Practice Life Issue 12 June:July 2016 by The Magazine Production Company

June/July 2016 www.practicelife.biz

Taking charge: future of the veterinary professions

Managing client expectations around cremation and disposal

Scaling up: managing a larger team

THE MAGAZINE OF SPVS AND VPMA

End-of-life:

special features on the client journey and aftercare

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EDITORS’ LETTERS

Editors’ Letters

elcome to this Summer edition of Practice Life. There’s nothing boring about life in practice, and this issue explores some of the less common scenarios we have to deal with. There’s some thought-provoking material on the continued need for data sheets, and on being presented with the difficult prospect of non-accidental injuries in pets. Reflecting on how diverse our roles as practice owners and managers are, it’s very timely that SPVS has launched its Wellbeing Award. We are ever more aware of mental health and wellbeing as being of importance not just at work, but in “real life”, and this new initiative

alf-way through the year already! I’m often surprised at how many people (particularly when you have the chance to chat en masse at conferences) still think of VPMA as a member organisation. Well, of course it is! But, like many limited companies with a board of directors, the VPMA is no different from any other responsible business, keeping its eye on the ball in challenging times. A couple of months ago, and following on from our earlier “blue sky” strategy day, the team were truly amazed to be faced with a collection of a dozen or so CVs from managers wishing to join the VPMA board. Cath, Ruth and I found the day when we met the candidates an incredibly uplifting experience and the outcomes (you’ll meet the new board members shortly) have served only to strengthen the way that VPMA continues to drive forward quality veterinary practice management. Our recruiting day has resulted in an assembled talent indeed. It was great to see so many familiar faces at BSAVA Congress again this year and I managed to catch up with

on the part of SPVS should help raise awareness and reflection of what we are doing well and what we can do better. I’m an especially good example of the pot calling the kettle black this month, having tried and failed to work through a viral illness and having been physically forced to prioritise my own health and delegate a great deal to my lovely team. A learning curve indeed – we literally had a ceiling fall in after a flood, and the world didn’t end. Please support our Wellbeing Awards (see page 13) and enjoy this packed edition of your magazine.

Leigh-Anne Brown, SPVS editor

one of our contributors to this issue, Sarah Page-Jones, to find out more about a couple of particularly hot topics in the veterinary world right now. If you have five minutes to spare over lunch, check out our CPD Shared feature, type the link into your browser and have a listen. It is scary to think that Practice Life magazine has been around for 11 issues now (assuming the dog hasn’t mauled one of my copies and mucked up the maths!). We do get a little blasé about formats and the layout, but we really would value your feedback as to how you see your journal shaping up into the future. Don’t forget you can drop an email to ian@practicelife.biz and, as the magazine is a member benefit, be assured your suggestions can make a difference. In the hope and anticipation that the sun is shining in flaming June wherever you are, have a great summer.

Ian Wolstenholme, VPMA editor

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

Practice Manager of the Year; impact of Budget 2016 on practice g

SPVS NEWS

NURSE TALK

COLLEGE CORNER

Eva Lambe eva@practicelife.biz

Remains to be seen…

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

© 2016 Practice Life All rights reserved. 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.

Looking to the future of the professions

Sales Administrator

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.

BVNA President Sam Morgan’s update

Cremation: fact vs fiction

www.spvs.org.uk www.vpma.co.uk

Wellbeing Award; Spotting the signs of abuse

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

Practice Life is the magazine of the Society of Practising Veterinary Surgeons and the Veterinary Practice Management Association. It is distributed quarterly to the members of both associations as well as a wider mailing list of veterinary practices annually.

HOT TOPIC

VDS NEWS

WELL-BEING

Mind Matters Initiative g

MANAGING PEOPLE

Upsizing your team g

CLIENT CARE AND MARKETING

27 27

End of life: the client’s journey g

BUSINESS HEALTH AND FINANCE

Preventing practice debt is the best cure g

PRACTICE DEVELOPMENT

Is it time you got a practice manager? g

CPD SHARED

Multichannel marketing – practice hints and tips g

CPD DIARY

WHAT’S COMING UP

Details of the Autumn 2016 issue

40 28

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

Practice Life z June/July 2016 z www.practicelife.biz

News & Views

PET LOSS RESOURCES LAUNCHED FOR VETERINARY STAFF AND PET OWNERS Pet loss support company, Compassion Understood, launched a resource at BSAVA Congress to help pet owners and veterinary staff. The website, www.compassionunderstood. com, has a strong client emphasis, and leads the pet owner through the many choices they have at end-of-life, as well as explaining what they might expect when they visit the clinic for euthanasia or end-of-life discussions. Veterinary practices are encouraged to direct their pet owners there for reliable, clear information, written by veterinary professionals. The site also contains a veterinary portal where practice team members can access online training in end-of-life,

as well as topical blogs and other information. The programme, which consists of videos, audios and articles, is suitable for the whole practice team, and covers clinical aspects, communication skills, compassion fatigue, as well as the client journey. It is based on extensive research with pet owners, which showed that 60% of owners felt their vet handled the euthanasia of their pet very well, leaving 40% who had a clear desire for veterinary staff to understand more and help prepare them better for their loss. For more information, visit: www.compassionunderstood.com or phone 01788 228811

Denplan has donated to Smokey Paws Pets are to receive oxygen masks when rescued from house fires with help from the Smokey Paws Charity. For almost 30 years, Denplan has developed its own Community Fund initiative to support local projects and charities. Denplan, as a provider of Pet Health Plans, decided this year’s donation should go towards Smokey Paws, a not-for-profit organisation that equips emergency first responders with lifesaving oxygen masks. Pets in Hampshire can now breathe a little easier after Hampshire Fire and Rescue Service took delivery of these specially designed oxygen masks for animals rescued from fires. Jim Green,

Hampshire Fire and Rescue Animal Rescue Specialist, said: “In 2013/14 our animal rescue specialists attended 40 fires. With around 60% of households having pets, these masks can mean the difference between life and death for the cats and dogs we rescue. Animal Rescue Specialists attend every animal-related incident in Hampshire and these masks will have an immediate positive impact.” Sharon Ellis, Community Fund Chairman and Head of HR at Denplan, commented: “We are delighted to support Smokey Paws in their mission to make these life-saving pet oxygen masks available across the UK. We understand the important role pets play in a family so it’s great to be able to provide the equipment for Hampshire Fire and Rescue, and support the county’s community, of which we’ve been part of for almost 30 years.” ‘Smokey Paws’ mission is to raise enough money through public donations to equip every first responder in the UK with these lifesaving masks. Visit www.smokeypaws.co.uk to make a donation.

Buoyant market for practice sales Mark Harwood, Partner at Hazlewoods Accountants, says ‘The market for buying and selling practices continues to be very strong with more buyers and options for selling than ever before. Every practice sale is unique, so there is no one size fits all approach but good preparation is important for everyone. If you are considering selling your practice, you will no doubt wish to ensure that you achieve the best

possible deal, as well as ensuring a smooth transition for both your staff and clients. Consider your options and wishes for the future of your practice. Talking this through at an early stage with an accountant or advisor, including taking advice on valuation and the buyers in the market will help you pinpoint your priorities. Preparing for sale in this way will help you greatly when negotiating.’

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 June/July 2016 z Practice Life

NEWS & VIEWS

VPMA supports Head VN Congress The VPMA was delighted to be asked to sponsor and support this year’s Head Nurse Congress, organised by the College of Animal Welfare. VPMA President Renay Rickard and board members Julie Beacham and Cath Grimsey attended the event, held over the weekend of May 14-15, both in a speaker capacity and on the VPMA stand. The team was very busy, with nurses keen to find out about the support that VPMA can offer as they move into a management role. The speakers were well received with subjects ranging from time management, social media, people management, and pet wellness. Renay’s talk on “Help I’m a Head Nurse! Now what?” causing many heads to nod and knowing smiles, as she discussed

OPEN DAY

OAKHAM VETERINARY HOSPITAL Oakham Veterinary Hospital staff were delighted with the amazing turnout for their Open Day on Saturday 23rd April, despite bracing winds. It marked the official opening of their new Small Animal Hospital extension which was completed recently. The new facilities include a separate cat waiting area, much larger cattery and kennels for inpatients, two new consult rooms, a new double operating theatre and dedicated scanning and recovery areas. In addition to the new facilities they have also recently been accredited with Cat Friendly Clinic gold level status, the only practice in the Stamford and Rutland area to hold this accolade. Catriona Laird and Chris Booth, Clinical Directors, cut the ribbon as Adrian Palmer from Palmers of Oakham handed over the new facilities. Over two hundred people enjoyed the self-guided tours of the practice, watching the ultrasound, laparoscopy and acupuncture demos from the vets. They also listened to First Aid talks and took part in interactive activities like the lambing machine (provided by the University of Nottingham) and dog agility. The Pet’s Corner was a big hit with younger visitors as were all the competitions and raffles, which raised a grand total of £437.44 for Canine Partners. The charity attended on the day with an information stall and some of their dogs in training. Their lunchtime demo was very well attended and gave people a chance to see some of the amazing work that these dogs do in giving independence to people with physical disabilities. www.oakhamvethospital.co.uk

the highs and lows of becoming a head nurse, with top tips on how to avoid some of the pitfalls when taking that step up. The event was a great success, with exhibitors set up in the same space as the speaker programme so that people could pop over for a chat throughout the day. “It’s easy to see from the success of this event that there is a real need for management training for this sector of our industry,” said Renay. “With the information we received at the HVN Congress and from talking to delegates, VPMA is committed to meeting the needs highlighted and to come up with quality training and other solutions. Our aim was to get the message across that VPMA is an association for anybody who is involved in the management of their practice, very much including head veterinary nurses, and the support that we can provide to our members. We are looking forward to continuing to support this great event.”

Informed consent – your input please! One of the panel discussions in the Big Issues stream at BSAVA Congress in Birmingham looked at informed consent. As veterinary surgeons and veterinary nurses, we are used to asking for consent for routine surgeries such as neutering, but how well are we doing it? Carol Gray, a well-known veterinarian, particularly in communication skills teaching is currently undertaking a PhD to investigate informed consent in practice. The initial study will look at surgical admissions procedures in veterinary practice, and has ethics approval from the University’s Humanities and Social Sciences Research Ethics Committee. Carol would like to investigate what is happening in practice when companion animals are admitted for routine surgical procedures, and is seeking help from veterinary practices. There is very little research available on either informed consent or admissions procedures in veterinary clinics, so this study will provide useful information for researchers and practitioners. All participating practices will be sent a final report on the findings of the study, and individuals participating will be offered feedback, if they wish, on their communication skills during the observed consultations (although this is not compulsory!) The project will involve Carol being present for admissions consultations between clients and either veterinary surgeons or veterinary nurses. She would like to audio-record these encounters for later transcription and analysis. Consent will be obtained from both participants before each consultation. Practice participation will be kept confidential, and all data will be made anonymous before use. The study aims to involve practices in any region of the United Kingdom, and a variety of practice types, such as independent, corporate and If your practice/group of practices would be interested in further details, please contact Carol on cag501@bham.ac.uk, or text 07543 660588. Carol will be in touch to arrange a preliminary meeting to go through the proposed study and answer any questions.

Practice Life z June/July 2016 z www.practicelife.biz

VPMA News President’s Welcome I cant believe that as this issue goes to press I will be nearly half-way through my presidential year. I was told it would go very quickly... and it’s flashing by. My first board meeting, as chair, was in March and I have to admit it made me slightly nervous as the realisation suddenly dawned that I was in fact in control (or not) of the proceedings. Not only did we have a full agenda, but we also had in attendance our prospective new VPMA board members as we look to replace members and increase the skill set of our team. We had a very successful day and look forward to introducing them to you in due course. Another highlight of the year so far was to be involved in the judging and subsequent presentation of the Petplan Practice Manager of the Year award. To be given the opportunity to celebrate and thank some of the people who work so hard in practice is rare and was also great fun. Congratulations to the winner, Carol Hudson, who we have profiled later in the magazine (see page 9). The Veterinary Awards ceremony itself is a special event, with top-class entertainment – who knew that lungworms, anal glands and ketamine could be turned into such a great rap...! I was also invited to attend the President’s Dinner at BSAVA, which was a lovely evening, with fantastic food and entertainment. By the end of BSAVA I had very sore feet and no voice after dancing and meeting up with so many people. The dance floor was full of VPMA past-presidents at one point and it was great to see you all. I have been trying to think of a collective noun for us all ever since... send in any suggestions! I also attended the VBMA Ireland Symposium in Dublin as a speaker. VBMA is a studentled organisation with one of its aims being to advance the veterinary profession by increasing the business knowledge of graduates. I was delighted to be involved in this as it is definitely an area that has been neglected in the education of veterinary students, but is now starting to be addressed by various universities. The management of a veterinary business is a team sport and not an individual event in my view. Here’s hoping that you all find some rest in the sunshine at some point over the upcoming months.

Renay Rickard RVN CVPM VPMA President

www.practicelife.biz z June/July 2016 z Practice Life

VPMA NEWS

CVPM – Strategic Management Roger Wilson What has strategic management got to do with me? That’s what the owners do, isn’t it? The owners of a practice make the decisions, but it’s the Practice Manger’s job to brief them and, if you can point out opportunities or problems, you take your contribution to the practice to a new level, which should have its rewards. What do we mean by strategic management? By this we mean looking at the strengths, weakness, opportunities and threats facing a business (carrying out a SWOT analysis). Also we would expect you to do a PESTLE analysis (which is a way of looking at the people who live in your area and the factors that affect the services they would like you to provide). These tools will help you develop a number of potential action plans (business plans) that will either help you develop opportunities for your practice or protect if from the threats you have identified. To pass the CVPM, you need to be able to develop a simple business plan, such as choosing and financing the purchase of an ultrasound scanner, and the setting up of the ultrasound service, with logically calculated fees, a marketing plan and suitable key performance indicators (KPIs) to monitor the success of the plan once implemented. We expect you to be able to set up a system to monitor the KPIs set for your practice, both internally and externally, so you can pick up at an early stage that something is going wrong, or, probably more importantly, that something is a great success and needs further development. We also expect you to have an understanding of how practices are set up; either as part of a corporate group (joint-venture partnerships, wholly owned subsidiaries, franchises and so on), a sole trader, partnership, independently limited companies or limited liability partnerships. We expect you to have some idea of the pros and cons of each type of business set-up. To summarise, being able to deliver the above is what owners expect a CVPM holder to be able to do and is why they are worth paying more. For most practice managers it isn’t what we do routinely, but it’s not difficult, it just needs a bit of thought to set it up and a bit of time to keep on top of. This month’s question is: • There has been a fall in practice profitability over the past year. You have been asked to investigate what has happened and report to the partners. What would you consider and include in your report? Answers may be written or recorded and submitted to C&T@vpma.co.uk by the end of July. Feedback will be given to those who put forward resonses.

Don’t forget there is still time to book onto our Sage training roadshows. Covering autoenrolment, debtor reconciliation and more. Best of all, they are free to VPMA members!

9th JUNE Wendover 22nd JUNE Wilmslow 6th JULY Sevenoaks Email secretariat@vpma.co.uk

VPMA NEWS

Regional 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

Once again the Regions – the backbone of our organisation – have been extremely active in the first part of the year, with many more meetings organised, so a big thank you to all our regional organisers for your hard work. We are part-way through the first of our road shows this year, which has been based around the implementation of the new auto-enrolment pension schemes. They have proved very popular and have also introduced some different people to the benefits of attending a VPMA meeting. These events remain our main source of information, networking and support throughout the year. VPMA’s plan is to hold another road show later in the year that will include information and an introduction to the Certificate in Veterinary Practice Management. We always welcome any new ideas at our meetings, or further road shows, so please contact me if you can help with this. We appreciate that taking time out of practice is not always easy and so we want to ensure that you get value from attending our meetings – but I still maintain the most value is sitting down with a cuppa and a piece of cake and just sharing information and problem-solving with a group of people who have the same problems and challenges... knowing you are not alone! Thanks and I hope to see you at a meeting soon.

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

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VPMA NEWS

SPONSORED BY

FIVE MINUTES WITH... Carol Hudson, Petplan Practice Manager of the Year 2016, of Millennium Veterinary Practice in Essex

“

There have been many changes during Carol’s employment but she has been there for us all. She has managed changes in practice partners, as vets retired and associates became partners (which was reflected in five name changes to the practice), moved premises once and managed three extensions. The small team that formed Farrow and Bayer 50 years ago has developed into a large experienced team of more than 65 members of staff – all of whom need managing.” “Over the years Carol has proved to be highly efficient, capable, versatile and empathetic with all aspects of veterinary practice. She is admired, liked and respected by all. Truly a practice manager for all seasons.” These were the words used to describe Carol on Millenium Vets’ website when they celebrated her 30 years’ service last year and probably explain why Carol received so many nominations for Petplan’s Practice Manager of the Year award. Q How does it feel to know you received 37 nominations for the Practice Manager of the Year award? Being nominated by 37 people makes me feel very valued and special… It really still hasn’t sunk in. Q VPMA is supporting the Head Nurse Congress this year and, as you started out nursing, what skills do you think nurses bring to practice management? Starting out in practice as a nurse has brought so many skills to my role now, mainly understanding the highs and lows of veterinary nursing. I can empathise with them and understand the progress they want to make in their roles. At management meetings we offer support and training to all our nurses, and we especially understand how vital the role of Head Nurse is – we very much value the contributions of our Head Nurse, Gary Rutland. Q You have celebrated 30 years of employment this year, how has the role of practice management changed since the early years? Being at the practice and watching it grow from a staff of nine to 67 over the 30 years has been amazing. So much has happened – offering new and exciting referrals and keeping our family feel to the practice, I feel very proud to have been such a big part of the growth. Our staff turnover is so low and I believe that really reflects the success of our practice. We are always looking to add to our services to ensure the clients and pets are getting the best we can possibly offer. The management system has helped us incredibly to establish client and pet needs, which was something we never had back in the day! Client cards and a tin for the takings was all we had. Q You hold a lot of events within your local community. Does your team enjoy getting involved in these and what benefits do they bring to the business? A We have a fantastic team who are willing and really enjoy being involved in local community events. Dot and Haley tend to head www.practicelife.biz z June/July 2016 z Practice Life

these, mostly visiting schools to educate and give the pupils some pet contact. They also visit care homes to again give them some pet contact and generally make them smile! They also get involved in dog walking events for so many good causes. These are great for business, there is nothing better than people talking about the business and generally being in the community. Open days at the practice are also enjoyed by staff and clients, they love to see around the practice. Q Your head nurse Gary Rutland was recently awarded Best Student for the Institute of Leadership and Management Level 5 Certificate in Coaching and Mentoring. Your receptionist Jenny Poulton also has 30 years’ employment; your practice is one that focuses on development and team longevity, what do you think this brings to the business? We are incredibly proud of Gary’s achievements, he is always striving to offer the best in his role and changing/adding to his role for the practice needs. The fact that both Jenny and I have been here for 30 years is testament to the fantastic practice we work in. From a client’s point of view, it is fantastic to have the same faces as they continue to come here and the staff all end up building a great relationship with the clients and pets.

VPMA NEWS

BUDGET 2016:

WHAT’S THE IMPACT ON LIFE IN VETERINARY PRACTICE? Chancellor “giveth and then taketh away…”

einforcing the VPMA’s position as the “voice of veterinary management” the organisation will be releasing position statements about various topics that impact veterinary practice and the wider economy in terms of effects on pet owners. The VPMA Board is already called on to comment on news stories and professional management issues in the media and is keen to get the voice of practice managers heard in a wider context. In its first such statement, VPMA Board Member Cath Grimsey wrote on the topic of the 2016 budget and its potential impact on practices and pet owners, including how changes to Insurance Premium Tax may start to take effect in the coming years.

Budget summary BUDGET 2016: “DOING THE RIGHT THING FOR THE NEXT GENERATION” George Osborne’s eighth Budget speech came at a time of growing economic uncertainty. The Office for Budget Responsibility has revised down its growth forecast for 2016 from 2.4 per cent to 2.2 per cent and the Chancellor warned that the global economic outlook is weak. Despite these challenges the government is committed to achieving a budget surplus in 2019/20. Against this backdrop, the Chancellor promised a budget that “puts the next generation first”.

may put insurance cover out of reach for a larger share of our pet-owning market – with implications for both practice profitability and animal welfare. In business terms, a few bones have been thrown our way in terms of corporation tax reduction with an additional 2% reduction for April 2020 (17%) being added to the already planned reduction to 19% from 20% on 1 April 2017, and several adjustments to the small business rate relief in England from April 2017, offering benefits to those with rateable values below £51,000. Particularly benefitting are those with rateable values less than £15,000. However, beware the Director who rubs his or her hands at the prospect of less Corporation Tax as the significant imminent increases in dividend taxation may see the Chancellor “giveth and then taketh away…” The VPMA’s position statements and further information on the association can be found at www.vpma.co.uk

VPMA’s view How does the 2016 Budget stack up for veterinary practices operating in the current generation? Weak global growth forecasts are always a bit gloomy; however, historically the UK veterinary industry has withstood fluctuations in the global economies in a robust manner, and the planned personal allowance increase from £11,000 in 2016/17 to £11,500 in 2017/18 presents an opportunity as people find a little extra change in their pockets to fund “affordable treats” for themselves and their pets. Slightly less sunny for pet owners and practices alike is the increase in insurance premium tax (IPT) from 9.5% to 10%. Although seemingly a small percentage increase, in actuality this will noticeably increase the cost of all insurance policies, and reduce clients’ disposable income. It will add significantly to practice premises and professional indemnity insurance policies, and the increase in pet policy premiums Practice Life z June/July 2016 z www.practicelife.biz

SPVS News President’s letter Stephanie Writer-Davies As Nick Stuart commented this time last year, the highlight of my presidency to date has been Snowscene, which took place in Tignes, France in March. The longest-running SPVS “scene” is traditionally hosted by the incumbent president and I was very happy to take on the job, having joined the trip regularly since 2009. Every year we say the trip was better than ever and this year was no exception, but to be fair, I think this was in no small part due to the fantastic weather conditions we were fortunate to have; heavy snowfalls the preceding week with mainly blue skies resulted in the perfect combination of great snow and good visibility that allowed us to make the most of the extensive ski area that the resort offered. Of course, it wasn’t all about the skiing – there was CPD to attend and Clive Elwood (Davies Veterinary Specialists) and Martin Whiting (RVC and RCVS DC) gave excellent presentations that were both relevant and thought-provoking and kept us all engaged. There will be a full article in the September issue of Practice Life, when I hope that details of next year’s trip will be available; if you’ve never been but fancy a week of skiing and learning I’d encourage you to think about joining us. One of the things that I really like about SPVS “scenes” is their friendly atmosphere; they provide excellent networking opportunities and it’s both refreshing and reassuring to discover that other people, in similar work positions to you, experience the same difficulties, frustrations and challenges, as well as successes. In 2015 we ran our first Cyclescene and another new idea, Spascene, and both will be repeated this year. I’ll definitely be attending the latter ... I’m not sure I’m up to attending the former, not being a great cyclist, but perhaps I’ll go for the CPD and conversation. Details, as always, are available on the SPVS website or via the SPVS Office. Since taking on the role of SPVS President I’ve been kept pretty busy. One of the nicest jobs was taking part in the judging for the Petplan Veterinary Awards and subsequently attending the awards ceremony at BSAVA Congress. Reading the nominations for those shortlisted for awards made me realise that there are a lot of people working in practices who are inspirational, be it for their veterinary skills or the way they help and support their colleagues or clients; it was a difficult task to choose the overall winners, but lovely to see them being recognised for their achievements. There’s no doubt that creating an award-winning practice involves all the staff and building a happy and well-managed team requires training; this year, VPMA/SPVS Events is running a Focus Day on the practice team in October, which I’m sure will be well worth attending for aspiring award winners. On the serious side, I was asked to be part of the VN Futures Action Group and attended its first meeting in Bristol. It was a day with plenty of discussion and brainstorming around issues such as the promotion of the veterinary nursing profession and how to solve the shortage of RVNs. There were lots of good ideas and possible solutions proffered and I look forward to seeing the launch of this at the Vet Futures Symposium in July. I’ve also been involved in discussions surrounding the continued development of our Survey and Benchmarking services with our partner, Veterinary Insights. The benchmarking facility, providing monthly figures that help to assess practice performance and allow comparison with other practices, is free to SPVS members who receive enhanced information via Vetviewer. The details of how to access this service are available on the SPVS website and I would encourage you to make the most of this useful member benefit and feed back any comments that may help improve it; you can contact me on president@spvs.org.uk

Stephanie Writer-Davies, SPVS President

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SPVS NEWS

SPVS Dates For Your Diary 2016 July 1-3 SPVS Final Year Seminar Lancaster University 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 you would like to put forward for discussion, contact honorary secretary, Hazel Bentall, or the SPVS office 4th - 9th September Dunkeld, Perthshire Cyclescene Following last year’s inaugural cycle event, if you would like to come along this year, please contact the office for more detiails

14th - 16th October Hoar Cross Hall, Staffordshire Spascene If more relaxing CPD is for you, contact the office for more information

2017 Snowscene Details of this year’s snowscene will feature in the September edition with dates and location for next year. However, if you can’t wait that long, please contact the office for more details.

For all the above events, email office@spvs.org.uk or telephone 01926 840 318.

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SPVS NEWS

VETERINARY MEDICINE DATA SHEETS – time to call it a day? Andrea Tarr looks at whether there is any need for the veterinary profession to carry on using data sheets when SPCs offer all the technical specifications a licenced product requires

hen I started working in the veterinary field about four years ago, I was puzzled about why people talked about data sheets. I trained as a pharmacist and have spent most of my career producing independent evaluated information on human medicines. The last time data sheets were mentioned in relation to human medicines was back in the 1990s. Data sheets for licensed medicines were produced by pharmaceutical companies and contained technical information on the products. But in the 1990s, European medicines legislation required all licenced medicines (human and veterinary) to have a summary of product characteristics (SPC). The SPC is a legal document that summarises the facts gathered in the process of getting the marketing authorisation (product licence) for a medicine. Data sheets for human medicines were phased out completely in the 1990s. But in veterinary medicine, data sheets continue to exist alongside SPCs. Why is that? And does it matter? What’s in SPCs and where can they be found? The SPC includes information about a medicine such as the licensed indication, dosage, adverse effects, contraindications and pharmacology. Its purpose is to ensure that prescribers have the necessary information to be able to prescribe the medicine effectively and safely. The SPC is written by the pharmaceutical company in a standard format and the wording is approved by the regulatory authority (either the VMD or the EMA, depending on the licensing route). SPCs are revised as more becomes known products; no changes can be made without the approval of the regulatory authority. The SPC for every licensed veterinary medicine in the UK can be found in the VMD’s online product database (www.vmd.defra.gov.uk/ProductInformationDatabase/). The database is easy to use and can be searched in many ways (e.g.

by species, generic name, therapeutic category) and there are links to the most recent version of the SPC for every licensed product. Not-so-friendly features are that you get the whole of the SPC and so you might have to scroll down to find the information you want; and for products that were approved by the EMA (a minority), the link takes you to the EMA’s website and after that there are several steps to get to the SPC – not easy if you’re not familiar with the site.

What are data sheets? NOAH (a trade association of the pharmaceutical industry) has been publishing a Compendium of data sheets for many years, since before SPCs came into existence. Originally the Compendium was only available as a book but now there is an online version (www.noahcompendium.co.uk). Many vets cite the NOAH Data Sheet Compendium as their main source of information on veterinary medicines. Pharmaceutical companies prepare and contribute the data sheets voluntarily. Data sheets contain the same information as SPCs, often in a different order, and sometimes omitting the pharmacokinetic and pharmacodynamic information. The Compendium also contains data sheets for unlicensed products that are available through the Small Animal Exemption Scheme. Not all companies belong to NOAH (for example, Norbrook Practice Life z June/July 2016 z www.practicelife.biz

SPVS NEWS

produces its own compendium of data sheets), so the NOAH Compendium does not contain data sheets for all licensed veterinary medicines. The NOAH Compendium has helpful features. The online version presents the data sheets in sections and so it’s quick and easy to get to the information you want; and changes to the documents are highlighted. Many find the Compendium book convenient, but like all reference books it is out of date as soon as it is published.

What about package inserts? Some people call the package insert the data sheet. The package insert is prepared as part of the licensing process and the wording is approved by the regulatory authority. It is intended to help the end user use the product safely and effectively. It would be useful to have a comprehensive online database of package inserts so that they could be printed when extra copies are needed. But too often package inserts are not written in user-friendly language – that’s another problem.

Why should we move over to SPCs? • The SPC contains the definitive information on a licensed medicine. • The SPC contains the full authorised information, including pharmacology information, which can help prescribers. • There is an SPC for every licensed medicine and a database containing every one of them. • Data sheets have no legal status. • Data sheets do not exist for every licensed medicine. • Relying on the data sheet Compendium alone means not being aware of all available licensed medicines. Understandably the data sheet Compendium is a very familiar resource. But it’s potentially confusing to have two documents that purport to fulfil the same purpose, side by side, separately

updated, with different names. The continuing existence of data sheets for licensed medicines also distracts the veterinary profession from SPCs. Official documents (e.g. the RCVS Practice Standards Scheme modules) cite only the SPC when referring to up-to-date information on licensed medicines. The recent TV advert for Drontal refers viewers to the SPC for further information, so patients will become more aware of SPCs.

How can we move away from data sheets? NOAH could include only SPCs in its Compendium. For users of the online version, this wouldn’t be too much of a change. But the book version would be probably be bigger (because there is more information in SPCs) and the layout of the information unfamiliar; but as veterinary professionals increasingly use digital resources perhaps the phasing out of the book is inevitable. The next question is whether we need two databases of SPCs? Is it possible for NOAH and the VMD to work together to create a user-friendly and comprehensive database of SPCs and (client-friendly) package inserts? The availability of prescribing information (on licensed and unlicensed medicines) for veterinary professionals overall could do with a review. And surely it’s time to consign data sheets for licensed veterinary medicines to history? Andrea Tarr is a pharmacist and a specialist in medicines information. She spent over 20 years producing independent information for doctors on medicines. In 2012 she founded Veterinary Prescriber, a unique source of independent information on veterinary medicines for veterinary professionals. Andrea has broad technical and clinical knowledge of medicines, an understanding of the practical and regulatory aspects of medicines use, and skills in critical appraisal of evidence, in integrating different types of evidence with clinicians’ views, and in communicating information in a succinct and practical way. To keep in touch with clinical practice, she works a regular session in a rural independent community pharmacy where she sees the occasional veterinary prescription.

SPVS/Mind Matters Initiative Wellbeing Award SPVS Senior Vice-President, Nick Stuart, announced at the BSAVA press conference that entries are now being accepted for the innovative SPVS/MMI Wellbeing Award.

he Wellbeing Award will recognise those practices with management systems and initiatives that motivate and engage their staff and who can demonstrate their commitment to being a better place to work.  Entries can be from branch surgeries or whole practices and there are three different categories, depending on number of employees. The prize for each category includes two registrations and banquet tickets for VPMA/ SPVS congress 2017.   Speaking at the launch, Nick said: “There is much discussion within the profession about preventing mental illness and suicide. While this is vitally important, there can be a danger of painting too gloomy a picture of modern UK veterinary practice. These awards will help the understanding of mental wellbeing and the role this can play in job satisfaction, with the knock-on effects

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of reducing staff turnover and increasing profitability. The awards recognise that there are many practices out there where the staff are motivated, feel valued, and look forward to coming into work each day!”   Neil Smith, Mind Matters’ chair, added: “We are delighted to support this exciting new award. Celebrating what practices are doing well is important in terms of inspiring change, offering positive case studies and, perhaps most importantly, maintaining a positive approach to wellbeing as a key activity for all of the veterinary team.” The awards website includes a wellbeing checklist that anyone can complete, whether or not they are entering, to audit their own practice performance and use to pick up tips on other activities they could implement. The closing date for entries is 30 September 2016. For further information, visit www.spvs.org.uk/wellbeing

SPVS NEWS

SPOTTING THE SIGNS Recognising abuse in animals and humans Most of us have never seen a case of animal abuse – or have we? We may have heard about the link between systematic abuse within human relationships and of animals, especially cats and dogs, but the reality is often that we think – hope perhaps – that others are dealing with it. Hazel Bentall, SPVS Hon Secretary, reports from a meeting discussing these issues. Herts and Beds Veterinary Society held a joint meeting with local GPs and child-safeguarding professionals, where Paula Boyden, Veterinary Director of Dogs Trust and a leading member of the Links Group, gave a very thought-provoking talk. The addition of some shocking images of victims of abuse, both child and animal, flagged up just how groundbreaking the early articles by Helen Munro and Mike Thrusfield were in raising awareness (JSAP 2001). It seems that those people, mainly men, who have a need or desire to control, may, occasionally, do so by physical abuse, violence, or psychological manipulation which may include maltreating a much-loved family pet or threatening to do so if someone tries to leave an abusive situation. Abuse can be mental or physical; of course physical leaves more of an evidence trail, but the message was that we need to be less believing, and more open to the possibility that injury could be non-accidental. Paula said that, as clinicians, we have particular barriers to opening our minds: • We find it hard to believe that our clients come to see us, and pay us, for them to lie to us; • We expect them to behave towards their pets in the way that most people do; • Perhaps subconsciously we are aware that we are often solitary workers in this situation, could be targeted as our work place is known, and that we could be disbelieved if we report suspicions; • We don’t feel equipped to diagnose abuse with certainty; and • We may be fearful of legal actions or complaints if we get it wrong. However, she gave examples of stories given by clients, which should alert us to inconsistencies between the history and the evidence before us, using our knowledge and experience. Her real examples included the following: • Cats do not fall down stairs; • Dogs do not play with matches; • Cats cannot turn microwaves on from the inside; • Dogs do not fracture their skulls falling off the sofa; • Animals do not attempt to or commit suicide; • After a dog has had two cans of Stella it’s not okay to amputate its injured leg. The meeting continued with presentations and discussions about child safeguarding and how agencies and individuals could better combine their efforts so that no-one falls through the safety net. It was clear that the links between human and animal abuse had not previously been known to most of the medics, and it provoked a lot of discussion

about how and where to report suspicions without breaching confidentiality and overstating the case. The experts clarified that the role of clinicians, both medical and veterinary, was to record and report, but not to take the position of expert witness or judge. This includes the practice team as well, since receptionists, veterinary nurses and others may spot inconsistencies and should record those and report to more senior staff. Forensic pathology in abuse cases is highly specialised and the best way that we can assist is to keep excellent records in all cases, with a chain of identification, good photographs, radiographs and clinical history, supported by witness statements if possible. It is uncontroversial and merely stating a fact to record an owner’s version of what happened as well as any other versions presented by others and to mention when there are inconsistencies with the clinical findings. Without contemporaneous recording, cases are remarkably difficult to prosecute and opportunities lost. Hertfordshire is developing a confidential database of reported suspicions, which would be accessible to (and only to) those involved with suspicion of abusive situations. It is hoped that this sort of information will potentially make patterns of abuse easier to identify and act on. In the meantime, the best way forward is to develop personal relationships across all local relevant agencies, including general practitioners, social workers, teachers, dog wardens, and, of course, other veterinary colleagues. The vigilance of members of the veterinary profession could help to prevent not only a continuation of animal abuse, but also its extension to children and vulnerable adults. There is information to inform and help practitioners, from the Links Group, BVA, and Medics against Violence (see below). A good start is to have joint meetings between professionals – it is usually pushing at an open door to initiate one. Further information http://www.thelinksgroup.org.uk/site/pdf/Recognising_Abuse_FINAL_Sep_2013.pdf http://www.bva.co.uk/News-campaigns-and-policy/Newsroom/News-releases/Spottingthe-link-between-animal-abuse-and-domestic-abuse-–-can-you-/ http://medicsagainstviolence.co.uk/DomesticAbuseTraining.html Hazel Bentall, BVSc, MRCVS, is Honorary Secretary of SPVS Practice Life z June/July 2016 z www.practicelife.biz

Nurse Talk

NURSE TALK

In association with

CLINICAL ABSTRACT SUBMISSIONS

Have you recently graduated or will be graduating in the summer, are a RVN or VS working on a research project or clinical audit? Why not submit an abstract to BVNA now? You have done the hard work already; share it and get some recognition for all your hard work and be a presenter at BVNA Congress 2016! BVNA invites the submission of abstracts in the following categories: Clinical Development in Veterinary Nursing Those with an interest in small animal or equine-related veterinary nursing practice are invited to submit poster abstracts on this topic from academic research or clinical audit.

Educational Innovations, Excellence and Research Those with an interest in teaching strategies, assessment and innovation in the modern veterinary nursing curriculum are invited to submit on an educational topic. Applicants can make submissions for Posters (producing a landscape A0 size poster, which will be displayed at BVNA Congress). You will be required to attend the abstract session to support the applicants who will be presenting. Alternatively, or as well, you could do an oral presentation (five minutes to outline your research; you will be interacting with the chairpersons and audience for a further two-minute question-and-answer session. In addition, you are required to produce a poster as detailed above). Successful applicants are given access to Congress for the day to attend lectures and visit the commercial exhibition. The closing date for submissions is June 30, 2016. Visit www.bvna.org.uk for more information.

Presidential update, Sam Morgan, BVNA President It has been six months already since I took up the post of President and it has gone by unbelievably fast! I wanted to provide a little update on what I have been doing these last couple of months in the BVNA presidential role. VN Futures This is a joint project between the RCVS and BVNA; the VN profession is a young one and we want to start it off right by pointing the way to the future and where we want to be in five years’ time. The VN Futures project kicked off with an initial meeting in January at the RCVS, with over forty representatives from across the profession in attendance. Some key themes emerged of where we need to focus efforts. RCVS and BVNA have since been ‘on the road’ and gathering the thoughts of the profession from around the UK. The final VN Futures report will be published at the VetFutures summit on the 4th July 2016. RCVS Ethics Review panel This panel is being funded by the RCVS for practising veterinary surgeons and veterinary nurses who wish to undertake practice-based research without access to university facilities.

It will be free to submit applications though this panel. Initially this will run for a year and it would only be for projects involving dogs and cats during this trial period. If you are a RVN and would like to start a research project in practice then please contact BVNA, we can put you in touch with one of our council members who can guide you through the application process when it opens in July. BHWT chicken rehoming day I had the pleasure in March to help out our Charity of the Year, the British Hen Welfare Trust, at one of its rehoming days. That weekend, the charity rescued 4,000 chickens from a battery farm and shipped them out to 15 ‘pop-up’ locations around the UK. When the chickens arrived they were unloaded from their crates and checked over before their new owners came to collect them. The birds are generally very hungry and thirsty, often haven being starved for a few days.

Some are cold and shocked so they need a bit of TLC prior to moving on. At this location we had around 250 hens and they all found wonderful new retirement homes from people who had pre-registered to collect them. All the volunteers adore the hens and really ensure their welfare is paramount. I want to thank everyone for the money we have raised so far for this amazing charity, spending just those few hours with the team and the hens has cemented my thoughts that the BHWT is a very worthwhile cause. If you are interested in volunteering, would like to register to receive some hens, or are interested in finding out more about the charity, visit www.bhwt.org.uk

BVNA WEBINARS: If you have not yet heard, BVNA has a new membership benefit… access to free webinars through VN Knowledge. VN Knowledge is an online platform delivering select webinars, webcasts and online learning tools for veterinary nurses, kindly sponsored by Merial. The webinars are designed to meet the current RCVS CPD requirements and also take into account the demands of the busy veterinary nurse of today. To get started all you need to do is register with the site (using the same details as your membership). This is quick, simple and FREE for BVNA members! Current webinars include: • Canine heart disease ,• Endoparasites • Equine wounds • Clinical examination of chelonia and snakes • Ectoparasites • Dog bite prevention and the law • Stress and compassion fatigue • Anaesthesia • Ultrasound With a new webinar being released every month, come and have a look! www.practicelife.biz z June/July 2016 z Practice Life

NURSE TALK

Life as a BVNA RCO BVNA has a dedicated Regional Coordinator team whose goal is to organise meetings and CPD seminars on behalf of the BVNA; they are also there to help any member in their area access BVNA support. However,

with a growing number of members we are looking for more volunteers to help us with this important work. As a BVNA RCO the main work is setting up and running regional meetings. You are expected to hold a minimum of eight hours’ CPD per calendar year. These meetings are offered to both BVNA members and non-members, enabling you to build a community of veterinary nurses in your region. Any expenses for your travel to the meetings, postage, stationery, and so on, are covered by BVNA. The BVNA Office team assist you with invites, e-mailshots, and any general queries you might have. BVNA will keep in contact with you throughout your time with us by using email along with a dedicated Moodle platform, which includes a forum, to discuss anything with the other RCOs from across the UK and Northern Ireland. For the past few years, Bayer Animal Health has kindly sponsored the BVNA RCO of the Year competition, whereby all BVNA RCOs are automatically entered into a competition that rewards them for their efforts in organising meetings

throughout the Council Year. Every year in October BVNA hold its annual congress and, as a thank you for your hard work during each year, you will be invited by the current RCO Team Leader to congress. Shared accommodation is provided along with a ticket for the Saturday evening dinner dance. BVNA will also cover your travelling expenses. We are looking for a RCO for each of these regions: • ‘Southern’ north-east • Northern Ireland • Scotland • London • Bedfordshire, Cambridgeshire and Hertfordshire • Norfolk • Cornwall and Devon • Dorset • Channel Islands • North Wales If you are interested and would like to receive a detailed information pack, along with an application form, contact Alison Watkins: alison@bvna.co.uk. We look forward to hearing from you and to you hopefully joining the team!

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COLLEGE CORNER

College Corner

TAKING CHARGE OF OUR FUTURE When it was launched at the end of 2014, the Vet Futures project had the very ambitious plan of helping the veterinary profession prepare for and shape its own future. Here, Lizzie Lockett, Director of Strategic Communications at the Royal College of Veterinary Surgeons (RCVS), looks at how the initiative has developed since, as well as the launch of the accompanying VN Futures project. Lizzie Lockett

Once the research stage of the project was finished, then came the hard task of analysing all the information and collating it into a report. The Vet Futures report – Taking charge of our future: a vision for the veterinary profession for 2030 – was launched at BVA Congress in November 2015 and contains 34 recommendations, organised under six ambitions: animal welfare; vets’ wider roles in society; mental health and wellbeing; veterinary careers; sustainable veterinary business; and leadership.

Action stations

hen the RCVS joined forces with the British Veterinary Association (BVA) to launch Vet Futures it is fair to say we were expecting some interest and engagement. After all, it was dealing with the pretty broad topic of the future of the veterinary profession – an important issue but one that isn’t necessarily addressed, or even thought about, by practising vets as they go about their busy lives. The overall aim was to get vets from all walks of life – including clinical practice, academia, industry and government – to think about what the threats and opportunities might be for the profession within a 15-year timeframe. Throughout the course of 2015 the RCVS and the BVA took these questions directly to the profession through various means – including surveys with vets, vet students and members of the public; a series of roadshow events attended by around 450 vets, veterinary nurses and other interested parties; faceto-face meetings with individuals and key stakeholder groups, focus groups and phone interviews; and, e-newsletters, polls and blogs, among other methods.

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While we had a lovely looking and comprehensive report, the project can’t rest on its laurels and words have to be turned into actions. This is why, at the end of 2015, we opened up applications for people to join the Vet Futures Action Group, which has been tasked with turning the report’s recommendations into actions. Members of the Action Group were chosen from over 80 applicants, and selected to ensure a balance that reflects both the profession at large and the range of experience needed, particularly in certain specialist areas, to rise to the challenges at hand. The group includes the current presidents and junior vicepresidents of both the RCVS and BVA, as well as a mix of individuals from practice, academia, industry, animal welfare and other organisations. For the full list of members and detailed biographies of each please visit vetfutures.org.uk/vetfutures-action-group. At the time of publication the group has held productive meetings, including hearing from those who are committed to taking action, and will launch an action report at a special Vet Futures Summit taking place on July 4 at the Royal Veterinary College in Camden. Anyone is welcome to attend this event and tickets (costing £20 to cover the catering) can be purchased at vetfuturessummit.eventbrite.co.uk.

VN Futures At the same event the VN Futures Action Group will also be delivering its own action plan dealing with the very specific issues affecting the veterinary nursing profession; for example, those around career structure, retention of staff and how veterinary nurses view Schedule 3 of the Veterinary Surgeons Act and what it means in practice. The VN Futures project and Action Group came out of one of the recommendations of the Vet Futures report to “encourage veterinary nurse leaders to develop a report and

COLLEGE CORNER

recommendations which are directly relevant to veterinary nurses and their future...”. Following a joint meeting between the RCVS VN Council and the Council of the British Veterinary Nursing Association shortly before the latter’s Congress in October 2015 it was decided that a VN Futures project would provide the leadership and engagement to achieve this. An initial meeting with a broad range of stakeholders took place on January 7, 2016 and, following this, the action group was set up to take the project forward and deliver an action plan on July 4. The Action Group comprises a mix of individuals involved in the training, representation, regulation employment and management of veterinary nurses. Full biographies of the team are available at www.vetfutures.org.uk/vnfutures While the timeframe for Vet Futures runs until 2030, it was felt that a shorter five-year time frame might be more appropriate for veterinary nursing as it is a younger profession with a shorter training cycle and lower retention rate. As part of our consultation process with veterinary nurses we have held a series of engagement meetings throughout March, April and May that have thrown up many interesting issues but also opportunities for the profession to take forward in the coming years.

Schedule 3 Related to the VN Futures project is a commitment by the DEFRA to carry out a review of Schedule 3 of the Veterinary

Surgeons Act 1966. We hope that this review will expand the role of veterinary nurses in assisting with anaesthesia, as agreed by RCVS Council in November 2015, as well as simplifying the language of Schedule 3 to give both veterinary surgeons and veterinary nurses more confidence in delegating and undertaking Schedule 3 activities, respectively. At BSAVA Congress in April we held a session on Schedule 3 in which we asked delegates from both the veterinary surgeon and veterinary nurse professions to provide feedback and ideas on how to strengthen and advance the veterinary nursing profession through potential changes to the Schedule. This feedback will be considered by a working party we will be commissioning to form a settled view on how Schedule 3 might be reformed before entering into formal discussions with the Department.

For more information More information about the Vet Futures project can be found at www.vetfutures.org. There is also a dedicated section of the website for VN Futures at www.vetfutures.org/vnfutures To read the 2015 Vet Futures Report in full visit www.vetfutures.org.uk/report

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HOT TOPIC

CREMATION AND DISPOSAL: separating fact from fiction

Many myths surround the cremation and disposal of pets, from both the perspective of the pet owner and the veterinary practice, which can make what is already a very tricky time even more sensitive if expectations are not tactfully managed. Here Helen Tottey tackles some of the areas that have given rise to concern from pet owners and practices alike.

s a veterinary practice you have a duty of care to your clients when it comes to the services offered for the disposal of deceased pets and body aftercare arrangements. Despite the actual processes happening off-site, a client’s “contract of sale” rests with the practice.

Role of the practice There is a duty of care obligation by vets to their clients to make sure all the different disposal options and services are explained fully to clients to avoid misunderstandings. Euthanasia is an extremely stressful time for owners and they are likely to be very upset, which means they may not take in information easily. Explaining the disposal options simply and clearly and giving the owners a leaflet or directing them to information on your own website or to a dedicated resource may help them make a decision once they’ve had time to think about it. Motivations behind such a decision will have many drivers, such as cost, emotional attachment, removing some of the burden from an owner’s hands, religious beliefs, and how a client may wish to remember their pet. Before offering any of the body after-care services, however, it’s wise to visit the crematorium premises of the company you are planning to use and include your team wherever possible. It’s neither sensible nor honest to describe the services or environment of a crematorium if you haven’t witnessed it for yourself! Veterinary teams that have taken the time to visit a crematorium or waste facility often report this to be of great personal help. It makes the explanation for the owners much easier if they understand the process more fully, and they will be in a better position to be able to reassure the client. Providing written confirmation of the services selected by your client is a way of ensuring they can read it back afterwards and get an idea of what to expect from the process.

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Things to note When a practice “sells” a cremation to a client they should be aware that that constitutes a contract of sale; therefore, the practice will be the first port of call in the event of any issues or complaint procedures. Provide written assurance of the procedures on the “sale” of such a service so that the client is absolutely sure of what will happen and therefore what their expectations are. If a practice is unsure about what or how to offer cremation services, consider offering a disposal service only (but ensure that you are familiar with what this means: see below) and suggest to clients that they may wish to contact a cremation provider themselves.

The disposal options What do people worry about? When talking to pet owners, one concern that recurs is that individual cremations don’t actually happen and that a lot of pets are all “shoved in together”. Therefore, the ashes that come back are not of the owner’s cherished pet, they are a mix of ‘all-sorts’. The disposal of animal carcases by incineration forms the basis of what we now know of as pet cremation; however cremation itself and the handling of ashes is not covered in regulations. This is, in fact, a concession within the Animal By-Products and Waste Regulations and there is no formal allowance for practices to arrange cremations or pass back ashes to clients per se. The regulations are only concerned with a premise’s practice as a waste disposal site; there are no regulations around how a pet cremation should be carried out. Clients, however, have clear expectations of how an individual versus a communal cremation should differ and these must be fulfilled.

Individual cremations There are two main ways that individual cremations are undertaken: in individual chambers or by a system of trays within the furnace. The former is considered more reliable and there is less likelihood of error or mixing of pets’ ashes. A tray system is often operated to help the crematorium to

HOT TOPIC

to have that conversation. Doing it in a tactful way is essential but, again, it must be done honestly so that a pet owner knows what to expect and to not get (another) shock when the bill comes to be paid. And on that thorny issue, it is best practice to ask owners upfront how they would like to pay for euthanasia and disposal. Some will prefer to pay before and some after, either in the consulting room to avoid having to stand in the reception queue, devastated, and explain what it is that they’re paying for, or some will choose to pay by invoice a few days later, depending on your practice’s protocols. Having the conversation in advance is helpful to both the owner and your team by avoiding the difficult conversation after their pet has passed away. keep up with demand (as often there is only one furnace), but the natural combustion that takes place with the burning of a body will mean that there is a degree of mixing. Depending on how frequently bodies and/or waste are collected from a practice (some crematoria will operate waste collections as well as body pick-ups), the turnaround time is typically one to two weeks; however, this may be speeded up if an owner collects the ashes his or herself directly from the crematorium. When visiting a crematorium facility, look for good protocols, clear labelling, separate sites dealing with clinical waste and deceased pets, as some pointers.

Group cremations Communal cremations are commonly offered and may be appealing to some clients due to the relative lower cost than individual cremations. Some crematoria offer for a token amount of ashes to be returned to the owner. However, due to the mechanical process of cremation, there is no guarantee that any of the token ashes returned will contain any from the pet so many crematoria do not offer this service.

But what does happen to the ashes? Following a group cremation, the ashes are disposed of in varying ways. Some crematoria will scatter the ashes in a garden of remembrance, or inter them. For larger crematoria this may be difficult, simply due to the large number of bodies presented. In this case a proportion may be scattered or interred, and the rest are disposed of as waste.

Burial Pet animal species may generally be buried at your own property or in a dedicated pet cemetery, but this may vary from county to county and also across Scotland, Wales, NI and England, so contact the Environment Agency or local Trading Standards for confirmation. Outside these areas permission must be sought to bury a pet. If the owner is renting, then they will need to seek permission from their landlord to bury the pet in the grounds. Farm animal species may not be buried and must be disposed of through an approved fallen stock scheme. Horses may be buried in England, but only pet horses may be buried in Scotland; visit https://www.gov.uk/government/ organisations/department-for-environment-food-rural-affairs. A pet’s ashes may be scattered at home but if you want to do this on private land permission from the landowner should be sought.

Within the veterinary practice: euthanasia While the body-care of deceased pets is carried out away from the veterinary practice, each practice is responsible for the way euthanasias are carried out and it should be top priority for staff to ensure every single one is carried out as smoothly and painlessly as possible for all concerned (practice staff as well as clients). Turn to page 27 in this issue for an article on euthanasia and the client journey.

Simple disposal Should an owner choose not to bury or cremate their pet, a simple disposal option may be available. Collection of the pet’s body from a practice by a licensed Animal By-products carrier is arranged, and the pet then disposed of through a regulated site, which may include landfill. Should this be offered by a practice, it’s important to clarify with the carrier exactly what will happen to the body, and ensure that the owner is comfortable with this. It’s not unreasonable for an owner to be very distressed if they find out at a later date how their pet was disposed of.

Charging the client While clients will likely know that euthanasia and cremation/ disposal will have an associated cost, many practices find it hard

Helpful resources for your clients about aftercare: www.compassionunderstood.com Details the various options, as well as other information on the pet loss journey www.theralphsite.com Includes a forum on pet loss www.bluecross.org.uk has a Preparing to Say Goodbye leaflet for pet owners which includes some information on cremation.

Practice Life z June/July 2016 z www.practicelife.biz

VDS News

REMAINS TO BE SEEN M

rs Pargetter wept as she faced the inevitable and finally agreed to have her 18-year old Miniature Poodle, Matilda, put to sleep. Through floods of tears, she informed the receptionist she was too old to consider getting another dog, and in any event Matilda was ‘simply irreplaceable’. To add to her anguish, the fees associated with individual cremation were beyond the munificence of a state pension. But she was greatly reassured by the kind-hearted receptionist who explained that Matilda’s ashes would be scattered in the Rest A While pet crematorium’s ‘spectacular’ gardens. Weeks later, Mrs Pargetter was still struggling to come to terms with her loss and, having plenty of time on her hands, decided to use her senior citizen’s bus pass to visit the Rest A While gardens, as they had sounded such an idyllic restingplace for poor Matilda. After three tortuous bus journeys, she rather regretted her decision. She found herself on a lacklustre out-of-town industrial estate, rather than in the peaceful rural countryside she had imagined after perusing the glossy crematorium brochure provided by the practice. Entering the crematorium’s unkempt offices, Mrs Pargetter was greeted by Alf, a rather dishevelled individual blending in nicely with the décor, who hastily pushed a bulging yellow bag out of view with his left foot. Although he was more than happy to answer Mrs Pargetter’s enquiries, after decades working with the dead he had been left with little sense of tact. The little old lady left the building with one sentence ringing in her ears “The ashes just go into landfill luv”. It came as quite a surprise to the practice when ‘nice old’ Mrs Pargetter wrote a strong

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letter of complaint, graphically outlining her unpleasant experience and seeking ‘significant compensation’ or, rather less practically, insisting Matilda’s ashes be recovered from the landfill site. The VDS took up the claim and explained to Mrs Pargetter, as sympathetically as possible, that while the practice was mortified to have misled her, albeit unintentionally, she had suffered no real financial loss and was not therefore due any compensation. The claims consultant was able to sweeten the pill by explaining that the practice hoped she would accept a memorial in the form of a bench, or tree, on Matilda’s favourite walk to give Mrs Pargetter something to remember her by, together with the reassurance that the practice had dispensed with Alf’s services. Mrs Pargetter, not a cantankerous soul by nature, was mollified, and accepted the offer. However, in closing the case, the claims consultant explained to the practice principal that this was not the first claim of this nature, and some had involved substantial loss and significant pay-outs. More importantly, such events were frequently accompanied by adverse publicity in the local rag and no little embarrassment for members. In addition, he pointed out there had also been a number of RCVS complaints involving less than open communication regarding a crematorium’s activities and it is therefore always advisable to ensure all members of the practice team know exactly what does happen to little Fido’s or even Neddy’s remains when they leave the surgery or stables. A practice outing to view the crematorium facilities is prudent, as it is best to be completely honest with clients, however unpalatable the truth might be.

WELL-BEING

MIND MATTERS AT BSAVA CONGRESS Lizzie Lockett, Mind Matters Initiative Project Director, looks at how far the initiative has developed in the year since its launch and the positive response it has received from across the veterinary professions

t last year’s British Small Animal Veterinary Association Congress only a few people had heard of the Mind Matters Initiative (MMI) – the project that is being driven by the Royal College of Veterinary Surgeons to help make a real difference to the mental health and wellbeing of members of the veterinary team. But then again, we had only just launched... What a difference a year makes! At this year’s Congress (April 7-10, Birmingham) we were inundated with vets, nurses and practice managers wanting to know more about what we were doing, understand how they could get involved, and share their experiences. The level of interest and engagement is an indication of the need for something such as Mind Matters in the veterinary profession, to raise awareness of the issues, help reduce the stigma around mental health, support those in difficulties and promote positive mental health and wellbeing. It’s also a reflection of a wider zeitgeist: everywhere you look there is more exposure being given to mental health issues – whether that’s a celebrity who has ‘come out’ as having a mental health issue, a call for more funding from Government or an awareness-raising campaign. Of course it’s not good news that such a project was needed within the veterinary profession in the first place, but we are where we are, so the positive momentum that Mind Matters is gathering is very encouraging. On the Saturday of BSAVA Congress we held a small press conference to recap on progress so far and announce some new initiatives.

Mental health awareness training We were able to announce that thus far we have taken around 150 members of the veterinary team through mental health awareness training, plus 50 RCVS staff, with great feedback. We are planning a series of courses across the country this year, the majority jointly with BSAVA, which is kindly sponsoring a series of sessions. These are small group courses – up to 25 delegates – so progress getting through all members of the profession is not going to be quick, but we hope that every person attending the course will spread the knowledge they have gained when they return to their places of work, like ripples in a pond. Dates and venues for the forthcoming sessions will be announced shortly.

Medical Minds Matter We also reminded the profession that we had organised an interprofessional symposium at Maudsley Learning – Medical Minds Matter – that brought together the medical professions to share issues around mental health and consider where we can work together to solve common problems. We have just produced a report of this event, and copies are available from me at lizzie@vetmindmatters.org.

Raising awareness Meanwhile, we have been keeping the conversation going around mental health, to try to change the culture and reduce stigma, with talks at events such as the London Vet Show, where MMI Chair, Neil Smith, spoke alongside commentator and political author Sir Anthony Seldon; taking part in the BVA’s Veterinary Visions video series; and talking to veterinary educators at a conference at the University of Liverpool last summer. Further afield, we sponsored veterinary surgeon David Bartram to talk at the first ever International Veterinary Wellbeing Symposium in Australia last year, and RCVS CEO Nick Stace outlined the Mind Matters project to around 50 Deans of US vet schools in January 2016, where there was a great deal of interest in what the UK profession is doing to tackle the issues. And we have since had interest in the project from regulators and representative bodies in France, the Netherlands, Australia and New Zealand. In January we were delighted to have mental health advocate Alastair Campbell as a speaker at the VPMA/SPVS Congress Mind Matters Stream (see short report in the March/April issue of Practice Life) – and even more delighted when he later heralded Mind Matters as ‘a big step forward’ for the profession. At BSAVA Congress we handed out small lapel badges bearing a mini version of the MMI logo so that people could show their support for the campaign. The badges are deliberately a bit oblique, so that they prompt a conversation about the project. If you would like one, please drop me an email and I will pop one in the post. So, with training courses, webinars and awards, there are lots of ways to get engaged with your own mental health and that of your profession. Follow us on Twitter to find out more @ vetmindmatters.org or email me on lizzie@vetmindmatters.org to be added to our email circulation list. Lizzie Lockett joined the RCVS in 2005, where her ‘day job’ is Director of Strategic Communications. In autumn 2014 she set up the Mind Matters Initiative (MMI), alongside its Chair, Neil Smith. MMI aims to make a difference to the mental health and wellbeing of members of the veterinary team and Lizzie runs the programme on a day-to-day basis. Practice Life z June/July 2016 z www.practicelife.biz

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MANAGING PEOPLE

SCALING UP:

moving from managing a smaller team to a larger one The change from a small team to a larger one presents many challenges, including communication, delegation, and giving effective feedback, explains Sarah Page-Jones BVSc, CertSAS, MBA, MRCVS

t is generally considered that small teams are innately effective and, consequently, many people find managing them very rewarding. However, with industry consolidation and numerous successful practices growing to become medium-sized enterprises, more owners and managers are being required to lead larger, more diverse and, sometimes, geographically dispersed teams. The size of a team may gradually increase over time as a business grows, or a promotion may mean that an individual is instantly required to lead a larger team and grow quickly into a bigger leadership role. Initially, it would seem that a gradual change is easier than an instant promotion, but this may not be the case. An instant change makes the need to develop further leadership skills and manage differently obvious, whereas a gradual change can find the individual in question puzzled as to why hitherto reliable approaches are now ineffective and unpopular. This can be compounded by management tasks taking up more time, further distancing owners and managers from the practice team and day-to-day events. No matter what your situation, there are many common personal and organisational considerations when transitioning to manage a larger team. In this article we will touch on some of the most important. These include: 1. Personal development; for example: • Transitioning into a bigger leadership role • Seeing yourself as a leader 2. Creating open communication channels, such as: • Sharing direction, objectives and goals • Discussing changes and new initiatives • Making information easily accessible 3. Effective people management, including: • Delegating appropriately • Giving timely and effective feedback

Personal Development People moving into bigger leadership roles often recognise that they need to think more strategically and use the skills of their team, but, in practice, this can be hard to do, particularly if you have perfectionist tendencies, like to be in control and/or find it difficult to trust others to do a good job. Pertinent questions to ask yourself include: • How am I doing my job? • How am I spending my time? • How do I see myself? These questions can help recognise what we’re actually doing compared to what we should be doing to take the business

forward and whether we see ourselves as effective leaders. This tends to dictate whether we continue with current behaviours because they fit with who we are currently and what others expect of us, or, if we can transition into and accept a new identity and feel comfortable acting accordingly – learning as we go from experience rather than relying on introspection. It can be helpful to take a step back and write down what someone in your new role should be doing and compare this to what you’re actually doing. It’s then possible to work towards spending time on the important areas of your enhanced role while moving away from tasks of the past. This can be easier said than done, however, particularly if you’ve been promoted within the same organisation. For example, if you were Head Nurse and you’re now Practice Manager, people will still come to you for all their nursing queries simply because this is what they’re used to. If you don’t acknowledge this from the start and direct people to the newly appointed Head Nurse (even if he or she then has to ask you for advice) you will continue to be Head Nurse despite your new job title. This means you won’t have time for your new role and your new Head Nurse is likely to become disillusioned and resentful. This particular transition further illustrates the importance of identity growth and transformation to believe in yourself as a leader since you are likely to be managing people who may previously have considered you equal or subordinate. This is where working reflexively on emotional skills and self-awareness will help you change your behaviours to reflect your new position without having to rely on hierarchical authority and a dominant style in an (often unsuccessful) attempt to make people do as you say.

Communication The importance of communication cannot be overemphasised; it underpins so much of what is important in managing larger teams. Small teams tend to communicate well as a matter of course since they work closely together every day. As a result, people feel listened to, well-informed and included in decision making without the need for any formal structure; this tends not to be the case in larger teams. This is particularly evident as practices grow and the owner(s) become more distant from employees. They continue to make decisions for the practice, but people no longer know what’s going on. Change appears to be imposed with no warning, people don’t feel listened to or included and this can significantly impact team motivation with employees and owners resenting each other and placing blame for breakdowns in relationships and trust. Practices that have run more like family concerns than businesses tend to strongly resist the implementation of structure and processes, but it’s important to instigate more Practice Life z June/July 2016 z www.practicelife.biz

MANAGING PEOPLE

formal communication channels and meetings in order to keep the team informed and involved, to communicate objectives, clarify responsibilities and discuss new initiatives and changes. Even with what might feel like an overly formal agenda, meetings can still be relaxed in style and approach and can be conducted anywhere that suits the team – including the pub! For those who manage remotely or have large mixed, farm animal or equine practices where people are spread far and wide, remote meeting tools can be very useful. Regardless of your situation, try to avoid simply telling employees what’s going to happen; listening and incorporating others’ views will lead to better decision making. It may be appropriate for smaller groups to hold information tacitly, but this doesn’t work well for large and growing teams. Making practice information explicit and available, perhaps via an intranet or a secure file-sharing site may make the business run much more efficiently and help standardise processes as you grow. This doesn’t mean everyone becoming robots but, if, for example, there’s a standard cashing-up procedure that everyone follows, this can save time and a lot of headaches for those trying to balance the books!

People management: delegation Delegation can be difficult, particularly if you like doing everything yourself – you want to retain control and you have exacting standards. You need to be clear about what to delegate and what to retain, be prepared to coach and develop others and delegate responsibility AND decision-making authority while maintaining overall accountability yourself. Don’t forget to communicate new roles and responsibilities to the team to avoid confusion. Avoid delegating responsibility without giving the recipients the necessary authority and then placing blame when things go wrong and reclaiming the task immediately. Also avoid retaining tasks that you like doing but that should be done by someone else, such as. organising social events; and, conversely, delegating things you’d rather avoid. For example, if there is a personnel issue you need to address, don’t try to make someone else do it; chances are you’ll end up in a worse situation with a more complex problem that at some point you will have to face anyway. Many people say they don’t have time to delegate and it’s quicker to do things yourself and/or there’s no one in the team with sufficient skill to do the job properly. This results in people continuing to do tasks that should be completed by others and, consequently, having no time for their actual role; in effect you work yourself into a competency trap (Figure 1). It also means that your team is denied developmental opportunities. The truth is, delegating a task does require an initial time investment, but you will be repaid handsomely with more time in the future to spend on (for example) strategy, innovation, leading change and developing people. Others will take longer and initially be less skilful than you, but, with time, they will improve and even if they don’t complete the task in exactly the same way as you, it can still be done well, or at the very least, well enough.

People management: effective feedback Managing a large team can mean that managers rely on yearly appraisals to give feedback, which may result in issues being www.practicelife.biz z June/July 2016 z Practice Life

Figure 1: The competency trap

saved up and employees being blindsided. It’s also difficult for someone to remember why, for example, they were late on three occasions four months ago, or understand why you didn’t mention that they were recording blood results wrongly when they joined the team. If you had, they would have rectified the situation immediately. This can result in small issues escalating or significant issues seeming irrelevant by the time they’re discussed, leading to resentment on both sides. It makes much more sense to address issues as and when they arise and resolve them rather than storing up criticisms for a future date, no matter how busy you are. Giving constructive feedback doesn’t mean wrapping up what is perceived as a negative comment within other positive ones; all you’ll succeed in doing is confusing the person. It means giving specific information on the issue – “You were 20 minutes late on the 15th and 30 minutes late on 21st”, not “Tracey told me you’ve been coming in late recently”. It also involves allowing the person to give their version of events and reasons together with their ideas for resolution, and for you both to agree specific actions and follow up. This allows you to uncover any underlying issues and move forward towards resolution, or, if necessary, it forms a basis for more formal action at a later date.

Concluding thoughts Leading a large team of committed and motivated people can be incredibly rewarding, but cannot be achieved without accepting the inevitability of change and continuing to reflect on and develop your personal skill set together with organisational practices, structures and processes. A level of vulnerability is necessary to push yourself to move away from current competencies and comfort zones towards personal (and perhaps organisational) transformation. Sarah qualified from the University of Liverpool in 1997 and completed a RCVS Certificate [in what?] in 2006. She held senior clinical and managerial positions in corporate and independent organisations prior to founding SPJ Consulting in 2011. Sarah completed an MBA in 2013, graduating with distinction, and is an associate member of the Centre for Evidence-Based Management. Her expertise lies in strategy and organisational change, leadership and people management and she is currently studying towards a PhD in Organisational Studies.

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CLIENT CARE & MARKETING

END OF LIFE: THE CLIENT’S JOURNEY Libby Sheridan MVB MRCVS reflects on her euthanasia experiences in practice and wonders if she got it right all of the time?

recently met a rather lovely pet owner called Lesley in the course of a project I was working on. Lesley was helping us with the filming of some video footage on her perspective as a pet owner, who over many years of ownership of various pets, had been on the pet end-of-life journey many times. As well as being incredibly warm, funny and articulate, Lesley very much reminded me of some of the lovely clients that I’d had over my years in practice. The particular clients that sprung to mind were absolutely dedicated to their pets and would follow my advice in a sensible and responsible way that respected my clinical judgment and recommendations. Lesley’s ponderings on end-of-life led me to think about my own role in performing euthanasia for many of the long-term patients that I’d cared for (as well as some shorter-term or unknown patients). I can remember many of them very clearly, and still have some photographs of the pets that owners had given to me after their passing. Looking back, I think on the whole I did a pretty good job. I’d have the relevant discussion when “the time” had come, and over the years I’d honed my technique for a gentle and smooth euthanasia, which was signposted to the owner carefully in advance of the procedure, and left them with five or 10 minutes afterwards to spend alone with their pet. And I got the thank-you cards and the boxes of chocolates, so I must have been doing it right, right? Some of the clients I saw again, and some I didn’t. I presumed they just hadn’t got a new pet yet, and over time they would slip from my mind www.practicelife.biz z June/July 2016 z Practice Life

as I carried on busily with my job. But my recent work has led me to reflect more deeply on that end-of-life journey. I realise that much of my thinking and reflections are (naturally) from my own perspective. How did I handle “the right time” conversations? Did I allow enough time for the euthanasia consultation to give the owner a “good experience”, but not put that afternoon’s appointment list too far behind? Did I get the vein first time every time? (I’m a typical vet perfectionist after all!).

The owner’s view But let’s flip that view. What does the owner see and, more importantly, feel? Did they feel involved in the decisionmaking around the end-of-life of their pet? Did they feel properly equipped with information to help judge their pet’s quality of life that didn’t leave them pondering afterwards whether it was too early, or worse, too late?* Did they feel affirmed in their decision? And what did they see? They’d see an “efficient” procedure. They’d see their pet’s head drop and deeper breaths as they pass. They’d sometimes see gasps or twitches, but they had been prepared for these eventualities in the conversation just before. But they also see their pet go from alive to dead in 30 seconds or so, and prior to coming into the room just five minutes ago, they had no idea what would happen next. And we know it’s followed, often, by the sense of very deep loss, or perhaps an emotional blunting, and often guilt. Years of companionship are condensed into an ending that takes

CLIENT CARE & MARKETING

15 minutes, or maybe half an hour, if they’re lucky in the appointment scheduling.

A long journey My reflections brought home to me that the end-of-life journey isn’t just what we do in the consult room either. While it’s so very important that we get that right, the journey of loss for the pet owner is so much longer. It starts right back at that consult where they are starting to see that their pet’s days are now numbered, through age, debilitation or disease. It’s in the back of their minds every time they bring their pet on a walk or have a cuddle on the sofa that this could be one of the last. They’ll often push it to the back of their minds, as they just don’t want to think about it too much, and carry on in the hope that day won’t come. I now know this to be anticipatory grief. Through my background learning, I’ve put a name to it, and suddenly I see and hear about it everywhere. Through the many conversations I’ve had with pet owners, I realise that it’s there in the background of the owners’ minds whose pets are now geriatric or terminally ill. If they’ve lost a pet before, it’s even more present, as they know what’s coming. And this pet loss journey continues in the weeks or days up to the end. Over 80 per cent of pets in this country are euthanased, so most will end their life in a veterinary clinic. The owner’s experience continues and includes the much-

talked-about client journey, from the telephone call to the clinic to book the euthanasia appointment, through to their departure from the clinic afterwards. Only this journey is different. There are very deep and painful emotions that now underlie the more superficial conversations that we’re having with them. I now know that their experience of being on the end of a phone, and having to talk about such matter-of-fact things as what time they would like to come in, did they want cremation, and the weight of their pet (as that will reflect in the cost), is very traumatic for them. What we in the clinic see as being efficient (again!) doesn’t make for a very nice experience on the other end of the phone, where words are hard to find, and the expediency of the discussion grates on delicate nerves. And then they arrive into the busy reception where there is no external recognition or acknowledgement of why they are there, and they’re asked to take a seat among the sniffing dogs, the chat about the new puppy, and where they wait and wait and wait. Afterwards, with empty lead or basket in hand, they have to stand at reception to pay, which again is handled in a polite, perfunctory way and they are told they’ll get a call in 10 days when the ashes are back. It’s all very streamlined and smooth and efficient. And we think we are doing a good job because we don’t get complaints and we get lots of chocolates and cards. But where’s the compassion? Where’s the true recognition that for our client this is an incredibly deep and painful Practice Life z June/July 2016 z www.practicelife.biz

CLIENT CARE & MARKETING

We’ve taken this extremely important and pivotal part of the pet owner journey and put it into a time-limited and rigidly defined box that doesn’t allow for emotional care-taking of our client as well as, no-less-importantly, ourselves. Are we contributing to the frustration of so many pet owners that they can’t openly express their grief as ‘it’s just a pet’? Our societal norms don’t allow for the same expression of grief or ritualisation that follows the death of a person. Yet this expression is so important in helping the bereaved come to terms with their loss. By not acknowledging the true depth of this pet loss experience for our owners and giving it due attention and time, are we guilty of perpetuating this disenfranchisement? This might go some way towards explaining why, on average, up to 20 per cent of clients don’t return to the same surgery with a new pet after the loss of their previous one (And now I wonder how many of my clients that I never saw again this might apply to?). Isn’t it time we made more time to look at end-of-life? experience? A client that has probably been with us for a very long time and we’ve got to know well. With their departure from the clinic, our job is done, and we get on with tending to the living.

*I was lucky to attend Shailen Jasani’s lecture with a similar title at BSAVA Congress 2016. If you’re a BSAVA member I’d recommend listening to the podcast for an interesting discussion.

VDS COMMENT ON EUTHANASIA Procedures best described as ‘the euthanasia from hell’ are a rite of passage for the majority of members at some stage in their careers, to some extent irrespective of the number of grey hairs they sport. The act is not an exact science, of course, and as the procedure is typically accompanied by an understandably upset client, it makes for a powerfully explosive mixture when things do not quite go to plan. Owners expect all to run smoothly, but the practical difficulties of hitting a vein and the occasional unpredictable vocal reaction to the drugs employed, lead to a steady stream of complaints and RCVS concerns. Even if the deed is carried out successfully the thorny issue of body disposal trips our members up repeatedly, with beloved pets sent inadvertently for mass, rather than private, cremation, creating another rich seam of bother for the practice.

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The underlying common factor is misinterpretation of the events set before the veterinary team by the grieving owner. Undoubtedly the spark for complaints is typically lack of adequate communication by the veterinary surgeon involved, perhaps related to the difficulty of discussing the death of an animal directly with a grieving client. However, euthanasia consultations undoubtedly offer the opportunity for us to shine in the communication department by explaining the nature of the procedure first, including all the various pitfalls and ensuring clear written instructions have been obtained regarding the pet’s final journey to the crematorium. This way you have fully informed consent; therefore, even if matters do not go perfectly and a complaint subsequently arrives, it can be batted away with ease.

CLIENT CARE & MARKETING

CASE STUDY: ISSIE Pet ownership is a bittersweet experience as a pet nears the end of its life. Seeing her parents go through this recently inspired Emma Dahm to recount the experience

saved Issie (full name a rather grand Isadora) from going back to Battersea Cats’ and Dogs’ Home, which is where she came from originally. She had been with her London owner for several years but, due to a change in circumstances, she couldn’t take her when she moved to a new flat; therefore, Issie was looking for a new home. As a family we’d had a tortie kitten, Pudding, in the late 1970s who lived until she was well into her 19th year and she was then euthanased in her favourite chair at home, very quietly but sadly missed. She was treated by the same vets for the whole of her life and when, after several years without a cat, I delivered Issie to my parents, she was duly registered with the same veterinary practice. They, in fact, had nearly 35 years’ continuous “service” from my parents, which may deserve a medal on both sides! She came with a little paper “passport” from Battersea, explaining how she loved to go outside and was a friendly girl, and the original felt mouse she was issued with, now wellchewed. We were told she was “about seven” – aren’t all rescue cats? – and in rude health and sound mind. Despite vague protestations from my parents when I delivered her, they doted on Issie and she adored them. Apart from routine health checks she had little reason to visit the vet until her teens she started to get bouts of FLUTD – amazingly, during a bout, she’d hop into the (white) bath to wee so of course the blood in her urine was visible, and off to the surgery they’d go. The condition was managed although they never got to the bottom of it and her next health scare was hyperthyroidism, in her mid-late teens. This of course involved lots of visits to the surgery for blood tests and to get the dosage right to manage the condition. Being a fairly small, independent practice, staff turnover was relatively low and my parents generally saw one of the “long-standing” vets, who got to know Issie and my parents well. Around a year ago she started to be sick a lot and wasn’t coping well with food generally. Numerous vet visits ensued and every strategy was tried to help her, and mostly she trundled along fine, while her thyroid meds were tweaked and dietary suggestions implemented. My parents were “the converted” and were compliant with everything the vets suggested, they were so afraid of losing her. Eventually she became very skinny and the vets gave her medication to help her stomach. It was with a heavy heart that I had “that conversation” with my parents and suggested they might have to think about putting her to sleep as she was becoming malnourished due to not being able to absorb any food. She was still very happy in herself. Neither of them wanted to hear it, this had not been discussed at the vets so I understood totally and I left it for a while. Further reports of poor Issie still being sick ensued, and another visit to

the vet. This is it, I thought, she won’t be coming back. I gently suggested this might be the case but my dad wasn’t interested. In between visits he’d start to talk about how he couldn’t take her “to be murdered” and that she was going to be okay. It was total denial and it broke my heart, especially as he went out and bought lots of special food, packets and packets of Lik-e-lix as she seemed to keep this down better than solid food, and kept giving her all her medication. But off to the vet she went and I expected the call that evening. I went to see them a day or two later only to be greeted by Issie wandering around and jumping onto everyone’s lap as usual. When I asked what happened, dad said: “yes, we took her, but the vet sent her home, said it wasn’t her time yet”. She continued to deteriorate and within a week she was back at the practice and this time she didn’t come home. My parents didn’t talk about it, other than to say that there was no way they could “go in while she was murdered”, and that “it was a shame that a different vet did it, as he didn’t really know her, and that they’d wished it had been the vet who had been seeing her for a long time”. Issie represents a common scenario in practice, a beloved pet with owners who are looking for hope to keep them with them for as long as possible and a veterinary team who find it difficult to broach the subject of euthanasia for fear of causing further upset. However from the practice’s perspective, this upset can be reduced by thinking about when the topic of euthanasia is discussed. My parents were not willing to make plans for Issie and carried on in denial that she would go someday; a lot of clients hope their pets will pass peacefully in their sleep. Unfortunately this is rare, so finding ways to share this information with your client, in a timely way, either in a consultation, through the giving of leaflets, or through information on your website, will help them and the practice team prepare for the pet’s end. Issie came back from a private cremation in a neat pet’s box with a rose stapled to the front. Neither of them had the heart to open it so she stayed placed on her favourite spot next to the radiator, and my parents were hugely upset and down about it. She was much more than “just a cat”.

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HEADING

BUSINESS HEALTH & FINANCE

DEBT PREVENTION IS THE BEST CURE Practices may fall into bad habits when it comes to collecting in client debt, but this means hard-working vets are falling short when it comes to being fairly paid for their professional services – so look at a preventive strategy, advises Mike Brooks

We live in a golden age of access to information: thanks to the internet you can find most information that you either need or want to know using your computer, tablet or smartphone. Based on a decade of experience working with over 300 veterinary practices, veterinary debt collection service, DSL, has found that the power of information acquired is not always focused or harnessed in the right direction. In many cases trust is placed in a client and there is a hope that payment for services rendered is made in a timely manner; while this may happen some of the time or even most of the time, it does not happen all the time. It happens because the average practice manager/owner believes the following reasons are somehow valid when it comes to collecting what is owed: • They seem nice, they will pay eventually; • I haven’t got time to chase customers, I’m too busy; • We don’t want to upset the customer; • They may move to another practice; • We phoned and sent letters, what more can we do?; and • I can’t believe the client hasn’t paid again (when they have a negative payment history) www.practicelife.biz z June/July 2016 z Practice Life

The reasons given above are by no means exhaustive; practice managers and owners tell themselves that engaging the services of a collection professional is: • Risky; • Expensive; • Time consuming; and • Difficult to justify to customers. Sometimes it seems easier for a practice to ask the bank to increase its credit facilities rather than to collect what’s owed to them. Why should hard-working, professional vets have to act as interest-free source of credit and end up out of pocket for professional fees and treatment? At my company, the engagement model with veterinary practices ensures there is no risk through a no-win no-fee model with clients. The idea is to work with clients to ensure that their terms and conditions are changed so that the vast majority of collection fees are passed on to the customer/debtor and not the practice. The provision of simple information from the practice to the collection service means that late payment debt collection is not a time-consuming exercise. Good clients who pay their bills on

BUSINESS HEALTH & FINANCE

time won’t object to you having terms and conditions that allow the passing of poor clients to a collection agency. So, what should I as a practice owner or manager do? Introduce clear guidelines One of your first jobs as a business owner should be to put in place a set of clear guidelines for the issue and recovery of invoices. All customers and staff should be made aware of the process of issuing and chasing invoices and this should be adhered to consistently – without fail. Don’t give second, third or fourth chances to customers – they’ll come to expect it and could end up taking advantage of you. Writing your guidelines When devising these rules, think carefully about your particular business. Running a veterinary practice, for instance, you will have a number of different income streams – those who are regular customers, those who are emergencies and those who are “commercial”. As each customer type arrives with an entirely different set of circumstances, each of these may be dealt with differently. An example of your guidelines could be: • Emergency customers must pay in advance/at the time of treatment; • Regular ongoing treatment may be completed under payment/credit terms;

• All credit customers must undergo credit checks first; • All invoices must be paid within one month; and • One reminder will be sent before further action is sought. You should set up your terms and conditions with a specialist to ensure that they meet all the correct legal requirements. Accountability Charge one staff member with the job of looking after the accounts and invoices. Having a clearly identified person as the point of contact for all clients and customers is vital for giving your accounts department a “human face”. This makes it harder for there to be instances of any miscommunication or misunderstandings – as there is one person who has dealt with the entire procedure. The right person should be friendly and understanding, but also willing to be hard when called on to do so. If problems arise internally and you’ve followed your own procedures, there should be no issue with passing on debt to a collection agency – after all, your customers know what is expected of them from the outset.

Mike Brooks, Director, Debt Solve UK Ltd (DSL) Mike has been involved in the collection industry for over 30 years, much of that time in management positions. As an active board member of the Association of Civil Enforcement Agencies, in 2006 he set up Debt Solve UK Ltd, specialising in veterinary debt.

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PRACTICE DEVELOPMENT

Is it time you got a practice manager? The veterinary world is expanding and “out of towners” – that is, people with non-veterinary experience, are enriching the world of practice management by bringing new experiences and management practices. Ian Wolstenholme shares his thoughts on the importance of this role

hat is a very good question! I am delighted that the couple of practices I have worked for and with have had the foresight to answer yes to that question, but more of that later. Time was when any small business, certainly true of the veterinary industry, ran its dayto-day affairs as a “one-man band”. Regulation was more relaxed, computer systems pretty much the domain of big players only and the vet tootled around the town in his Ford Granada estate. During the electrical retailing boom of the 1980s all this changed as the high street became swamped with tech, supermarket-style shopping became the norm. In short, I, like many digital immigrants, witnessed a whole new style of “the team getting the best out of the job and the job getting the best out of the team”. Traditionally, and despite this new-wave of thinking, retail had had a hierarchy of director, manager, deputy manager and staff. This was not the case with veterinary land. So, after having seen it all come and go, in 2005 I was asked to join a family practice one evening, after a meal and, frankly, too much vino. Being a fairly level-headed sort of chap, I naturally asked what was to be expected from a veterinary practice manager. To be truthful, little enlightenment was forthcoming at the table, other than something along the lines of “...well you know, dealing with clients, sorting out the staff and making sure bills are paid”. A fairly bland canvas one might say and certainly “do-able” for one with 24-years of doing that under his belt in a retail store setting. I felt flattered that this professional person, vet, owner, family member and colleague had created a brand new post for little old me that was both challenging and exciting. With little hesitation (and at the behest of a long service award in electrical retailing) I accepted. In reality, of course, veterinary practice management was nothing like retail management. I suddenly found myself bewildered by health and safety, drugs and procedures’ terminology plus a host of “add-ons” and realised that to avoid floundering, I should consult like-minded individuals. So began a long association with the Veterinary Practice Management Association and I’m glad to say that 10 years on, VPMA is still there for me and any practice manager who is in need. That’s the background over. Now, how to address “that” question. The veterinary landscape has changed in the same way that my old electrical retailing experience did. We now have the animal equivalents of Comet, PC World/ Dixons and Colorvision with the various group/corporate practice models, such as Vets4Pets, Medivet and so on. These are the big players that run www.practicelife.biz z June/July 2016 z Practice Life

with military precision at all levels like well-oiled machines, and their influence has done much to raise the question within the independent sector. What is a little all over the place right now is the diverse role of a practice manager and this varies enormously from practice to practice. On one hand she or he is little more than someone who orders the stationery, through to a major decision-maker with full budgetary control over the practice purse strings. It seems that, thanks to education, the majority in the role occupy at least the middle ground and are accountable for financial, asset and personnel management, statutory and ethical requirements, strategic management, stock control, marketing and communications. These headings underpin many protocols and processes and, if a practice has, say, one owner providing 24/7 care for clients and patients, to maintain any sort of realistic work-life balance, these additional (often thought to be cumbersome) duties may be neglected or overlooked altogether. As the team increases in size, some of the above list takes on a greater relevance and it is here where a quality practice manager can really shine. Trust and reliability are key in the owner-manager relationship and the ability to let go of the reins (even a little bit) can be met with huge resistance. This is of course perfectly understandable, particularly if a practice owner has invested time, blood, sweat, tears and cash into a business, without any “interference” from an outsider. Frankly, I have no advice on how this barrier is easily overcome. In my case, my former employer never really could grasp that mantle despite numerous examples over a decade of quality work, huge practice development, increased revenue and profit, loyalty-driven marketing and much more. When, late last year, it was apparent that a business plateau had been reached, the reputation that many a practice manager often develops was, in my case, recognised by an alternative provider of veterinary care, resulting in me being “kidnapped” (their words) by a nearby RCVS-accredited small animal practice that had been without a manager for around six months. In our discussions it came to light that my new employer had never intended to refill the vacancy. I was curious, therefore, as to “why me”? Practice owner Joanna Bednarska explains: “We heard of Ian’s availability on the grapevine and knew of his work at the other practice, which had been recognised by Petplan as he had been a national finalist [in the annual Veterinary Awards]. It was an opportunity too good to miss and we wanted to use his extensive knowledge and ability to benefit our practice. My advice to owners who don’t have a practice manager is to be bold, discuss the subject with practices that have reaped the benefits in so many different areas and to get one”.

PRACTICE DEVELOPMENT

I’m now blushing! Seriously though, it can be daunting starting any new job and I worried about what this new team would be like to work with, how much of my “reputation” had been muttered about and how I would avoid turning up on day one with previous “veterinary baggage”. Of course, those fears were totally unfounded and in the ensuing days following my Christmas week arrival in post, it soon became clear that everyone – vets, nurses and front of house – were totally on my side. I sat down with everyone individually to find out about their strengths and areas they wanted to develop and (I like to think) restored some practice management faith in a team that had perhaps felt let down by a previous incumbent. There are times, as any other leader will tell you, when you cannot simply lock yourself in an office chained to the desk, and for me that’s one of the best parts of PM-ship. Yes, there was a stack of paperwork to sort through, but the “human” in human resources was paramount as I embarked on what I hope will be a future-proof tenure at County’s End.

So I’ve tried to answer the opening question myself as honestly as I can. The role of the practice manager in a modern, progressive setting, is as important as that of the rest of the clinical staff. We’ve just completed a long-overdue performance management process, which has really boosted confidence and identified future training needs. The Practice Standards Scheme assessment is due in the next few weeks and we have engaged the whole team with the organisation of a client evening as part of National Pet Month. All these jobs should be grist to the mill for any practice manager and I wonder for those practice owners holding back, just how many engagement, marketing and bonding opportunities are passed by? With my VPMA board member hat on, I’ve just had sight of the 2016 Congress “wash up” details and, perhaps of relevance to this article, it seems highly likely that included in next year’s congress will be a presentation on the benefits of hiring a practice manager. I for one will be on the front row; wouldn’t it be great to see some practice owners who may have mulled over the question vying for a place there too?

Reliable & RESPONSIBLE

Here, Ian Wolstenholme tells us a bit more about his new practice and the circumstances around the need for the role

wo words that should be at the heart of every practice manager, but as for the “meat on the bones” of a job description, this varies dramatically. If you search the internet you will find the expected skills of finance (so simple banking procedures) and the knowledge to present simple accounting, inventory or stock control (this is becoming increasingly automated with many practice management systems but relies on a good manager to make sure it runs well), managing staff rotas and holidays/leave (often rotas can be delegated to nurses but, again, the effective manager needs to ensure fairness) and payroll (which may be done entirely inhouse or with the intervention of an accountant). These skills are usually high on the list of a practice owner who cannot wait to employ a manager to take over what are often thought to be onerous duties. They haven’t really changed all that much since the post was first introduced many years ago. But what has changed, however, is the way that practice managers themselves have re-evaluated their role. Much emphasis now (and I’m bound to say that which has been successful in the United States) concentrates on additional coaching-type HR skills, such as developing training programmes, encouraging communication across the entire practice team, using IT in all its many guises and, crucially, “walk the talk”. Practice managers now have to get their hands dirty and be willing to perform the tasks they ask of others. Until you’ve tried this you don’t realise just how fulfilling it really is! It’s no longer acceptable to simply look at your own internal facts and figures. With the impact of big-buck group and corporate practices popping up, the “new age” practice manager has to be benchmarking, comparing data, looking for USPs, bargaining with drug companies and wholesalers, wheeling and dealing all day long. Forget being desk-bound. By the time you read this I will have been at my new practice around six months.

For six months before that, the practice was, by its own admission, somewhat in the wilderness. The previous manager had moved on and, sadly, such was the disillusionment of how this person had worked in the role, the plan was to simply not hire a replacement. Personally, I’m glad they did of course, but I asked the owner and one of the senior vets to tell me some of the things that were lacking in the running of the practice up to my starting. It seems that within a short time (less than a month) stock control started to become an issue with items not being added to the PMS or “a bit of a bodge-it job” to add correct margins to stock items. Think about how many new products some through your practice doors each week and, even if it’s just a few pounds missed off the system, this can soon have a serious financial effect. Reps (OK, territory managers) were either postponed, inconvenienced or ignored altogether, resulting in missed opportunities. Correspondence, emails and so on not dealt with efficiently soon makes the practice look incompetent or uncaring. Often, accounts payable…were not…until the red reminders started to arrive. Add to this pastoral issues, with staff members unsure who to turn to for help or advice, maintenance of expensive practice equipment and a person able to take pressure off the vet when clients start to complain and you can see how this practice soon started to flounder. I love my job. Vets love theirs. Nurses love theirs and client care teams love theirs too. I cannot for the life of me understand an owner who will spend thousands of pounds of a new toy for the practice and then let it sit idle in the corner and still deny the need for a manager. If you have been considering recruiting a manager for your practice, there are many resources available to help you get the right person. Why not make 2016 a leap of faith year? Practice Life z June/July 2016 z www.practicelife.biz

PRACTICE DEVELOPMENT

CASE STUDY: ARK VETERINARY CENTRE, EWELL Sinead Armstrong, MA, VetMB, MRCVS – Practice Director, Ark Veterinary Centre, Ewell

started the practice from scratch in 2007; I was running it single-handed for the first five years, then I took on a part-time vet. The hours didn’t match with the continuity of care we were trying to offer at the practice so we decided to up this to a full-time position. Right from the start I’ve been a VN Training Centre so have always taken on trainee nurses, who have worked on reception too. Gradually the vets followed and we are now two vets who each work 4.5 days per week and I’ve just had a dedicated receptionist start. I had one VN doing reception and I trialled having four VNs in the team (upping it from three) but the dynamics didn’t work. The team of three worked really well together and so I decided I’d rather take on a pure receptionist. Now I have a dedicated reception team, split between mornings and afternoons, to cover the day from 8am to 7pm, and it works fantastically. I’ve also totally rewritten the website – quite an undertaking – so now my next job is to focus on recruiting a Practice Manager! It’s been on my list of things to do for a while now, and we’re ready to get someone onboard to do all the stuff that takes me away from consulting. I’ve always wanted a Practice Manager; I just wanted to be a vet, not a manager, but haven’t justified it until now. I find it frustrating if I can’t get on with being a vet, it can be hard jumping from all the nitty-gritty of management straight into clinical consults, there’s always something on your mind. If I went to a three-vet practice then I realised I would spend at least half of each day doing management stuff and this isn’t what I want to do. Never having written a job description for a Practice Manager before, I’m doing a lot of research. I think as vets we’re almost meant to know how to do these things, but that’s not the reality! I’ve been making a list of all the non-clinical tasks I do, which will keep them busy for a while. These are things like: • Developing new client packs; • Organising an open day; • Getting a new phone system installed; • Looking at the buying group and other options; • Developing Facebook and social media; • SMS update; • Targeted email drives; • Vaccination amnesty; • Cat Friendly Clinic accreditation (we’re nearly there!); • Looking at health plans; and • Practice Standards Scheme accreditation – the paperwork takes so long! Ideally I’d like someone who can do two to three days a week (at least initially). I’m not looking for somebody from within the veterinary world necessarily; I’ll be advertising locally and on the internet and hope to encourage all sorts of people www.practicelife.biz z June/July 2016 z Practice Life

with management skills gained outside of practice. I’d welcome people with a different perspective – I can happily teach them about the ways of veterinary practice and get them up to speed, it’s the other skills they need to already have. I would encourage them to join VPMA, for example, which has a great support network. It’ll be an interesting dynamic for all of us, how to cope with a PM, but as long as he or she does their job well I don’t care, I’ll cope. Just don’t be precious about it. The VNs are happy and looking forward to a Practice Manager starting – the rotas will be done faster, things that need fixing will be done quicker, and that “to do” list will be worked through much faster, which will benefit all of us. I’ll be getting an HR person to check over the advert to make sure we’ll be targeting the people with the right skills set and also to appeal to the right person and make sure they want to apply. I’ll also involve my husband in the process as a fresh pair of eyes to help “vet” the candidates! It takes time to get the right person; I had to advertise three times when I was recruiting for a full-time vet previously before I was happy with my decision, so I know it could take a while, but it’ll be worth it.

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Multichannel Marketing Emma Dahm reports from the SPVS-VPMA Day run by VetHelpDirect’s Susie Samuels.

he advent of digital marketing has proved to be a game-changer for veterinary practices. There is now a level playing field on which independent practices and corporates alike may compete, due to the plethora of digital marketing tools available – many of which are free. The Multichannel Marketing course, run as one of the VPMA-SPVS series of events, offers practices –anyone involved in marketing the business – an insight into the marketing channels available and the pros and cons of each. It was a day packed with tips on the marketing channels that work well for veterinary practices; despite it being a whistlestop tour, it was a very useful one for those just venturing into marketing and those already using social media but wanting assurance of which social media alleyway may bring the most rewards. It is impossible to report everything and do it all justice, but the below should give some hints and tips to use in your practice marketing plans. Presenter Susie Samuels introduced the course with a look at the customer journey and how this has departed from the traditional model with the advent of online marketing. Traditional marketing is a three-step process, but the digital customer journey involves a four-step process, with the inclusion of the “zero moment of truth” or ZMOT, as termed by Google. To put this is a veterinary context, when a potential client is searching online for a new practice, they may not necessarily know what exactly it is they are searching for, so they will look at lots of different sources of input before making a decision. Susie quoted that for the average search, people look at 10.4 information sources before making a decision such as which veterinary practice to choose. These could include on and offline information, such as asking friends, visiting various vets’ websites or Facebook pages, comparing prices and consulting online reviews for a practice. Therefore, making sure your website and social media accounts are up to date and appealing is essential. The various channels were then given a brief “pros and cons” treatment in terms of their usefulness for veterinary practice.

Channels Twitter

A truly international channel, Twitter will expose you across the globe – but veterinary practices need local presence and accessibility so therefore it’s of limited use. It works well in central London, one delegate explained, as her practice had more clients on Twitter than on Facebook. It can take a long time to realise return on investment from it, however, and Facebook is much more effective for this.

about their experience (thanking the practice) and also pictures of their pets. YouTube

Video can work really well for vets, and you can use YouTube to host your videos so you don’t have to do anything to increase the functionality of your website. An example given of where this has worked well was www.inglisvets.co.uk The theory behind this being a popular media is that people feel like they get to know the staff and faces on the video and they may be less likely to price-check. WhatsApp

This channel may work well for some practices to communicate with clients, but of course not everyone is on it. The same goes for Messenger, and this can only be used as an individual communication method, not as a business.

Images Instagram, Pinterest, Snapchat

Image sharing sites may have some application in vet practice, although they are certainly not “changing the status quo” as yet. Whitecross Vets are using Instagram with some effect, according to Susie. There are huge numbers of pets on Instagram and you can tag them with your practice logo. Once a picture is pinned on Pinterest it will get re-pinned many times and the exposure will last for months, which is far longer-lived than a post on Facebook, for example. Your audience

Facebook

Of all the social media channels, Facebook works really well for veterinary practices. Return rates for people coming back to visit your page are much higher than for other social media and people like to interact with it and will post their own comments

Susie talked through the concept of creating personas – madeup profiles of various client types that enable you to target your marketing campaigns to these people. The idea is to make sure you don’t just look at everything in the way you would and to give other perspectives. Give them a name, age, gender, the type Practice Life z June/July 2016 z www.practicelife.biz

CPD SHARED

of client they are, where they’re likely to look for information, and so on. “They’re not a scientific method,” said Susie, “but a tool to help you find out how people will be using social media; it removes the tendency for us to use ourselves and what we’d do in a certain situation.” Website

And what of websites – in this digital age are websites old hat? Not at all, explained Susie. They are the one platform where a practice is in control and it is your property, as opposed to other digital channels. Clients will find you through a web search so you need to include key words relevant to your local area. Your website performs many functions, including the following: • Increase conversions (people who call up, get them to sign up to your newsletter, for example, on your website) • Retain existing clients with more information on the website • Educate clients/improve compliance • Offer a “brochure type” experience for potential clients The standard of a veterinary practice will be judged by potential clients by the standard of its website. We know that’s nonsense but it’s how clients see things. Elements you need for a good website: Design Clear brand message, with nice photos, and simple calls to action. Do include text as this helps with Google search and where you appear in the search hierarchy, but split it up well. Medivet_PracticeLife-JUN16[1].pdf

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Employ a professional photographer to get maximum effect, and for your staff and practice photos. Pictures of staff with pets are often very effective and give a warmth to the practice’s image. Stock photos are not so emotive. Include the practice’s full name, address and phone number (and email where appropriate) so it can be seen on every page. Ensure it is text and not an image, so Google can index it. Staff pics and biographies

These are the most popular pages on websites. Blogs are very important; they can form the centrepoint for your campaigns. Use social media to promote them and link people to the blog section on your website. Use the whole team to write blogs and take it in turns. Diarise the activity and write and publish them regularly. Always write unique content, do not copy it from elsewhere! Use vouchers to engage clients; they are also fantastic for measuring the response rate to a particular promotion you’ve run. Newsletter signup

Put this on your website and start communicating with your clients on a regular basis. Email is still a very successful marketing communication method.

Reviews Reviews of products or services are becoming increasingly important for people at the “Zero moment of truth” and they

TURNING DREAMS INTO A REALITY

by working together! By fine-tuning our hub-and-spoke model to improve collaborative working, we’re helping to change the face of veterinary care! At Medivet, we encourage our clinicians to hone their skills and play to their strengths. Working collaboratively is not a pipe dream. It’s a practical and commercial reality that has been a part of our culture for thirty years. Knowledge and equipment is shared. Experienced is gained. Vet, nurse, pet and client are all better off! Our model offers solutions to challenges like work-life balance, the rapidly rising cost of offering a truly comprehensive service and ensuring the future financial viability of your practice. We’re looking for partners and vet assistants to join our family and work together to deliver the best outcomes. Contact Daniel today – he’d be delighted to hear from you!

www.practicelife.biz z June/July 2016 z Practice Life

Call Daniel on 01923 470 046 vetrecruitment@medivet.co.uk www.medivet.co.uk

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have been proven to increase conversion rates. This is not an area that vets would traditionally be particularly comfortable in, but it is becoming increasingly part of any selection activity, Susie said. Additional bits you may wish to add include the RCVSAccredited logo, an appointment booking system, social media plugins, symptom checker, pet health advice sheets, and a “see inside the practice” video. Ensure your site is mobile-friendly. If not, Google will downgrade its ranking in the search engine results pages (SERPs).

a different metatag and write them manually. Put “how to write metatags” into Google and you will find the information. Google My Business

Claim your place on here, verify the information and then you are set up to be found. It involves registering and receiving info through the post. Paid: Google Ads

Talking of SERPs, if a site is ranked #1 in Google, the clickthrough rate is 36%; if it is ranked #10 the click rate will drop to 2% – a very big difference in exposure indeed! SEO is such a huge topic, it could take weeks or months to cover, but get the basics right and the results should follow. There are two types of search: paid (Google AdWords; pay-per-click and non-paid (organic). Organic search is where you can gain most impact and has the longer-term benefit.

Susie described the difference between paid search and organic: “SEO is a long game. Google AdWords is a “sticking plaster” on the way up to SEO/organic top search”. For veterinary practices you should target local key words, such as “vets in Winchester”. You should also set a daily budget and ensure that searchers land on a landing page that relates to their search – so if they searched for “puppy parties Market Harborough” make sure they see relevant information, rather than generic copy such as opening hours. Susie warned about using only good agencies for paid search, or for doing the process yourself manually.

Link building

Analysing results

A search engine’s “robots” crawl the web and navigate through/to your website by following links. Add a “useful links” page to your site and add your business’s details to lots of directories, which will direct people back to your site. Go for higher quality sites though, such as local newspapers, the BBC, and so on.

Every marketing campaign must be monitored to check its success – doing this digitally is just as important. The only package you need, advised Susie, is Google Analytics (GA). It’s industry-leading and it’s free. Set up an account and then cut and paste the line of code generated and send it to your web developer to embed into your site. You can then look at your total number of visitors, sessions, the pages they visit most, bounce rates, and almost endless other statistics. A quick check on GA takes five minutes to gain insight and from this you can build up and see the trends of who what and how visitors use your website.

Search engine optimisation (SEO)

Content

Identify what people type in to Google when they are looking for your practice; to do this you can use Keyword Planner. You should then make sure you include these words and search terms in your website content. Give each of your website pages

BSAVA Congress Interview Ian Wolstenholme met up with Sarah Page-Jones at BSAVA Congress and asked her about leadership, skills and sexism in the profession. Ian – Sarah, all too often in practice I think colleagues with plenty of leadership experience are often thrust into doing a management role and expected to just simply get on with it. What are the pitfalls best avoided in that sort of situation? Sarah – I think that as vets we’ve got lots of great skills that transfer into management in terms of our ability and training with logical problem-solving and decision-making that translate very well to the day-to-day running of a business in terms of managing practices and protocols that are going to make the business run smoothly. What can be really difficult is the people side of things and that more emotional side of leadership, which can make things more tricky for new managers. Ian – You were speaking moments ago to a lady who I overheard has been a relatively new practice manager who had previous experience in the banking industry. What is your opinion on practice managers being leaders from

outside of the industry not necessarily armed with baggage of veterinary skills and knowledge... What are your thoughts on that? Sarah – I think it can be really useful. I am a great advocate of diversity, not only within leadership teams but generally within a business and I think people coming from outside the business – they can meet with some difficult conversations with people saying “well you don’t know anything about the industry” or “you don’t know what you’re talking about”. But a lot of the time people can, as you say, come without the veterinary baggage and with new ideas and ways of doing things from other industries where the management and leadership is far more advanced. And what is great as well is that in those situations when people take the time to learn about what’s unique about the veterinary industry and come and spend some time with the clinical staff so they can really see what’s happening and start to understand those peculiarities of the industry as well as bringing in their own management skills externally. Practice Life z June/July 2016 z www.practicelife.biz

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Ian – You said in one of your slides that managers are rational, leaders are emotional. Is there no chance of a crossover of those skills; are they transposable in any way or is it that just hard research that we have to accept? Sarah – No, its certainly possible to – not necessarily be both but to have developed skills in both areas. What tends to happen when clinical people are moved into a management role is they take those rational/logical skills with them and are very good at the day-to-day management tasks; setting goals, getting things done, getting through the day and pets being fixed and clients being happy. But in terms of getting to grips with the people side of the business – the emotional side of leadership – not necessarily people getting emotional but understanding the emotional skills and self-awareness, that takes work. So you can develop yourself in order to be able to learn those skills and, in the process, actually what tends to happen is you develop in terms of your identity, so then you may become more of a transformational leader, and you have to realise that maybe you’re not quite so good at the day-today stuff anymore and you might need someone else to do that for you. Ian – It’s very tricky isn’t it! I want to just turn to the gasps of shock and horror that were palpable in the room at BSAVA today [during Sarah’s talk on “Developing yourself as a leader: does gender make a difference?] when you introduced your character on screen called “Ted”. Thank goodness he was an image rather than an animation because I suspect the ladies in the room might have hurled rotten vegetables! You’re not telling me there www.practicelife.biz z June/July 2016 z Practice Life

are characters in the industry like that who are coming out with demeaning and demoralising comments about the feminisation of the profession? Are we going to see a sea change? Sarah – I think what’s important to understand is the conversation with that person was completely anonymous and that “Ted” is a real person. We had an open and honest conversation on the understanding that anything I did use would be anonymised. In that situation, what that person was doing was giving me his version of the reality of the situation. Now what we don’t see is people coming out with those kinds of statements in public. But that doesn’t mean necessarily that there aren’t still underlying biases and this is what I was talking about – those classic biases or underlying issues that are still present within the industry but they are not explicit. You are quite right, we don’t hear people saying these things in public, but we certainly have people who think these things or make these assumptions and judgements but would not talk about it perhaps openly. Ian –You’ve opened a can of worms and you’re not ashamed to do that. Sarah – No. Ian – What a great thing. I wish you all the success with that as it’s a huge challenge. And thank you for talking to Practice Life. To listen to the interview with Sarah, visit http://bit.ly/1rP5hg9

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