via our website https://helpline.vetlife.org.uk/ References CHIEF MEDICAL OFFICERS OF ENGLAND, WALES AND NORTHERN IRELAND (2011). Start active, stay active: a report on physical activity from the four home countries’ Chief Medical Officers. Crown. DEPARTMENT OF HEALTH (2004). At least five a week: Evidence on the impact of physical activity and its relationship to health. A report from the Chief Medical Officer. NICE (2008). NICE Guidelines: Physical Activity in the Workplace. RCPSYCH (2016). Physical Activity and Mental Health [Online]. Available: http://www.rcpsych. ac.uk/healthadvice/treatmentswellbeing/physicalactivity.aspx [Accessed January 2016]. ROSENBAUM, S, TIEDEMANN, A, SHERRINGTON, C, CURTIS, J & WARD, P B (2014). Physical activity interventions for people with mental illness: a systematic review and meta-analysis. The Journal of clinical psychiatry, 75, 964. SEDENTARY BEHAVIOUR AND OBESITY EXPERT WORKING GROUP (2010). Sedentary Behaviour and Obesity: Review of the Current Scientific Evidence. London: Department of Health. WHO (2010). World Health Organization Global Recommendations on Physical Activity for Health

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MANAGING PEOPLE

MAKING THE MOVE into management...

Moving into a position where you either have direct management responsibility, or at least some form of responsibility over the performance of others, is a career goal held by many. But once faced with the reality of management there are many issues that may catch you by surprise – Nick Steele guides you through.

hat does it mean to manage people? What’s the difference between management and leadership? How do I apply these in my day-to-day work? what does it actually mean to manage a team’s performance? Let’s explore these topics in turn. When you have responsibility over others, it’s important to take a step back and examine your position within the practice with regard to the stakeholders around you – think in terms of the following: • Who are my stakeholders (those above you in the management hierarchy, those below you and those who are your peers)? • What is important for them to do their job well? What are their priorities? • How will these stakeholders affect you and your role within the practice? • How will you impact upon them? What do you think they will expect of you? Taking time to think through these questions will provide you with good insight as to where you fit and what will be expected of you. Sit down with your own manager after doing the exercise to talk through your thoughts and gain their feedback so you both have absolute clarity on what’s expected of you. What about management and leadership? Will you be expected to be more of a leader or a manager, or will it be a combination of the two? What is the difference anyway? In simple terms, leadership is about identifying and describing the strategy the team will follow to achieve the desired goals and inspiring them to deliver the goal, whereas management is more about supporting the team to action the tactics that execute the strategy and ensuring they are performed in the right way. A quote from Covey (1989) perfectly describes this difference: “Management is efficiency in climbing the ladder of success; leadership determines whether the ladder is leaning against the right wall.” Or the version by Drucker (2000): “Management is doing things right. Leadership is doing the right things.” It’s important to reflect on this and identify if you are naturally more of a leader or a manager and then look back to the stakeholder exercise and see what the role requires you to be – leader, manager, or both? This is such an important foundation to establish as you can probably see how it can go

wrong if you don’t get the balance right. There are many tools out there to identify what your natural leadership style is, but the one I like describes the natural styles as: • Controlling: very good at defining goals, setting standards and giving clear instructions; can be overbearing and inflexible • Influencing: strong social and persuasive skills, can identify the needs of others and use them whilst negotiating; can be manipulative and coax others into decisions they would make themselves • Conferring: include the team in decision-making, clear sense of task, good at making a final decision; might consult with the team, but not adopt ideas • Involving: open and diplomatic, seek team consensus; might take too long to make decisions by seeking consensus • Delegating: empower team to make decisions, make good use of resources; might give too little instruction, might give too much autonomy to the team The key here is that we all possess each of these styles, but display them differently; we will have one or two that are very natural to us, but the others are styles we consciously need to work on. An interesting exercise is to think about the stakeholders above you in the hierarchy and identify what their natural style is. So how do you know when to use the different styles? Just as there are styles for leadership and management, there are supportive needs styles for team members: • Autonomous – get on with things; • Receptive – tell me what is expected of me; and • Participative – I want to work with my manager to identify actions.

The two sets of styles fit together as follows: You can see how getting the combination right is essential and how some combinations would not work well at all. Now we’ve worked to identify what’s expected of you, whether you need to be more leader or manager, what your natural style is and how to apply your style flexibly, let’s move on and think Practice Life z March/April 2016 z www.practicelife.biz

MANAGING PEOPLE

about managing the performance of a team. When we start to diagnose the performance of an individual, there are a number of factors that need to be considered: • experience/competency level of the individual; • skill set of the individual; • motivation and attitude of the individual (their level of will); • any issues that may be affecting performance, such as environmental changes or personal circumstances. Let’s look at some tools that support each of these. The model I like to use to set out the experience level of an individual team member is the competence ladder:

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This describes how we build ability, or competence, when we embark on a new role or learn a new skill. Team members at the various steps of the ladder will display different behaviours, which will help you diagnose their competence level and you can apply this to their role, or to specific tasks they need to perform:

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MANAGING PEOPLE

Motivation

The next step is to layer on their level of motivation and here I use the ‘Skill/Will’ matrix. Notice that the competency ladder falls along the horizontal axis – steps one and two will fall into the ‘low skill’ quadrant and steps three and four into the ‘high skill’ quadrant. You need to use your observations to diagnose the team member’s level of will or motivation. It’s a really good exercise to map your team onto this matrix as it identifies what you need to do with the individuals in each quadrant:

References: Covey, S R (1989) Seven Habits of Highly Effective People, Drucker, P F (2000), The Essential Drucker

MANAGING PEOPLE

When we identify team members with low levels of will, we need to take one more step to diagnose the performance issue and here I use the BECKS model:

You use this model by working up from the bottom and answering yes or no to the questions it asks:

1. Does this colleague have the necessary skills? No: training 2. Does this colleague have the necessary knowledge? No: training 3. Does this colleague have clarity on what’s required of them? No: feedback and provide clarity 4. Is there something within the work environment affecting their motivation? Yes: address the issues 5. This is chosen behaviour and needs to be addressed through the appropriate process Time and time again, the BECKS model reveals that it is a lack of clarity that’s responsible for performance issues – think back to the beginning of this article when we talked about you seeking clarity from your manager on what’s expected of you. So, while not an exhaustive list of what to do when moving up into this type of role, I hope that working through the various exercises I’ve described will at least provide you with a good foundation on which to build.

Nick Steele, national consulting manager at Zoetis, is responsible for managing the consulting business to deliver business improvement to veterinary practices across the UK. Joining Zoetis in 1997, he has a proven track record in a variety of business management roles and more than ten years’ experience in learning and development management roles helping to develop Zoetis leaders at all levels across the business and facilitate organisational change. Nick now applies his expertise, knowledge and skill in helping develop veterinary practice teams to enable them to deliver business results now and for the future. He is also a regular speaker at both major veterinary events and CPD meetings.

CLIENT CARE & MARKETING

MAKE THE MOST OF YOUR DATA The powerhouse of any practice is its database, but it must be maintained and updated to maximise returns from client marketing campaigns, writes Kingsley Daniels.

he efficient creation and management of client databases is critical to the success of a practice and its marketing processes. It is also vital when considering the valuation of a vet practice. While most people can appreciate the role their database plays in organising clients and maintaining up-to-date contacts, it is the most forwardthinking practices that understand how a well-managed database is far more powerful than simply being a source for the odd mail merge. The ability to manipulate data and details via a practice management system gives practice staff the flexibility to devise and execute targeted marketing campaigns that will improve their business outcomes. But there is no silver bullet to database management. Success relies on constant and continuous care in order to maintain data in a useable and relevant form, and managers and business owners need to both appreciate its value and have in place appropriate processes to ensure data management is an area that is given the consideration and resources it deserves. In my opinion, there is a simple three-step approach to achieving best practice in database management: first, ensure client contact information is up to date and complete; second, use segmented data to create targeted campaigns; and third, have in place a process by which to capture response and measure return on investment (ROI).

Data cleansing and updates Every piece of communication activity a practice undertakes is driven from the data points within its practice management software, so it follows that if the data is inaccurate the activity is less likely to be successful. Data cleansing is an arduous but necessary task. Ensuring that client data is as complete as possible is vital for effective communication. The various practice management systems deal with this in different ways, with some prompting the user to collect critical data or flagging up missing data from certain fields.

Segmented data for effective communication Targeting communications at the relevant audience is the basis of all great marketing and the ability to target specific clients

and/or animals is one way of achieving this. Reports can be generated around products sold and products not sold, which indicate where repeat purchases of prescribed medication have not been continued. This simple analysis enables the practice to identify where gaps in potential additional revenue exist. It follows that a reminder system can then be established for future capture of the repeat activity, which ensures the animal receives treatment for the necessary length of time and the purchase of medication is not left to the mercy of the owner’s memory. Sending this type of reminder is a simple but necessary and highly effective process which can have a significant impact on revenue. Ensuring that all routine communications, including reminders, are set up to automatically send is one of the ways in which database management can play an important role in ensuring client care is top of a practice’s agenda.

Capture response and measure success Establishing protocols that deliver good data management ensures that targeted marketing campaigns can be measured and analysed. Using a practice management system to manage data, execute communication and assess success creates an integrated approach that reduces the amount of human resources required to carry out these functions. Practice management software is now capable of analysing success in terms of numbers of reminders/communications answered, appointments booked and treatments performed in relation to a specific marketing activity, enabling practices to gain a true indication of their ROI. Marketing is sometimes considered a dirty word in professional circles, but if we look at this another way and consider this communication in the realms of client care, I think we would all agree that this is an important message. Communicating the right things to the right client at the right time improves client care and leads to an enhanced client:vet relationship, developing loyalty and, ultimately, increasing revenues. Ensuring that the functionality associated with delivering improved client care is as efficient and streamlined as possible is vital when considering how best to use the data within your practice system. My quest is to demonstrate to vets how simple and easy it is to take control of their database and the positive results that can be derived from this activity. I believe that a huge untapped opportunity exists within practice databases in terms of the ability to communicate with existing clients, as opposed to always trying to attract new ones. The cost of acquiring new clients is clearly greater than selling more to existing ones, and achieving the correct blend of new and existing business is an important part of a vet’s overall business plan. By using the data within your practice’s system more smartly, it is Practice Life z March/April 2016 z www.practicelife.biz

CLIENT CARE & MARKETING

possible to maximise the business gained from existing clients, which can ultimately be supplemented and supported by the acquisition of new clients. The veterinary sector is relatively immature in the marketing arena and practices often don’t know what they don’t know. Left unmanaged, databases can quickly become unwieldy, so taking advantage of training options can be a fantastic investment in terms of harnessing the power of your database.

Kingsley Daniels joined Vetsolutions in February 2013 as Head of Sales and Marketing, having held a number of positions running sales teams in a number of industries. His ability to embrace the nuances of the veterinary market have made Kingsley a knowledgeable and engaging commentator on how techniques and theories from outside the sector can have a positive impact on the growth and success of individual veterinary practices.

HARNESS YOUR DATA TO INCREASE THE QUALITY OF PATIENT CARE The power of data is undeniable in a digital age; get it right and reap the rewards or get it wrong and watch clients slip away. Here, Justin Phillips, VMA Young Marketer of the Year 2013 shows you how one vet group has reinvented its database marketing techniques.

ou already have the data at your fingertips to be able to transform your practice; 2016 is the time to use it. The information contained within your practice management system (PMS) is undoubtedly one of your most valuable assets – on a par with the quality of your team members and a regular flow of new clients.

Targeted, relevant and timely The accuracy of the information in your PMS is the responsibility of the entire team, not just one individual. The client care team must take ownership of ensuring contact information is checked with the client at each visit while the clinical teams ensure data linked to the wellbeing of the pet is maintained. The details contained within your PMS empower you to communicate effectively with your clients at each key stage of the pet owner journey, as follows: • Key milestones – new client registrations; • Compliance reminders – vaccinations and parasite treatments; • Showing how much you care – birthdays; and • Life stages – neutering and senior pet checks. Your practice’s ability to harness this data and produce timely and relevant communications is essential for the health of each pet and for the financial wellbeing of your practice.

Reinventing our recall systems At our practice we had one key objective: to build an efficient and measurable recall system that would provide a quality level of service to our clients and their pets. We looked to boost retention and drive footfall back into all 14 White Cross Vets practices. We achieved this by centralising the process to ensure consistency and accountability. For annual boosters we implemented a

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three-stage process with the initial reminder sent by SMS followed by a second “oops” reminder to non-responders a month later. If a client’s mobile number is not available, personalised cards are printed and posted to reflect our personal approach. To provide the best preventive care for pets failing to attend after two reminders we coordinate phone calls offering a “vaccination amnesty” – a booster or a full course plus health check for a discounted price. Automated SMS appointment reminders are sent daily to remind clients two days prior to their visit, and SMS reminders are also used to recall clients for free six-month health checks, kennel cough vaccinations and parasite treatments.

Results • These enhancements to the reminder system save £28,000 in labour costs per year. The 26 hours that were spent in each practice every month are now directed towards providing a higher level of service for our patients. • Missed appointments have reduced by 28 per cent following the introduction of SMS reminders. • Recall for annual vaccinations has risen from 73 per cent to more than 90 per cent. And my number-one rule: Absolutely no selling! Ever. We’re veterinary professionals not used-car salesmen. Our approach should be consistent with this responsibility at every client touchpoint and across everything we do. Clients trust us to help them take the very best care of their family pet and this is a responsibility that we should all take extremely seriously.

Justin Phillips is Marketing Manager at White Cross Vets, a family owned group of practices with a focus on care and quality.

BUSINESS HEALTH & FINANCE

STOCK MANAGEMENT Stock management is the second biggest expense after staff wages, so to ensure your business is successful, it’s important to understand how it affects your profitability. Here, Nathalie Weatherley takes a look at how to be efficient when it comes to keeping your stock in order.

oone gets it exactly right. At the end of the day most vets are busy putting their clients’ animals’ welfare first. However, practices are often surprised by the amount of money that can be lost through stock errors. If you are carrying too much stock your capital is tied up unnecessarily and there is a greater risk of loss, damage or products going out of date. Too little stock means lost sales, disappointed customers and potentially having to cancel appointments and operations. By getting your stock levels just right, you can release cash flow, reduce finance costs and even insurance liabilities. Every practice needs to determine the ideal stock level for them, many practices reckon on around three to four weeks’ stock in hand. Volumes may vary according to seasonality or to reflect manufacturer deals, but you should be able to rely on your wholesaler to have availability. Whether it’s pharmaceuticals or consumables, there really shouldn’t be the need to stock up. Most of your suppliers will be able to deliver small amounts on a regular basis, so as a practice manager you need to weigh up whether saving a few pounds on an online deal is really beneficial to your business overall. It’s not just about getting the correct level of stock. The discrepancy between stock coming into the practice and stock recorded out is known as the “bleed rate”. In an ideal world, the two would be equal, but in my experience the best case scenario for our industry is around 2-3 per cent. Small animal practices tend to have the lowest bleed rates and large animal practices are naturally higher. Many SA practices are running at around 5 per cent, but I know of a £1 million mixed practice account that started off with a bleed rate of 14 per cent! Reasons for differences in stock levels might include breakages, out of date stock, part-used vials having to be disposed of or even theft. Sometimes there are simple errors, such as products being incorrectly booked in – like the practice that was dispensing a six-pack of flea treatment, but actually only charging for a three-pack. Many practices are astonished to discover that they are undercharging customers or simply not charging customers at all for drug treatment. This can often be the case for farm and equine vets who might be using products in the field and then forgetting to raise charges later. A lot of practices have multiple locations where products are stored, whether it’s the pharmacy, consulting rooms or theatre, and that makes it easy to lose track of items. I worked with one mixed practice that identified £5,000 worth of stock in the car boot of one of the large animal vets. We constantly stock take using a cycle count methodology – using an ABC approach we classify our products to prioritise

our stock. High turnover and high value products are regularly monitored and other products are counted less frequently. We also take into account product seasonality – especially important with large animal pharmaceutical products. One easy way to see the benefit of this approach is to identify 20 products that are important to your business (eg, vaccines, flea and tick treatments, pet food or pain relief) and then stock take those items every week for a month. You’ll be able to pick up on any errors straight away and you and your team will soon realise how important stock management is to your business. It’s a good idea to establish protocols and get the whole team on board. Although it’s good to have one person with overall responsibility, it works best when everyone plays their part. Don’t try to do too much all at once, it will be hard to manage and be a negative experience for all involved. Aim for manageable chunks to start with and get the systems in place first. Most practice management systems have the facility to do much of the hard work for you. By making sure your product codes are up to date and downloading product data with quantity, batch and expiry information, you are starting with accurate information of what is coming into the practice. Make sure you record any product returns and if out of date stock needs to be written off, make a note. One of the most difficult parts of any stock take is the potential disruption to the working day. Most of my customers dread stock taking because of the need to close the practice or ask staff to come in out of hours or at the weekend to help. Stock management really doesn’t need to be a headache, provided you have a few simple processes in place. It can actually be a really rewarding exercise as many practices can see a real benefit in just a few weeks.

Action Points 1. Determine your ideal stock level 2. Make sure codes and prices are up to date in your practice management system 3. Download product details and batch / expiry where possible 4. Record all sales, breakages and disposals accurately 5. Monitor the locations around the practice, including cars 6. Little and often is best (cycle count) 7. Make the most of technology 8. Consider specialist help and advice from consultancy services Natalie Weatherley, Key Account Manager. Natalie has been with Henry Schein Animal Health for six years, previously working in human pharmaceutical sales. She is part of a team offering consultancy services to UK vet practices and regularly presents to regional VPMA groups on stock management. Practice Life z March/April 2016 z www.practicelife.biz

BUSINESS HEALTH & FINANCE

CASE STUDY: WHAT’S IN THE BOOT? Never has there been a more challenging time to efficiently manage the process of stock maintenance and stock control in ambulatory vets’ cars, writes Julian Samuelson.

et’s be honest, ambulatory vets’ cars are not always the cleanest, tidiest or most hospitable environments for the transport of veterinary pharmaceuticals, but with everincreasing regulation and scrutiny, together with competition from internet pharmacies and threats to remove vets’ rights to dispense, it has never been more important for us to be cognisant of the challenges we face. Essentially, these challenges fall into two categories: stock storage and stock control 1) Stock storage Let’s deal with the “impossible” first, then move on to the “just very difficult”! After having numerous discussions with colleagues, I don’t think anyone in the UK has found an efficient and reliable solution to the storage of “cool-chain” products, such as vaccines and the like. It can be done, as demonstrated by vets operating in much hotter climates, but we in the UK are not geared up for that. The good news is that although there is a requirement for vets to regularly record and log the maximum and minimum temperatures of products stored in vehicles, there seems to be a tacit understanding that making the best effort to achieve the required standard is a reasonable substitute for complete compliance. Let’s hope this pragmatism endures. With effect from November 30, 2015, changes to the Misuse of Drugs Act 1971 has resulted in the reclassification of ketamine as a Class B drug under Schedule 2 of the Act. This means that ketamine is now subject to the same strict storage, prescription, dispensing, destruction and record keeping requirements as other medicines in the schedule. As many ambulatory equine vets will routinely carry ketamine, it is now a requirement for this to be kept in an additional locked unit within the vehicle and for this to be secured to the vehicle’s structure to prevent its removal. A locked car and/ or a locked glove compartment are not considered to be such a receptacle within the meaning of the Misuse of Drugs (Safe Custody) Regulations 1973. Somulose (Schedule 3) should be stored similarly. All other POM products should be stored in a clean and tidy fashion and out of site of the public. Much like a “C list” celebrity or less legitimate drug dealer, this can be achieved by having blackout windows, but most equine vets seem more comfortable with just using vans or boxes and draws. Medicinal products once opened should bear the time and date of first opening and then used according to manufacturer’s instructions. In some cases, this is virtually impossible to achieve without reverting to the product for single use only. For example, the manufacturers’ recommendation for tetanus antitoxin is for it to be used within 10 hours of opening! www.practicelife.biz z March/April 2016 z Practice Life

Vets are, therefore, faced with the decision whether to use the product outside of the manufacturer’s recommendations, charge the client for a whole bottle, or resort to the alternative of using Tetanus Toxoid and hoping that the onset of protection timeframe matches the requirement. Similar dilemmas will occur with other infrequently used products, such as atropine. 2) Stock control Unfortunately, the situation here is not much better. Again, after much research, I have yet to find a computerised stock control process that works for vets’ cars and most practices resort to the tried and tested – but very inefficient – use of lists and clipboards, with the inevitable resulting lack of compliance and reconciliation. It is surprising that in this digital age a workable solution has not yet been developed and this must surely represent a great opportunity for an enterprising pharmaceutical wholesaler or practice management software developer? In the meantime, there are a few good practice protocols that can improve the situation. We now have a standard list of the stock that each ambulatory vet should carry. The list excludes infrequently used items that invariably went out of date before being used, these items can be posted to the client instead. Restricting the selection to frequently used products that come in multi-use bottles also helps to overcome the common 28-day shelf life of these products after breaching. The list also allows for lower volumes of products, so that the car stock is turned over regularly and the product is in the optimum condition before being dispensed. One area where IT has come to our rescue is with the ability for real-time patient-side billing. Immediate or prompt billing of dispensed products is undoubtedly the best way at present of ensuring that the minimum amount of stock is left unaccounted for.

PRACTICE DEVELOPMENT

Working Together: BENEFITS OF SHARING RESOURCES WITH NEIGHBOURING PRACTICES Collaborating with local practices may not seem like the obvious business strategy, but it can reap rewards for client, patient and the practices involved, write Adi Nell and Erwin Hohn a vested interest in the primary practice doing as much as it can before referral, and an opposing interest in the referral practice getting the case early with lots of funds remaining. This is an interesting moral, ethical and professional dilemma – but it’s not a comfortable one. Happily, there are solutions to this. One of these is very well known to the authors – let’s have a look.

From dream to reality

Adi Nell

Erwin Hohn

he challenges facing our profession have been well rehearsed and remain topical, as illustrated by the VetFutures report, released in November 20151. Challenges include work-life balance and financial viability, the rise of corporates and feminisation of the profession, as well as standards of care. There are others: business skills, lack of leadership, excessive regulation and legislation, lack of evidence-based veterinary medicine, competition from non-vets, online pharmacies, the internet and its legions of unqualified “experts”, the rapidly rising cost of offering a comprehensive service, and rising client expectations, to name just some. In an article by Hohn and Nell2 a model of cooperative working is proposed that could change the face of veterinary care. This approach potentially offers solutions to many of the challenges mentioned above. It is how many human community health programmes work around the world, right now. In fact, this model has been employed in the veterinary sphere for almost 30 years – but more of that later. Our proposal was that vets should play to their strengths by allowing each one to do what they do best. We should refer to each other internally or between branches, as benefits each case best. We could work collaboratively with those we think of as competitors. This would improve clinical outcomes, reduce costs and, as a happy corollary, improve profits. This already happens to some degree when we refer to specialist centres, for example. The problem here is that it tends to be a one-way trip: animals go to the specialist for enhanced care, but little flows back to the referring practitioner. Even worse, practices compete with their own referral centres with regard to funds: each animal has a certain “pot” of funds available for its care. There is

It’s a common misconception that corporates are all monoliths. This may be true of some, but others are more of a community of independent practices working together under a common banner. In some senses, the practices could be seen as competing with their local neighbours for clients and market share. But a key attribute of this community is the alignment achieved between clinical and financial outcomes, and the way in which resources and expertise are pooled and shared. There are several ways in which this collaboration is achieved. One critical component is a hub-and-spoke system that encourages clinicians to take advantage of the expertise of their colleagues and the specialised equipment available at many main centre hospitals. The benefits to this system are many. Advanced equipment is expensive and needs to earn its keep. In many practices, ultrasound equipment, laparoscopic kit or MRI units are severely underutilised, both from a clinical and financial perspective. It is difficult to become expert at a technique or the use of a technology unless it is used regularly and frequently. To be expert with a wide array of equipment is harder still. Similarly, the more often a CT unit, endoscope or any other expensive toy is used, the lower the cost per use to the practice. The model we proposed sees these expensive items grouped at main centre hospitals, where they are used far more frequently than they would be in any stand-alone branch or group. This use is enhanced by a system of internal referrals – any branch can send a case to the main centre for an MRI, and pay simply for that single use of the equipment. Similarly, the expertise of the MRI operator, ultrasonographer or laparoscopic surgeon is greatly enhanced by frequent practise. And the referring clinician can learn from the experience of the regional expert by attending the main centre with his or her patient. In this way there is little competition for funds. The referring practitioners can decide how involved they want to be with the case. If they wish, they can accompany the animal to the main Practice Life z March/April 2016 z www.practicelife.biz

PRACTICE DEVELOPMENT

CASE STUDY: MISHA Misha*, Mrs O’Connor’s cat, had been her sole companion since her husband’s death two years earlier. When Medivet’s partner at the Faringdon practice, Graham Pursey, saw Mrs O’Connor and Misha for her annual health check, he noticed a heart murmur. He explained that the sound he was hearing might be nothing to worry about, but it could be something that would benefit from further investigation and treatment.

raham is an extremely competent and experienced general practitioner, with very many years of small animal practice behind him. While he has a keen interest in feline medicine, he is not a cardiologist or ultrasonographer. Presented with Misha, Graham emailed all 250 Medivet vets via the internal system and, within a few minutes, started to receive advice and replies. He drew up a plan of action, including an echocardiogram as one of the early steps. Graham has access to Medivet’s 24-hour veterinary hospital at Woodstock, Oxfordshire. He contacted Woodstock partner, Dimitar Mitev, and agreed a time to bring Misha in for her scan. Dimitar is an experienced echocardiologist and has performed many procedures. His Woodstock Hospital, as the region hub, has a new, state-of-the-art ultrasound and echo machine that he is expert in using. This kit didn’t come cheap, and he wants to use it often so it pays its way. He gets to use his skills and time in an area that he enjoys. He also avoids getting bogged down in all aspects of managing Misha’s care, as he would have with a traditional, direct referral. Another benefit for Dimitar is that he gets to discuss the intricacies of Misha’s findings and care colleague-tocolleague, leaving Graham to speak to Mrs O’Connor. Graham brought Misha over at the agreed time and he and Dimitar scanned her together. Dimitar demonstrated a number of specialised views and approaches to Graham, and also showed him how the various heart measurements were taken. Graham paid only for that single use of Woodstock’s equipment and for Dimitar’s time – a fraction of what it would have cost him to own and run his own machine. And, even if Graham had bought his own machine, would he ever have had the case load to develop his skills to the necessary level, let alone the level that Dimitar can offer? Scan completed, Graham and Misha returned to Faringdon where Graham discussed the findings with Mrs O’Connor. Misha’s murmur turned out to be benign, and no further

intervention was needed. A happy ending for client, patient, Graham and Dimitar! For Graham, the benefits of the Woodstock hospital are not limited to cardiology. The main hospital also provides inpatient care for his animals, out of hours cover, a range of advanced equipment and expertise and, just as importantly, a central hub where vets and nurses meet to discuss cases, share experiences and support each other. Of course, this benefits Dimitar, the Woodstock partner, too. A final thought: this case remained in Graham’s care throughout. The costs to him were very small – a little time and a small financial contribution for the use of the main centre’s skills and equipment. Contrast that with the usual pattern of external referral: little or no input into clinical care, loss of continuity when patients return before the report, little new learning and a total loss of income for the primary care practice.

centre and do all the work themselves before returning with the patient to their practice. Alternatively, the vets might prefer to work under expert guidance. Or they could arrange for the patient to be taken to the hospital where the experts will do all the work for them. In each case, they will pay the main centre a proportion of the fees charged, depending on their level of involvement. Even if the main centre does most of the work, the referring vets will retain the majority of the case fees in most situations. There are more benefits to a hub-and-spoke setup: the main centre provides night and bank holiday cover, and animals can be hospitalised for extended periods without having to move

back and forth between practices daily. The branch clinicians and their patients and clients benefit, as does the main centre, whose specialist skills and equipment are used and paid for far more frequently than they would otherwise be.

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* “Misha” is an illustration, based on similar cases seen at the Woodstock hospital.

What’s in it for me? For clients, they need only pop in to their local practice and see their own vet – the rest happens behind the scenes. This model allows clients and patients access to a much greater array of diagnostic and therapeutic options than is available in most single sites or even in small groups of practices. Animals will receive better care, better continuity of care and better outcomes.

PRACTICE DEVELOPMENT

For vets, there is not only the satisfaction of caring for animals in a progressive, collaborative and positive environment, there is also the option of choosing your own clinical style. Some vets prefer to focus on clients and leave the advanced work to their specialist or expert colleagues. Others strive to be specialist clinicians, developing their own spheres of expertise and offering these services to others. And many vets want to know that they’re doing a good job for their clients and patients, leaving the rare or most specialist procedures to others. All these options are available in this hub-and-spoke model, without sacrificing all income or clinical input. In fact, many practice owners within this community earn significantly more than the UK average for veterinary practice owners, and at a higher percentage profitability. The hub-and-spoke stimulates a sense of community: a whole group of vets, nurses, managers and other staff working together to deliver the best outcomes they can for patients and clients alike, as well as for their colleagues. Knowledge is shared and experience gained. Everybody wins. Collaborative working with other practices can take elements of the model, as appropriate, and that will work within individual setups and according to resources and specialisms/interest areas.

Pie in the sky? We believe this collaborative approach deals with many of the challenges the profession has identified. By specialising in what each party does best, costs are reduced and financial viability is enhanced. Those who do what they love doing have fewer

problems with work-life balance. Client expectations are much easier to meet if we play only to our strengths, and our patients get better care. It’s easier to develop business skills for a narrower range of services than for a much broader one – and it’s easier to choose your own hours. That same focus makes legal and regulatory compliance easier. Non-veterinary competitors can become collaborators. Rising costs are controlled by the same narrower focus, and evidence-based medicine is enhanced by sharing outcomes. As we have seen, working collaboratively is not a pipe dream. It’s a practical and commercial reality that is available to all. Adi Nell, BVSc, CertVD, MBA, FCMI, MRCVS Adi is a Senior Partner at Medivet, one of the UK’s larger practices. He has many years’ experience in clinical practice, including running a 24-hour hospital, and is involved in strategy and planning for his group. He is a regular speaker on management topics and has a particular interest in business skills for veterinary practice owners. Erwin Hohn, BVSc, BA(Hons), MBA, MRCVS Erwin is a Senior Partner at Medivet where he is involved in marketing, strategy and organisational development. He has experience in clinical practice, university lecturing and headed multidisciplinary international projects. He has also owned and managed an international business consultancy. References 1 BVA Vet Futures report, 2015. http://vetfutures.org.uk/resources/ (accessed December 21, 2015). 2 Hohn, E W, 2014. The Development of Veterinary Community Health: WSAVA, 2014 249-252.

National Veterinary Specialists

Are there other options?

moore scarrott

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.

What will we do after w e've sold?

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

Thinking of selling?

• 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

moore moore scarrott scarrott

Head Office: Calyx House, South Road, Taunton, Somerset, TA1 3DU Telephone: 01823 282100 Fax: 01823 254396 Regulated by the Institute of Chartered Accountants in England and Wales for a range of investment business activities.

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.

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Practice Life z March/April 2016 z www.practicelife.biz

PRACTICE DEVELOPMENT

CASE STUDY: COLLABORATION IN PRACTICE In recent years, significant changes have occurred at practice level as a result of increasing globalisation of the veterinary marketplace. Independent veterinary businesses need to understand and embrace these changes if they are to be successful, rather than allow themselves to become victims of market forces beyond their control, writes Joanne Sharpe.

LVets is unique; it exists as a collaborative group of independent practices that cooperate across a wide range of initiatives. The group’s 52 members work together to share best practice and advice with other members at local, national and international level. XLVets began as a farm/mixed practice initiative in 2005, but as the value of the concept grew, two further divisions were added: XLEquine and XLVets Small Animal. By working together, opportunities to strengthen veterinary businesses, for mutual benefit, become a possibility. Practice exchanges enable staff members to see how other practices work and find out what they do the same and differently – and take ideas back to their respective practices. For some team members, such as head nurses, exchanges offer an opportunity to spend time with others in a similar role, which is helpful when they do not have an equivalent counterpart in their own practice. Jacqui Dodds of Paragon Veterinary Group encourages all practices to consider exchanges or collaborative working. “It’s something any practice can consider doing and will benefit from – perhaps look beyond your local area to reduce the sensitivities around sharing information. All roles experience similar issues within the practice and, by engaging with others, we have undoubtedly enhanced our skills, knowledge and abilities. Our practice benefits from this collectively through improved protocols, systems and teamwork to help keep the business moving forward.”

www.practicelife.biz z March/April 2016 z Practice Life

There’s also the opportunity to share best practice. On the farm side, a clinical audit is currently underway to evaluate the success rates of various Caesarean section techniques in cattle. Within the group, over 300 vets have come together and submitted information on around 3,000 C-section cases so far. The results of this research will be of benefit within the XLVets group, to their farm clients, and the wider veterinary profession. Benchmarking is another tool that has been successful at both a national and regional level within the group. Financial key performance indicators are evaluated at a practice level across the three species groups. Business owners within the practices are using this information to learn what they are doing well, and find areas where they may be able to improve. By identifying another practice that is excelling in a certain area, vets can learn from each other and improve the financial health of their businesses. Rob Smith of Farm First Vets said: “With current pressures on farm margins, benchmarking with some of the dedicated farm animal veterinary practices within XLVets will prove invaluable. It’s early days with the project, but hopefully it will give us an insight into areas where we can improve or make cost savings and we can start making decisions on how to change or expand what we offer as a business.” But it’s not only financial benchmarking that can provide benefits to the practice and its clients. Several practices in the South of England, led by Jim Willshire of Endell Veterinary Group, have got together to benchmark their use of antimicrobials. “Creating a robust method for quantifying antimicrobial usage at a practice and client level, while sharing the data in a confidential and non-judgemental environment, has allowed the group to promote responsible use within, and between, practices. It’s also allowed us to create a ‘line in the sand’ regarding our performance in support of the Government’s five-year strategy. The practices have gone on to use the data as an opening to engage with clients regarding their usage, and to give them feedback regarding how they rank within the practice and group distributions,” said Jim. Here we’ve discussed just a few of the successes that can be achieved through collaborative working. While competition between practices may exist at a local level, many of the XLVets practices have realised that there is more to be gained by working collaboratively, while accepting that healthy competition can exist – a concept in the business world termed “co-opetition”.

CPD SHARED

SPVS/VPMA Congress 2016

review

The Celtic Manor in Newport, Wales, was once again host to over 500 delegates attending what is now confirmed as one of the most popular events in the veterinary calendar: SPVS-VPMA Congress. Practice managers, owners and team members arrived during Thursday for the evening’s networking dinner, which included a quiz with the theme of “Around the World”. For those who arrived later, or who didn’t take part, unsurprisingly for a veterinary event the bar was the other networking area as people caught up with friends over the odd drink! Those who may have spent a little longer in the bar than they had intended, may have had some regrets: Friday started with a 3.20 am fire alarm! Meeting colleagues in pyjamas in the foyer was certainly a new experience for most! However, veterinary teams are used to disturbed sleep so it was no surprise that the 8 am breakfast meeting hosted by platinum sponsor Citation, was a popular start to Congress (see breakfast meeting summary). This year, Congress was opened by Alastair Campbell, communications strategist, writer, mental health campaigner and son of a Yorkshire vet. Alistair also took part in the Mental Health stream in partnership with the RCVS’ Mind Matters initiative, chaired by Radio 4 presenter, Claudia Hammond. One of the sessions

challenged the stigma around mental health within the profession, with contributions from vets and a practice manager who had had first-hand experience. His book, “Winners and how they succeed” was given to delegates who had the opportunity to have their copy signed by Alastair. Other sessions throughout the two-day event covered leadership, the art of pricing, and what vets can learn from the NHS. Rick DeBowes, from Washington State University College of Veterinary Medicine, wowed audiences with his high-energy sessions on leadership, as did Bash Halow, also from the US with his marketing and social media insights. The New to Management stream was a new addition to the programme and it proved very popular with delegates (many prebooked); it was over-subscribed on the day and some delegates were unfortunately turned away. Practice Life z March/April 2016 z www.practicelife.biz

CPD SHARED

Friday’s lectures ended with Supervet Professor Noel Fitzpatrick in conversation with Martin Whiting, Lecturer in Veterinary Ethics and Law, on the impact of his television programme. Questions focused on how vets can work with clients to ensure treatment choices are in the best interests of pet and owner. This was streamed live into the congress exhibition area courtesy of Petplan, so those who were enjoying happy hour could still listen. The exhibition was once again well supported, with 63 companies attending and the majority taking part in the competition that offered delegates the chance to win an assortment of prizes. Those who were lucky enough to attend the (sold-out) banquet were treated to a James Bond opening featuring Howard Brown and Nick Stuart – Daniel Craig shouldn’t be too worried! After a sumptuous meal and when the fancy dress winners had been crowned, the Bogus Brothers filled the dance floor. Those who were not feeling energetic enjoyed the pop-up casino with their SPVSVPMA fake money, while others chatted away into the small hours. Saturday morning started with platinum sponsor Merial hosting a business breakfast on social media before the rest of the day’s lectures started and ended with coffee and cake for the journey home after another packed day of lectures.

A huge thanks to our sponsors

What the delegates said: “As a first-time attendee, I was impressed by the breadth of themes... high-profile speakers gave a really professional feel” “Alastair Campbell, as opening speaker, was phenomenal.... the lectures were thought-provoking and interesting” “Best two days of the year again. A chance to bond with our practice management team” “Friday’s ball was excellent... and an opportunity to catch up with old friends” “Coming to congress was the best decision of the year so far. I spent the whole day in the exhibition and made some great business contacts for my new practice”

THE ART AND SCIENCE OF PRICING Julie Beacham, VPMA Junior Vice-president, reviews the popular session by Bal Bains of Zoetis. With so many interesting lectures on offer at Congress this year, I decided to flit between streams and picked out those of particular interest. One topic I have always felt I should learn more about is pricing and I assumed that big businesses invested a lot of time and expertise into getting it right. It was a real surprise to learn that the vast majority of Fortune 500 companies don’t have a dedicated pricing team, nor do they do any research on pricing. Hardly any business schools teach the subject. So it seems that art rather than science is what matters most in this area. Bal demonstrated just how important all those marketing tricks are and what an impact they have on sales, even though we all feel sure we are not influenced by them. For example the “Magic Nine”, where items are priced at, for example, £19.99 rather than £20, really does work since we read from left to right and concentrate on the leftmost digit. There should also be a difference in how we price items that are emotional purchases rather than rational ones. Emotional purchases should be priced in www.practicelife.biz z March/April 2016 z Practice Life

rounded numbers, for example £19, whereas rational purchases should be exact, so £19.25. We also learned about price anchoring and price referencing and how limiting availability increases sales. One tip that can certainly be put into practice for sales in the waiting room or pet shop was that people perceive prices to be better value if a small font is used on the price ticket and this is positioned at the bottom left of a product. Another is that reviews and recommendations can increase sales by 20 per cent. Finally, Bal shared some interesting data from the Harvard Business Review showing how changes in various factors, such as reducing costs, increasing the sales volume or increasing price, impact on profit. Of those, price is the biggest lever, with a 1 per cent increase in price leading to an impressive 11.1 per cent improvement in operating profit. I know what I’ll be doing this week! Julie Beacham BSc(Hons) CVPM Practice Manager, Wendover Heights Veterinary Centre VPMA Junior Vice President

CPD SHARED

Breakfast Meetings

And a bit more...

As if there are not already enough great lectures on offer, prior to Congress, delegates were asked if they would like to attend 8am Business Breakfast meetings. These were hosted by SPVS-VPMA Congress’s platinum sponsors and included a hot breakfast to get the day off to a “learning start”. Catherine Hare from Citation hosted the first Business Breakfast on the Friday. Those of those of us who had managed to get out of bed despite the unfortunate 3.20am fire alarm were treated to some legal updates. First she spoke about the Working Time Regulations, after a question had been asked to the High Court about whether, while a worker is asleep, if he or she is considered to be working? A judgement was given that confirms if a person’s employer is required by statute to have someone on the premises – for health and safety purposes, for example – and that person would be disciplined if they left the premises, then they are entitled to be paid the national minimum wage for this time, even if they were sleeping. This ruling will also have an impact on the amount of rest breaks an employee is entitled to. Catherine told us that this is already having an impact within the care home sector and advised thought from the profession as to how this may impact on-call duties for veterinary staff. Another scenario that was discussed was travel to work time. If there is no fixed place of work, will all travelling time be work time? It has recently been determined that, where a worker has no fixed place of work, the time spent travelling to the first job of the day and from the last job of the day home, should be considered working time. Catherine also discussed the ongoing situation regarding holiday pay and whether commission or overtime payments should form part of holiday pay. An appeal decision is pending, which should provide some clarity for this situation. Fitness to work, performance management and employee engagement were also discussed, giving those who had made the early start food for thought for the rest of the day. Julia Bramble hosted Saturday’s Business Breakfast, on behalf of Merial, about social media. She spoke about how to double the effectiveness of using social media and Facebook advertising, and introduced a new feature to help grow online relationships (not a dating site!). Julia also gave some tips on what was freely available to help our ever-increasing online world. One was to set up Google alerts for business topics as it allows you to receive alerts when the keywords you have set are found. Julia also confirmed that for those who use social media, Hoot Suite was a must for scheduling multiple social media postings.

Another excellent few days at Celtic Manor Resort, attended by 500-plus delegates, surely guarantees “same time next year”. If you were there, you will attest to the packed seminars, bustling exhibition and phenomenal social programme – if you weren’t, VPMA’s man on the ground Ian Wolstenholme guides you through some of the highlights.

These Business Breakfast meetings are an important addition to the Congress schedule and their informal, small group setting offers real insight to areas of business all owners and decision makers should be thinking about.

Our congress organisers Jenny and Libby have this event nailed and quite how it gets better year after year is a mystery! It is physically impossible to be everywhere at the same time and with 10 streams for the whole practice team to enjoy, no matter what age, ability or experience, Newport was certainly the place where the practice team came together. One of the plus points for me this year were the double sessions. Sometimes an hour is simply not enough. Rick DeBowes from Washington State entertained a packed room with a workshop session on communication and compliance and I thought that his simple definitions of some well-used practice language, such as the word “care” defined as “watchful attention” and “client” defined as “dependant”, really made the listener think. Once again, I spent a few minutes talking to a couple of the speakers; visit the link to listen to Rick: http://tiny.cc/r1h98x Making a return visit to our congress this year was Bash Halow from Halow Tassava Consulting who presented five steps to successful marketing – know who you are, create goals, plan, track and improve. There were lots of practical tips about using technology to benefit the practice and the suggesion nowadays is to have a simple, effective, optimised website (Wordpress is used extensively, creating one in four websites worldwide), a practice YouTube channel and digital support materials, such as digital puppy and kitten packs. More of Bash’s comments can be found by visiting this link: http://tiny.cc/x2h98x

Details for 2017 congress to be announced shortly... Practice Life z March/April 2016 z www.practicelife.biz

CPD DIARY

CPD programme soaring ahead! SPVS-VPMA 2015 CPD courses were the best yet, both in terms of delegate feedback and numbers attending, writes Jenny Stuart. At the time of writing, we were already well subscribed for our 2016 CPD programme, with our first event, Training the Veterinary Receptionist, already sold out.

Zoetis and Royal Canin are once again our programme sponsors and our media partner will be VBJ. We are repeating our most popular courses in different parts of the country, but we also have some brand new courses with new speakers, so take a look at www.spvs-vpma-events.co.uk Last year, many courses sold out, so make sure you book early. If your practice books four people in a single calendar year, we will give you a voucher for a free place at any future course in 2016. In 2016 we will spread our wings... literally... to take our first course to Northern Ireland and are delighted to be running this in partnership with the Association of Veterinary Surgeons Practising in Northern Ireland (ANSPNI), offering their members our usual member rates. Our spring programme has a social media theme to it with the return of Video Making for Social Media, Facebook Focus, and a new course on Multi-channel Marketing from Susie Samuel of VetHelpDirect. For this new event, Susie considers how to plan an effective multi-channel marketing strategy. She will talk about the importance of content and how to ensure your message is consistent and easily accessible across all channels. And if you book Facebook Focus and Multi-channel Marketing together you get a 10% discount! Is your website mobile friendly? Do your emails get the response you want? Has your whole team bought into your message and your brand? And is all of this taking up way more time than it should!? Susie will share the latest ways to use the same content easily and efficiently across multiple channels without losing spontaneity or the personal touch. Perhaps most importantly, she will demonstrate how to measure a campaign so that decisions can be made about where to prioritise effort and evaluate new campaigns. Another spring course is Appraisals and Recruitment, with Margaret Burnside of eras ltd., who will address whether appraisals are worthwhile or a timewasting drain for both the person running the appraisal and those on the receiving end. If you can keep staff engaged and challenged, she suggests, employee turnover will be reduced, leading to less time and expense spent on recruitment. But if you do need to recruit, then this workshop will help you learn from some of the common mistakes, exploring how to identify the core requirement and how you can find, attract and select the best candidate. Margaret will also look at the psychology and neuroscience behind some of the successful tools used, investigating which are truly effective. www.practicelife.biz z March/April 2016 z Practice Life

And let’s not forget veterinary nurses. We are offering BVNA members a discount when attending The Consulting Nurse, which last year proved very popular. Brian Faulkner from The Colourful Consultancy and Clare Hemmings from Royal Canin will equip attendees with the skills and confidence to run successful nurse consultations. For more information about the 2016 CPD programme, and details of other discounted courses for nurses, visit http://vpma-spvs-events.co.uk/cpd-2016/

What the 2015 delegates said: “Good content... friendly speakers... important and relevant topics” “Gave me another outlook on practice” “Addressed excellently important management/communication/ marketing issues” “Exhibition had some new innovative ideas which really made the trip worthwhile” “Friendly atmosphere” Focus on Digital Technology and Marketing. June 14, 2016. Stamford Court, Leicester Sponsored by Zoetis Love it or hate it, internet and digital technology are essential elements of a profitable practice, from digital phones to website and Facebook pages; from how you store and retrieve x-rays and scans, to managing your client database. But just when you think you’ve got your head around one piece of technology, along comes another and you have to start relearning all over again. This one-day event consists of practical lectures and a focused exhibition, enabling you to refresh what you know and also learn about innovations in the field of technology. For more information about this day, visit the website: http://vpma-spvs-events.co.uk/focus-days-2016/

WHAT’S COMING UP

Media Partner

vbj

Look out for the Summer issue of Practice Life...

Out June/July 2016 Scaling up: Going from a small team to a larger one SPECIAL FEATURE: The pet loss journey – crematoria myths Practice Life z March/April 2016 z www.practicelife.biz

Join the conversation at facebook.com/JungleForPets

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Get behind the Be Lungworm Aware 2016 campaign. Order your practice materials from vetcentre.bayer.co.uk or speak to your Territory Manager. Use Medicines Responsibly (www.noah.co.uk/responsible). Reference: 1. Eliminates L4 & immature adult stages preventing establishment of adult worms in dogs; Schnyder M. et al., Vet. Parasitol. (2009); 166(3-4):326-32. Advocate for dogs contains 100mg/ml imidacloprid & 25mg/ml moxidectin POM-V (UK) POM (IRL). Advocate for cats and ferrets contains 100mg/ml imidacloprid & 10mg/ml moxidectin POM-V (UK) POM (IRL). Advice should be sought from the medicine prescriber. Further information from the datasheet at www.noahcompendium.co.uk or on request. ® Registered Trade Mark of Bayer AG. Bayer plc, Animal Health Division, Bayer House, Strawberry Hill, Newbury RG14 1JA. Tel: 01635 563000. Bayer Ltd., Animal Health Division, The Atrium, Blackthorn Road, Dublin 18. Tel: (01) 299 9313. L.GB.MKT.11.2015.1386A

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STOPS FLEAS, WORMS AND MITES IN ONE

National Veterinary Specialists

moore scarrott

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

moore moore scarrott scarrott

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.